6
The Cadaver Who Joined the Army
The sticky ethics of bullets and bombs
For three days in January of 1893 and again for four days in March, Captain Louis La Garde of the U.S. Army Medical Corps took up arms against a group of extraordinary foes. It was an unprecedented military undertaking, and one for which he would forever after be remembered. Though La Garde served as a surgeon, he was no stranger to armed combat. In the Powder River Expedition of 1876, he had been decorated for gallantry in confronting tribes of hostile Sioux. La Garde had led the charge against Chief Dull Knife, whose name, we can only assume, was no reflection on his intellectual and military acumen or the quality and upkeep of his armaments.
La Garde received his strange and fateful orders in July of 1892. He would be receiving, the letter said, a new, experimental .30-caliber Springfield rifle. He was to take this rifle, along with his standard-issue .45-caliber Springfield, and report to Frankford Arsenal, Pennsylvania, the following winter. Taking shape in the rifles’ sights would be men, a series of them, naked and unarmed. That they were naked and unarmed was the less distinctive thing about them. More distinctive was that they were already dead. They had died of natural causes and had been collected—from where is not revealed—as subjects in an Army Ordnance Department experiment. They were to be suspended from a tackle in the ceiling of the firing range, shot at in a dozen places and with a dozen different charges (to simulate different distances), and autopsied. La Garde’s mission was to compare the physiological effects of the two different weapons upon the human body’s bones and innards.
The United States Army was by no means the first to sanction the experimental plugging of civilian cadavers. The French army, wrote La Garde in his book Gunshot Injuries, had been “firing into dead bodies for the purpose of teaching the effects of gunshots in war” since around 1800. Ditto the Germans, who went to the exquisite trouble of propping up their mock victims al fresco, at distances approximating those of an actual battlefield. Even the famously neutral Swiss sanctioned a series of military wound ballistics studies on cadavers in the late 1800s. Theodore Kocher, a Swiss professor of surgery and a member of the Swiss army militia (the Swiss prefer not to fight, but they are armed, and with more than little red pocket knife/can openers), spent a year firing Swiss Vetterli rifles into all manner of targets—bottles, books, water-filled pig intestines, oxen bones, human skulls, and, ultimately, a pair of whole human cadavers—with the aim of understanding the mechanisms of wounding from bullets.
Kocher—and to a certain extent La Garde—expressed a desire that their ballistics work with cadavers would lead to a more humanitarian form of gun battle. Kocher urged that the goal of warfare be to render the enemy not dead, but simply unable to fight. To this end, he advised limiting the size of the bullets and making them from a material of a higher melting point than lead, so that they would deform less and thus destroy less tissue.
Incapacitation—or stopping power, as it is known in munitions circles—became the Holy Grail of ballistics research. How to stop a man in his tracks, preferably without maiming or killing him, but definitely before he maimed or killed you first. Indeed, the next time Captain La Garde and his swinging cadavers took the stage, in 1904, it was in the name of improved stopping power. The topic had been high on the generals’ to-do lists following the army’s involvement in the Philippines, during the final stage of the Spanish-American War, where its Colt .38s had failed, on numerous occasions, to stop the enemy cold. While the Colt .38 was considered sufficient for “civilized” warfare—“even the stoical Japanese soldier,” wrote La Garde in Gunshot Injuries, “fell back as a rule when he was hit the first time”—such was apparently not the case with “savage tribes or a fanatical enemy.” The Moro tribesman of the Philippines was considered a bit of both: “A fanatic like a Moro, wielding a bolo in each hand who advances with leaps and bounds … must be hit with a projectile having a maximum amount of stopping power,” wrote La Garde. He related the tale of one battle-enlivened tribesman who charged a U.S. Army guard unit. “When he was within 100 yards, the entire guard opened fire on him.” Nonetheless, he managed to advance some ninety-five yards toward them before finally crashing to the ground.
La Garde, at the War Department’s urging, undertook an investigation of the army’s various guns and bullets and their relative efficacy at putting a rapid halt to enemies. He decided that one way to do this would be to fire at suspended cadavers and take note of the “shock,” as estimated by “the disturbance which appeared.” In other words, how far back does the hanging torso or arm or leg swing when you shoot it? “It was based on the assumption that the momentum of hanging bodies of various weights could somehow be correlated and measured, and that it actually meant something with regard to stopping power,” says Evan Marshall, who wrote the book on handgun stopping power (it’s called Handgun Stopping Power). “What it actually did was extrapolate questionable data from questionable tests.”
Even Captain La Garde came to realize that if you want to find out how likely a gun is to stop someone, you are best off trying it on an entity that isn’t already quite permanently stopped. In other words, a live entity. “The animals selected were beeves about to undergo slaughter in the Chicago stock-yards,” wrote La Garde, deeply perplexing the ten or fifteen people who would be reading his book later than the 1930s, when the word “beeves,” meaning cattle, dropped from everyday discourse. Sixteen beeves later, La Garde had his answer: Whereas the larger-caliber (.45) Colt revolver bullets caused the cattle to drop to the ground after three or four shots, the animals shot with smaller-caliber .38 bullets failed even after ten shots to drop to the ground. And ever since, the U.S. Army has gone confidently into battle, knowing that when cows attack, their men will be ready.
For the most part, it has been the lowly swine that has borne the brunt of munitions trauma research in the United States and Europe. In China—at the No. 3 Military Medical College and the China Ordnance Society, among others—it has been mongrel dogs that get shot at. In Australia, as reported in the Proceedings of the 5th Symposium on Wound Ballistics, the researchers took aim at rabbits. It is tempting to surmise that a culture chooses its most reviled species for ballistics research. China occasionally eats its dogs, but doesn’t otherwise have much use or affection for them; in Australia, rabbits are considered a scourge—imported by the British for hunting, they multiplied (like rabbits) and, in a span of twenty years, wiped out two million acres of south Australian brush.
In the case of the U.S. and European research, the theory doesn’t hold. Pigs don’t get shot at because our culture reviles them as filthy and disgusting. Pigs get shot at because their organs are a lot like ours. The heart of the pig is a particularly close match. Goats were another favorite, because their lungs are like ours. I was told this by Commander Marlene DeMaio, who studies body armor at the Armed Forces Institute of Pathology (AFIP). Talking to DeMaio, I got the impression that it would be possible to construct an entire functioning nonhuman human from pieces of other species. “The human knee most resembles the brown bear’s,” she said at one point, following up with a surprising or not so surprising statement: “The human brain most resembles that of Jersey cows at about six months.”* I learned elsewhere that emu hips are dead ringers for human hips, a situation that has worked out better for humans than for emus, who, over at Iowa State University, have been lamed in a manner that mimics osteonecrosis and then shuttled in and out of CT scanners by researchers seeking to understand the disease.
Had I been calling the shots back at the War Department, I would have sanctioned a study not on why men sometimes fail to drop to the ground after being shot, but on why they so often do. If it takes ten or twelve seconds to lose consciousness from blood loss (and consequent oxygen deprivation to the brain), why, then, do people who have been shot so often collapse on the spot? It doesn’t happen just on TV.
I posed this question to Duncan MacPherson, a respected ballistics expert and consultant to the Los Angeles Police Department. MacPherson insists the effect is purely psychological. Whether or not you collapse depends on your state of mind. Animals don’t know what it means to be shot, and, accordingly, rarely exhibit the instant stop-and-drop. MacPherson points out that deer shot through the heart often run off for forty or fifty yards before collapsing. “The deer doesn’t know anything about what’s going on, so he just does his deer thing for ten seconds or so and then he can’t do it anymore. An animal with a meaner disposition will use that ten seconds to come at you.” On the flip side, there are people who are shot at but not hit—or hit with nonlethal bullets, which don’t penetrate, but just smart a lot—who will drop immediately to the ground. “There was an officer I know who took a shot at a guy and the guy just went flat, totally splat, facedown,” MacPherson told me. “He said to himself, ‘God, I was aiming for center mass like I’m supposed to, but I must have gotten a head shot by mistake. I’d better go back to the shooting range.’ Then he went to the guy and there wasn’t a mark on him. If there isn’t a central nervous system hit, anything that happens fast is all psychological.”
MacPherson’s theory would explain the difficulties the army had in La Garde’s day with the Moro tribesmen, who presumably weren’t familiar with the effects of rifles and kept on doing their Moro tribesman thing until they couldn’t—owing to blood loss and consequent loss of consciousness—do it anymore. Sometimes it isn’t just ignorance as to what bullets do that renders a foe temporarily impervious. It can also be viciousness and sheer determination. “A lot of guys take pride in their imperviousness to pain,” MacPherson said. “They can get a lot of holes in them before they go down. I know an LAPD detective who got shot through the heart with a .357 Magnum and he killed the guy that shot him before he collapsed.”
Not everyone agrees with the psychological theory. There are those who feel that some sort of neural overload takes place when a bullet hits. I communicated with a neurologist/avid handgunner/reserve deputy sheriff in Victoria, Texas, named Dennis Tobin, who has a theory about this. Tobin, who wrote the chapter “A Neurologist’s View of ‘Stopping Power’ ” in the book Handgun Stopping Power, posits that an area of the brain stem called the reticular activating system (RAS) is responsible for the sudden collapse. The RAS can be affected by impulses arising from massive pain sensations in the viscera.* Upon receiving these impulses, the RAS sends out a signal that weakens certain leg muscles, with the result that the person drops to the ground.
Somewhat shaky support for Tobin’s neurological theory can be found in animal studies. Deer may keep going, but dogs and pigs seem to react as humans do. The phenomenon was remarked upon in military medical circles as far back as 1893. A wound ballistics experimenter by the name of Griffith, while going about his business documenting the effects of a Krag-Jorgensen rifle upon the viscera of live dogs at two hundred yards, noted that the animals, when shot in the abdomen, “died as promptly as though they had been electrocuted.” Griffith found this odd, given that, as he pointed out in the Transactions of the First Pan-American Medical Congress, “no vital part was hit which might account for the instantaneous death of the animals.” (In fact, the dogs were probably not as promptly dead as Griffith believed. More likely, they had simply collapsed and looked, from two hundred yards, like dead dogs. And by the time Griffith had walked the two hundred yards to get to them, they were in fact dead dogs, having expired from blood loss.)
In 1988, a Swedish neurophysiologist named A. M. Göransson, then of Lund University, took it upon himself to investigate the conundrum. Like Tobin, Göransson figured that something about the bullet’s impact was causing a massive overload to the central nervous system. And so, perhaps unaware of the similarities between the human brain and that of Jersey cows at six months, he wired the brains of nine anesthetized pigs to an EEG machine, one at a time, and shot them in the hindquarters. Göransson reports having used a “high-energy missile” for the task, which is less drastic than it suggests. What it suggests is that Dr. Göransson got into his car, drove some distance from his laboratory, and launched the Swedish equivalent of Tomahawk missiles at the hapless swine, but in fact, I am told, the term simply means a small, fast-moving bullet.
Instantly upon being hit, all but three of the pigs showed significantly flattened EEGs, the amplitude in some cases having dropped by as much as 50 percent. As the pigs had already been stopped in their tracks by the anesthesia, it is impossible to say whether they would have been rendered so by the shots, and Göransson opted not to speculate. And if they had lost consciousness, Göransson had no way of knowing what the mechanism was. To the deep chagrin of pigs the world over, he encouraged further study.
Proponents of the neural overload theory point to the “temporary stretch cavity” as the source of the effect. All bullets, upon entry into the human form, blow open a cavity in the tissue around them. This cavity shuts back up almost immediately, but in that fraction of a second that it is agape, the nervous system, they believe, issues a Mayday blast—enough of one, it seems, to overload the circuits and cause the whole system to hang a Gone Fishing sign on the door.
These same proponents believe that bullets that create sizable stretch cavities are thus more likely to deliver the necessary shock to achieve the vaunted ballistics goal of “good stopping power.” If this is true, then in order to gauge a bullet’s stopping power, one needs to be able to view the stretch cavity as it opens up. That is why the good Lord, working in tandem with the Kind & Knox gelatin company, invented human tissue simulant.
I am about to fire a bullet into the closest approximation of a human thigh outside of a human thigh: a six-by-six-by-eighteen-inch block of ballistic gelatin. Ballistic gelatin is essentially a tweaked version of Knox dessert gelatin. It is denser than dessert gelatin, having been formulated to match the average density of human tissue, is less colorful, and, lacking sugar, is even less likely to please dinner guests. Its advantage over a cadaver thigh is that it affords a stop-action view of the temporary stretch cavity. Unlike real tissue, human tissue simulant doesn’t snap back: The cavity remains, allowing ballistics types to judge, and preserve a record of, a bullets performance. Plus, you don’t need to autopsy a block of human tissue simulant; because it’s clear, you just walk up to it after you’ve shot it and take a look at the damage. Following which, you can take it home, eat it, and enjoy stronger, healthier nails in thirty days.
Like other gelatin products, ballistic gelatin is made from processed cow bone chips and “freshly chopped” pig hide.* The Kind & Knox Web site does not include human tissue simulant on its list of technical gelatin applications, which rather surprised me, as did the failure of a Knox public relations woman to return my calls. You would think that a company that felt comfortable extolling the virtues of Number 1 Pigskin Grease on its Web site (“It is a very clean material”; “Available in tanker trucks or railcars”) would be okay with talking about ballistic gelatin, but apparently I’ve got truckloads or railcars to learn about gelatin PR.
Our replicant human thigh was cooked up by Rick Lowden, a freewheeling materials engineer whose area of expertise is bullets. Lowden works at the Department of Energy’s Oak Ridge National Laboratory in Oak Ridge, Tennessee. The lab is best known for its plutonium work in the Manhattan (atomic bomb development) Project and now covers a far broader and generally less unpopular range of projects. Lowden, for instance, has lately been involved in the design of an environmentally friendly no-lead bullet that doesn’t cost the military an arm and a leg to clean up after. Lowden loves guns, loves to talk about them. Right now he’s trying to talk about them with me, a distinctly trying experience, for I keep shepherding the conversation back to dead bodies, which Lowden clearly doesn’t enjoy very much. You would think that a man who felt comfortable extolling the virtues of hollow-point bullets (“expands to twice its size and just thumps that person”) would be okay talking about dead bodies, but apparently not. “You just cringe,” he said, when I mentioned the prospect of shooting into human cadaver tissue. Then he made a noise that I transcribed in my notes as “Olggh.”
We are standing under a canopy at the Oak Ridge shooting range, about to set up the first stopping-power test. The “thighs” sit in an open plastic cooler at our feet, sweating mildly. They are consommé-colored and, owing to the cinnamon added to mask the material’s mild rendering-plant effluvium, smell like Big Red chewing gum. Rick carries the cooler out to the target table, thirty feet away, and settles an ersatz thigh into the gel cradle. I make conversation with Scottie Dowdell, who is supervising the shooting range today. He is telling me about the pine beetle epidemic in the area. I point to a stand of dead conifers in the woods a quarter mile back behind the target. “Like over there?” Scottie says no. He says they died of bullet wounds, something I never knew pine trees could do.
Rick returns and sets up the gun, which isn’t really a gun but a “universal receiver,” a tabletop gun housing that can be outfitted with barrels of different calibers. Once it’s aimed, you pull a wire to release the bullet. We’re testing a couple of new bullets that claim to be frangible, meaning they break apart on impact. The frangible bullet was designed to solve the “overpenetration,” or ricochet, problem, i.e., bullets passing through victims, bouncing off walls, and harming bystanders or the police or soldiers who fired them. The side effect of the bullet’s breaking apart on impact is that it tends to do this inside your body if you’re hit. In other words, it tends to have really, really good stopping power. It basically functions like a tiny bomb inside the victim and is therefore, to date, mainly reserved for “special response” SWAT-type activities, such as hostage rescue.
Rick hands me the trigger string and counts down from three. The gelatin sits on the table, soaking up the sunshine, basking beneath the calm, blue Tennessee skies—tra la la, life is gay, it’s good to be a gelatin block, I…BLAM!
The block flips up into the air, off the table, and onto the grass. As John Wayne said, or would have, had he had the opportunity, this block of gelatin won’t be bothering anyone anytime soon. Rick picks up the block and places it back in its cradle. You can see the bullet’s journey through the “thigh.” Rather than overpenetrating and exiting the back side, the bullet has stopped short several inches into the block. Rick points to the stretch cavity. “Look at that. A total dump of energy. Total incapacitation.”
I had asked Lowden whether munitions professionals ever concern themselves, as did Kocher and La Garde, with trying to design bullets that will incapacitate without maiming or killing. Lowden’s face displayed the sort of look it displayed earlier when I’d said that armor-piercing bullets were “cute.” He answered that the military chooses weapons more or less by how much damage they can inflict on a target, “whether the target be a human or a vehicle.” This is another reason ballistic gelatin tends to get used in stopping-power tests, rather than cadavers. We’re not talking about research that will help mankind save lives; we’re talking about research that will help mankind take lives. I suppose you could argue that policemen’s and soldiers’ lives may be saved, but only by taking someone else’s life first. Anyway, it’s not a use of human tissue for which you’re likely to get broad public support.
Of course, the other big reason munitions people shoot ballistic gelatin is reproducibility: Provided you follow the recipe, it’s always the same. Cadaver thighs vary in density and thickness, according to the age, gender, and physical condition of their owners when they stopped using them. Still another reason: Cleanup’s a breeze. The remains of this morning’s thighs have been picked up and repacked in the cooler, a tidy, bloodless mass grave of low-calorie dessert.
Not that a ballistic gelatin shootout is completely devoid of gore. Lowden points to the toe of my sneaker, at a Pulp Fiction fleck of spatter. “You got some simulant on your shoe.”
Rick Lowden never shot a dead man, though he had his chance. He was working on a project, in cooperation with the University of Tennessee’s human decay facility, aimed at developing bullets that would resist corrosion from the acid breakdown products inside a dead body and help forensics types solve crimes long after they happen.
Rather than shooting the experimental bullets into his cadavers, Lowden got down on his hands and knees with a scalpel and a pair of tweezers and surgically placed them. He explained that he did this because he wanted the bullets to end up in specific places: muscle, fatty tissue, the head and chest cavities, the abdomen. If he’d shot them into the tissue, they might have overpenetrated, as they say, and wound up in the dirt.
He also did it that way because he felt he had to. “It was always my impression that we couldn’t shoot a body.” He recalls another project, one in which he was developing a simulated human bone that could be put inside blocks of ballistic gelatin, much as banana and pineapple chunks are floated inside Jell-O. To calibrate the simulated bone, he needed to shoot some actual bone and compare the two. “I was offered sixteen cadaver legs to shoot at. DOE told me they would terminate my project if I did that. We had to shoot pig femurs instead.”
Lowden told me that military munitions professionals even worry about the politics of shooting into freshly killed livestock. “A lot of guys won’t do that. They’ll go get a ham from the store or a leg from the slaughterhouse. Even then, a lot of them don’t openly publish what they do. There’s still a stigma.”
Ten feet behind us, sniffing the air, is a groundhog who has made unfortunate real estate choices in his life. The animal is half the size of a human thigh. If you shot that groundhog with one of these bullets, I say to Rick, what would happen? Would it completely vaporize? Rick and Scottie exchange a look. I get the feeling that the stigma attached to shooting groundhogs is fairly minimal.
Scottie shuts the ammo case. “Create a lot of paperwork, is what would happen.”
Only recently has the military dipped its toes back into the roiling waters of publicly funded cadaveric ballistics research. As one would imagine, the goals are strictly humanitarian. At the Armed Forces Institute of Pathology’s Ballistic Missile Trauma Research Lab last year, Commander Marlene DeMaio dressed cadavers in a newly developed body armor vest and fired a range of modern-day munitions at their chests. The idea was to test the manufacturer’s claims before outfitting the troops. Apparently body armor manufacturers’ effectiveness claims aren’t always to be trusted. According to Lester Roane, chief engineer at the independent ballistics and body armor test facility H. P. White Labs, the companies don’t do cadaver tests. H. P. White doesn’t either. “Anybody looking at it coldly and logically shouldn’t have any problem with it,” said Roane. “It’s dead meat. But for some reason, it’s just something that has been politically incorrect from before there was a term for politically correct.”
DeMaio’s cadaver tests represent a distinct improvement over how vests were originally tested by the military: In Operation Boar, during the Korean War, the Doron vest was tested simply by giving it to six thousand soldiers and seeing how they fared compared to soldiers wearing standard vests. Roane says he once watched a video made by a Central American police department that tested their vests by having officers put them on and then shooting at them.
The trick to designing body armor is to make it thick and unyielding enough to stop bullets without making it so heavy and hot and uncomfortable that officers won’t wear it. What you don’t want is what the Gilbertese Islanders used to have. While I was in D.C. to see DeMaio, I stopped at the Smithsonian’s Museum of Natural History, where I saw a display of body armor from the Gilbert Islands. Battles in Micronesia were so pitched and bloody that Gilbertese warriors would outfit themselves head to foot with doormat-thick armor fashioned from the twisted fibers of coconut hulls. On top of the significant humiliation of making one’s entrance onto the battlefield looking like an enormous macramé planter was the fact that the armor was so bulky it required the assistance of several squires to help maneuver you.
As with automotive cadavers, DeMaio’s body-armor bodies were instrumented with accelerometers and load cells, in this case on the sternum, to record the impact forces and give researchers a detailed medical rendering of what was happening to the chest inside the armor. With some of the nastier-caliber weapons, the cadavers sustained lung lacerations and rib fractures, but nothing that translated into an injury that—if you weren’t already a cadaver—could kill you. More tests are planned, with the goal of making a test dummy along the lines of those used by the automotive industry—so that one day cadavers won’t be needed.
Because she had proposed to use human cadavers, DeMaio was advised to proceed with extreme caution. She gathered the blessings of three institutional review boards, a military legal counsel, and a card-carrying ethicist. The project was ultimately approved, with one stipulation: no penetration. The bullets had to stop short of the cadavers’ skin.
Did DeMaio roll her eyes in exasperation? She says not. “When I was in medical school I used to think,‘Come on, don’t be irrational. They’ve expired, they’ve donated their bodies, you know?’ When I got into this project I realized that we are part of the public trust, and even if it doesn’t make scientific sense, we have to be responsive to people’s emotional concerns.”
On an institutional level, the caution comes from fear of liability and of unpleasant media reports and withdrawal of funding. I spoke with Colonel John Baker, the legal counsel from one of the institutions that sponsored DeMaio’s research. The head of this institution preferred that I refrain from naming it and instead refer to it as simply “a federal institution in Washington.” He told me that over the past twenty-some years, democratic congressmen and budget-minded legislators have tried to close the place down, as have Jimmy Carter, Bill Clinton, and People for the Ethical Treatment of Animals. I got the feeling that my request for an interview had brought this man’s day crashing down like so many pine trees behind a DOE shooting range.
“The concern is that some survivor will be so taken aback that they’ll bring suit,” said Colonel Baker from his desk at a federal institution in Washington. “And there is no body of law in this area, nothing you can look to other than good judgment.” He pointed out that although cadavers don’t have rights, their family members do. “I could imagine some sort of lawsuit that is based upon emotional distress…. You get some of those [cases] in a cemetery situation, where the proprietor has allowed the coffins to rot away and the corpses pop up.” I replied that as long as you have informed consent—a signed agreement from the donor stating that he has willed his body to medical research—it would seem that the survivors wouldn’t have much of a case.
The sticking point is the word “informed.” It’s fair to say that when people donate remains, either their own or those of a family member, they usually don’t care to know the grisly details of what might be done with them. And that if you did tell them the details, they might change their minds and withdraw consent. Then again, if you’re planning to shoot guns at them, it might be good to run that up the flagpole and get the a-okay. “Part of respecting persons is telling them the information that they might have an emotional response to,” says Edmund Howe, editor of the Journal of Clinical Ethics, who reviewed Marlene DeMaio’s research proposal. “Though one could go the other way and spare them that response and therefore ethically not commit that harm. But the downside to withholding information that might be significant to them is that it would violate their dignity to an extent.” Howe suggests a third possibility, that of letting the families make the choice: Would they prefer to hear the specifics of what is being done with the donated body—specifics that may be upsetting—or would they prefer not to know?
It’s a delicate balance that, in the end, comes down to wording. Observes Baker, “You don’t really want to be telling somebody, ‘Well, what we’ll be doing is dissecting their eyeballs. We take them out and put them on a table and then we dissect them into finer and finer parts and then once we’re finished we scrape all that stuff up and put it into a biohazard bag and try to keep it together so we can return whatever’s left to you.’ That sounds horrible.” On the other hand, “medical research” is a tad vague. “Instead, you say, ‘One of our principal concerns here at the university is ophthalmology. So we do a lot here with ophthalmological materials.’ ” If someone cares to think it through, it isn’t hard to come to the conclusion that someone in a lab coat will, at the very least, be cutting your eyeball out of your head. But most people don’t care to think it through. They focus on the end, rather than the means: Someone’s vision may one day be saved.
Ballistics studies are especially problematic. How do you decide it’s okay to cut off someone’s grandfather’s head and shoot it in the face? Even when the reason you are doing that is to gather data to ensure that innocent civilians who are hit in the face with nonlethal bullets won’t suffer disfiguring fractures? Moreover, how do you bring yourself to carry out the cutting off and shooting of someone’s grandfather’s head?
I posed these questions to Cindy Bir, who brought herself to do exactly that, and whom I met while I was at Wayne State. Bir is accustomed to firing projectiles at the dead. In 1993, the National Institute of Justice (NIJ) commissioned her to document the impact effects of various nonlethal munitions: plastic bullets, rubber ones, beanbags, the lot. Police began using non-lethal bullets in the late 1980s, in situations where they need to subdue civilians—mostly rioters and violent psychotics—without putting their lives in danger. In nine instances since that time, “nonlethal” bullets have proved lethal, prompting the NIJ to have Bir look into what was going on with these different bullets, with the aim of its not going on ever again.
As to the question “How do you bring yourself to cut off someone’s grandfather’s head?” Bir replied, “Thankfully, Ruhan does that for us.” (The very same Ruhan who preps the cadavers for automotive impacts.) She added that the nonlethal munitions were not shot from guns but fired from air cannons, because doing so is both more precise and less disturbing. “Still,” concedes Bir. “I was glad when that one finished up.”
Bir copes like most other cadaver researchers do, with a mix of compassion and emotional remove. “You treat them with dignity, and you kind of separate the fact that … I don’t want to say that they’re not a person, but … you think of them as a specimen.” Bir was trained as a nurse, and in some ways finds the dead easier to work with. “I know they can’t feel it, and I know that I’m not going to hurt them.” Even the most practiced cadaver researcher has days when the task at hand presents itself as something other than scientific method. For Bir, it had little to do with the fact that she was directing bullets at her subjects. It is the moments when the specimen steps out of his anonymity, his objecthood, and into his past existence as a human being.
“We received a specimen and I went down to help Ruhan, and this gentleman must have come directly from the nursing home or hospital,” she recalls. “He had on a T-shirt and flannel PJ pants. It hit me like … this could be my dad. Then there was one that I went to look at—a lot of times you like to take a look at the specimen to make sure it’s not too big [to lift]—and this person was wearing a hospital gown from my hometown.”
If you really want to stay up late worrying about lawsuits and bad publicity, explode a bomb near the body of someone who has willed his remains to science. This is perhaps the most firmly entrenched taboo of the cadaveric research world. Indeed, live, anesthetized animals have generally been considered preferable, as targets of explosions, to dead human beings. In a 1968 Defense Atomic Support Agency paper entitled Estimates of Man’s Tolerance to the Direct Effects of Air Blast—i.e., from bombs—researchers discussed the effects of experimental explosions upon mice, hamsters, rats, guinea pigs, rabbits, cats, dogs, goats, sheep, steers, pigs, burros, and stump-tailed macaques, but not upon the actual subject of inquiry. No one had ever strapped a cadaver up against the shock tube to see what might happen.
I called up a man named Aris Makris, who works for a company in Canada called Med-Eng Systems, which engineers protective gear for people who clear land mines. I told him about the DASA paper. Dr. Makris explained that dead people weren’t always the best models for gauging living people’s tolerance to explosive blasts because of their lungs, which are deflated and not doing the things that lungs normally do. The shock wave from a bomb wreaks the most havoc on the body’s most easily compressed tissue, and that is found in the lungs: specifically, the tiny, delicate air sacs where the blood picks up oxygen and drops off carbon dioxide. An explosive shock wave compresses and ruptures these sacs. Blood then seeps into the lungs and drowns their owner, sometimes quickly, in ten or twenty minutes, sometimes over a span of hours.
Makris conceded that, biomedical issues aside, the blast tolerance chaps were probably not highly motivated to work with cadavers. “There are enormous ethical or PR challenges with that,” he said. “It just hasn’t been the habit of blasting cadavers: Please give your body to science so we can blow it up?”
One group recently braved the storm. Lieutenant Colonel Robert Harris and a team of other doctors from the Extremity Trauma Study Branch of the U.S. Army Institute of Surgical Research at Fort Sam Houston, Texas, recruited cadavers to test five types of footwear either commonly used by or being newly marketed for land mine clearance teams. Ever since the Vietnam War, a rumor had persisted that sandals were the safest footwear for land mine clearance, for they minimized injuries caused by fragments of the footwear itself being driven into the foot like shrapnel, compounding the damage and the risk of infection. Yet no one had ever tested the sandal claim on a real foot, nor had anyone done cadaver tests of any of the equipment being touted by manufacturers as offering greater safety than the standard combat boot.
Enter the fearless men of the Lower Extremity Assessment Program. Starting in 1999, twenty cadavers from a Dallas medical school willed body program were strapped, one by one, into a harness hanging from the ceiling of a portable blast shelter. Each cadaver was outfitted with strain gauges and load cells in its heel and ankle, and clad in one of six types of footwear. Some boots claimed to protect by raising the foot up away from the blast, whose forces attenuate quickly; others claimed to protect by absorbing or deflecting the blast’s energy. The bodies were posed in standard walking position, heel to the ground, as though striding confidently to their doom. As an added note of verisimilitude, each cadaver was outfitted head to toe in a regulation battle dress uniform. In addition to the added realism, the uniforms conferred a measure of respect, the sort of respect that a powder-blue leotard might not, in the eyes of the U.S. Army anyway, supply.
Harris felt confident that the study’s humanitarian benefits outweighed any potential breach of dignity. Nonetheless, he consulted the willed body program administrators about the possibility of informing family members about the specifics of the test. They advised against it, both because of what they called the “revisiting of grief” among families who had made piece with the decision to donate and because, when you get down to the nitty-gritty details of an experiment, virtually any use of a cadaver is potentially upsetting. If willed body program coordinators contacted the families of LEAP cadavers, would they then have to contact the families of the leg-drop-test cadavers down the hall, or, for that matter, the anatomy lab cadavers across campus? As Harris points out, the difference between a blast test and an anatomy class dissection is essentially the time span. One lasts a fraction of a second; the other lasts a year. “In the end,” he says, “they look pretty much the same.” I asked Harris if he plans to donate his body to research. He sounded downright keen on the prospect. “I’m always saying, ‘After I die, just put me out there and blow me up.’ ”
If Harris could have done his research using surrogate “dummy” legs instead of cadavers, he would have done so. Today there are a couple good ones in the works, developed by the Australian Defence Science & Technology Organisation. (In Australia, as in other Commonwealth nations, ballistics and blast testing on human cadavers is not allowed. And certain words are spelled funny.) The Frangible Surrogate Leg (FSL) is made of materials that react to blast similarly to the way human leg materials do; it has mineralized plastic for bones, for example, and ballistic gelatin for muscle. In March of 2001, Harris exposed the Australian leg to the same land mine blasts that his cadavers had weathered, to see if the results correlated. Disappointingly, the bone fracture patterns were somewhat off. The main problem, at the moment, is cost. Each FSL—they aren’t reusable—costs around $5,000; the cost of a cadaver (to cover shipping, HIV and hepatitis C testing, cremation, etc.) is typically under $500.
Harris imagines it’s only a matter of time before the kinks are worked out and the price comes down. He looks forward to that time. Surrogates are preferable not only because tests involving land mines and cadavers are ethically (and probably literally) sticky, but because cadavers aren’t uniform. The older they are, the thinner their bones and the less elastic their tissue. In the case of land mine work, the ages are an especially poor match, with the average land mine clearer in his twenties and the average donated cadaver in its sixties. It’s like market-testing Kid Rock singles on a roomful of Perry Como fans.
Until that time, it’ll be rough going for Commonwealth land mine types, who cannot use whole cadavers. Researchers in the UK have resorted to testing boots on amputated legs, a much-criticized practice, owing to the fact that these limbs have typically had gangrene or diabetic complications that render them poor mimics of healthy limbs. Another group tried putting a new type of protective boot onto the hind leg of a mule deer for testing. Given that deer lack toes and heels and people lack hooves, and that no country I know of employs mule deer in land mine clearance, it is hard—though mildly entertaining—to try to imagine what the value of such a study could have been.
LEAP, for its part, turned out to be a valuable study. The sandal myth was mildly vindicated (the injuries were about as severe as they were with a combat boot), and one boot—Med-Eng’s Spider Boot—showed itself to be a solid improvement over standard-issue footwear (though a larger sample is needed to be sure). Harris considers the project a success, because with land mines, even a small gain in protection can mean a huge difference in a victim’s medical outcome. “If I can save a foot or keep an amputation below the knee,” he says, “that’s a win.”
It is an unfortunate given of human trauma research that the things most likely to accidentally maim or kill people—things we most need to study and understand—are also the things most likely to mutilate research cadavers: car crashes, gunshots, explosions, sporting accidents. There is no need to use cadavers to study stapler injuries or human tolerance to ill-fitting footwear. “In order to be able to protect against a threat, whether it is automotive or a bomb,” observes Makris, “you have to put the human to its limits. You’ve got to get destructive.”
I agree with Dr. Makris. Does that mean I would let someone blow up my dead foot to help save the feet of NATO land mine clearers? It does. And would I let someone shoot my dead face with a nonlethal projectile to help prevent accidental fatalities? I suppose I would. What wouldn’t I let someone do to my remains? I can think of only one experiment I know of that, were I a cadaver, I wouldn’t want anything to do with. This particular experiment wasn’t done in the name of science or education or safer cars or better-protected soldiers. It was done in the name of religion.