Robert S. Ledley, a dentist turned biomedical researcher and computing
trailblazer who invented the first CT scanner capable of producing
cross-sectional images of any part of the human body, died on Tuesday in
Kensington, Md. He was 86.
The cause was Alzheimer’s disease, his son Fred said.
Nearly every field of medicine has been affected by the whole-body CT scanner,
short for computerized tomography. “Many of the CT scanners we see in hospitals
are based on the Ledley design,” said Joseph A. November, a professor of history
at the University of South Carolina, who is writing a biography of Dr. Ledley.
Before the advent of CT scanning in the early 1970s, radiologists had limited
tools. CT scanning gave them not only a far higher resolution than traditional
X-rays but also three-dimensional, cross-sectional images to work with,
significantly reducing the need for exploratory surgery and its attendant risks.
It also changed the way physicians follow cancers and their response to therapy.
Dr. Ledley was an early advocate of computer-based medical diagnostics, a full
half-century before medical residents began punching patients’ symptoms into
online diagnostic programs.
In 1959, he published a paper in the journal Science titled “Reasoning
Foundations of Medical Diagnosis.” It had a broad impact in the medical field.
“In the summer before I started medical school, I read that paper, and it was
eye-opening,” said Dr. Alan N. Schechter, chief of the molecular medicine branch
at the National Institutes of Health and a longtime colleague of Dr. Ledley’s.
“The idea that computers could assist physicians in diagnosis and choice of
therapy was a totally new understanding of the process of medical diagnosis.”
Robert Steven Ledley was born on June 28, 1926, in Flushing, Queens. His father,
Joseph, was an accountant; his mother, Kate, was a teacher. He attended the
Horace Mann School and studied physics at Columbia. Dr. Ledley hoped to pursue a
career in physics, but his parents, worried about the scarcity of jobs in the
field, urged him to become a dentist.
“His family said he could study physics as long as he also became a licensed
dentist, so he could always make a living doing dentistry,” Professor November
said.
After receiving his D.D.S. from New York University in 1948, Dr. Ledley enrolled
as a graduate student at Columbia to study physics. He received his master’s
degree in physics in 1950. His professors included the Nobel Prize winners
Enrico Fermi, Hans Bethe and I. I. Rabi. “Rabi joked that Ledley was the only
physicist who could pull a man’s tooth,” Professor November said.
The year before, he had married Terry Wachtell, a music major at Queens College.
At his urging, she switched to math, earned a master’s degree in the subject and
became a mathematics teacher.
In 1951, during the Korean War, Dr. Ledley was in the Army Dental Corps,
assigned to a research unit at Walter Reed Army Medical Center in Washington,
where he worked on improving prosthetic dental devices.
Dr. Ledley set out to optimize the fitting of dentures by determining the mean
slope of each tooth relative to the surface of the piece of food being chewed.
His work, which married dentistry and physics, attracted national attention. An
article by The Associated Press carried the headline “Mathematics Used to Keep
False Teeth in Place.”
After his discharge from the Army, he went to work in Washington at the National
Bureau of Standards’ Dental Materials Section, where he also helped his wife get
a job, as a programmer on the Standards Eastern Automatic Computer, or SEAC. It
was she who introduced him to computers.
Fascinated by the machine, he learned to program the computer by studying the
manuals and programs — punched out on long strips of paper tape — that his wife
brought home. Before long, Dr. Ledley was working directly with the SEAC and
focusing on the role that computers might play in solving biomedical problems.
“I had previously realized that although, conceptually, physics equations could
be written to describe any biomedical phenomenon, such equations would be so
complex that they could not feasibly be solved in closed form,” he said in a
1990 talk. “Thus SEAC would be my panacea, because the equations would become
tractable to numerical methods of solution.”
In 1956, Dr. Ledley was hired as an assistant professor of electrical
engineering at the George Washington University School of Engineering and
Applied Science. That year, he began to collaborate with Lee B. Lusted, a
radiologist and electrical engineer, on developing ways to teach physicians and
biomedical researchers to use electronic digital computers in their work.
In 1960, Dr. Ledley founded the National Biomedical Research Foundation, a
nonprofit organization dedicated to promoting the use of computing methods among
biomedical scientists.
In addition to his son Fred, Dr. Ledley, who lived in Laurel, Md., is survived
by his wife; another son, Gary; and four grandchildren.
Dr. Ledley began his work on CT scanning in 1973. Building on earlier work by
the British engineer and Nobel Prize winner Sir Godfrey Hounsfield, whose
scanner could be used only on patients’ heads, he assembled a group at
Georgetown to build the Automatic Computerized Transverse Axial, or ACTA,
scanner, which could scan the entire body.
“He’s best known for the CT scanner, but that was a natural outgrowth of a
career of working in the field of pattern recognition, image analysis and
applications of computers to medicine,” Fred Ledley said.
In 1974, Dr. Ledley established the Digital Information Science Corporation,
selling the machines for $300,000 each. The next year, soon after obtaining the
patent for the ACTA scanner, he sold his company to Pfizer, which briefly
dominated the medical imaging market before losing ground to General Electric
and Siemens.
Dr. Ledley was inducted into the National Inventors Hall of Fame in 1990 and
awarded the National Medal of Technology and Innovation by President Bill
Clinton in 1997. The original prototype of the ACTA scanner is at the
Smithsonian Institution.
January 7, 2012
The New York Times
By NATASHA SINGER
PEOPLE wear 3-D glasses for new movies like “The Adventures of Tintin.” But
for medical school?
The answer is yes at the New York University School of Medicine, which is using
3-D technology to update a rite of passage for would-be doctors: anatomy class.
In a basement lab at NYU Langone Medical Center in Manhattan last month,
students in scrubs and surgical gloves hovered over cadavers on gurneys,
preparing, as would-be doctors have for centuries, to separate rib cages and
examine organs. But the dead are imperfect stand-ins for the living. Death — and
embalming fluid — take a toll.
So, in an adjacent classroom, a group of students wearing 3-D glasses made by
Nvidia, a graphics processing firm, dissected a virtual cadaver projected on a
screen. Using a computer to control the stereoscopic view, they swooped through
the virtual body, its sections as brightly colored as living tissue. First, the
students scrutinized layers of sinewy pink muscles layered over ivory bones.
Then, with the click of a mouse, they examined a close-up of the heart, watching
as deep blue veins and bright red arteries made the heart pump.
Compared with the real cadavers in the lab next door, the virtual one seemed as
dynamic as Imax.
“It’s like a living digital textbook,” said John J. Qualter, a research
assistant professor of educational informatics at the medical school who helped
design the 3-D installation.
The virtual human body is the creation of BioDigital Systems, a medical
visualization firm in Manhattan that Mr. Qualter helped to found. It develops
animations of the anatomy for drug makers like Novartis, medical device makers
like Medtronic, television shows like “Mystery Diagnosis” and medical schools.
The virtual body, introduced last month at N.Y.U., represents an unusual
collaboration between industry and academia. The companies, which originally
paid BioDigital to develop medical animations of certain body parts for
commercial purposes, agreed to let the design firm freely use the digital models
for educational purposes. In recognition of N.Y.U.’s involvement, the company
has pledged a small share of future revenue to the medical school.
But the medical students were merely testing an early incarnation of an
ambitious project.
BioDigital plans to develop the virtual cadaver further on its new medical
education Web site, biodigitalhuman.com, with the aim of providing a searchable,
customizable map of the human body. Right now, Mr. Qualter said, the site is
available only in a beta version. But in the coming months, the company plans to
offer its code to, say, health Web sites that want to embed images of the
respiratory system, or to doctors who want to show animations of prostate cancer
surgery to patients.
“We wanted to use our data visualization to improve knowledge of complex health
topics,” Mr. Qualter said. His firm hopes to position the virtual body as the
health education equivalent of Google Maps — available as a free, easy-to-use
public Web site and in an upgraded, fee-based professional version.
“We want to become a scalable model,” Mr. Qualter said, “a Google Earth for the
human body.”
Mr. Qualter and his business partner, Frank Sculli, a software engineer, founded
BioDigital Systems in 2002 to help companies and institutions use 3-D
storytelling to make medical topics more comprehensible and compelling. For
instance, the firm created an animated heart to demonstrate how an implant from
Medtronic could fix a prolapsed heart valve. At N.Y.U., the firm worked with the
medical school to develop animations of operations for surgical education.
Those kinds of commissions helped make BioDigital successful as a small
business. But its executives concluded that its growth potential would be
limited if they remained focused on one-off projects for limited audiences. Last
year, they decided to combine all of their commissioned medical illustrations
into one virtual human.
“As a private company, as a service business, we can make a couple of million
dollars annually,” Mr. Qualter said. But, as a product firm with a searchable
map of the human body to market, he said, the company has greater potential to
increase revenue and improve health education. “Once the BioDigital Human is
really being used by a lot of people, we can leverage that.”
IT is too soon to tell whether studying a digital human model will help medical
students understand anatomy more deeply than they can by dissecting cadavers
alone. But the virtual body certainly offers some advantages.
In the N.Y.U. lab, Chana Rich, a 21-year-old first-year student from Fairfield,
Conn., dissected an older, female cadaver. But the dead woman had undergone a
number of surgeries during her lifetime, and her body was now missing its
appendix, spleen and right lung.
“She’s skinny and female,” Ms. Rich said, “so sometimes it’s hard to visualize
the smaller vessels.”
A few minutes later, Ms. Rich was in the projection room, isolating the liver of
the virtual cadaver and examining the blood vessels connected to it.
“In a cadaver, if you remove an organ, you cannot add it back in as if it were
never removed,” she said as she adjusted her 3-D glasses. “Plus, this is way
more fun than a textbook.”
But her colleague, Susanna Jeurling, a first-year medical student from
Washington, disagreed. Dissecting a real cadaver, she said, gives students a
unique, tactile understanding of the body.
“I don’t think this will ever replace cadavers,” said Ms. Jeurling, 24. “There’s
something about being able to hold it and turn it in your hand.”
Administrators at the medical school say they have no plans to phase out
dissection, an educational method that dates back to the Ptolemaic era. The 3-D
digital human body is merely a complementary teaching method, said Dr. Marc M.
Triola, associate dean for educational informatics.
“It’s an amazing blend of one of the oldest medical education techniques and the
absolute newest,” Dr. Triola said.
September 9, 2011
The New York Times
By BROOKS BARNES
SALT LAKE CITY
INSIDE an unmarked warehouse here, not far from a depressing stretch of
fast-food joints and the Southern X-Posure strip club, Robert MacDonald —
nickname: Maximus — is torturing a group of people.
Or at least that’s how it looks. One man, howling in agony a second ago, has
collapsed in a pool of sweat. A woman wipes away tears. A few of the rest are
limping.
Maximus is not sympathetic. After all, they had been warned. It’s right there on
the Web site: “You were free to choose and you did. Now lie in it.”
This is Gym Jones, a no-frills private club that caters to extreme fitness
buffs, professional athletes, the military’s special operations and — on the
opposite end of the pampered scale but only slightly less secretive — movie
stars. (Jude Law didn’t get those contoured pectorals in “Repo Men” by
accident.)
Yes, the name is an overt nod to Jim Jones, the sect leader who steered more
than 900 people to suicide in 1978. No, the couple that owns the gym, Lisa and
Mark Twight, don’t see anything obnoxious about that. “We knew some people would
call us a cult,” Ms. Twight said, “so we decided to own the joke.”
The zealous devotion clients have toward the gym and its fitness philosophy,
which turns as much on psychology as it does on physicality, can indeed be a
little frightening. Picture Scientologists, except with really big biceps.
One prominent fan is Zack Snyder, the Warner Brothers director whose
testosterone-turbocharged “300” became a global smash in 2007. It was Gym Jones,
using a mix of power lifting and military-style calisthenics, that whipped
Gerard Butler, the star of that film, into loincloth shape.
Superman himself has recently been training here. Henry Cavill, hired to play
the title character in Mr. Snyder’s coming “Man of Steel,” arrived with
eight-pack abs, or close to it, from training for another film. But Warner
brought on Mr. Twight to mold the British actor into a true superhero; the two
have been working together since April. “It’s not just about muscles,” Mr.
Snyder said. “In fact, that’s the least of it. They have a way of making you
find things in yourself, and it’s fantastic.”
That’s easy for him to say. Mr. Snyder’s days don’t include a 5,000-calorie diet
and more than three hours of pumping iron, like Mr. Cavill’s. “Mark gave me, or
perhaps I could say allowed me, to discover my love of pushing myself beyond my
notions of limits,” Mr. Cavill wrote in an e-mail. “He also gave me not an
arrogance but a humble and healthy belief in my physical abilities, which I
never before possessed.”
Trainers of this elite caliber tend to dismiss celebrities as dabblers who want
results without the work. And don’t get the serious fitness crowd started on the
use of steroids in some corners of moviedom.
Gym Jones is no exception. But the Twights and Mr. MacDonald, the gym’s manager,
have also learned to open their minds. “Take Jude Law,” Mr. MacDonald said. “At
first I wasn’t interested in Jude Law at all. He smoked, drank and was out of
shape. But he surprised me and worked really hard. He proved me wrong.” (Mr. Law
declined comment.)
A willingness to take on famous clients has actually been problematic for Gym
Jones. The studio cash is nice, and the “300” notoriety was rewarding; a version
of a 300-rep workout designed for the cast as a graduation test has gone viral
and was even plugged by Men’s Health. But the Twights prefer privacy. They
aren’t angling for their own line of protein powders or a reality show, and
accept only 30 to 40 clients at a time. If you are hearing about them through
their work with stars, a tiny part of the gym, your chances of getting in are
pretty much zero.
The Twights generally require an interview or a referral from a current Gym
Jones client, the completion of a written application that’s more of a fitness
SAT than anything and, if you pass that step, a workout with Mr. MacDonald, a
world champion mixed-martial-arts fighter. “If I’m surrounded by substandard
people, I’m not going to work that hard myself,” Mr. MacDonald said. Again, it’s
right there on that full-of-itself Web site: “We choose clients. Clients don’t
choose us.”
Gym Jones has another reason to guard its privacy: its military customers like
it that way. Although the Twights refuse to talk much about this side of their
business, which occurs inside the gym and in the nearby mountains, it appears to
be considerable and to involve people who are supposed to be invisible. Six of
Mr. Twight’s former students, for instance, were among the 30 Americans — most
of them Navy Seals, including members of the team that killed Osama bin Laden —
who died in Afghanistan in August when their helicopter was shot down.
But don’t push for more details: “ ‘No’ is a complete sentence,” Ms. Twight
said. “I don’t need to give a reason.”
GYM JONES, of course, is not the only fitness business thriving on tough love.
From the boot camp programs that have become trendy in big cities to the
screeching trainers on “The Biggest Loser” to CrossFit, a chain that has gained
attention for promoting risky exercise, Americans seem to want their workouts
served with hiss and spit.
Theories abound as to why. Fads tend to oscillate: the karate- and
steroid-fueled bodybuilding of the 1970s (which notably accompanied the rise of
women in the workplace) gave way to Jane Fonda’s aerobics in the ’80s and
spinning and cardio hell in the ’90s. Next came yoga and Pilates. More recently,
economic and political upheaval, not to mention two grinding wars, have tipped
people toward strength training and militaristic exercise.
Superbods have also returned as a Hollywood staple. Since April, studios have
served up a mega-pumped Dwayne Johnson in “Fast Five,” a hulking Chris Hemsworth
in “Thor,” a bare-chested Chris Evans as “Captain America” and a ripped Jason
Momoa in “Conan the Barbarian.” Taylor Lautner’s beefcake werewolf returns soon
in “The Twilight Saga: Breaking Dawn - Part 1.”
Theater is a big part of Gym Jones, which the Twights founded in 2003 in a
garage with no air-conditioning and no heat. (The couple moved to Utah from
Colorado in 2001 to operate a climbing-equipment company and later started Gym
Jones as a side project. Eventually, the Twights decided to go full time with
Gym Jones.)
Everything about the gym’s current configuration screams hard core, from the Web
site (“Don’t complain if the work is too hard, or if you pass out, drop a
barbell on your head, a kettle bell on your toes”) to cold décor: cinderblock
walls, black rubber floor mats, fluorescent lights, no mirrors or windows.
Outside magazine described the gym as “part martial-arts dojo, part smash lab,
part medieval dungeon.”
Gym Jones calls clients “disciples” and prominently displays a quote from “Fight
Club,” the 1999 film starring Brad Pitt. It reads in part: “Quit your job. Start
a fight. Prove you’re alive.”
But once you’re past all that, the mood at the gym is surprisingly warm. Mr.
MacDonald, 33, has a daunting physical presence (at 6-foot-3, he can dead-lift
550 pounds) and blunt speaking style, but he also once taught kindergarten. The
pixie-ish Ms. Twight, a 50-year-old jujitsu practitioner, has a quick,
infectious laugh. A celebrated mountain climber, Mr. Twight, 50, is direct and
aggressive but also quite polite and generous with his time.
And despite his stoic manner, Mr. Twight was clearly emotional over the deaths
of his former students in Afghanistan. “Different from the many fatalities that
occurred throughout my climbing career, but the impact is still quite strong,”
he wrote in an e-mail.
The Gym Jones Way notably does not involve a bodybuilding-centered program of
progressive overload and over-feeding. Pushing people so hard that they risk
rhabdomyolysis — a condition brought on when severely damaged muscle tissue
releases toxins into the bloodstream —“is a tremendous failure,” Ms. Twight
said. She added that the gym encourages its trainers to get to know their
subjects personally, whether than means going shopping at the grocery store
after a workout or lending a sympathetic ear.
“It’s like sex,” she said. “You can’t just get up and leave afterwards. This is
a relationship.”
It’s possible that a reporter’s visit has prompted this convivial tone, but Mr.
Snyder and other clients — sorry, “disciples” — insist otherwise. “They don’t
belittle you,” said Mr. Snyder, who has trained with Mr. Twight over the years.
Carolyn Parker, a climbing guide who lives in Albuquerque, where she goes by the
nickname Blitzkrieg Barbie, also emphasized the lack of drill sergeant behavior.
“They’re more interested in training the mind than in physical fanaticism,” she
said of the Twights.
Working with Gym Jones involves completing excruciating tasks. They use some
basic machines — rowers, Airdyne stationary bikes — but mostly rely on free
weights, kettle bells and low-tech equipment like weighted sleds. The Jones
Crawl involves three rounds of dead-lifting 115 percent of your body weight 10
times and then jumping on and off a box 25 times as fast as you can. “Recovery”
at the end of a workout might involve a 30-minute run and an ice bath. But not
at the gym; it has only one shower, which is for “emergencies,” Ms. Twight said.
At the end of the day, working out is just picking stuff up and putting it down.
The complicated part, at least at Gym Jones, is the mental workout: constant
awareness of what helps or hurts progress, including maintaining proper
nutrition and executing recovery accurately. “Breaking someone in a workout is
pointless without post-training discussion and analysis,” Mr. Twight said.
FITNESS companies inspired by Gym Jones are popping up around the country,
mostly opened by people who have apprenticed with Mr. MacDonald and the Twights.
Ms. Parker owns Athena Fit in Albuquerque; one in St. Louis is called Project
Deliverance.
The Twights say they have no plans to expand beyond Utah, but they have
increased the number of seminars they hold, which cost $1,500 to $2,000 a person
and range from a two-day Fundamentals course to the five-day Advanced Program
Design and Theory. Sessions with a trainer cost from $100 to $300 an hour;
clients come either for a few days or on a regular basis.
The Twights now offer Web-based memberships starting at $500 a year;
participants log into GymJones.com, which has more than 70 videos and 17
training plans, among other materials.
It was the advanced program that Mr. MacDonald, barefoot and in cargo shorts,
was teaching in early August, the one that culminated in tears and sweat. But
that was only a small part of the course. The eight participants spent much of
their time in front of a white board at the back of the gym.
There, they sat in folding chairs and listened to Mr. MacDonald give a lecture.
The class members, some of whom had traveled from as far as London and New York,
took notes and followed along with a 135-page study guide.
“You can never get rid of endurance work,” Mr. MacDonald said, stabbing at the
board with a marker. “If you need to get rid of something in your workout, it
needs to be the weight room.”
He put the cap on the marker. “And always — always — be prepared to go to a dark
place,” he said. “Now, who’s ready to work out?”
September 13, 2010
Filed at 2:34 a.m. ET
The New York Times
By THE ASSOCIATED PRESS
GARY, Ind. (AP) -- Dot Purcell always knew she would donate her body to
science. Even when young, the mother of 11, a doctor's daughter, would say,
''there's something good in here'' that might help others.
That death talk made her doting husband squeamish, and Jim Purcell tried to talk
her out of it, saying, as they aged, that her body would be too old to be
useful. He didn't want to contemplate losing his beautiful, fun-loving wife, who
cherished life but accepted death. But when the moment came, after 64 blissful
years of marriage, and her wish was carried out, neither of them could have
imagined just how much Dot's decision would help, and heal.
Every year, thousands of people donate their bodies to science, becoming an
essential part of hands-on medical training. Their gift allows students to study
human anatomy and the effects of age, trauma and illness in close-up detail.
Yet, despite this intimacy, usual protocol calls for some distance. Donors are
anonymous, and while many U.S. schools hold memorial services to honor them,
details of what goes on in the dissection lab just aren't talked about much,
certainly not with the surviving family members. It's all too awkward, too
indelicate, too personal.
Which is why the story of what happens at Indiana University Northwest, where
Dot Purcell's body ended up, is so unusual.
At the tiny medical school, a vibrant oasis in Gary, an otherwise decaying steel
town, medical students are told the donors' names, given their medical records,
and encouraged to get to know their families. These cadavers are the students'
first patients, with lives worth knowing, not just for humanistic reasons, but
to help students better understand the bodies they dissect.
Ernest Talarico, assistant director of medical education at IU Northwest, is the
brains behind the idea. When he was in school, students often gave the
unidentified cadavers crude nicknames. ''Salty'' was the moniker given a cadaver
whom Talarico helped dissect -- because the man had a nude woman tattoo on his
chest.
''I found that disrespectful because they had a name and a life, and we should
respect that as part of the tremendous gift they give to us,'' Talarico said.
So last October, a year after Dot's death, Purcell got a letter from Talarico.
Dot's body, donated to the state anatomical gift association, had been sent to
the Gary school, just 10 miles from the family's home in Munster, and they were
invited to meet with the four first-year medical students who would be working
on her.
''I was not that eager to meet them,'' Purcell said. At 90, the retired public
relations executive is still grieving for the woman who ran their busy household
and made him feel whole.
Dot had been mostly healthy until she was diagnosed in early 2008 with an
extremely rare type of melanoma, the most dangerous form of skin cancer.
''It was devastating to me and to everyone in the family,'' Purcell said with a
deep, heavy sigh, ''because it just came on suddenly, and then she was gone.''
Dot's diagnosis came several months before she died, but after six decades
together, months seem like days and life without Dot was unimaginable to Jim.
More receptive to the idea of meeting the students was his son, Mike, ninth out
of the 11 kids and more like Dot -- an outgoing, glass-half-full kind of guy. He
gently tried to convince his dad that it might be a good idea.
''The more my dad and I thought about it, we were like, you know what, she's
come home. This is great,'' said Mike Purcell, 46.
First-year medical student Lucas Buchler had his own trepidations about meeting
Dot's family. He thought the dynamics of the whole thing were pretty weird. Here
were students on an amazing high, starting medical school -- for some,
fulfilling a lifelong goal -- and they'd be meeting with families ''in grieving
mode,'' reeling from the loss of a loved one.
''It's a fairly emotional experience,'' Buchler, 23, said during a recent
interview, a few weeks before starting his second year.
For many students, it's the first time they'd ever seen a cadaver, and even
medical students get squeamish. But also, they can be overcome by appreciation
for the donors and ''their ultimate gift.''
''We all prepared ourselves for an awkward interaction,'' Buchler said.
When the day arrived, there were more than just polite handshakes. The
businessman in Jim Purcell approached it like interviewing a job candidate, and
he grilled the students.
''I asked them what brought them into medicine,'' Jim Purcell said.
For Buchler, a handsome, serious young man with a thick brown buzz cut and an
almost Marine-like bearing, it was an intense interest in the human body and how
it works, plus a genuine desire to help people, that made him want to be a
doctor.
He found Purcell's questions welcoming, not challenging.
''I could tell by how he listened to our answers he had a genuine interest,''
Buchler said. ''It was wonderful for us.''
Throughout the semester, while working in the dissection lab, the students kept
in touch with the Purcells, gaining an understanding of the family's deep grief
while getting to know who Dot was.
She was an uncommon mix of elegant and practical, a buoyant blonde who met Jim
while they were in college -- he at Notre Dame, she at its sister school, St.
Mary's College. Dorothy -- everyone called her Dot -- was a former teacher who
loved sparkly jewelry and never left the house without her makeup just so, but
wore gym shoes with everything because of chronic foot pain.
She helped design the spacious two-story house she and Jim built 50 years ago,
with fancy French provincial decor and washer and dryer on the main floor
instead of the basement, decades before that became fashionable, to make them
more accessible.
She loved books and music, going out on the town with her husband and
ice-skating with her kids. She had a great sense of humor, and taught her
children to challenge everything.
Coincidentally, the music Dot's student team chose to listen to during
dissections was the same kind of classical music she loved.
''We knew right away that they clicked with my mom,'' Mike Purcell said.
Buchler, especially, clicked with the Purcells. Since that first meeting, and
even after the semester ended, he's been in weekly contact, by e-mail, phone, or
personal visits, with Jim and Mike, who also lives nearby. First, it was to fill
them in on what he was learning in class, now it's to keep them updated on
research he's doing.
Buchler says learning about Dot the person has helped what he's learned in the
lab make more sense.
Along with melanoma, Dot had a blood condition related to leukemia, and doctors
had told the family that it was the cause of death. But Buchler and his team
learned the melanoma, which had spread to her liver, was the true cause. It's a
type of cancer that invades mucous membranes rather than other skin surfaces.
There are fewer than 300 reported cases worldwide, and Buchler said research on
Dot will improve understanding of risk factors for this rare cancer.
The students also discovered that Dot had a bone abnormality called Charcot
foot, which explains why her feet were always so painful and swollen. Although
she didn't have diabetes, the foot condition is common in that disease, and
Buchler says the knowledge he's gained from Dot will help him treat future
patients with diabetes.
Late in life, Dot developed unusually hard patches of skin on her calves. She
never got a diagnosis. Studying tissue samples under the microscope, Buchler's
team found bone tissue had developed deep inside the skin -- another extremely
rare condition that he will describe in a research paper.
All families involved in the program have questions. Most want general
information about what killed their loved one, minus graphic details. Students
give them updates, explaining that they're now working on the musculoskeletal
system, for example, without getting too descriptive.
If families' queries veer into graphic territory, students steer them back ''so
that things aren't uncomfortable for them or us,'' Buchler said. ''We'd say
those are details we'd rather not discuss, for reasons you understand.''
The Purcells just wanted to know what the students were learning and tried not
to think about what goes on in dissections.
That became a challenge, though, at the end of the semester, when students hold
a memorial service for the donors -- in the anatomy lab, with the bodies present
and loved ones invited to attend. The cold steel dissection tables where the
bodies lie all semester are covered with metal hoods, draped tastefully with
cloth and topped with flower bouquets, candles and donors' photos. But still.
''When I first saw that it was going to be in there,'' Mike Purcell says, ''I
had no desire to go in there.''
Jim Purcell was particularly hesitant. ''All he thought about was all the
chopping and cutting,'' Mike Purcell says.
But the Purcells are glad they attended. They are Roman Catholic but never had a
wake or funeral -- donated bodies must be whisked away right after death to be
properly preserved. The ceremony in that dissection room helped move them closer
to closure.
The students read letters of appreciation to the six donors present. And a
member of the clergy spoke of God and the afterlife.
Like most donor bodies, Dot's was cremated at semester's end, her remains mailed
back to her family in an unmarked square box. Jim Purcell placed the box, still
wrapped in postal paper, in a cabinet in the family living room, on a shelf in
between two statues of angels.
The box is unopened, Mike says, reflecting his father's wishes. ''He doesn't
want to think of her as being reduced to that.''
But in a way, she's not. The knowledge the Purcells have gained about Dot's
death and how it will help these future doctors treat patients has, in a sense,
revived her and kept her memory alive, in the service of science.
''They have been very thorough in telling me what happened and why, which was
very comforting to me,'' Jim Purcell said. ''They've demonstrated to us how
valuable it is both to medical people and families to get answers to why your
loved one dies.''
Says Mike Purcell: ''It's cathartic. It's great.''
The Purcells' relationship with Buchler goes beyond medical science. As fans,
they talk Notre Dame football, and Jim plans to have the students out to his
club for dinner. He has vowed to attend their graduation from medical school in
three years, God willing.
Buchler smiles broadly when Jim says Dot ''would have been thrilled with the
whole process. She would have loved these students.''
Jim, once so opposed to the idea of donating a body to science, says now he's
even considering doing the same thing.
Mike chuckles at the thought, thinking of his mother's continuing influence.
Amid renewed calls
for UK sperm and egg donors to be paid,
how much you can earn
from selling bits of yourself?
Tuesday 28 July 2009
The Guardian
Leo Hickman
This article was first published
on guardian.co.uk at 00.05 BST
on Tuesday 28
July 2009.
It appeared in the Guardian
on Tuesday 28 July 2009
on p9 of the Comment &
features section.
It was last updated at 09.48 BST
on Tuesday 28 July 2009.
Typing "sell your body for cash" into an internet search engine is not an
activity for the faint-hearted. But amid the deluge of questionable adult
services on offer, you will soon chance upon companies offering money for body
parts and/or fluids. Such a trade is illegal in the UK but, due to the severe
shortage in egg and sperm donors in this country – made worse by the lifting of
donor anonymity in 2005 – there are now calls to start paying donors again to
encourage greater numbers (currently, donors can receive a maximum of £250 in
expenses). So what else are people around the world harvesting from their body
for cash – and how much can they expect to earn?
Blood
In the UK, there is a tradition of donating blood as part of your civic duty,
but in some countries donors are paid. A clinic in Stuttgart, Germany, offers
roughly £20 a donation, but puts a cap on how much blood each individual can
donate over a period of time. In the US, there are around 400 for-profit blood
plasma centres offering $9-$35 a donation – but if you have piercings "other
than your earlobes", or a tattoo, you will have to call ahead first. Some US
medical centres also pay $50 for every "donation" of blood platelets.
Bone marrow
In the US, a handful of cancer research institutions pay for bone marrow and
white blood cells as part of clinical trials. It was reported in 2005 that a
Californian medical centre was paying local students $200 for 50cc of bone
marrow, while for a four-day procedure to remove white blood cells, it paid
$750.
Kidneys
Last week, it was widely reported in the US that a suspect in a New Jersey
corruption investigation told an undercover officer that he had been trading
human organs for 10 years, and that the going price for a kidney was $150,000.
It highlighted the notorious and illegal international trade for kidneys, with
reports of organs being secured from donors in India and Pakistan for as little
as $1,000-$2,000, only to be sold on for huge profit to recipients in the west.
In theory, organs such as livers and spleens can also be harvested for saleable
material, but reports of this are extremely rare.
Sperm
In Romania, where payments are legal, a clinic in the western city of Timisoara
is offering donors the equivalent of £35 a donation, while around 100 car
workers at a factory in Campulung have pledged to sell sperm to a fertility
clinic to try to reduce their company's debt. In the US, a donor can earn
$40-$120 a donation. But there are conditions: he must be under 45 and pass an
extensive health questionnaire (for example, no mental illnesses, drug taking,
STDs, family history of cancer etc). Some sperm banks only accept donors with a
certain IQ level or above.
Eggs
According to Lisa Jardine, head of the Human Fertilisation and Embryology
Authority, British women might expect to receive a fee equating to the cost of
one IVF treatment cycle – around £3,000. In India, where the market is
unregulated, a donor egg can be sold for anything from £500 to £7,000 depending
on how ethical the clinic is, and how well educated the donor is. In the US, the
classified ads website Craigslist is currently running an advert in the New York
area that states: "Jewish Egg Donor Needed by Loving Jewish Couple $20,000+ All
Expenses Paid not an agency." Most donors are expected to be between 18 and 30,
and they must expect to take hormone-boosting drugs, before 10-15 eggs are
extracted via a needle while the donor is under sedation.
Breast milk
Some lactating mothers choose to donate their breast milk or colostrum to the
local neonatal unit (ask your doctor for the nearest milk bank); however, it is
not unknown for mothers to sell their milk in the local classified ads or
online. Listings sites such as Craigslist ban users from advertising bodily
fluids, but that doesn't stop some people from placing ads requesting them, both
here and abroad.
Hair
Wig-makers in the UK pay goodmoney for well-groomed hair. Our main hair buyer,
Banbury Postiche (Wigs UK), pays £3 an ounce if your hair is 6-12in long and £5
an ounce if it is more than 12in long. In many other countries, though, the sums
earned from selling human hair are far more trivial, and many women are tricked
and exploited into cutting off their hair. The pop singer Jamelia vowed never to
wear hair extensions made from human hair again after travelling to India and
Russia to investigate the trade for a BBC documentary earlier this year
Stupid questions, tedious stories
and pats on the back:
the three different reactions I get
when people find out I have no legs
Monday 20 July 2009
The Guardian
Richard Pollins
This article was first published
on guardian.co.uk
at 00.05 BST
on Monday 20
July 2009.
It appeared in the Guardian
on Monday 20 July 2009
on p12 of the Comment &
features section.
It was last updated at 00.05 BST
on Monday 20 July 2009.
I was born without legs. I've used artificial ones for most of my life, and
at first glance it's not obvious why I need crutches (stick with me; you need
this information for background). For some time now, I've been fascinated by the
strangely formulaic responses and reactions I get from people who are meeting me
for the first time, or even just looking in my direction.
The British are, as we know, fairly reserved, polite, and often awkward. Which
means most of the time when I meet new people, they don't ask why I'm on
crutches. All that changes, however, if I'm out at night and the drinks are
flowing. The interest levels seem to rise in parallel with the alcohol levels,
and it's extraordinary how often I am clocked over the course of an evening by a
sincere nod and the phrase: "Well done for coming out, mate."
Occasionally this phrase is accompanied by a reassuring squeeze of my left
shoulder but that's it: no further conversation, no attempt to discover how
difficult it has been for me to "come out". Which is a shame, because I usually
have a fascinating tale to tell about a contact lens crisis that could so easily
have scuppered my plans.
Other times I'll get a "well done for coming out, mate" shout from a stranger
walking in the opposite direction – without either of us slowing our steps. It
makes me wonder if there was a day at school I missed when textbook uses of the
phrase were taught. It just seems so peculiar that so many people use the exact
same wording. "Well done for coming out, mate" – it's like an automatic response
every time they see someone on crutches having a drink.
And (if it's OK with you) I do enjoy having the odd drink. In fact, back in my
"wild" student days, my party trick in nightclubs was to hop out of my
artificial legs, walk upside-down on my hands, climb podiums and make a general
spectacle of myself. There's a club in Leeds – at least, there was in my day –
which served double tequila shots for a pound a go (if you don't know it, it's
the only one I know of with a St John ambulance parked permanently outside). I
still maintain I'm the only person who has ever been asked to leave this
particular establishment and needed two taxis to transport all of me home.
On another occasion, I remember finding out who I could impress by jumping out
of my legs and climbing up to the top of the dance podium (well, it seemed a
good idea at the time). A literal out-of-body experience: when I looked down, my
legs were crowdsurfing all around the dance floor.
I'm older and possibly a little wiser now, and I have come to the conclusion
that the world can be divided into three distinct groups. The aforementioned
"well done for coming out, mate" group, the Inquisitors, and the Troubled.
The Inquisitors are interested, curious – and demand answers. Normally a short,
occasionally awkward conversation ensues while I explain my lack of legs.
Commonly, an Inquisitor's mission during this conversation is to find a line of
questioning that is staggeringly original. I'm 30 now, and I can count on one
hand the number of times they have succeeded. One such time, I remember being
questioned in a dark and loud club at about 2am by a girl who wanted to know
what my legs were made from. This in itself is not unusual, and I went into my
automatic response mode.
"They're very complicated," I explained condescendingly, "but there's a lot of
foam, cables and metal inside."
"Oh," she replied, "which metal?"
This had me scrabbling into the depths of my memory for early physics lessons at
school, never a subject that filled me with confidence.
"Titanium?" I hesitatingly suggested.
"Don't you know for sure?" she sneered. "I would have thought you'd know exactly
which metal was in your legs."
Sometimes curiosity gets the better of an Inquisitor, and they ask if they can
"have a feel". I assume this is partly to check whether I've been lying to them,
and it can give off the wrong impression having strangers squeezing me up and
down while I nurse a drink and chat to friends. When the examination is over,
the Inquisitor usually turns to me and agrees that I was right – I don't have
any legs.
Another characteristic of an Inquisitor is that they are keen to "have a go" on
my crutches. And it doesn't seem to matter where I am. I might be in the middle
of the dance floor, precariously holding a pint of lager when someone approaches
and asks if I'm using those crutches. It's hard to find an answer sarcastic
enough for this question, but I find "no, no, they're just accessories"
suffices.
I'm being unfairly harsh; in fact, I have been known to let someone "have a go"
if I'm sitting down or leaning against a pillar and my sticks are redundant. But
what I do know is that you should never, ever lend your crutches to a hen do –
not if you want to see them again, anyway.
On the whole, I reckon I can cope with Inquisitors. The Troubled are my bete
noire. They're well-meaning, of course, but exasperating. The Troubled presume,
after finding out why I'm on crutches, that I will naturally also be interested
in their tales of skiing accidents, sprained ankles, and the time they tripped
up over a raised paving stone. Typically, no names have been exchanged
beforehand and no breath is inhaled while I'm forced to listen to this tedium in
minute detail.
Occasionally, the Troubled wish to talk about more serious times; they want to
share with me their personal family tragedies. (Why? As any of my friends will
testify, sympathy is not my greatest trait.) And so I find myself nodding,
trying to look sympathetic, as a stranger tells me about his second cousin's
motorbike accident five years ago.
I don't wish to sound heartless, but when you're on a night out with your
friends, enjoying a few drinks and having a good time, finding yourself
embroiled in a stranger's troubles can be a little . . . deflating. I understand
that seeing someone on crutches can remind you of your time on them (and I do
even enjoy having my ego massaged by a temporary crutch user about my abilities
on sticks), but it doesn't follow that I'm the best person to talk to about more
severe, general disasters.
So, when a guy who had been telling me about his cousin's motorcycle accident
finally stopped for a moment to ask how his cousin's paralysis compared to my
life, all I could tell him was that it didn't compare at all. I was very sorry
to hear about his cousin's situation, but I had no concept of what life was like
for him. How could I?
Still, the Troubled, the Inquisitors and the "well done for coming out, mate"
groups do all share one positive influence on my life. I should, at least, be
grateful to them all for never allowing me to feel like I'm fading into the
background, ignored. And when I've made such a show of my artificial legs and
crutches in the past, I can hardly gripe when people notice, can I?
March 27, 2009
The New York Times
By CHRISTINE MONTROSS
Providence, R.I.
AT the risk of sounding like a fuddy-duddy, I would like to say that
sometimes, medical imaging isn’t all it’s cracked up to be.
As a resident in psychiatry, I depend on the technology to treat my patients.
From countless computers in the hospital’s hallways and at nurses’ stations, I
call up images of the people I treat: the black, white and gray CT scans of
their skulls, the nuanced M.R.I.’s of their spinal cords and ligaments, the
rotating Spect scans that show in three dimensions how well — or how poorly —
blood flows through their brains. I can leave the room of an 89-year-old woman
who has begun picking imaginary bugs out of the air, look into a screen, and see
the tumor that is causing her delirium.
Now however, many medical schools are beginning to argue that imaging technology
has improved to the point where it should be used in place of the dissection of
human cadavers as the central tool of instruction for young doctors-to-be. This
is a mistake. No matter how detailed and versatile they become, computer images
can never provide the indelible lessons that novice doctors learn from real
bodies.
Nearly every medical student in America begins his career by entering a room
full of cadavers and taking one of them apart, layer by layer, piece by piece.
Doctors have shared this experience for centuries, ever since Vesalius, Da Vinci
and Michelangelo defied religion and government, stole bodies from graves and
churches, and dissected by candlelight in an audacious pursuit of knowledge
about the human body. The process is what you would expect: messy and smelly,
tedious and time-consuming, emotionally and physically difficult. It is at times
awe-inspiring, and at other times profoundly upsetting. It is also, for the
medical schools, very expensive. Even though cadavers are donated, it can cost
more than $2,000 to prepare a body for dissection.
So medical schools are beginning to re-evaluate their anatomy curriculum in the
face of the perhaps inevitable argument: Why not reduce, or eliminate
altogether, the burdensome cost of dissecting cadavers and replace it with this
new and astounding technology? The computers and software — a considerable
expense, but one that need be incurred only once — allow students to study
images of the body from every angle and on every plane. They can peel away the
muscle on a virtual leg to see the bone beneath, then click a different button,
reattach the muscle and see how the limb moves.
Computers can show things that still and lifeless cadavers cannot — blood
pumping in real time through the heart’s chambers, for instance. And it is far
easier to visualize nerves and vessels when they’re color-coded on a computer
than it is to pick through the indistinguishable gray-green tangles inside a
formalin-embalmed cadaver. Because all of this can be done anywhere on any
screen, students can study anatomy in this way in the library, in their
apartments or, surely someday if not already, on their iPods and cellphones.
At the end of the academic year, there would be no need for old cadavers to be
cremated, for new human donors to be found, for deep cleaning the anatomy lab.
Come September, the whole system would simply reboot.
But what kind of doctors will they be, these students who have never experienced
human dissection? They would have been denied a safe and more gradual initiation
into the emotional strain that doctoring demands.
Someday, they’ll need to keep their cool when a baby is lodged wrong in a
mother’s birth canal; when a bone breaks through a patient’s skin; when
someone’s face is burned beyond recognition. Doctors do have normal reactions to
these situations; the composure that we strive to keep under stressful
circumstances is not innate. It has to be learned. The discomfort of taking a
blade to a dead man’s skin helps doctors-in-training figure out how to cope,
without the risk of intruding on a live patient’s feelings — or worse, his
health. We learn to heal the living by first dismantling the dead.
The dissection of cadavers also gives young doctors an appreciation for the
wonders of the human body in a way that no virtual image can match. It is
awe-inspiring to hold a human heart in one’s hands, to appreciate its fragility,
intricacy and strength.
But most important, the cadavers on their stainless steel tables are symbols of
altruism to medical students: They are reminders of how great a gift one can
give to a stranger in the hopes of healing. Isn’t that the most fundamental
lesson we want our doctors to carry to the bedsides of their patients?
Christine Montross,
a resident in psychiatry at Brown University,
is the
author of “Body of Work:
Meditations on Mortality From the Human Anatomy Lab.”
April 22, 2008
The New York Times
By JOHN SCHWARTZ
Roberta Corson recalled her father’s dissection lab as a happy place.
Her father, David L. Bassett, was an expert in anatomy and dissection at the
University of Washington. For more than 17 years, he was engaged in creating
what has been called the most painstaking and detailed set of images of the
human body, inside and out, ever produced. In 3-D.
Working closely with William Gruber, the inventor of the View-Master, the
three-dimensional viewing system that GAF Corporation popularized as a toy in
the 1960s, Dr. Bassett created the 25-volume “Stereoscopic Atlas of Human
Anatomy” in 1962. It included some 1,500 pairs of slides, along with line
drawings that made the details more discernible. The paired slides could be
examined with a View-Master, making the chest cavity look cavernous, and making
details of structure and tissue stand out unforgettably.
The atlas was an immediate success and the images became an important resource
for medical students, even more so as schools have de-emphasized gross anatomy
and cadaver work. But the atlas eventually went out of publication in the 1960s.
Thanks to Stanford University’s school of medicine, however, the work will soon
be available to the world. The school is bringing the images online, (See a
sampling.). The school has also worked with eHuman, a company in Silicon Valley
that hopes to charge students and the curious for access to the trove. Rolling a
computer mouse over an image at the eHuman site will highlight anatomical
details, and bring up the line drawings from the atlas. So far access to the
head and neck collection is $8 a month. Nothing else is online yet.
Even without the stereoscopic boost, the images are stunning, though perhaps not
best examined over breakfast. Blood vessels cluster in a cobwebby tangle along a
spinal column, and pelvic bones stand out like butterflies against a stark black
field. The back of a man’s head, its layers of flesh and bone sliced away, shows
the excavation from the scalp down to the brain as if looking at a stratified
canyon wall. The original Kodachrome slides, carefully preserved, still provide
images of tremendous clarity.
Looking at the images today is a little like viewing the “Body Worlds”
exhibition but without unsettling concerns about the exact provenance of the
bodies. Critics and the exhibitors give different accounts of where the bodies
came from. It is quite clear that Dr. Bassett’s cadavers were people who had
willed their bodies to science.
Robert Chase, the Emile Holman Professor of Surgery, Emeritus, at Stanford
University and curator of the Bassett collection, said, “It’s never going to be
duplicated” because the work was so precise and arduous few institutions could
afford to recreate it. “And they’re in stereo — that’s really a double whammy,”
Dr. Chase said. Dr. Bassett’s widow, Lucille Bassett, gave the collection to
Stanford in her will.
Eventually, it will be possible to see the images online in stereo for anyone
who owns the increasingly popular eyeglasses that provide a sense of
three-dimensional depth in video games, said Robert Austrian, eHuman’s chief
executive. The devices have rapid electronic shutters that provide the optical
illusion of three dimensions when each eye is fed a different perspective.
It was the close collaboration of two very different men that made possible the
creation of the collection. Dr. Bassett was an academic and an anatomist, a
gregarious man with a great talent for dissection. His daughter recalls that his
fingers were so nimble and precise that he once caught a fish with his bare
hands.
Mr. Gruber was a former pipe organ maker from Germany; his interest in
photography and stereography had led him to create the View-Master, an invention
that made him wealthy enough to take on projects simply because they fascinated
him. And he chose corpses, formaldehyde and the dissecting skills of Dr.
Bassett.
Mrs. Corson provided notes from her mother’s unpublished memoir, in which she
said that before Mr. Gruber approached her husband about creating a stereoscopic
atlas, a similar project intended just to produce two-dimensional images had
been attempted at the University of California. An anatomist “tried to work on
unembalmed bodies of prisoners who had been executed.” The result, she wrote,
“was a crude and bloody mess.”
By using embalmed bodies, Dr. Bassett and Mr. Gruber reasoned, they could work
with better preserved tissues. Dr. Bassett had devised his own embalming fluid
that would retain “near normal color” of the tissue, Mrs. Bassett wrote.
Her husband began the great work of his life with the head and neck; Mrs. Corson
was 3 years old at the time. “I certainly grew up around bodies, and his
dissections,” she said — along with her three brothers. “We would go over there
to pick up the mail,” and “I grew up with a sense of comfort with the anatomy
labs, and with the corpses.”
She recalled: “There was nothing gross or ugly about it. It was beautiful.”
Dr. Bassett would come home to eat dinner, Mrs. Corson said, and “my mother
would scratch his back, and then he would go back to the lab.” Often, she
recalled, “my mother would go over to the lab and talk to him while he
dissected.”
Mr. Gruber’s visits were frequent; Dr. Bassett would prepare the specimens, and
Mr. Gruber would arrive for a three-day visit, staying at the Bassett home. Dr.
Bassett would perform the dissections, and Mr. Gruber would shoot from the
slightly different angles that provided stereoscopic viewing. They worked into
the night. “Bill would take the shots, and my dad would dissect deeper into the
area,” exposing layer upon layer of anatomical detail. “He was a craftsman,” she
said.
The images, when presented to the medical profession, were a sensation. In an
essay that Dr. Chase wrote in a scientific journal in 1992, he recalled that
when Dr. Bassett took three test booklets and six View-Masters to the American
Association of Anatomists annual meeting in Detroit in 1951, a line “through the
door and down the hall formed to get a glimpse of the unusual anatomical views.”
The work was completed by 1962, with the 25 volumes packed with thousands of
pictures and diagrams, and hundreds of View-Master reels. That year, Mr. Gruber
wrote to Dr. Bassett to congratulate him on having finished the project, saying:
“No one outside of Lucile and myself will ever know what torturous 10 years of
slavery you went through to reach the top. Let me add my prayer and hope that
you will not have to die to earn your just recognition.”
He added, “Things should really begin to pop from now on.”
But things don’t always work out the way people hope. Dr. Bassett died in 1966,
at just 52. He had planned to create a less expensive student edition that could
get the anatomical knowledge out to a broader audience, but “he was never able
to finish that,” said Mrs. Corson, 64, a retired United Methodist minister and
clinical psychologist in Saratoga, Calif.
Mrs. Corson said she hoped the Stanford project and its commercial counterpart
would bring her father the recognition he deserved, and “finally our dad’s atlas
will be a valuable contribution to science and the understanding of the human
body.”
She said she believed the formaldehyde that was such a large part of her
father’s work contributed to his death, from a combination of rare biochemical
diseases that caused his heart, lungs and other organs to thicken. “I always
wondered,” she said.
Still, the work survives. For all his knowledge, Mrs. Corson said, her father
retained a sense of “amazement and wonder” at the complexity of the bodies he
deconstructed.
Once, she recalled, he held up his hand and turned it over before her. “I know
every muscle,” he told her. “I know ever nerve and every vessel in the hand. But
there’s so much I will never know.”
February 27, 2008
The New York Times
By JESSE McKINLEY
SAN LUIS OBISPO, Calif. — On a winter night in 2006, a disabled and brain
damaged man named Ruben Navarro was wheeled into an operating room at a hospital
here. By most accounts, Mr. Navarro, 25, was near death, and doctors hoped that
he might sustain other lives by donating his kidneys and liver.
But what happened to Mr. Navarro quickly went from the potentially life-saving
to what law enforcement officials say was criminal. In what transplant experts
believe is the first such case in the country, prosecutors have charged the
surgeon, Dr. Hootan C. Roozrokh, with prescribing excessive and improper doses
of drugs, apparently in an attempt to hasten Mr. Navarro’s death to retrieve his
organs sooner.
A preliminary hearing begins here on Wednesday, with Dr. Roozrokh facing three
felony counts relating to Mr. Navarro’s treatment as a donor. At the heart of
the case is whether Dr. Roozrokh, who studied at a transplant fellowship program
at the Stanford University School of Medicine, was pursuing organs at any cost
or had become entangled in a web of misunderstanding about a lesser-used
harvesting technique known as “donation after cardiac death.”
Dr. Roozrokh has pleaded not guilty, and his lawyer said the charges were the
result of overzealous prosecutors. But the case has sent a shudder through the
tight-knit field of transplant surgeons — if convicted on all counts, Dr.
Roozrokh could face eight years in prison — while also worrying donation
advocacy groups that organ donors could be frightened away.
“If you think a malpractice lawsuit is scaring surgeons off, wait to see what
happens when people see a surgeon being charged criminally and going to jail,”
said Dr. Goran B. Klintmalm, president of the American Society of Transplant
Surgeons, who added that he considered the case unprecedented.
David Fleming, the executive director of Donate Life America, a nonprofit group
that promotes donations, said the case had “given some support to the myths and
misperceptions we spend an inordinate amount of time telling people won’t
happen.”
Mr. Fleming said about 18 people a day die in the United States waiting for
transplants. That has created a tremendous demand for donor organs, and over the
years the medical community has established strict protocols to govern organ
harvesting.
Transplanting organs from patients whose hearts have stopped, or cardiac-death
donations, began to go out of vogue in the late 1960s and early ’70s after
medical advances like life support and subsequent changes in the legal
definition of death made donations from those declared brain dead more
efficient. But health officials have encouraged cardiac-death donations in
recent years.
There were 670 cardiac-death donations through the first nine months of 2007,
the most in any year this decade, according to the United Network for Organ
Sharing, which oversees organ allocation. Over the same period, there were
12,553 brain-dead donations, according to the network.
In brain-death donations, the donor is legally dead, but machines keep the
organs viable by machines. In cardiac-death donations, after the patient’s
ventilator is removed, the heart slows. Once it stops, brain function ceases.
Most donor protocols call for a five-minute delay before the patient is declared
dead. Transplant teams are not allowed in the room of the potential donor before
that.
Cardiac-death donations can make some doctors and nurses skittish if they have
not previously witnessed one, said Dr. Robert Sade, the former chairman of the
American Medical Association’s Council on Ethical and Judicial Affairs.
“It all works exactly the same, the cuts and the procedure,” Dr. Sade said. “But
the circumstances are quite different.”
Several days after Mr. Navarro was hospitalized at the Sierra Vista Regional
Medical Center here, a decision was made to remove his ventilator. According to
the criminal complaint, Dr. Roozrokh ordered excessive doses of morphine and
Ativan, an anti-anxiety medicine, both of which are used to comfort dying
patients. In the most shocking accusation, the complaint said Dr. Roozrokh
introduced Betadine, a topical antiseptic, into Mr. Navarro’s system; Betadine,
the complaint said, is “a harmful substance that may cause death if ingested.”
Mr. Navarro died about eight hours later of what the coroner ruled was natural
causes. In the end, however, because his death was not more immediate, his
organs had deteriorated too much to be usable for transplant.
Prosecutors have charged Dr. Roozrokh with felony counts of dependent adult
abuse, mingling a harmful substance (Betadine) and prescribing a controlled
substance (morphine and Ativan) without medical purpose.
The doctor’s lawyer, M. Gerald Schwartzbach, said that Dr. Roozrokh, 34, who
moved to Wisconsin from Iran when he was a toddler and excelled as a collegiate
swimmer, did “nothing that adversely affected the quality or length” of Mr.
Navarro’s life.
“Dr. Roozrokh is a brilliant young surgeon, who has dedicated his life to saving
lives,” Mr. Schwartzbach said. Neither the police nor prosecutors would comment
on the case.
Mr. Navarro was diagnosed with adrenoleukodystrophy, a neurological disorder,
when he was 9. “He would walk like he was drunk,” said his mother, Rosa, a
Guatemalan immigrant. “And when he would play, he would fall like Bambi.”
By his early 20s, however, Mr. Navarro’s mental and physical condition had
deteriorated to a point where he was placed in an assisted-care facility.
On Jan. 29, 2006, Ms. Navarro received a call from the facility that her son had
been found unconscious, in cardiac and respiratory arrest, but that he had been
revived and transported to Sierra Vista. His brain had been damaged from lack of
oxygen.
Several days later, Ms. Navarro says she was told by a doctor at the hospital,
whose name she did not know, that her son would not recover and that he would be
disconnected from life support.
Ms. Navarro, a machinist from Oxnard, Calif., who is on disability, said she did
not have enough money to stay another night near her son. She said that shortly
after leaving the hospital, she received a call from the California Transplant
Donor Network, a nonprofit organization. On a tape recording made by the
network, Ms. Navarro agreed to donate her son’s organs, saying she did not want
him “to suffer too long.”
Late on Feb. 3, a transplant team including Dr. Roozrokh arrived at the
hospital.
According to a police interview with Jennifer Endsley, a nurse, the transplant
team, including Dr. Roozrokh, stayed in the room during the removal of the
ventilator and gave orders for medication, something that would violate donation
protocol. Ms. Endsley, who stayed to watch because she had never participated in
this type of procedure, also told the police that Dr. Roozrokh asked an
intensive care nurse to administer more “candy” — meaning drugs — after Mr.
Navarro did not die immediately after his ventilator was removed.
Mr. Schwartzbach said he would address the accusations in court. “I think a
great many people, lay and medical, will realize they have been significantly
misinformed,” he said.
Several months after the incident, federal health officials cited the hospital
for a series of lapses, including failing to grant temporary clinical privileges
to Dr. Roozrokh, who was under contract with the donor network. Last February,
the United Network for Organ Sharing reprimanded the California Transplant Donor
Network for breaking “established protocol” in the case. The donor network
declined to comment.
Ms. Navarro has filed a civil suit against Dr. Roozrokh, the donor network and
other doctors in the operating room, and has settled a lawsuit against the
hospital. A spokesman for the hospital, Ron Yukelson, said a plan to correct the
problems had been accepted by federal health officials.
Ms. Navarro said she remained angry about the way her son’s life ended.
“He didn’t deserve to be like that, to go that way,” she said. “He died without
dignity and sympathy and without respect.”
Friday February 8, 2008
Guardian Unlimited
Anil Dawar
A pensioner's body lay undisturbed for years on a sofa while his
elderly flatmate continued with his life around him, it has emerged.
The man's corpse was discovered only last week, when council
workers went to investigate the smell coming from the property.
The man, who has not been formally identified, was in his seventies and had been
dead "several years", police said.
According to local reports, the dead man had not been seen for up to eight
years, and repeated complaints about the smell from the first-floor flat went
unheeded.
Bristol city council has started an internal inquiry into how the body lay
undetected in a warden-controlled complex of flats for so long.
Council cleaners discovered the man's corpse last Wednesday, after complaints by
neighbours about a smell coming from the flat in the Bedminster district of
Bristol.
Police sealed off the flat and arrested the 67-year-old occupant, who was the
official tenant, on suspicion of murder. He was later bailed pending further
inquiries, but detectives say they are no longer treating the death as
suspicious.
Kate Hartas, a spokeswoman for Bristol council, refused to speculate on how
council staff remained unaware of the body for so long.
She said: "We are shocked and concerned by this discovery and are carrying out
an urgent internal review of the circumstances of the tenant.
"A police investigation is ongoing and it would be inappropriate to comment
further while this is taking place."
The investigation will look at the mental condition of the tenant and examine
why he did not alert authorities about the death of his lodger. It will also
examine the work of the wardens who visit the site.
The flat has been stripped and cleaned but remains locked and empty. The tenant
has been rehoused in another part of the complex.
The police have been unable to determine how long the corpse was in the flat.
Ian Drury, a spokesman for Avon and Somerset police, said: "A man was living in
the flat at the time, although at this stage that individual is not believed to
be connected with the death.
"Our inquiries continue but so far no evidence of foul play has been found. We
are in the process of compiling a report for the coroner."
Mervyn Kohler, a special adviser to Help the Aged, said: "This is a very
uncommon case, normally it is people living alone who go undiscovered.
"The warden activity at this site has to be investigated. It seems a bit odd
that if there were complaints about the smell that the discovery wasn't made
earlier. If he was worried about getting into trouble for sub-letting his flat
without the council knowing, it is a disproportionate reaction not to tell
anyone the man was dead. It is obvious the tenant was not getting the support he
needed."
January 22, 2008
The New York Times
By EMILY VOIGT
Around Oak Ridge, Tenn., Harry Hitchcock, a 61-year-old science teacher with
owlish wire-rimmed glasses, a few wisps of white-blond hair and a gentle drawl,
is known by his old military nickname, Whitey.
On a recent Saturday morning, Dr. Hitchcock and eight students from his
physiology class at Clinton High School had the opportunity to bestow a nickname
on another gentleman, a portly older man who lay before them in the laboratory
of a local community college. Dead.
“The kids called him Max, for Maximus,” Dr. Hitchcock, who has a Ph.D. in
education, said later. “We always give them names.”
Max is the third cadaver that Dr. Hitchcock has acquired over the last five
years to provide a handful of his most ambitious students with a gross anatomy
lesson typically reserved for the first year of medical school.
Each cadaver comes from a willed-body program and costs Dr. Hitchcock about
$1,200 in preservation and shipping fees. He raises the money from a consortium
of Tennessee universities.
“It caused our school board a little anxiety,” he acknowledged, adding that he
requires a notarized permission slip from each student’s parents. But he said
the learning experience was definitely worth the trouble.
“It’s like watching ants on something,” he said. “The kids are just one on one
leg, one on the other, one on the arm, one on the other arm, one on the head.
They do an amazing job.”
Animal dissections remain popular in the high school biology curriculum, with
millions of vertebrates like frogs and cats going under students’ knives each
year. The National Science Teachers Association and the National Association of
Biology Teachers endorse that practice, though the biology teachers are careful
to specify “nonhuman animals.”
Perhaps not surprisingly, dissecting a person is an endeavor that crosses few
high school teachers’ minds. “I’ve done a lot of searching on the Internet, and
all I ever come up with is classes that go out and view and look,” Dr. Hitchcock
said.
His class is one of the very few hands-on cadaver-based courses at the
secondary-school level, where a teenager may wield a bone saw. A number of
universities do offer workshops that give high school students glimpses of their
own interiors.
But such programs tend to use “prosected” cadavers that have been dissected and
reassembled, with their rib cages lifting off like lids to reveal a jigsaw
puzzle of organs within.
One of the largest such programs is at the St. Louis University School of
Medicine, where high school students witness “general cadaver demos,” as well as
other cadaver-based workshops about sports medicine or forensic science.
Three days a week, 20 to 25 students gather around a table in the St. Louis
dissection hall, where a professor or fourth-year medical student unzips a body
bag, removes a sheet and walks the class through a tour of the body’s inner
workings.
“Students actually put on gloves and can touch the cadaver,” said Ray Vollmer,
who coordinates the 17-year-old program, Adventures in Medicine and Science.
“The diaphragm is nice. You forget what the diaphragm looks like. That thin
tissue that’s actually a very strong muscle.
“Or maybe they want to see what a biceps feels like. It’s a nice easy thing to
get them started with, easier than reaching in and feeling a lung or part of a
brain.”
Anatomists usually lament the shortage of high school teachers with hands-on
training in gross anatomy. “Teaching anatomy is less and less common all the
time,” said Chris Hubbard, an associate professor of biological sciences at
Northern Illinois University, who attributes the decline to a shift toward
molecular biology.
But the growing number of visits to programs like St. Louis’s suggests an
enduring fascination.
In 2002, Dr. Hubbard established the High School Short Course in Anatomy with a
grant from the American Association of Anatomists. He was inspired by a former
graduate student, Julie Larson, who became a teacher at Victor J. Andrew High
School, several hours away, where the curriculum included cat dissection.
Yearning for more familiar domain, Ms. Larson arranged to take her students to
Dr. Hubbard’s lab.
Six years later, a new high school class visits Northern Illinois for the short
course every other week in the spring semester. In addition to two prosected
cadavers for demonstrations, two other bodies are available for students to try
dissecting.
“This is not an academic exercise,” Dr. Hubbard tells the students. “This is
your body. This is how it works. This is not a rat, not a frog. This is you.”
Because of Ms. Larson’s connection, her class is given the enviable task of
preparing the prosected cadavers at the beginning of the semester in a weekend
adventure called “Cadaver Camp.”
“I know only so many people can have this opportunity,” Ms. Larson said. “I
really wish more could. I would love to have a cadaver in my classroom.”
For several decades, a scattering of public high schools in California have
indeed boasted on-site cadaver-based anatomy programs. Jerry Lasnik taught such
a course at Agoura High School in Los Angeles County for 20 years, before
retiring in 2001.
“I would always have at least three cadavers,” he recalled. “I just kept them in
body bags, locked up in a closet.”
Around 1990, Nancy Bowman, a teacher at Westlake High School, 10 minutes away,
went to visit Mr. Lasnik’s class. A former varsity basketball coach and
self-described “adrenaline junkie,” Ms. Bowman set out to design the most
intensive cadaver-based course she could.
Like Mr. Lasnik, she taught herself the art of dissection, poring over textbooks
and practicing on a cadaver in her classroom after hours. Today, she offers a
yearlong gross anatomy lab with an emphasis on biomedical ethics.
To take it, each student has to submit a hefty application and undergo a panel
review. The 30 seniors who are admitted are privy to a rare opportunity.
“What makes us incredibly unique is that we’re able to receive an allocation of
five cadavers per year,” Ms. Bowman said, adding that she finances the course
almost entirely through student fund-raisers. “As well as I’ve been able to
track them, 35 percent of the kids who take the course become doctors, and
another 30 percent end up in some other area of science.”
In Oak Ridge, Max lay face down on his stomach atop a dissecting platform. Dr.
Hitchcock handed the scalpel to a senior, Jordan Fuhrman, an aspiring surgeon.
Jordan had rehearsed the first incision the weekend before, running his finger
down his father’s back, a used copy of Gray’s Anatomy in hand.
He inserted the knife a few inches above Max’s neck and tentatively moved it in
a long, shallow cut along the spine. When Jordan’s father, Mark, who runs a
landscaping business, came by to watch, he encountered his son and seven teenage
girls painstakingly removing the fat from a dead man’s back.
“I’d never seen anything like this before, but I thought if my son can handle
it, I can,” Mark Fuhrman said in an interview later. “I start looking at the
cadaver closer. It’s got hair. I think: ‘This is not a chunk of meat. This is a
person, or what’s left of a person.’ ”
The students were so absorbed in their work, talking about muscle tissue and a
basketball game in the same breath, that they barely noticed a visitor.
Eventually, Jordan looked up and asked his father what was for dinner.
Organ transplant surgery is one of the great breakthroughs of modern
medicine. It has already prolonged thousands of lives. And it has the potential
to help countless more. But, here in the UK, it is under increasing pressure
because of a lack of donors. More than 8,000 people are waiting for organ
transplants in Britain. And the list is rising by 8 per cent a year. There were
2,400 organ transplants last year. But the withholding of consent from families
of the deceased meant four out of 10 organs considered suitable for transplant
went unused.
The problem lies in the issue of consent. Nearly three-quarters of the British
public claim they would be willing to donate their organs in the event of a
fatal accident or premature death. But only a quarter of us are on the register
giving our explicit consent for our organs to be used in this way. Britain's
register of potential donors is smaller, relative to our population, than
several of our European neighbours.
To remedy this, the Government is proposing an overhaul of the UK organ donor
network. One of the ideas is to double the number of dedicated "transplant
co-ordinators" in the NHS. To them falls the sensitive task of identifying
potential donors in intensive care and – when the time comes – persuading
bereaved families. Another idea is 24-hour organ retrieval teams, to work
closely with the critical care teams in hospitals. Finally, it is proposed that
Britain move to a system of "presumed consent" in which everyone is a potential
donor unless they choose to opt out.
All these ideas seem sensible. The presumed consent system operates in Spain,
which has three times more available organs. Concerns about undue pressure being
applied to families should not be dismissed out of hand, but they appear
misplaced. The point of this system is to encourage a culture of donation,
rather than forcing families to consent. In Spain the law presumes consent, but
in practice families are always given the final say. This is where the skills of
transplant co-ordinators come in. Since Spain invested heavily in their
recruitment in the mid-1990s, the refusal rate has come down from 30 per cent to
15 per cent.
The benefits of transplants should not be underestimated. A single decision to
donate can help three or four patients (who may need a kidney, lung, liver or
cornea). The alternative for those denied a transplant is years of painful and
invasive treatment or, more often, death. It is estimated that 1,000 people die
every year because of the lack of donors. If the new system managed to increase
the consent rate by just 10 per cent, an extra 1,200 transplants could be
performed every year.
The life-prolonging element of transplants is paramount. But the money-saving
potential of the technique cannot be ignored either. Dialysis for kidney failure
patients costs around £25,000 per year. Meanwhile, a transplant costs £45,900
initially, followed by annual treatment costing £7,100. A greater number of
transplants could save the NHS some £500m over the next decade. It would be
wrong for a financially stretched NHS to fail to explore this potential saving.
The organ transplant technology revolution is not over. The success of
scientists from the United States in regenerating a dead rat's heart using stem
cells is a promising development. If this could be applied to humans, it would
make transplanted organs far less likely to be rejected by the hosts' immune
system. But that is for the future. At the moment, the primary concern for our
medical system and the Government should be to persuade more of us to make the
humane decision about what should happen to our organs after death.
January 14,
2008
The New York Times
By LAWRENCE K. ALTMAN
Medicine’s
dream of growing new human hearts and other organs to repair or replace damaged
ones received a significant boost Sunday when University of Minnesota
researchers reported success in creating a beating rat heart in a laboratory.
Experts not involved in the Minnesota work called it “a landmark achievement”
and “a stunning” advance. But they and the Minnesota researchers cautioned that
the dream, if it is ever realized, was still at least 10 years away.
Dr. Doris A. Taylor, the head of the team that created the rat heart, said she
followed a guiding principle of her laboratory: “give nature the tools, and get
out of the way.”
“We just took nature’s own building blocks to build a new organ,” Dr. Taylor
said of her team’s report in the journal Nature Medicine.
The researchers removed all the cells from a dead rat heart, leaving the valves
and outer structure as scaffolding for new heart cells injected from newborn
rats. Within two weeks, the cells formed a new beating heart that conducted
electrical impulses and pumped a small amount of blood.
With modifications, scientists should be able to grow a human heart by taking
stem cells from a patient’s bone marrow and placing them in a cadaver heart that
has been prepared as a scaffold, Dr. Taylor said in a telephone interview from
her laboratory in Minneapolis. The early success “opens the door to this notion
that you can make any organ: kidney, liver, lung, pancreas — you name it and we
hope we can make it,” she said.
Todd N. McAllister of Cytograft Tissue Engineering in Novato, Calif., said,
“Doris Taylor’s work is one of those maddeningly simple ideas that you knock
yourself on the head, saying, ‘Why didn’t I think of that?’ ” Dr. McAllister’s
team has used a snippet of a patient’s skin to grow blood vessels in a
laboratory, and then implanted them to restore blood flow around a patient’s
damaged arteries and veins.
The field of tissue engineering has been growing rapidly. For many years,
doctors have used engineered skin for burn patients. Engineered cartilage is
used for joint repairs. Researchers are investigating the use of stem cells to
repair cardiac muscle damaged by heart attacks. Also, new bladders grown from a
patient’s own cells are being tested in the same patients.
Dr. Taylor is a newcomer to tissue regeneration. She began her professional
career at the Albert Einstein College of Medicine in the Bronx investigating
gene therapy and then cell therapy. She said she switched to tissue regeneration
when she realized the limiting step in trying to generate an organ was not the
number of cells needed, but the complexity of creating a three-dimensional
structure.
“The heart is a beautiful organ,” Dr. Taylor said, “and it’s not one that I
thought I’d ever be able to build in a dish.”
Her view changed about three years ago when she recalled that cells were removed
from human and pig heart valves before they were used to replace damaged human
ones. As she contemplated replacing the old rat cells with new ones, Dr. Taylor
followed another of her mantras: “Trust your crazy ideas.”
Progress came in fits and starts. “We made every mistake known, did every
experiment wrong and had to go back and do them right,” Dr. Taylor said.
She poured detergents like those in shampoos in the rat’s arteries to wash out
the heart cells and then injected neonatal cardiac cells. The first two
detergents she tested failed. But a third concoction led to a clear, translucent
scaffold that retained the heart’s architecture.
After injecting the young rat heart cells into a scaffold, she stimulated them
electrically and created an artificial circulation as the equivalent of blood
pressure to make the heart pump and produce a pulse. The steps also helped the
cells mature. Tests like examining slices of the heart under a microscope showed
they were living cells.
To test the biological compatibility of the new hearts, the team transplanted
them into the abdomen of unrelated live rats. The hearts were not immediately
rejected. A blood supply developed. The hearts beat regularly. And cells from
the host rats moved in and began to reline the blood vessels, even growing in
the wall of the hearts.
Dr. Taylor is now conducting similar experiments on pigs as a step toward human
work. “Working out the details in a pig heart made a lot more sense” because the
anatomy of the porcine heart is the closest to humans and pigs are plentiful,
she said.
“The next goal will be to see if we can get the heart to pump strongly enough
and become mature enough that we can use it to keep an animal alive” in a
replacement transplant, Dr. Taylor said.
As for human hearts, the best-case situation would be to obtain them from
cadavers, remove their cells to make a scaffold and then inject bone marrow,
muscle or young cardiac cells from a patient. The process of repopulating the
scaffold with new cells would take a few months, she said.
The body replaces its proteins every few months, so the hope is that the body
will create a matrix that it recognizes as its own.
One potential problem is that antirejection drugs might be required to prevent
adverse immune reactions from the scaffold. In that case, Dr. Taylor hopes such
therapy would be needed only temporarily.
Many things that work in experiments on animals fail in humans because of the
species barrier. Dr. McAllister said that in Dr. Taylor’s case “the principal
problem in escalating it to humans is one of scale, not of cell biology, and
that is an easier problem to solve potentially.”
Dr. Taylor said, “If it works, it means that there will be many more organs
available for transplants.”
Because the components of the biologic matrix differ for every organ, Dr. Taylor
expects that scientists will be able to do tests to answer two fundamental
questions: Can a stem cell be placed anywhere in the body and still produce a
heart, kidney or other organ? Or must a stem cell be placed in its anatomic
position to do so?
Such tests might include taking stem cells from one organ, for example a kidney,
and putting them in a kidney, liver or heart to begin to understand if the stem
cells are innately committed to produce kidneys or whether they will convert to
produce livers or hearts.
Beginning Jan. 15, Adam Liptak’s column, “Sidebar,”
will appear on Tuesdays. Dan
Barry’s column, “This Land,”
September 29, 2007
Filed at 3:39 a.m. ET
The New York Times
By THE ASSOCIATED PRESS
CHICAGO (AP) -- A badly decomposed body found behind several vacant
businesses in Calumet City this week is that of a Chicago woman reported missing
nine days ago, authorities said Friday.
Dental records were used to identify the body of Nailah Franklin, 28, who was
reported missing Sept. 19 after she didn't show up for a work meeting, Chicago
police spokeswoman Monique Bond said. The cause of death has not been
determined, though forensic evidence was still being processed, Bond said.
The woman's unclothed body was discovered Thursday not far from where her car
was found in Hammond, Ind., last week.
Family members declined to comment Friday afternoon at the home of Franklin's
sister.
Bond said investigators have not determined where the woman died, and department
investigators are working with the FBI and Calumet City police. She said the
case is being characterized as a death investigation, not a homicide
investigation, because the cause of death had not yet been determined.
Franklin, a sales representative for Indianapolis-based Eli Lilly, had recently
filed a police report about threatening phone calls she received from a man she
dated briefly. Chicago police have said they have interviewed someone Franklin
dated, but have not named a suspect in her disappearance.
Her disappearance triggered a frantic search. Family members and volunteers
papered the city with fliers, took out a newspaper ad seeking the public's help
and launched a Web site. The family also offered a $10,000 reward for
information leading to her whereabouts.
March 20, 2007
By THE ASSOCIATED PRESS
Filed at 12:13 p.m. ET
The New York Times
In a March 19 story about splitting donated livers, The Associated Press
erroneously identified the location of Dr. George Mazariegos. He is transplant
chief at Children's Hospital of Pittsburgh, not Philadelphia.
------
WASHINGTON (AP) -- The transplant surgeon had good news: A donated liver was on
the way for critically ill Maggie Catherwood. Then he asked: Would she let
doctors cut off part of her new liver to share with an equally sick baby?
''I can't imagine anyone saying no,'' the 21-year-old college student said last
week as, teary-eyed, she met 8-month-old Allison Brown, carefully cuddling the
wide-eyed baby so as not to bump each other's healing incisions.
Actually, few ever get the choice -- something the nation's transplant network
soon may change. There's a push to increase liver-splitting that could have many
more people who are awaiting transplants being asked to share a piece of their
new organ.
If the proposed changes are enacted, ''I think it's safe to say we could nearly
eliminate death on the pediatric liver waiting list,'' said Allison's surgeon,
Dr. Thomas Fishbein of Georgetown University Hospital.
A liver is unlike any other organ: A piece of a healthy one can grow into a
whole organ in about a month. That's why some people receive liver transplants
from living donors who have just a portion of their organ cut out and given
away.
Split-liver donation is different. It divides an organ donated when someone
dies, to try to save two lives with one donation.
It doesn't happen very often, accounting for between 2 and 3 percent of the more
than 6,000 liver transplants annually. Just 123 split-liver transplants were
performed in the U.S. last year, according to the United Network for Organ
Sharing, which runs the transplant system.
Particularly rare, says Fishbein, is an adult agreeing to share a liver that the
waiting-list rules deem completely his or hers. Usually when a liver is split,
an organ too large for a baby or small child had to be cut to fit anyway -- and
pediatric surgeons who don't want to waste the rest offer it to the next
candidate on the waiting list.
''I didn't even know it was possible'' to split a liver, said Catherwood. But
she said yes, and her first question upon waking up from surgery was, ''How's
the baby?''
''The fact that someone else was willing to give up part of that liver they need
is amazing to me,'' said Terri Brown, Allison's mother, in an emotional meeting
with Catherwood 12 days after the transplants.
''Oh, she's adorable, oh my gosh!'' exclaimed Catherwood from her wheelchair as
Allison's father, Brian, handed her the baby, tiny white dog slippers peeking
from beneath her blanket.
Not every transplant center has the expertise or incentive to split livers,
especially those that treat only adults. It's a more technically challenging
operation. It poses a slightly higher risk of post-surgery complications, such
as maintaining the good blood flow necessary for the organ to survive.
Nor is every donated liver splittable. It must be a very healthy organ, not the
marginal ones often transplanted; typically, the donor was a young adult who
died from an accident.
But a rough estimate from the United Network for Organ Sharing is that more than
1,000 livers donated a year might qualify for splitting. Fishbein is part of a
the network committee charged with spurring those transplants to try to save
more youngsters. Between 10 percent and 13 percent of young children die while
on the liver waiting list, including 41 babies last year.
Pending proposals would mandate that all transplant centers be notified when a
potentially splittable liver is donated, and that the search for a matching
recipient identify those willing to accept a partial organ.
''This is a really important topic,'' said Dr. George Mazariegos, transplant
chief at Children's Hospital of Pittsburgh, who says liver-splitting today is
too dependent on individual surgeons.
''We want to take it to ... a national type of initiative where it's always
thought of and always considered when there are certain criteria that are met.''
Catherwood's symptoms started in the fall, when suddenly she couldn't keep food
down. The day after her 21st birthday, she learned she had Wilson's disease --
her liver couldn't properly dispose of the copper in food. The quiet buildup was
destroying it. In early February, the Sterling, Va., woman joined the nearly
17,000 people on the waiting list for liver transplants.
Allison was 3 1/2 months old when doctors discovered her worsening jaundice
meant biliary atresia -- the Waldorf, Md., girl was born without all her major
bile ducts. She joined the transplant list in early December, the whites of her
eyes turning canary yellow as the months ticked by and her liver shut down.
Livers are distributed to the sickest patients first. Late on Feb. 27,
Georgetown's Dr. Cal Matsumoto got word that the transplant network had flagged
Catherwood to receive a liver from a teenager who had just died. Knowing Allison
was a match, too, he broached the two-for-one transplant.
Most surgeons insist on splitting the liver themselves to be sure it's done
right. Fishbein is used to middle-of-the-night trips to far-away hospitals to
retrieve one piece. This time, the organ was flown on ice to Georgetown, for
Fishbein and Matsumoto to divide. The left lobe -- just under 20 percent -- went
to Allison, the rest to Catherwood in an adjoining operating room.
Surgeons carefully calculate the minimum amount of healthy liver a patient needs
in the month it will take to regenerate. Indeed, the slight risk associated with
split-liver transplants is usually due to not getting a big enough piece,
problems with how the organ was divided, or delays in transplanting, explained
Pittsburgh's Mazariegos.
A liver also can be sliced into 60-40 sections for two adults, as is done with
living donors. But split-liver transplants between two adults are controversial.
It's harder to calculate the right volume fast enough, before the organ
deteriorates.
For Catherwood and Allison, the transplant seems to be working, although they
have the same risk of long-term organ rejection as any transplant recipient.
Catherwood was recuperating at home, well enough even before she was discharged
to indulge in chocolate. Allison remained in the hospital for observation, but
her liver was clearing away the jaundice.
''It's so exciting to see what her eyes look like,'' her father said. ''We got
so lucky.''
CASCADE TOWNSHIP, Mich. (AP) - Two packages containing human body parts -
including a liver and part of a head - meant for a medical research lab instead
were delivered to a home.
The body parts, sent from China, were mistakenly dropped off Thursday at Franck
and Ludivine Larmande's home by a DHL express driver who believed the
bubble-wrapped items were pieces to a table.
``My husband started to unwrap one and said, 'This is strange, it looks like a
liver,''' Ludivine Larmande said. ``He started the second one, but stopped as
soon as we saw the ear.
``Something wasn't right. It was scary, and I'm glad I didn't open them.''
The couple called Kent County sheriff's deputies, who determined the preserved
body parts were for medical research, Lt. Roger Parent said.
Authorities believe 28 more bubble-wrapped human organs and body parts could be
dispersed across the country, The Grand Rapids Press reported. Two of five
packages headed to the northern Michigan lab broke open, scattering their
contents.
``There will definitely be a shock to people if they see these things, but there
is no hazard to health,'' Parent said.
DHL is investigating whether it should have shipped the body parts and how the
packages were dispersed, spokesman Robert Mints said.
Ever since she was little,
Susan Smith has felt
there is something wrong with
her body.
Her determination to 'fix' things
has twice landed her in hospital
Monday January 29, 2007
The Guardian
I was six when I first became aware of my desire to lose my legs. I don't
remember what started it - there was no specific trigger. Most people want to
change something about themselves, and the image I have of myself has always
been one without legs.
To the general public, people like me are sick and strange, and that's where
it ends. I think it is a question of fearing the unknown. I have something
called body identity integrity disorder (BIID), where sufferers want to remove
one or more healthy limbs. Few people who haven't experienced it themselves can
understand what I am going through. It is not a sexual thing, it is certainly
not a fetish, and it is nothing to do with appearances. I simply cannot relate
to myself with two legs: it isn't the "me" I want to be. I have long known that
if I want to get on with my life I need to remove both legs. I have been trapped
in the wrong body all this time and over the years I came to hate my physical
self.
As a teenager, in the privacy of my own home, I used to play by myself at being
an amputee. I would pretend I had one leg, strapping the other one up behind me
and wearing oversize trousers so there was no shape. I knew even then that it
wasn't normal, that it wasn't something to share with friends or my parents.
But, trussed up like that, I would be quite happy and satisfied for a while.
At 23, I met my future husband and we were very happy together - but I was
leading a double life. He did not know about my BIID at first so it wasn't easy
to pretend. I went through periods when having him around was very disturbing. I
gradually withdrew into myself, becoming private and secretive.
There is no instruction manual for those who want to remove their own limbs, but
I always knew I would do it. I had eventually, told my husband that one day I
would lose my legs. It took many years for him to understand why, but he did
realise it was part of me, and I suppose he accepted it.
Two years ago, I told him that now was the time and I was going to remove my
left leg. My first attempt was in March 2005. Of course I was scared of dying,
but I had got to a point in my life where I could no longer fight it.
First I needed to freeze and kill the leg so that surgeons would amputate it
afterwards. I ordered dry ice pellets from a company near Edinburgh (the same
stuff that is used in discos for the smoke effect). Nobody asked what it was
for. I bought 40kg - it evaporates very quickly, so you have to buy a great
deal. I put on layers of pantyhose, because you do not want it sticking to you,
spread it in the back of the car and sat with my leg immersed in it for one
hour. The pain was indescribable: it hurt so much I passed out a few times. I
was scared, but more so of failure. I am that kind of person - I never fail.
I had not damaged the leg enough to have it amputated in hospital, so the
following September I made a second attempt, and this time I stayed in the dry
ice for four hours. I was sat with my legs across the back seat of the car, the
windows wide open and the footwell filled with dry ice, covering the leg and
topping it up as it evaporated. When I could bear no more I called my husband,
who came and pulled me out. The leg was hard as stone. I had third-degree burns
and the pain was horrible. But it wasn't enough: I now know you need a minimum
of six hours to kill a leg completely.
My husband drove me to hospital, but they refused to amputate. Incredibly, they
said the wounds were superficial and that I would be walking within a few
months. I really thought this time that the surgeon would give me the amputation
I needed, but they seemed resolute. I went through all sorts of stages as they
worked on my leg to save it. Sometimes I found the whole thing very funny, at
other times I was crying, and sometimes I didn't think I would live through it.
I reached my lowest point when they discharged me from hospital four weeks
later, after eight sessions of surgery, with the leg still attached. I thought I
was going to have to make a third attempt. But this time I would have to do it
differently, perhaps put my leg under a train so they would have nothing more
than a stump to stitch up.
I slowly recovered my strength back at home. I had dropped from 9 stone to under
7 stone during the operations and wanted to give myself time physically to
recover before trying again. But the leg became so infected that there was a
danger of the bacteria getting into the bloodstream and killing me. I had so
much fever I was sleeping 24 hours a day. My mum sat by my bedside, waking me
every hour to make sure I was still alive. She has known about my condition
since I was a teenager, but I know it shocked her to see me finally make an
attempt. After nine months of agony, I told my GP that if I didn't see someone
fast, I would take off the leg myself. Within two days I had an appointment with
a different surgeon.
The amputation, last June, went without a problem, and my left leg was removed
from just above the knee. I felt better as soon as I came round. In fact, I felt
so good in hospital that I was ready to go home straight away had they let me.
My bag was packed and I was ready to leave. The Tuesday after the operation I
drove myself home in an automatic car, and the next day I was almost back to my
normal life.
I already feel more complete now that one leg is off. I have always been an
outgoing kind of person, but my confidence is much higher now as my body is more
like I want it to be. For the first time I feel able to move on and lead the
life I have always wanted. In many ways I am starting again. I know it sounds
odd, but it is incredibly exciting. Running the house, doing the gardening,
going shopping - these are all things I manage easily by myself, even though now
I might use a wheelchair or crutches. My husband has been supportive. He thinks
I look a little strange missing a leg but says that, after all he has seen me go
through, he accepts it. For now, he is just happy that I am happy, and I have
promised to leave the remaining leg on for as long as possible; I know that
losing that will be really difficult for him.
My youngest child is 10 and the eldest 15, and they do not know the truth about
the removal of my leg yet. I told them I had a problem back in March and have
had complications since. As a mother, I felt bad about not telling them the
truth, especially when I was so ill I thought I might not make it. But now I
feel it is better to protect them until they are old enough to understand that
this was my choice. They will probably be in their 20s before I reach that
point. Maybe they will figure it out for themselves before then, anyway. But I
have given so much to my home and family that I feel entitled to do this for
myself.
Only a handful of people know the truth about what I have done, and some of them
call me crazy or mad. I suppose it is understandable. Even my sister doesn't
accept me as an amputee. She lives just up the road but hasn't come to see me in
months. In her eyes I am not a complete person any more. But I can't let that
affect me; the problem is more hers than mine.
I think BIID will stay taboo until people get together and bring it out. A
hundred years ago, it was taboo to be gay in many societies, and 50 years ago
the idea of transsexuals was abhorrent to most. I have tried to make the
condition more understood but it is difficult to get a case out in the open by
yourself. My psychiatrist went to a meeting last year in Paris, and many doctors
there told her that they had operated on people who needed an amputation under
mysterious circumstances, and how happy the person was when they woke up. It led
them to believe that perhaps BIID is more prevalent than people think.
Removing the next leg will not be any easier than the first; the pain will be
horrendous. But I have no regrets about the path I have chosen. In fact, if I
regret anything, it is that I didn't do this sooner. For the first time in my
life, I can get on with being the real me.
· Susan Smith is a pseudonymn. As told to John Cantlie.
Posted 11/25/2006
9:26 PM ET
By Martha Irvine, Associated Press
USA Today
Zach Plante is close with his parents — he
plays baseball with them and, on weekends, helps with work in the small vineyard
they keep at their northern California home.
Lately, though, his parents have begun to
notice subtle changes in their son. Among other things, he's announced that he
wants to grow his hair longer — and sometimes greets his father with "Yo, Dad!"
"Little comments will come out of his mouth that have a bit of that teen
swagger," says Tom Plante, Zach's dad.
Thing is, Zach isn't a teen. He's 10 years old — one part, a fun-loving
fifth-grader who likes to watch the Animal Planet network and play with his dog
and pet gecko, the other a soon-to-be middle schooler who wants an iPod.
In some ways, it's simply part of a kid's natural journey toward independence.
But child development experts say that physical and behavioral changes that
would have been typical of teenagers decades ago are now common among "tweens" —
kids ages 8 to 12.
Some of them are going on "dates" and talking on their own cellphones. They
listen to sexually charged pop music, play mature-rated video games and spend
time gossiping on MySpace. And more girls are wearing makeup and clothing that
some consider beyond their years.
Zach is starting to notice it in his friends, too, especially the way they treat
their parents.
"A lot of kids can sometimes be annoyed by their parents," he says. "If I'm
playing with them at one of their houses, then they kind of ignore their
parents. If their parents do them a favor, they might just say, 'OK,' but not
notice that much."
The shift that's turning tweens into the new teens is complex — and worrisome to
parents and some professionals who deal with children. They wonder if kids are
equipped to handle the thorny issues that come with the adolescent world.
"I'm sure this isn't the first time in history people have been talking about
it. But I definitely feel like these kids are growing up faster — and I'm not
sure it's always a good thing," says Liz Alderman, an adolescent medicine
specialist at Montefiore Medical Center in New York City. She's been in practice
for 16 years and has noticed a gradual but undeniable change in attitude in that
time.
She and others who study and treat children say the reasons it's happening are
both physical and social.
Several published studies have found, for instance, that some tweens' bodies are
developing faster, with more girls starting menstruation in elementary school —
a result doctors often attribute to improved nutrition and, in some cases,
obesity. While boys are still being studied, the findings about girls have
caused some endocrinologists to lower the limits of early breast development to
first or second grade.
Along with that, even young children are having to deal with peer pressure and
other societal influences.
Beyond the drugs, sex and rock'n'roll their boomer and Gen X parents navigated,
technology and consumerism have accelerated the pace of life, giving kids easy
access to influences that may or may not be parent-approved. Sex, violence and
foul language that used to be relegated to late-night viewing and R-rated movies
are expected fixtures in everyday TV.
And many tweens model what they see, including common plot lines "where the kids
are really running the house, not the dysfunctional parents," says Plante, who
in addition to being Zach's dad is a psychology professor at Santa Clara
University in California's Silicon Valley.
He sees the results of all these factors in his private practice frequently.
Kids look and dress older. They struggle to process the images of sex, violence
and adult humor, even when their parents try to shield them. And sometimes, he
says, parents end up encouraging the behavior by failing to set limits — in
essence, handing over power to their kids.
"You get this kind of perfect storm of variables that would suggest that, yes,
kids are becoming teens at an earlier age," Plante says.
Natalie Wickstrom, a 10-year-old in suburban Atlanta, says girls her age
sometimes wear clothes that are "a little inappropriate." She describes how one
friend tied her shirt to show her stomach and "liked to dance, like in rap
videos."
Girls in her class also talk about not only liking but "having relationships"
with boys.
"There's no rules, no limitations to what they can do," says Natalie, who's also
in fifth grade.
Her mom, Billie Wickstrom, says the teen-like behavior of her daughter's peers,
influences her daughter — as does parents' willingness to allow it.
"Some parents make it hard on those of us who are trying to hold their kids back
a bit," she says.
So far, she and her husband have resisted letting Natalie get her ears pierced,
something many of her friends have already done. Now Natalie is lobbying hard
for a cellphone and also wants an iPod.
"Sometimes I just think that maybe, if I got one of these things, I could talk
about what they talk about," Natalie says of the kids she deems the "popular
ones."
It's an age-old issue. Kids want to fit in — and younger kids want to be like
older kids.
But as the limits have been pushed, experts say the stakes also have gotten
higher — with parents and tweens having to deal with very grown-up issues such
as pregnancy and sexually transmitted diseases. Earlier this year, that point
hit home when federal officials recommended a vaccine for HPV — a common STD
that can lead to cervical cancer — for girls as young as age 9.
"Physically, they're adults, but cognitively, they're children," says Alderman,
the physician in New York. She's found that cultural influences have affected
her own children, too.
Earlier this year, her 12-year-old son heard the popular pop song Promiscuous
and asked her what the word meant.
"I mean, it's OK to have that conversation, but when it's constantly playing, it
normalizes it," Alderman says.
She observes that parents sometimes gravitate to one of two ill-advised extremes
— they're either horrified by such questions from their kids, or they "revel" in
the teen-like behavior. As an example of the latter reaction, she notes how some
parents think it's cute when their daughters wear pants or shorts with words
such as "hottie" on the back.
"Believe me, I'm a very open-minded person. But it promotes a certain way of
thinking about girls and their back sides," Alderman says. "A 12-year-old isn't
sexy."
With grown-up influences coming from so many different angles — from peers to
the Internet and TV — some parents say the trend is difficult to combat.
Claire Unterseher, a mother in Chicago, says she only allows her children —
including an 8-year-old son and 7-year-old daughter — to watch public
television.
And yet, already, they're coming home from school asking to download songs she
considers more appropriate for teens.
"I think I bought my first Abba single when I was 13 or 14 — and here my
7-year-old wants me to download Kelly Clarkson all the time," Unterseher says.
"Why are they so interested in all this adult stuff?"
Part of it, experts say, is marketing — and tweens are much-sought-after
consumers.
Advertisers have found that, increasingly, children and teens are influencing
the buying decisions in their households — from cars to computers and family
vacations. According to 360 Youth, an umbrella organization for various youth
marketing groups, tweens represent $51 billion worth of annual spending power on
their own from gifts and allowance, and also have a great deal of say about the
additional $170 billion spent directly on them each year.
Toymakers also have picked up on tweens' interest in older themes and developed
toy lines to meet the demand — from dolls known as Bratz to video games with
more violence.
Diane Levin, a professor of human development and early childhood at Wheelock
College in Boston, is among those who've taken aim at toys deemed too violent or
sexual.
"We've crossed a line. We can no longer avoid it — it's just so in our face,"
says Levin, author of the upcoming book So Sexy So Soon: The Sexualization of
Childhood.
Earlier this year, she and others from a group known as the Campaign for a
Commercial-Free Childhood successfully pressured toy maker Hasbro to drop plans
for a line of children's toys modeled after the singing group Pussycat Dolls.
Other parents, including Clyde Otis III, are trying their own methods.
An attorney with a background in music publishing, Otis has compiled a line of
CDs called "Music Talking" that includes classic oldies he believes are
interesting to tweens, but age appropriate. Artists include Aretha Franklin,
Rose Royce and Blessid Union of Souls.
"I don't want to be like a prude. But some of the stuff out there, it's just out
of control sometimes," says Otis, a father of three from Maplewood, N.J.
"Beyonce singing about bouncing her butt all over the place is a little much —
at least for an 8-year-old."
In the end, many parents find it tricky to strike a balance between setting
limits and allowing their kids to be more independent.
Plante, in California, discovered that a few weeks ago when he and Zach rode
bikes to school, as the two of them have done since the first day of
kindergarten.
"You know, dad, you don't have to bike to school with me anymore," Zach said.
Plante was taken aback.
"It was a poignant moment," he says. "There was this notion of being embarrassed
of having parents be too close."
Since then, Zach has been riding by himself — a big step in his dad's mind.
"Of course, it is hard to let go, but we all need to do so in various ways over
time," Plante says, "as long as we do it thoughtfully and lovingly, I suppose."
* Revealed: 1 in 100 young women
suffer from anorexia or
bulimia
* GPs told: examine all underweight girls
for signs of eating disorders
Published: 29 October 2006
The Independent on Sunday
By Sophie Goodchild and Marie Woolf
The Government last night called on GPs to screen all
underweight women for signs of anorexia and bulimia following an investigation
by The Independent on Sunday into the growing problem of eating disorders.
In the first major survey of its kind, this newspaper can reveal that more than
one in 100 young women is affected by clinical eating disorders and up to six
women in every 10 have "psychological issues" with food as a result of low
self-esteem.
Doctors and government experts also called for a ban on the growing number of
websites that promote the deadly illnesses as a "lifestyle choice" and encourage
them to starve themselves to achieve "perfection".
Rosie Winterton, the health minister, said: "It is crucial that people with
anorexia and bulimia receive the treatment they need and medical professionals
need to be vigilant for the symptoms."
The IoS can also reveal that doctors are facing a disturbing new type of
"multi-impulsive" bulimia that affects a third of patients. It is thought to be
linked to an obsession with body size and image.
Women with this form of the illness, unheard of 10 years ago, not only purge
themselves of food, but also cut their bodies, overdose and abuse alcohol.
Experts believe the current obsession with obesity is confusing young women
about their relationship with food.
The extent of the problem has prompted calls for greater emphasis on treatment
for all. Psychiatrists have condemned the massive variation in services for
eating disorders and the lack of specialist teams available to provide therapy
for sufferers. The lack of services are particularly acute in Scotland, Wales
and north-west England.
Many vulnerable patients are having to travel for treatment, putting an added
strain on them and their families. One London clinic said it was receiving
referrals from Yorkshire.
Professor Hubert Lacey, director of the UK's largest eating disorder clinic at
St George's Hospital in London, warned that long-term anorexics were being left
lonely and isolated because of the treatment gap.
The Government last night called on GPs to screen all underweight women for
signs of anorexia and bulimia following an investigation by The Independent on
Sunday into the growing problem of eating disorders.
In the first major survey of its kind, this newspaper can reveal that more than
one in 100 young women is affected by clinical eating disorders and up to six
women in every 10 have "psychological issues" with food as a result of low
self-esteem.
Doctors and government experts also called for a ban on the growing number of
websites that promote the deadly illnesses as a "lifestyle choice" and encourage
them to starve themselves to achieve "perfection".
Rosie Winterton, the health minister, said: "It is crucial that people with
anorexia and bulimia receive the treatment they need and medical professionals
need to be vigilant for the symptoms."
The IoS can also reveal that doctors are facing a disturbing new type of
"multi-impulsive" bulimia that affects a third of patients. It is thought to be
linked to an obsession with body size and image.
Women with this form of the illness, unheard of 10 years ago, not only purge
themselves of food, but also cut their bodies, overdose and abuse alcohol.
Experts believe the current obsession with obesity is confusing young women
about their relationship with food.
The extent of the problem has prompted calls for greater emphasis on treatment
for all. Psychiatrists have condemned the massive variation in services for
eating disorders and the lack of specialist teams available to provide therapy
for sufferers. The lack of services are particularly acute in Scotland, Wales
and north-west England.
Many vulnerable patients are having to travel for treatment, putting an added
strain on them and their families. One London clinic said it was receiving
referrals from Yorkshire.
Professor Hubert Lacey, director of the UK's largest eating disorder clinic at
St George's Hospital in London, warned that long-term anorexics were being left
lonely and isolated because of the treatment gap.
DETROIT, Oct. 21 — Veterine Thames watches the
world from a custom hospital bed in the back room of a modest yet bustling
five-bedroom brick-and-aluminum-sided ranch in Louisville, Miss. She cannot move
her legs, she cannot move her torso and she cannot grasp anything. She has been
in this condition for more than 24 years.
But Thames can talk, she can see and she has persevered. She reared five
children, mostly on her own, while lying on her back. One of them is Marcus
Thames, who plays for the American League champion Detroit Tigers.
When Thames bats against the St. Louis Cardinals in the World Series, many fans
may know him as an outfielder and designated hitter who labored through parts of
nine seasons in the minor leagues. He emerged this season as a solid power
hitter with 26 homers in 348 at-bats. Finally, at 29, Thames made an impact in
the major leagues. As Veterine’s son, it was only natural that Marcus would
persevere.
But most fans do not know 1 percent of his life story. An automobile accident on
June 19, 1982, changed everything. It brought his tight family even closer and
maybe, in a way, helped Thames become a survivor.
The accident happened on State Highway 14 in Louisville. Veterine was a
passenger in a car driven by G. W. Hughes, the father of four of her children,
including Marcus. Two vertebrae in her spine were seriously damaged, said Ethel
May, Veterine’s sister. Hughes, who was not much involved in his children’s
lives, was not injured.
Thames, 52, did not want to revisit the specifics of the crash. “I think about
it all the time,” she said in an interview at her home. “I want to get up, but I
can’t. It’s hard. I used to cry all the time about the things I want to do.”
Marcus, the middle child, was 5 when his mother was paralyzed, and he said he
had never asked her about the accident. Like Veterine, Marcus said he had often
pined for normalcy.
“I want her to be able to do things,” he said. “I want to be able for her to
walk around. That’s my mom.”
Thames (pronounced timms) added: “When I go to the field, I like to drive there
by myself. I turn the radio off and I think about her. It lights a fire under me
to get me going.”
On an 88-degree day this week, Thames was propped up in bed in the bright,
air-conditioned room, her gray-specked black hair tied behind her head. She was
eager to talk about Marcus, whom she still sees as a little boy nicknamed Slick
because he sucked his thumb. Before she could speak, she needed a tube inserted
in her throat because of the tracheotomy she has had for four years.
Thames nearly cried before the third syllable. Speaking softly and pausing to
catch her breath, she said she believed that her paralysis had motivated Marcus
to excel.
“It made him want to show that he could make something out of himself,” she
said.
After his mother’s comments were relayed to Thames, he nodded.
“When you have somebody who can’t get themselves a glass of water, you look at
this baseball stuff and it’s easy in comparison,” Thames said Friday before the
Tigers worked out at Comerica Park.
“You can’t take life for granted. She was probably all happy and smiling that
day. And, that night, boom, she can’t move her legs anymore. It just made me a
stronger person.”
The accident caused the Thames family to mobilize, and caring for Veterine has
been as natural to them as singing hymns. May simplified the devotion to caring
for Veterine and her children by saying, “It was a job that had to be done, and
someone did it.”
Everyone did it. While Marcus lived with his Uncle Lester and Aunt Ada after the
accident, his mother and four siblings lived with his grandmother Ethel Thames.
At one point, Ethel, the mother of 11, had 18 people living in her home. She
said she did not know how to make a small meal and placed her hands 18 inches
apart to show how high plates would be stacked.
About four years after Veterine was paralyzed, she shocked her mother by
announcing that she planned to move into her own home with her five children,
Stacy, Tabitha, Marcus, Carnetta and E. W. Ethel Thames was bewildered.
“I was worried that she wasn’t going to make it,” she said.
Veterine reasoned that they could stay together because Stacy, her oldest son,
was 14 and responsible, and Tabitha, her oldest daughter, was 12 and could cook.
She read recipes to Tabitha for chicken and pork chops, she reminded the
children to do their homework and chores, and they somehow managed with about
$400 a month in welfare and food stamps. Marcus had to walk to the grocery store
and buy the right items on the list or, he said with a smile, risk being scolded
by his mother and Tabitha. Kenny Gill, whom Veterine described as a special
friend, moved in with them and is still caring for her.
When it came to disciplining her children, she would coax them to come close,
place their heads on her shoulder and slap them with her other hand.
“Trust me, if she wanted to get you, she’d get you,” Marcus said. “She’d call
you over to the bed. You see her arms, they’re big, and bam.”
Although Thames is resourceful, she faces daily medical challenges. Seven months
ago, May said, Veterine’s heartbeat accelerated to a dangerous level.
“At 6 in the morning, we got word to come to the hospital because she was
dying,” May said. “By 1 in the afternoon, she was revived.”
As May recounted that day, Thames never blinked.
“The doctors gave up on me two or three times,” she said. “I didn’t give up.”
Marcus was a freshman in high school and Stacy was a freshman in college when
their mother contracted pneumonia and was placed in intensive care. The boys
took turns skipping two weeks of school to be with her.
“I said then, if I want something, I got to fight for it just like she’s here
fighting for her life,” Thames said. “The doctors gave up on her. She kept
fighting. When I got a chance to play and then I got sent down or got released
by Texas, it just made me hungrier.”
As usual, Veterine was released from the hospital and went back to her bedroom,
which is filled with almost 50 family photographs. The largest picture is of
Marcus.
The Yankees drafted him out of East Central Community College in Decatur, Miss.,
in 1996. Thames made his major league debut in 2002 with the Yankees, and he
homered off Randy Johnson on the first pitch he saw. He played briefly with the
Texas Rangers in 2003 and bounced between Detroit and Class AAA Toledo in 2004
and 2005.
Thames said that he hoped to win a title with the Tigers — which would probably
mean a World Series share of more than $300,000 — and continue to improve as a
player so he can buy his mother a new house.
From the lush lawns and pristine homes at one end of Louisville to the ranch
homes like the Thameses’ on the dusty streets across the railroad tracks,
everyone seemingly knows Marcus. At Louisville High School, the morning
announcements include updates about his career. The athletes who congregated for
football and baseball practice this week have repeatedly been told to try to
emulate Thames.
“We use Marcus a lot,” said Brad Peterson, the football coach, who played
baseball with Thames. “We probably use him too much.”
Thames, who lives about 30 miles away, in Starkville, in the off-season, has
remained close with Charlie Smith, his former baseball coach. Smith planned to
attend at least one World Series game.
“He wanted to play, he wanted to be good, and he’s talented,” Smith said. “But I
think the driving force of his mom is 90 percent of it for him.”
To earn extra money, Thames joined the National Guard after his junior year in
high school. He gained 20 pounds during nine weeks of basic training and
returned to school stronger and more confident. He was not a starter in baseball
or football until his senior year.
“The National Guard made me,” Thames said. “I was skinny and weak before I went
there. I came back and I was a whole different person.”
Thames, his mother and his brothers and sisters will always be different. They
are a proud, spiritual, connected family.
Thames said the years had not made it easier to accept his mother’s disability.
He wishes she could attend the World Series. Instead, she will watch her Slick
on television, from the bed that has been and will always be her home.
“When Marcus was little, he always said that he was going to play ball,” she
said. “When I see him on TV, sometimes I say, ‘I wish I was there.’ ”
THE body parts market is lucrative and lightly
regulated in the US. Estimates of its value range from $500 million to $1
billion (£530 million) a year.
The use of tissue goes far beyond the familiar world of organ transplants, and
involves a host of different materials including bone, skin, muscle, tendons and
ligaments.
Bones can be used in fracture repair, skin can aid wound healing, and heart
valves can be used as replacements in ailing patients.
Tendons and ligaments may be used to treat sports injuries, long bones to
replace those damaged by cancer, shaped-bone products in spinal surgery, and
ground bone in dental surgery. Collagen can be used to plump up lips, while
bodies or body parts can be used in crash tests or in demonstrations of new
techniques for surgeons.
In Britain the number of body parts that are taken in is unknown, because there
is no requirement to keep a tally. Premises that store tissues, however, have to
have a licence from the Human Tissue Authority (HTA), and of these 41 are either
importing or exporting tissues.
The quantity of such imports and exports is not known, because the HTA does not
gather figures.
There are moves to change the law so that such data would in future be
collected. Up to 77 patients in Britain may have had grafts from bones imported
from the New Jersey company involved in the Alistair Cooke case, the Medicines
and Healthcare products Regulatory Agency said last month.
Patients were offered screening and counselling to detect any problems.
Every year it is estimated that 25,000 US bodies are used as source material for
as many as 750,000 operations and procedures.
Heart valves can fetch up to $7,000 each, and skin $1,000 per square foot. A
body could be worth about $150,000 if broken down into its component parts,
according to Art Caplan, Professor of Bioethics at the University of
Pennsylvania.
There are two legitimate sources of body parts in the US. The vast majority of
bodies donated to science go to medical schools, where they are used to teach
anatomy.
Surplus parts can be sent to not-for-proft biomedical corporations, and it is
illegal to charge for them. But medical schools can charge fees to cover
administrative costs, and these can be high.
A second source is the tissue and organ banks, non-profit organisations to whom
individuals can leave their bodies. They are often linked to trading companies
to whom they pass on the parts.
There is no real ethical reason why the trade should not continue, so long as
proper consents are obtained.
But some orthopaedic surgeons, such as Professor Angus Wallace, of Nottingham
University, believe that officials are discouraging the harvesting of parts
because of fears of an Alder Hey-style public backlash.
He believes that it is unethical to treat British patients with imported body
parts and could be dangerous because of uncertainties over quality.
