[Tonal sound of water on rims of glass bowls, footsteps approaching.]
The bodies float. Well, the body floats—two torsos, four arms, and four legs, but one face. The body floats in its large glass display, skin marble white, hands resting on knees—peaceful, like the twins’ eyes may open any minute. I wonder who positioned them like that, so they look like they’re asleep. We’re in the surgical pathology collection of the UTMB Hospital in Galveston. I’m using my flashlight to illuminate the cursive label: “monosymmetrical janiceps. Monster.”
The word is typed alongside the prognosis: “The fetus was not viable. Monster.” The display is alarming, but I can’t look away from the twins’ arms, neatly tucked around each other in an underwater embrace, so peaceful that you can almost overlook the jar. This specimen became the focus of ongoing questions I had about the history of dissection and the decisions that put some people in jars while others observe. Like how does a person become a monster? And how do monsters become specimens?
[Choir begins singing.]
The history of fetal monsters actually takes us back to the history of American dissection—and even further back, to the history of colonial medicine. Because the monstrous depends on the normal and the holy. And what is possibly the least holy place? [Chorus ends] The toilet.
The porcelain throne…not what comes to mind when we talk about dissection, but colonial medicine had an obsession with the toilet[1] for its close ties to another concept core to disgust[2] and dissection: cleanliness. In the colonized Philippines, White American doctors launched a campaign to redesign local sanitation with plumbing and powerful chemicals. When the concepts of cleanliness, disease, and health became racialized, the disgust reserved for island pathogens extended to include everyone who might contain those pathogens. The colonial space and the bodies within it were sanitized, and doctors attempted to make their subjects pure and white with American bleach. The links to racial cleansing are clear—in the colonial laboratory, brown skin was inherently dirty.
[Drumbeat from Sam Lee’s Lay This Body Down plays.]
In antebellum America, racial disgust had infected medicine. Black bodies became the white doctor’s medical laboratory. Black patients held what historian Stephen Kenny[3] describes as a “double character”: they were considered more prone to disease, yet they were physically stronger than White bodies. By this logic, White doctors justified both unethical medical examination and the cruel conditions of systemic racism that produced their supply of injured subjects.
Dr. Marion Sims famously developed gynecological surgical interventions[4] through hundreds of operations on six enslaved women. To Sims, these women were cursed with a disgusting fate, and he sought to use them to cure their conditions. Sims’s supporters argued that the enslaved women’s contributions were necessary for the sake of medical knowledge, that the women ultimately benefited from Sim’s surgeries.
[Arizona Dranes’s 1926 spiritual Lamb’s Blood Has Washed Me Clean fades in.]
One may imagine that slavery’s abolition in 1865 would have ended the supply of bodies to a medical establishment founded on racialized dissection.[5]
But in 1923, nearly sixty years later, the Journal of Obstetrics and Gynecology[6] publishes an image of a young woman’s skeleton. From the head down, her body has been dissected to the bone, but her intact face remains visible in the photo. The woman, J. L., had come to UTMB at the end of a long and undiagnosed battle with breast cancer. Her large tumor, present from the age of 10, was brushed aside as an injury from her work on the cotton plantation. In the Black-only hospitals, resources and time were scarce, so a 10-year-old with breast cancer was easily overlooked. By age 27, the disease had spread to her bones—the cancer was only diagnosed after J. L. fractured her arm while singing during a church meeting.
[Dranes’s voice amplifies, then recedes.]
When J. L. reached UTMB, her cancer was too far advanced to benefit from treatment. Instead, she was observed in the hospital for a year before she died and was promptly dissected, for the betterment of medical education.
[David Lang’s 2003 wind quintet arrangement breathless begins playing.]
To our original question: how does a doctor trap a monster in a jar?
By dissecting her—by pathologizing[7] her—by dehumanizing her.
The label of “human” indicates connection and respect. In order to transgress these boundaries during dissection, that label must be handed in for something more distant. Even the word “monster” has evolved over time. It comes from the Latin monstrare[8], meaning to show or to signify.
The people whose bodies are scattered throughout jars in medical schools and museums: they were made monstrous with purpose: to reveal the workings of those bodies showed what was significantly wrong. Some even argued that the bodies were beside the point—the heart of medicine was really about disease and its progression. And to understand disease, one must abstract the body altogether.[9]
[Wind instruments fade out.]
So, the disgust that put the twins in a jar? It’s the essence of anatomy. To excavate the unfamiliar—to categorize and conquer what makes us squeamish.
[Lee’s Lay This Body Down plays as episode closes.]
Notes
[1] Warwick Anderson explores the colonial dedication to managing waste in “Excremental Colonialism: Public Health and the Poetics of Pollution.” Notably, American medical measures in the Philippines served to protect American settlers, at the heavy expense of Filipino wellbeing and life.
[2] Disgust is inherent to many commonplace Western biomedical legacies. The European framework of excavating illness in marginalized populations—people of color, poor people, women—involved depersonalizing the body to address the disease. See Ragab’s “Two Students and a Corpse” and Tierney’s “Anatomy and Governmentality” for discussion of disgust and bodily abstraction, respectively.
[3] Kenny, Stephen C. “The Development of Medical Museums in the Antebellum American South: Slave Bodies in Networks of Anatomical Exchange.” Bulletin of the History of Medicine (2013).
[4] Sims operated to develop a surgical solution for vesicovaginal fistulas (VVF), painful tears between the vaginal wall and the bladder that could occur following prolonged, obstructed labor. Sims offered to lodge these six enslaved women in exchange for the slaveowners’ permission. Because VVF was such a debilitating condition, slave owners had (purely financial) motivations for restoring the women’s health. Read C. Riley Snorton’s chapter “Anatomically Speaking” for more detail on the troubling work and complicated legacy of Marion Sims.
[5] Spoiler: it didn’t. In fact, the legacy of racialized medical teachings exists in unexpected ways today. See Black or ‘Other’? (https://www.cnn.com/2021/04/25/health/race-correction-in-medicine-history-refocused/index.html) for a report on “race corrections,” a vestigial practice in diagnostic equations that increases the risk of renal failure diagnosis in Black patients compared to others and assumes lower cognitive functions for Black patients, resulting in underestimation of brain damage following concussion in Black athletes.
[6] Thompson, James E., and Violet H. Keiller. “Multiple Skeletal Metastases from Cancer of the Breast.” Surgery, Gynecology, and Obstetrics. (1924): 367–75.
[7] See Carrie Yang Costello’s “Teratology: ‘Monsters’ and the Professionalization of Obstetrics” for further discussion on the intent behind medicalizing obstetrics and gynecology. As British obstetricians established their professional merit around the turn of the 20th century, birth defects and mortalities increased, creating further demand for medical treatment or euthanasia of children with resulting disabilities. In pathologizing birth, medical treatment and examination was made necessary, where midwives once sufficed.
[8] Again, see Costello’s “Teratology” for further discussion on the professional function behind the definition of fetal monsters.
[9] This quote comes directly from Foucault’s perspective on the body in The Birth of the Clinic: “the patient adds, in the form of so many disturbances, his predispositions, his age, his way of life, and a whole series of events that, in relation to the essential nucleus, appear as accidents. In order to know the truth of the pathological fact, the doctor must abstract the patient.” See Tierney’s Anatomy and Governmentality (1998).
References
Adami, J George. “Monstrosities and Abnormalities.” Essay. In The Principles of Pathology 1, 1:193–234. Philadelphia and New York, New York: Lea & Febiger, 1908.
Anderson, Warwick. “Excremental Colonialism: Public Health and the Poetics of Pollution.” Essay. In Colonial Pathologies American Tropical Medicine, Race, and Hygiene in the Philippines, 104–29. Duke University Press, 2006.
Bell, Charles, and NIH. Plan of the Aortic System. Photograph. U.S. National Library of Medicine Digital Collections. Bethesda, 2010. National Library of Medicine, National Institutes of Health. http://resource.nlm.nih.gov/101594959.
Costello, Carrie Yang. “Teratology: ‘Monsters’ and the Professionalization of Obstetrics.” Journal of Historical Sociology 19, no. 1 (January 26, 2006): 1–33. https://doi.org/10.1111/j.1467-6443.2006.00267.x.
Dittmar, Jenna M., and Piers D. Mitchell. “From Cradle to Grave via the Dissection Room: the Role of Foetal and Infant Bodies in Anatomical Education from the Late 1700s to Early 1900s.” Journal of Anatomy 229, no. 6 (2016): 713–22. https://doi.org/10.1111/joa.12515.
Goss, Adeline L., Vidya B. Viswanathan, and Horace M. DeLisser. “Not Just a Specimen: A Qualitative Study of Emotion, Morality, and Professionalism in One Medical School Gross Anatomy Laboratory.” Anatomical Sciences Education 12, no. 4 (March 1, 2019): 349–59. https://doi.org/10.1002/ase.1868.
Kenny, Stephen C. “The Development of Medical Museums in the Antebellum American South: Slave Bodies in Networks of Anatomical Exchange.” Bulletin of the History of Medicine 87, no. 1 (2013): 32–62. https://doi.org/10.1353/bhm.2013.0016.
Ragab, Ahmed. “Two Students and a Corpse: the Semantics of Disgust in the Making of Colonial Knowledge.” History and Technology 34, no. 1 (September 28, 2018): 79–88. https://doi.org/10.1080/07341512.2018.1516865.
Snorton, C. Riley. “Anatomically Speaking.” Black on Both Sides, 2017, 17–53. https://doi.org/10.5749/minnesota/9781517901721.003.0002.
Thompson, James E., and Violet H. Keiller. “Multiple Skeletal Metastases from Cancer of the Breast.” Surgery, Gynecology, and Obstetrics 2. (1924): 367–75.
Tierney, Thomas F. “Anatomy and Governmentality: A Foucauldian Perspective on Death and
Medicine in Modernity.” Theory & Event 2, no. 1 (1998). muse.jhu.edu/article/32499.