In a chilled room off the lab, a small body lies on a metal table, a towel draped over her recently shorn head. ‘I only know one haircut,’ says Terry Regnier, whose own hair is neat and grey, combed back like Elvis, with matching sideburns and a moustache I would file under both ‘trucker’ and ‘porno’. ‘Nobody’s studying the hair. Plus, one of my bigger fears is that somebody would know the donor. Shaving the head helps them become less recognisable.’ Somewhere, echoing off cold steel, I can hear a radio playing. Terry reaches behind some equipment and flips the switch, killing ELO’s ‘Sweet Talkin’ Woman’.
For weeks after dressing the dead man at the funeral home, I kept thinking about what a waste death is. A body that has spent years growing, repairing itself, retaining knowledge of viruses and diseases and immunity, is just buried or burned. It should always be your choice to do whatever you like with your body, but seeing them all there in the glimpses through the refrigerator door, their heads resting on pillows, waiting to disappear, felt to me like there could be something more to this. I don’t believe our sense of meaning or value in life or death should come solely from a place of utility, but there is space for it and always – even in a time of 3D prints and virtual simulations – a need for it. I wanted to see what happened to the bodies that people donated to science, the ones that didn’t go straight to the grave or the crematorium, the ones that had a second life in places like this, at the Mayo Clinic in Minnesota. And I wanted to know whether a sea of anonymous dead faces would change the nature of the job for whoever was caring for them. Did knowing a dead person’s name make any difference in how you treat them or what it means to care for them? There is no shopping bag of clues beside a medical cadaver. There isn’t one now, beside the new arrival.
She is hooked up to the embalming machine, a black rubber pipe disappearing under another towel towards her upper thigh, pumping a combination of alcohol, glycerine (a moisturiser), phenol (a disinfectant) and formalin (a preservative) through her vascular system. It will add 30 per cent to her weight in fluid; unlike in a funeral situation, where a body rarely needs to be around longer than a few weeks, this body will need to be usable for about a year, so here they go overboard. She’ll look bloated, shrinking over the months as she dehydrates. Beneath her head, a ceramic bowl fills with the blood pushed out of her veins by the incoming embalming fluid. It’s dark red, almost black, some congealed into clots. I can’t smell the blood, or the woman: the room smells like steel and formalin, that same chemical odour from the high-school biology lab, the one that engulfed you if you ever took the lid off a jarred toad. Her face and body are covered, but pale winter skin is visible on her liver-spotted arms. She had only died that morning, so she hadn’t yellowed or greyed or greened. In her life she’d only had a gallbladder removed. Her whole body was good to use.
I walk around to the other side of the table, brushing up against a bone saw. One hand peeps out from beneath the fabric that covers her, nails painted bright orange, the nail on the ring finger a glittering gold. Terry used to remove the nail polish, but after hearing one student speak about her cadaver’s nails, he stopped. For the student, the painted nails were the thing that humanised this inanimate meat. It said to her: this is a person who lived and died and gave you this gift to learn from. Terry never touched another bottle of nail polish remover. ‘I’ve had guys come in and their grandkids have done their fingernails. I’m leaving that on too.’
After a body is embalmed and before it is assigned to an educational course, Terry allows it to lie in state for two to three months to allow the chemicals to firm the tissues. The refrigeration and delay helps kill any harmful bacteria, on top of the safety precaution of rejecting donors if there is infectious concern, like HIV, hepatitis or bird flu. This lady with the gold and orange nails won’t be meeting her students for a while yet. When she does, parts of her will be thawed according to need. If she is required on a course that studies the airways in the neck, they will pack the rest of her in dry ice, thawing the head and neck alone. Extremities and heads take a day to thaw; torsos, depending on the size, more like three. ‘We try to keep it as pristine as possible, yet thawed enough for their use. It’s cold enough in Minnesota,’ he chuckles. ‘We don’t want the tissue to be frozen as well.’
Terry opens the huge silver door on the right, revealing a cool room with multiple shelving units, four shelves high. There’s a black plastic chest on the top shelf, empty for now but used as a transport system for torsos. There’s a bag filled with fluid the colour of chicken stock, suspending the spindly strands of a strange, excised tumour that once crept along the branches of a nerve path. Near my feet, a pair of red lungs sit in a bucket. There’s room in here for twenty-eight bodies, but only nineteen lie here, wrapped like mummies on silver trays, in once wet but now frozen white towels. The fabric is soaked in water and humectants which keep the skin moisturised – with the combined effects of the airflow in the lab and the amount of chemicals in the embalming fluid, it wouldn’t take longer than a week here for a body to dehydrate to the point of leather.
The bodies are sealed inside plastic bags, tied with an ID number on a tag the shape of a fifty-pence piece that matches the one around their neck. Some are resting in an inch of amber-coloured liquid – embalming fluid leaking out of the pores and the injection site. The leak carries on the longer the body stays in the programme; most of the embalming fluid is water, and the human body is not watertight. I ask Terry if this is a messy job and he gives me a look that says, You have no idea. He points at the drains in the floor, says the flooring has no seams in it for a reason.
‘You smell like it when you go home at night.’
Earlier that morning I had arrived on the ninth floor of the Stabile Building to bustle in the front office. Dawn the receptionist told me to take as much Laffy Taffy as I liked from the bowl on the counter, then she was back on the phone, typing notes, the receiver pinned between shoulder and cheek. Shawn was in blue scrubs with his back to me at the computer, and Terry was nowhere to be seen. I filled my pockets with pink, green and yellow candy and looked around the office – piles of paper, inboxes, outboxes, computers, a plant. I was out of stuff to look at and about to read the joke on the back of my candy wrapper when Terry appeared wearing the same blue scrubs as Shawn. It was 9 a.m. and he’d already been here for two and a half hours. He handed a stack of papers to Shawn and said that I’d arrived on a busy morning: they’d had two donor deaths to deal with, and one of them had just pulled into the car park. Shawn is out of his seat and on the case: tall, thin, with intense eyes and a reassuring smile that cracks his face in half. Donate your body to the anatomy school at the Mayo Clinic and these are the guys who look after your corpse.
There’s not much else here in Rochester, Minnesota, apart from the clinic. In 1883, three decades after the town was founded, a tornado tore the place apart, leaving thirty-seven dead and two hundred injured. There were no hospitals in the immediate area, just a small practice run by Dr William Mayo. Aided by his two sons – who were practising eye surgery on a sheep’s head in a slaughterhouse shortly before the storm hit – he treated the wounded in homes, offices, hotels, even a dance hall, before asking Mother Alfred, of the Sisters of Saint Francis, to use her empty convent as a temporary hospital. It was her idea to raise funds and open a permanent one in a cornfield. She said she’d had a vision from God that it would become world-renowned for its medical arts.
Look at the map and the city looks like it grew around the hospital, with everything feeding back to that shining, iconic facility. Hotels of decreasing appeal spread out from the centre, banners stretched across the fronts of far-flung motels promising free shuttles to the clinic but explicitly no free cable. Other hotels dotted between the high-rise hospital buildings connect doctor and patient by subterranean wheelchair-friendly tunnels carpeted in the kind of techni-colour design you’d either want to avoid or seek out while high. In the white, Midwestern winter, nobody has to step outside unless they’re leaving town or have run out of restaurants – the tunnels stretch for miles, with overlit gift shops along the way selling ‘Get Well’ balloons and stuffed bears clutching red love hearts. Antique dealers rack decorative rifles in their windows beside oil paintings of fruit bowls and English hunting dogs, preying on the desire for distraction from what is, if not imminent death, at least something so medically complicated they had to come to one of the world’s most respected and experimental medical destinations to try and cure it. They have treated the Dalai Lama for prostate cancer, former President Ronald Reagan underwent brain surgery here, and the comedian Richard Pryor, who was treated for multiple sclerosis, said at a later gig at the Comedy Store, ‘You know this shit is bad when you gotta go to the fucking North Pole to find out what’s wrong with you.’ According to the leaflets piled around the hotel lobby, the Mayo is ‘a place for hope where there is no hope’. I have never seen a breakfast buffet crowd lower in spirit.
Terry started here at the Mayo after years of working as a funeral director in this same town. It’s an unusual environment for a funeral director – people come here from all over the world to receive treatment, which doesn’t always work, and if they die, those bodies need to be returned home. Instead of organising ceremonies and having the connection to families that Poppy does, he was mostly preparing bodies for transport and sending them elsewhere. It was a lot of physical work, and he got burned out on the night calls in particular – death has no consideration for the living’s business hours – so when a position opened up here in the clinic twenty-one years ago, he happily bailed.
Now as the director of anatomical services, the state-of-the-art anatomy lab is under Terry’s control: he signs you up while you’re alive, receives your body when you die, preserves you and files you away in a freezer. In most other academic institutions cadavers are sent to different labs across campus, some pushed across roads on metal gurneys in the dark of early morning, but here, if students and doctors want to work on a body, they come to where the bodies are. They come to Terry.
I found Terry through an ex-colleague of his, Dean Fisher, who I had interviewed the previous year for a WIRED magazine article about a new, more environmentally sound method of cremating bodies with super-heated water and lye instead of fire. The process – known as alkaline hydrolysis – was only commercially legal in a dozen or so US states at the time, and Fisher had a machine at the UCLA campus, where he was doing the same job as Terry, and where the machine was used (non-commercially) for the disposal of medical cadavers. When I asked if he could show me how the donated body department worked, he put me in touch with Terry instead – his old college classmate, his fishing pal, his ‘brother from another mother’. Fisher said they had worked at the Mayo Clinic together for years and there was more to see there. It was Fisher who had given Terry the job and saved him from the night shifts.
Terry takes me into one of the empty classrooms where an antique wired skeleton – once belonging (externally, not internally) to prominent endocrinologist and Mayo co-founder, Dr Henry Plummer – dangles from a hook by the whiteboard. ‘We get a lot of misdirected calls from people who want to donate organs, or they want to donate money,’ he says, dragging a couple of chairs over to a desk. ‘But we want all of you! We want something more valuable than your money.’
He sits down and slides a letter and contract in front of me. It’s the one he sends to all of the prospective donors – who could be patients here, or have family being treated here, or have nothing at all to do with the clinic in life – pre-signed by himself. ‘It is my desire to make my body or portion thereof available to further the advancement of medical education and research,’ it begins. On the back there are reasons for possible refusal of this gift: ‘communicable diseases that pose risk to students and staff, obesity, extreme emaciation, bodies that have been autopsied, mutilated, decomposed, or, for some other reason, are determined to be unacceptable for anatomical donation.’
‘Are people ever offended when you reject a body?’ I ask, scanning the list of entry requirements, checking if I’d make the cut.
‘Oh yeah, they’re on the phone dropping F-bombs! Mostly it’s because they didn’t read that far into the information. It used to be seven or eight pages, so we’ve tried to condense it. But the vast majority fit our criteria. Usually the ones that are a hundred years old are in a lot better shape than the ones that are thirty, forty, fifty, sixty – because if they died that young there are some significant issues. You don’t live to a hundred by accident.’
He explains that the main thing is that donors have their anatomy intact: once organs are missing, through partial donation or autopsy, students can’t learn how everything connects, how the heart relates to the lung, how the arterial system relates to the brain. If you’re too fat, they can’t find your organs among the adipose (a thick grease that is the colour of butter and just as easy to grip) in the time they’re given to complete their modules, and the tables in the lab aren’t large enough to accommodate some people. If you’re emaciated, there’s not much muscle to see and identify, so there’s no educational point cutting you open – your bicep might be nothing but a thin strand. ‘We don’t go off BMI, because it’s nonsense,’ he says. ‘It says I’m obese, but I’d take my body. We look at their age, their activity. A 160-pound female who’s been in a wheelchair for years versus a 160-pound female who’s been active is gonna be two different bodies, from our perspective.’
There’s also the edema (fluid) that pools in swollen extremities after chronic heart failure that makes things more difficult. The goal here is to study textbook anatomy, how the body works and functions. Until students have a grasp of what it should look like when everything’s fine, they don’t have a baseline to address abnormalities. There’s a bit at the end saying that once the clinic accepts a body, you cannot visit it or take it back. He thanks you at the bottom for considering this most precious gift and signs his name in blue biro.
This isn’t all stated as plainly on the contract as Terry lays it out for me now, sitting in this empty classroom with his hands clasped in his lap. But if you had questions before signing, Terry is not the kind of guy to euphemise facts and bubble-wrap your feelings: he’ll tell you anything you want to know and some things you don’t. If he’s anything like he is with me today, he’ll be laughing all the way through, the kind of laughter that sits just before the tip into hysterics. He is not the first person I’ve met in the death industry to make me believe you require a natural level of cheer high enough that the dip, when it comes, doesn’t scrape the bottom of your heart.
Read the history of anatomy and scientific enlightenment and the names of doctors are lit up like saints and gods. But the history of medicine is built on a bed of corpses – most with no names recorded at all.
Academics knew that to further understand the workings of the human body, and in turn save future lives, they needed dead bodies to take apart and figure out how they worked. Dissecting a pig could only tell you so much about a human. They could learn more from the quiet, inanimate dead than the screaming, conscious patient, and if they knew what they were doing, fewer people would die on the table. But there was no system for a person to will their body to science. There was no contract. There was no Terry.
The shift from carrying out dissections on animals to the human dead was a focus of political, societal and religious tension, all of which is discussed at length in Ruth Richardson’s excellent book Death, Dissection and the Destitute. Initially, it had been ruled by James IV in 1506 that the Edinburgh Guild of Surgeons and Barbers could have access to certain executed criminals for dissection. England then followed in 1540, when Henry VIII granted anatomists an annual right to the bodies of four hanged felons, and later six, when Charles II – a patron of the sciences – gave them a further two. Dissection became recognised by law as a punishment, added to the array of existing punishments – a special fate worse than death, to be carried out publicly, described as ‘further Terror and a peculiar Mark of Infamy’. It was an alternative to being hanged, drawn and quartered – where body parts were hoisted on spikes throughout the city, the ultimate punishment in a religious society where bodies were supposed to remain whole in preparation for the resurrection. Some prisoners who had been sentenced to death but not dissection would – prior to their execution – barter their own corpses with agents of surgeons so they could buy fancy outfits to die in. They were the first, purely by shitty circumstance, to opt in to body donation.
The problem was there weren’t enough bodies. Anatomists did what they felt they needed to do: William Harvey, whose published work in 1628 proved the circulation of blood, dissected his own father and sister. Others robbed fresh graves in the night, or their pupils did. The corpse, because of its scarcity, became a commodity, and to make up for the shortfall in supply from the gallows, the bodysnatching industry was created. ‘Resurrectionists’ would dig up the recently dead – most often the mass graves of the urban poor – and deliver them to the anatomy schools in exchange for cash. By the 1720s – a hundred years after William Harvey dissected his family to discover the path of blood – stealing bodies from London graveyards was, if not exactly common, at least widespread enough that it was verging on being so. The two leading anatomists of their generation, William Hunter and his younger brother John, worked constantly on the bodies of humans and animals, a method that would have been impossible with the number of corpses provided by the hangman. In the 1750s, when John Hunter was responsible for sourcing bodies for his older brother’s anatomy school, he bought them from resurrectionists or dug them up himself. It was during this period that he filled his famous museum, the Hunterian, with medical marvels and mutations. It still stands by Lincoln’s Inn Fields in London, with disembodied hearts and tiny babies staring out of the same chemical that preserves two-headed lizards and a lion’s toes. I have stood there in front of the cabinets and stared back.
By the time Mary Shelley was born in 1797, bodysnatching was rife, and it was no secret, either; when she was a young adult, various contraptions, like iron cages to hold coffins, were being sold specifically to thwart the resurrectionists. Bodies were stolen from the churchyard where her mother Mary Wollstonecraft was buried, where the story goes that her father had taught her to write her name by tracing over the carved letters on her mother’s headstone. Ultimately, it fed into her work: none of the bodies that became the monster in Frankenstein had signed a contract to be there – he is nameless, a product, a belonging – while the real monster was the scientist, who was so gripped by the idea of his own creation that he disregarded what was right.
Things reached a head in 1828 when Burke and Hare made themselves infamous in Edinburgh for skipping the exhumation and going straight to murder, with payment on delivery. Burke was executed for his sixteen suffocations and sentenced to dissection as an ironic post-mortem punishment. His skeleton still stands in the anatomical museum in the University of Edinburgh with a paper sign pinned to his rib: (IRISH MALE) The skeleton of WILLIAM BURKE, THE NOTORIOUS MURDERER. Some 332 miles south, a piece of his brain sits at the bottom of a jar in the Wellcome Collection in London, pale and shrunken. When I saw it in an exhibition in 2012, it was placed on the same shelf as a slice of Einstein’s brain. Genius or villain, the mind as matter looks much the same.
Something had to be done to kill the industry of bodysnatching while continuing to feed the machine of science and education. So came the Anatomy Act of 1832, which stipulated that surgeons could take the unclaimed dead from prisons, poorhouses, asylums and hospitals – thereby equating ‘poor’ with ‘felon’, which led to a whole other world of social turmoil. But the anatomists got their bodies, regardless of the dead’s wishes, and the poor had something new to add to their list of fears.
One of the first people to voluntarily donate their body to science was the English philosopher Jeremy Bentham, whose severed head we were celebrating 186 years after all life had left it. When he died in 1832, two months before the Anatomy Act was passed, he had stipulated in his will that he wished to be publicly dissected by Dr Southwood Smith, who had previously written about how burial was a waste of bodies that could be better used in teaching. Bentham too wanted to demonstrate the usefulness of the corpse to the living – and the comparative uselessness of burying a tool of scientific study for the worms to eat – and light the way for a movement that would benefit the world. On a pamphlet handed out at the dissection was a line from his will about his decision: ‘This my will and special request I make, not out of affectation of singularity, but to the intent and with the desire that mankind may reap some small benefit in and by my decease, having hitherto had small opportunities to contribute thereto while living.’
Despite his efforts, anatomical donation wouldn’t catch on for another hundred years or so. Ruth Richardson speculates in her book that since the rise in bequests coincides with an increased cremation rate, perhaps the spiritual associations of the corpse had changed in the post-war period: cremation would render a corpse no longer whole for the resurrection, as would dissection.
Today’s UK medical cadavers are now exclusively the bodies of those who have donated them, which isn’t true of everywhere in the world: most countries in Africa and Asia study unclaimed bodies, while Europe, South America and North America are a mix of unclaimed and donated. There is, occasionally, a strange blend of the old world and the new – where someone has opted in, but perhaps not to the extent the future has taken it. Currently, a virtual autopsy table called the Anatomage is available for use in medical training: it’s a touchscreen tablet the size of a real autopsy table, programmed with layers and layers of images, each a 1mm ‘slice’ of the body, together creating a three-dimensional whole that students can look inside without actually touching a real person. Two of the four bodies, one male and one female, were part of the Visible Human Project – a project run by the US National Library of Medicine in the mid-nineties – who made the images by freezing the body, then grinding a 1mm layer off each time a new photograph was taken. At a conference in Manchester, I got to try out the table while the hovering sales representative explained its functionality. I stooped there in the small crowd, poking, prodding, turning the body, zooming in on organs most will likely never see in real life, in full, detailed colour. The one I was looking at was an executed murderer from Texas, Joseph Paul Jernigan, who agreed to donate his body to science, though the ethics of its current use have been questioned. He would have been unaware of the availability of the images: an interactive autopsy table had not yet been invented when he was killed by lethal injection in 1993.
Last year, 236 people who signed Terry’s contract died and made their donation, willing their body to a fate once reserved for criminals. Twenty years ago that number topped out at fifty. Popularity is growing, and currently around 700 new donors sign up every year. Considering that bodies are willed directly to the Mayo (instead of a central body-brokering organisation that divides them among various facilities, which is how many other donation programmes work), I ask Terry why this place would receive so many. It feels so deliberate. Their numbers are higher than UCLA, which has a similar direct-donation programme, and has averaged 168 bodies a year over the last ten; but California has a population of nearly 40 million, with 4 million in Los Angeles alone. In Minnesota, there’s just over 5 million people spread out over the state, which in terms of landmass is not far off the entirety of England. Driving to Rochester from the main airport in Minneapolis, you’re on flat, endless roads. You’re in cornfield country. There’s nobody but you and some dairy cows.
‘A lot of it comes from the good care they had when they were a patient here; they want to give something back,’ he says. ‘They’re training the next generation that’s going to provide good care to their next generation. Coming from the funeral director’s side, we bury or cremate the bodies – that’s the end of their story. Their contribution to society ends. Here, it continues.’
What more can you give back than your whole self?
When Terry was eighteen, he was enlisted in the Navy, mainly working in the Intensive Care Unit at a large Naval hospital in Virginia, where he drew blood as part of the crash team. It was the tail end of the Vietnam War, and there were guys his own age coming in to be treated. It was the first time Terry had been around the dying, and the deaths were hard to emotionally compute – young men admitted for what appeared to be nothing more exotic than asthma would leave in a body bag. ‘There were babies in the neonatal department that had a lot of problems, and that was easier to take than someone who was talking to me last week, joking around like a normal person you’d meet on the street, and then watching him die.’ Terry would escort the deceased patients to the morgue, and it was there he met his first funeral directors. He wasn’t sure what he wanted to do as a career, and there they were, taking care of people past the point where he was able.
William Hunter, the older anatomist brother, said in an introductory lecture to students that ‘anatomy is the very basis of surgery … it informs the head, gives dexterity to the hand, and familiarises the heart with a sort of necessary inhumanity.’ In other words, clinical detachment is necessary for this system to work. Medicine would not have advanced as much as it has if it were not for the dead in the anatomy rooms. We needed to learn about ourselves to save ourselves. But while clinical detachment is a necessity, Terry is keen to get across the fact that respect for the dead is what rules this hospital kingdom. Someone untrained in the funeral industry might run this programme very differently, but for him the science never fully separates the body from the person they were. ‘The needs of the patient come first, and we hold that true here even though they’re deceased. We treat them like a patient, we protect their medical records, their name, their privacy, their confidentiality,’ he says. ‘We maintain that like they are alive.’
He spends a lot of time trying to get this through to the students, who see a divide between themselves and the body in front of them. ‘Maybe it helps them emotionally, to pretend death didn’t happen,’ he says. ‘Maybe it gives them some security to think about them as more of an inanimate object, because they’re young, they haven’t seen much of death. So they kind of minimise the gift, or minimise the person to an object that they can make fun of. I don’t think it’s purposeful, I think it’s a coping mechanism.’ For the students, this is usually their first sight of a dead body, and fainting is not uncommon. Terry says he’s picked most of them up off the floor. ‘I’ve caught people in the hallways, or here in the classroom – they just turn into a noodle, and they slide off the chairs.’
The divide is something I can empathise with, but for a different reason. I think back to the virtual autopsy table I saw at the conference in Manchester and how, surrounded by people excited by a new machine, I immediately selected the option to look at the rudest parts. I didn’t want to see his lungs, I wanted to see the dead man’s dick – everybody did. There was a disconnect: even though we were being told that these were images of a real person, the novelty of the touchscreen worked as a barrier. These were just photographs, this was like a game. There was no personality to piece together like I did with Adam in the mortuary; death did not feel tangible through the glass. There was no reverence: the man was naked, devoid of personality, whatever it is that makes us more than pure anatomy. But this is why Terry keeps the nail polish, the tattoos – he keeps just enough to serve as a reminder that this was a living, breathing person. In some programmes, he also gives out their cause of death, age, occupation. If I were a medical student, I doubt that I could ever feel that same connection to a body through a screen, to feel what Terry says is essential to learn not just the mechanics but the meaning of the job you’re studying for. The experience has been hollowed out: the most important person isn’t there, so death isn’t either. You would need to, like I did in that sunlit mortuary, touch them. Be in their presence, even if it overwhelmed you, initially, to the point of fainting. They might not feel what I did instantly with Adam, but it would come. Terry makes sure of it.
‘Our donors are the best people in the world,’ he says, with genuine wonder. ‘It’s a very, very personal gift, giving someone your body. Can you think of anything more personal or private? Some of the eighty- or ninety-year-olds – they lived through miniskirts and all that, this very conservative generation. To allow someone to dissect and go through every bit of their body? It’s quite a sacrifice, to gift someone something that they’ve protected, and been conservative with, all their lives.’
Terry goes to check what’s going on in the lab and returns in a white lab coat, the coast apparently all clear of I’m not exactly sure what. We walk down the hall past framed photos of all the staff. Everyone is smiling big American smiles.
The anatomy laboratory is brightly lit and Terry asks me what it smells like – he can’t tell any more. ‘The dentist?’ I say. He laughs. ‘I’m worried about your dentist.’ A ventilation system pushes the heavy carcinogenic gas used in the embalming of bodies (the injectable preservative fluid ‘formalin’ is formaldehyde gas saturated with methyl alcohol so it becomes liquid, but evaporation turns it gaseous again) towards the bottom of the room and pumps in oxygen from above, a constantly moving cycle of air, so that the preservatives in the bodies don’t negatively affect the health of those working on them, and there’s less likelihood of the nausea that sent my fellow students in high school fleeing from their dissected toad. He points at the vents in the ceiling and the others near the floor, which is sealed to allow water from arthroscopic surgery – a kind of keyhole surgery with a camera – to pour down. The water is needed for the clarity of the image the camera captures, he tells me: it’s like wearing a scuba mask on the beach versus wearing it underwater. He pushes heavy plastic work tables around with ease to show that they move on wheels. Anglepoise lamps hang from the ceiling every couple of feet. There are wires and plugs and sockets, computer monitors and television screens, and on the far right of the room there are glass-fronted cabinets filled with anatomy books and bizarre objects. He opens one and points at something large and grey. ‘You know regular household latex that sits in the cracks in your walls?’ He picks up what looks like sun-faded coral intricately carved from styrofoam. Terry had poured latex into a pair of inflated lungs and submerged the whole thing in bleach, and when the tissue dissolved it left him with these: a 3D roadmap for oxygen, feather-light human lungs.
From a high shelf he pulls down a huge Tupperware container of artefacts found inside cadavers over the years, kept to show the students earlier versions of what they may be learning to install. A Harrington rod that once fused a spine, a heart bypass valve, a grape-sized testicular implant that bounces once as he chucks it back in the box. A plastic patella. A pacemaker. A bone screw. An antique breast implant. Aortic mesh. Stents that propped open the chambers of hearts. These are the things we ordinarily bury with our dead. Even greener, natural burial grounds are littered with the metal of factory-made knees.
Now he’s opening drawers and lifting things up into the light, making them worse by naming them: bone saws, delicate needle-eye-sized skin hooks for plastic surgery, hip retractors, rib shears, chest spreaders. Curettes for scraping, scissors with blades that bend at all kinds of angles to get into the most difficult-to-reach areas. Scalpels, mallets, chisels and forceps. ‘It’s Tool Time goes to college, you know?’ He holds up something that looks truly evil, like a metal snake with a serrated mouth, and says, ‘This thing oscillates back and forth and chews up the tissue, then it sucks it out.’ Small bits of shining steel are glinting in their neat dividers, everything put away in its labelled drawer. ‘These are about a grand apiece!’ he says, obviously thrilled to show off the collection.
On the bench are sutures, tape, paper towels, skin staplers. There are gloves and aprons of all sizes, a sink, an autoclave – even though there’s no risk of infection from one patient to the next, the implements are kept surgery-spotless. There are boxes of eye protectors, full face shields, partial face shields, knee-high shoe covers for the wet lab. Now he’s pulling out the equipment they’ll be using in a hip-replacement class this afternoon: the ‘reamers’ that clear out the marrow before insertion of a rod or nail, various hammers, the ball joints in green, blue and pink plastic. He shows me what looks like a golf-ball-sized cheese grater and tells me that this is what they use to make space in the socket for the joint. He twists it in the air, miming the motion of grating. Parts of me begin to ache.
‘I don’t faint around dead bodies,’ I say, in case my face is about to ruin my chances of seeing the whole of the lab. ‘But, uh, bone graters might be beyond my limit.’ He chuckles again and points across the room. ‘Well, those are carts full of brains.’
He invites me to open a tub of my choosing. We peer in at the blue-veined grey slices, cut uniformly like a loaf of bread. In fact, that’s the lab terminology: this brain has been ‘breadloafed’ along the axial plane. ‘Do you ever look at that and think about how this chunk controlled a whole person?’ I ask, the slices jostling against each other in the preservative.
‘The whole body is a miracle. And looking at how the brain contributes it’s … it’s just mind-boggling. So these are the stainless operating tables that I talked about, the ones that open like clams—’
As Terry talks about the Wi-Fi connection and the various upgrades made over the years, my eyes wander across the room and I see a body lying on a table. It’s covered in a white sheet, some brownish-red stains here and there. Two feet stick out: old and gnarly, the toenails extend a centimetre beyond the toe itself. It’s the body of a man, but the feet are shaped like he’s been shoehorning them into the pointiest of uncomfortable stilettos. He has no head. He’s patiently waiting for his new hip.
‘Legs are in the back, heads and uppers on the sides,’ Terry says, stepping out so I can go in on my own, a slim walkway between shelving so high you’d require a ladder to reach the top level. This is the freezer where the fresh tissue is kept; unlike those in the cool room, there is no preservative in these bodies. ‘We want to try to create a model that’s close to what the user will see in their patient, minus the pulse and breathing,’ he explains from the doorway. Not only does embalming limit the flexibility of the tissue, the chemicals tend to bleach it of its colour; students approaching a live body for the first time, having only operated on an embalmed one, would have learned their way on a faded map. ‘We try to recreate that surgical environment to get them as close as they can be to real patient care. This is the spot to make their mistakes.’
There are no whole bodies here, just pieces of what Terry estimates to be about 130 donors. Stand in a cemetery surrounded by thousands of bodies and you don’t think about the difference six feet of earth makes; here the visual crowd is what staggers. Hundreds of bags of shapes line the walls. I can see fingers and feet, and what could be footballs were it not for the noses pressed against the plastic. One bagged head has a doctor’s name written on it in permanent blue marker – reserved for later use. On the floor there’s a whole leg with a hip joint attached, its bare foot poking out from the towel. The green bags denote ‘finished’ pieces – these body parts are ready to be cremated, and are just waiting here for the rest of the person to turn up, all identified by a unique number. When they all get here, Terry will lay the pieces out and rebuild a human, but he won’t stitch them together: the flesh is too frozen to take a needle and thread, and if they thawed they would leak. They’ll be cremated in full, and get their name and identity back. ‘That’s a promise that we hold very, very strong to our families. We don’t lose anything.’
‘Some people might view this as disrespectful,’ he says, motioning past me into the depths of the freezer. ‘To me it would be disrespectful to have tissue go to waste.’
I paused there in the cold, looking down at these pieces of people, patches of crystalline frost misting up the plastic. I tried to work out what it was I was feeling. When I first contacted Terry, I predicted this scene would be more shocking to the senses, that despite years of staring into jars at pathology museums, this would be different and likely harder to look at. These would not be the pale specimens from long ago – these would be recent, fleshy, distinctly human, and somewhere in a computer system they would have names. Someone would still be grieving for them. But there was a disconnect, not just physically with the bags and towels, but emotionally: none of these items corresponded to people as I recognise them. The only thing that got me were the hands, with their perfectly polished nails or roughly bitten ones – that student was right. Hands retain a personality even after they are severed. They are things that people held, they’re the thing we’re supposed to know the back of better than anything. On a shelf beside me were arms half wrapped in small towels, twisted into clear bags, separated from the body just below the shoulder. Here were hands paused mid-sentence in sign language, caught in a moment of effusive gesticulation, here they were frozen in time – collected gestures removed from body and context, orphaned frames of a Muybridge set. Bare hands in bags have more personality than entire bodies.
But I felt almost nothing, or at least none of what I had expected. There was no shock, fear or repulsion in the freezer of decapitated heads: it was pure science and Futurama. I had felt the loss of thirteen lives in Poppy’s mortuary, but though here there were ten times that in pieces in front of me, there was a strange emotional silence.
Charles Byrne, the seven-foot-seven Irish Giant, knew when his health began to deteriorate in the 1780s that the anatomists were after his body. He did not want to end up in John Hunter’s museum of pathological specimens, a freak show preserved in a glass cabinet for centuries, looking down at the tourists in their puffer jackets. So he asked to be buried at sea, and when he died at the age of twenty-two his body was taken to the coast. Most of the pieces of people in the Hunterian Museum are anonymous, bodysnatched. But there Byrne stands: the stolen, named skeleton who never made it to the ocean, whose empty coffin was weighed down with rocks by the bribed undertaker so the pallbearers wouldn’t notice. Looking up at his thick bones, you cannot help but feel the emotional weight of them. He did not want to be there.
It hit me, slowly, that everyone in that freezer at that moment, including Terry, and including me, wanted to be there. All of this death, layer upon layer of frozen flesh, bag upon bag of legs and torsos, could drown the life in the room if you let it. The relentless butcher-shop sameness, the cold and the thaw, the filing and the numbering – it could render all of this meaningless or worse. But here the sheer scale of it performed a cosmic trick. Zoom out and take it in all at once: this scene was not shocking or sad, because every single person wanted some good to come from their death, and this was what they chose. Here was a picture of profound generosity and hope, framed by the rubber seal of a heavy-duty silver door.
Decapitate the common snapping turtle and the jaw will still clamp, like an amputated lizard’s tail will still twist in the grass. Its heart can beat cold blood for hours. Thanks to its strength and hardness of shell, the snapping turtle has no natural predators bar fans of turtle soup, passing cars and bored boys.
It was the mid-1960s, in Florida, when seven-year-old Terry found the remains of a turtle neighbourhood bullies had tormented and abandoned. He returned to the crime scene daily, marvelling at the life remaining in the animated head, the pure reactive nature of muscle biology, the trademark snap that gave the reptile its descriptor. Crouching over it in the sticky heat, he became fascinated with the miracle of a body in life and death, its function and base mechanics. In his memory, it took five days for the decapitated turtle to stop biting the stick.
Terry looks at me like a man who hasn’t thought about this in a while. After the snapping turtle he took his Red Ryder BB gun to the Everglades National Park to hunt bobwhite quail, armadillos, raccoons and possums. He’d remove the viscera, always curious about what was on the inside. ‘Instead of having Kool-Aid stands, I’d go out and shoot sharks, cut their jaws off and see what they’d been eating. Then I’d sell the jaws on the A1A, the big highway in Florida. And coconuts. I couldn’t believe all the old people that were buying coconuts.’ All this might sound like the makings of another Jeffrey Dahmer, but an interest in death doesn’t always lead down the same path. Terry was looking for the life in the body, the thing that electrified the parts.
Now, using medical equipment on established surgical planes, Terry takes apart the bodies to preserve the structures the students need to study. To partition a shoulder, he will cut along the clavicle, follow the rib cage, and separate the arm with the shoulder blade attached. To get the maximum use out of knees and ankles but reserve the hips for another department, he will leave a third of a femur for the orthopaedic students to observe the hip approach. To take a head off a body, he uses a bone saw to cut through the flesh and disarticulates the vertebrae somewhere above the shoulders, keeping as much of the neck as possible so someone can study the airways.
I ask if any of this bothers him. He laughs and says no, he’s seen worse things picking up bodies at crime scenes than anything he could personally do in the prep room. He doesn’t know what it is about him that allows him to do this job that others can’t, what it is that precludes him from nausea and nightmares and fainting. When he was a funeral director, the coroner in Rochester didn’t have a removal team, so Terry was regularly asked to do it. While he methodically went about picking up pieces of bodies in the aftermath of a car explosion that melted the seats to springs, colleagues retched in front of local news cameras. Others coated their nostrils in Vicks and stood aside while Terry bagged up a suicide that had lain dead in a squat for weeks, beside a handgun wrapped in magazines to muffle the noise. He’s collected people whose pets have eaten their faces off, and all of it has been fine. I keep asking how he stands it, how he does it, and he keeps chuckling. He doesn’t know. I let the question hang a little longer.
‘Well, I had to take a friend’s head off. That was…’ He trails off. ‘There’s still not a day in my career that I don’t remove somebody’s head or arm, that I wonder how I got this job. How did I end up here?’
The friend was a colleague at the Mayo who had willed his body to the programme. Terry reasoned with himself that the guy knew what he was signing up for and who was going to be doing it, so he was carrying out his wishes. ‘I’ve accepted quite a few donors in my years here that I’ve known, and it changes it. I still detach myself and keep my promise that we’re gonna do everything we can do to honour their gift, but there’s always a personal side of things. But you have to just go on. I’m sure the physicians and healthcare providers, if their friends or family come in, it changes things for them too. It’s a little more pressure, you still want to do a good job, but you’re gonna do everything the same for the other patient you don’t know. But it changes the emotional approach to it.’
Sometimes you have to keep watch on your own heart, though: there is now a system in place, an agreement with a neighbouring university in Minneapolis, whereby they can swap bodies if they’re too close to the staff or students.
‘Did you do anything differently for your friend?’ I ask. ‘Did you cover his face?’
‘Nope. I just went to work and tried to squash my emotions and just do my normal, good job to fulfil their wish of participating.’
I wonder, though, if it’s a learned habit; even for a funeral director, a freezer full of decapitated heads is an unusual sight. So I ask if this was a shock on his first day, when they had thirteen heads lined up across two tables for courses in thyroplasty and rhinoplasty. ‘I didn’t run away,’ he says. ‘I just thought, Well, that’s weird.’ He believes that working in funeral homes probably had more emotional downsides: funeral homes, unlike the Mayo’s anatomy department, deal with the bodies of children – something he has always found particularly hard to process. ‘You’re dealing with grief all the time. I deal with that a little bit in this role, but it also gives the family a lot of hope and optimism, something positive coming out of a really bad situation.’ He thinks about it a little longer, searching for something else to explain why the heads don’t faze him. ‘No, I’m comfortable as heck!’ he says, coming up with nothing. ‘Doesn’t bother me at all. If we just cut the heads off without seeing the benefit, I might have bigger issues.’
Terry is sixty-two, and in two years he’ll be retiring, though he seems like the kind of person who will always be two years away from retiring. But he hasn’t planned his life around it – he knows there’s a chance a person won’t make it to retiring age. He also knows that the human jaw does not live on like a snapping turtle, but a body can keep on giving once the life in it has gone: it can help the living in more ways than offering up a warm liver in the last moments on a hospital bed. It’s impossible to quantify the number of errors prevented or successes they’ve achieved in this lab, because it’s all part of training young doctors – but there is a very direct line from the dead in his freezers to the living on the street.
Once or twice a month a doctor will ask for his help. There was the doctor who perfected his tool to cure carpal tunnel syndrome on the wrists of the dead. Then there was the doctor who came to him with the problem of a tumour so complex and potentially fatal that surgeons worldwide had refused to touch it; it started at the neck and wrapped its way down around the patient’s spinal column like the red stripe on a barber’s pole, stopping below the chest. A multidisciplinary team would need to be involved with the different stages of removing this twisted mass – rolling through the surgical specialities as they moved further down the spine, front to back, front to back, rotating the man like a rotisserie chicken – so they practised in Terry’s lab, arriving at 10 p.m. after work, leaving at dawn, turning the bodies of the dead, working out their plan. The patient survived.
Then there was the face transplant. I had already heard about it: the fifty-six-hour marathon surgery was so successful it made international news. The thirty-two-year-old patient, Andy Sandness from Wyoming – a state in the heart of the American male suicide epidemic – destroyed most of his face with a self-inflicted gunshot wound to the chin at twenty-one. A decade later, Calen Ross shot himself and died in south-western Minnesota. Their ages, blood type, skin colour and facial structure were a near-perfect match. The doctors had spent three years waiting for the right donor, practising. To prepare for the operation, the surgeons, nurses, surgical technicians and anaesthetists spent fifty weekends in Terry’s lab, divided into two small rooms to replicate the cramped operating room. They studied every branch of nerves and what they did for the face; they took pictures and videos, and practised joining them up. Every time they came in, they worked on two different heads. They swapped 100 faces. The donors don’t leave here in one piece, but Terry makes sure they leave with the right ones. So when the surgeons were done, he would stay behind and swap the faces back. No one would ever have known if he hadn’t. There is no bone in the facial flesh that would end up in the wrong urn after the cremation. He did it because it was the right thing to do, in much the same way that he, as a funeral director, always made sure everyone was buried in outfits complete with underwear and socks, even if their family had forgotten to add them to the shopping bag of clothes. Sure, no one would know if he didn’t do it – but he would.
It’s this part of the work that keeps him going through the bone saws and the decapitations: the scientific advancement, the possibilities, the fundamental good that is intrinsic in the work that is carried out here. He has an assistant who also cuts up the bodies, and Terry encourages him to occasionally come out of the freezer to see the students, to see what his work leads to; without the science and the hope, Terry knows the environment could be a sad one to work in. But his face lights up when he talks about his involvement in the continuing lives of the living, as hidden in the cold backroom as he may be.
A podiatrist, failing spectacularly at small talk at a party, once told me that everyone wants to keep their foot in a jar. She mostly worked with returned veterans who – through neglect or diabetes, usually both – had let their feet rot. She said nobody wants to lose their foot no matter what state it’s in, that people would rather keep it rotting on the end of their leg and have it kill them than have it taken away. If they concede the foot is a lost cause, they ask if they can keep it. People don’t want to let pieces of themselves go.
I think of these men looking up from their wheelchairs, desperately pleading to keep their putrid feet in jars, as Terry slows the body collection van to a stop in Oakwood Cemetery. He’s out of his scrubs now. In his orange plaid Harley-Davidson shirt, blue jeans and brown boots he looks more like he should be leaning on his 1800cc Ultra Classic outside a dive bar, not driving a white Dodge van through a neat graveyard in rural Minnesota. He jokes that I’m the only passenger he’s ever had sit up front.
He winds down the window and points at the grey granite memorial that has been erected for every donor that ever came through the Mayo Clinic, a vault for the people who gave away their entire bodies knowing no specifics about what it would go through or by whose scalpel they would be taken unskilfully apart. Engraved into the front of the monument are these words:
DEDICATED TO THE INDIVIDUALS
WHO HAVE DONATED THEIR
BODIES TO MAYO FOUNDATION
FOR ANATOMICAL STUDY
SO THAT OTHERS MIGHT LIVE.
Terry comes here regularly to keep an eye on the damp inside the vault, to trim the grass around the stone, and every year he comes to add more ashes. He tends this grave for the thousands of people he never knew while they were alive, but whose bodies he looked after until they were cremated, in pieces, a year after they died.
Not everybody is here: if the families want the ashes back, they collect them at an annual service called the Convocation of Thanks, where they go from anonymised body to person again. On black plastic urns they get their names back, and their donor serial number too – a double life in one body. The ceremony gives thanks to donors but also some kind of conclusion to families – these people haven’t had their funeral yet. This year’s ceremony is happening tomorrow, and Terry tells me to get there early if I want to secure a seat. They’re expecting hundreds.
The next day a crowd is funnelled through a door in the side of the building and directed into a huge auditorium. Medical students read poems at the podium, ones they have written themselves, then return to their seat, not knowing if the person beside them is the brother, son, daughter, wife of the person they dissected. Every poem talks about the basic things they will never know about these people, despite knowing the intricacies of their literal heart. Did they tap their fingers on the steering wheel at stoplights? Did they eat peanut butter out of the jar? In the audience, there are old men in braces, young men wearing cowboy boots and boleros, farmers looking uncomfortable in suits. Wearing blue eyeshadow like 1960s time capsules, hunched women in the line to the bathroom gush about how many girls are in the group photos of young orthopaedic surgeons. The room is buzzing.
Hundreds of donor names are listed on a giant screen and read out one by one by a pair of trainee surgeons, but whoever it was that taught them, personally, the workings of the human body, goes by anonymously in the roll call. A weirdly high number of them are called Kermit. A handsome older man sitting next to me in his suit and yellow tie leans over and tells me quietly but proudly as her name comes up, ‘Selma was my mother – 105 and a half!’ She was widowed for four decades and won exercise competitions at the nursing home before donating the body she had looked after so carefully – the body that grew this man from an egg she was born with.
Later, around an emptying buffet, people politely wait for the right time to ask Terry for their person back. He’s in a dark suit now, and speaks to the families with a quiet and gentle reverence, as if he were by a graveside. Some try their luck and ask if the students ever found anything abnormal inside their father. How big was the cancer in the end? Do you think it’s genetic? The plates of food congeal. The man in the yellow tie collects his mother. Outside in the Minnesota sunlight, on Cinco de Mayo, old people in wheelchairs wait for ramps to unfold from taxis, boxes of bone dust in their laps.