Good job, ‘obesity autopsy’

Earlier this year, I was rereading Christine Montross’ Body of Workan excellent book on the process of taking part in a human anatomy course in medical school. It’s a fascinating, sensitive, thoughtful exploration of the experience of medical students as they cross over into a world of incredible intimacy with a body over the course of a year, and one thing that struck me about it throughout was the rest and care with which people handled their cadavers. The anatomy lab Montross describes isn’t as somber and solemn as a church — there are moments of levity and casualness and even fun — but it’s also one that fundamentally honours the fact that these bodies belonged to people who chose to give up something important to science.

Just days later, I was reading about the ‘obesity autopsy,’ in which a pathologist and accompanying technician sliced up the body of a fat woman for BBC3, an online-only venue, with the goal of also syndicating onto other BBC channels for the British public. This was pitched as educational, so people could ‘see the effects of obesity on the body,’ and it was billed as brave and daring and sombre and all sorts of things. What it fundamentally was, though, was a sensationalised, exploitative b-movie presentation akin to the public dissections once conducted in places like Britain as punishment for people who had committed particularly heinous crimes. It wasn’t enough to die in these cases: People have to be given an extra insult after death, in an era when people believed that you could not be resurrected and brought into heaven without a whole body. This was a denial of future salvation, performed in a titillating way, with members of the crowd dodging in for keepsakes and doing things like making wallets out of human skin.

We don’t know much about the donor, other than the fact that she lived in the United States. Some moaning was made about how restrictions on cadaver donation in Britain didn’t ‘allow’ them to use a British body, and they had to hack the woman’s arm off before shipment so she would legally qualify as an anatomical specimen. They had to literally dehumanise her before bringing her on television to be ripped apart for the masses. And maybe she consented to this before her death, but it seems unlikely.

In the lascivious programme, they make all sorts of assertions about what ‘obesity’ does to the body, and imply that her weight was the cause of death. That’s not really knowable, and neither were many of the assertions they made about her weight, stress on her internal organs and skeleton, and related issues. Basically, the message they wanted to send was that being fat is bad, that fat will kill you, and that the inside of your gross disgusting fat body looks like this gross disgusting fat corpse.

The thing about body donation is that with rare exceptions, you don’t actually get to designate an anatomical gift. Your body could be used in medical schools, safety research, forensic science, and any number of other things. One reason for that is that death and demand are unpredictable — you might die at a time when a medical school needs fresh cadavers, in which case you’ll be used by medical school students learning about the body. Or you might die when people desperately need cadavers to throw out of airplanes. There’s no way to know, and some people might be squeamish about potential uses of their body, which is understandable.

But there’s also an assumption of a certain amount of ethical responsibility. No, a cadaver is not a human being, and shouldn’t be subject to the same stringent requirements surrounding research on human subjects. But it used to be, and a dead body is a really socially and culturally loaded thing. It’s not just a dead body, and it cannot be — aside from the experiences of the person who lived in that body, that person had a family, friends, loved ones, people who might be perturbed by how the body is being used.

So there’s kind of a general sense that bioethics are important here, and that people should think carefully about how and why they want to use cadavers, to determine whether they are doing an okay thing, or not. And in this case, clearly none of this consideration was applied. I cannot imagine being dissected on television to teach people that bodies like mine are gross and wrong, to have my very identity pathologised in edutainment television that’s really just designed to scare people.

This really hit home for me for a lot of reasons, but one of those reasons was my consideration of possibly donating my own body after death. There are a lot of positive things about body donation — I’m constantly reading about the great discoveries that wouldn’t be possible without anatomical gifts. If my organs aren’t usable, it seems like being an educational tool, or furthering safety research, or improving forensics, would be a really great use of my body, recycling, if you will. But as I watched the obesity autopsy unfold, I realised that this just isn’t an option for me. I don’t want my corpse to become an object of spectacle and lurid fascination after I die — I can think of few things less pleasurable, actually. It’s not even about how I would feel, because I’d be dead and incapable of feeling anything. It’s the thought of having my body used as a blunt instrument. You can leave me in the middle of a field and watch me decay to understand more about differential decay in bodies of different sizes, something that could help solve crimes and make the world a better place, but you cannot use me as your puppet to advance things that are wrong, that I do not agree with, that hurt people.

Even the prospect of having my body used this way is too terrifying to contemplate, and it made me lose all interest in body donation. One body more or less won’t make a huge difference, and the taboo surrounding anatomical gifts isn’t as extreme as it once was, so it’s not like people are desperately hurting for bodies, but I wonder how many people came away from this programme with this feeling, and how much the ‘obesity autopsy’ set back the world of cadaver donation.

Image: Story of life, houman_thebrave, Flickr