It’s a delicate balance that, in the end, comes down to wording. Observes Baker, “You don’t really want to be telling some-body, ‘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 nonlethal 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 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.