Postmortem, Ep. 4: The anatomy lab

As haunting as the Harvard morgue scandal is, you don't have to go back very far in history to find practices for sourcing bodies that would be shocking today. Reporter Ally Jarmanning finds that for more than a century, medical schools relied on grave robbing and body snatching to supply anatomical dissection classes.

In Episode 4 of Postmortem: The Stolen Bodies of Harvard, she talks to medical school professors and historians about this grim reality, shedding light on how new the notion of ethics in this field is. And we hear from an FBI agent who's investigated the world of body brokers.

If you have questions, comments or tips about this story, you can reach us at LastSeen@wbur.org.

Ally Jarmanning: A heads up, this episode could get graphic, at times. We're talking about dead bodies here. Take care while listening. 

Ally Jarmanning: I'm in a bright white windowless room at Quinnipiac University's Netter School of Medicine. And in front of me, on a stainless steel table, is a dead body.

A woman — at least, that's what I'm told. I can't see her. The body is encased in an opaque white plastic bag. I call it a body bag, and I'm quickly corrected.

Jesse Gomes: No, we don't call it, um, body bags. We call them donor bags, donor receptacles.

Ally Jarmanning: Jesse Gomes is the head of the anatomical gift program. He's the one who coordinates the body donations, from signing folks up, to hand-delivering the cremated remains to their families.

And he's quick to correct my language — at my request. Because for Jesse and his coworkers, the respect they give to the people who donated their bodies starts with the words that they use.

Jesse Gomes: They are donors when they come here.

They've given us their donation, essentially. So they're not bodies, they're not human remains, they're not cadavers. They're donors. They're mentors.

Ally Jarmanning: I'm here with Jesse and Quinnipiac's director of anatomy, Dr. Maureen Helgren. It's her job to teach students not only about the bodily systems that make up a gross anatomy course, but how to treat the donors under their scalpel.

Maureen Helgren:  Oftentimes we refer to the donors as as silent mentors. Because they're teaching so much and not, you know, not verbalizing that, but they are teaching so much.

Ally Jarmanning: As Dr. Helgren talks, she rests her gloved hand on the donor, like you'd put a hand on someone's shoulder as a gesture of connection, or reassurance. I ask her about it.

Maureen Helgren: To me, it's a gratitude, right? I have a connection with this donor. I am thankful for this donor. This donor is helping me to do my job, right? I like to think that in our lab and in our programs, we can really teach some humanism through our anatomy experience.

Ally Jarmanning: Dr. Helgren's worked with thousands of donor bodies in her career. The donor in front of her, she's about to dissect and film to create an instructional video for the students.

Ally Jarmanning (on tape): How do you think about the donors? Do you think of them as humans? Do you think about their humanity? Do you have to put that in a box to kind of do your job or how do you separate—?

Maureen Helgren: I don't have to separate because the humanity is always there. Does it mean that I don't get emotional? I do get emotional. Our world is a hard place right now. And then, when you think about how selfless someone has been for the benefit of somebody else that they don't know, that overwhelms me at times.

Ally Jarmanning: And in all the hustle and bustle of the labs, they make time to recognize that.

Maureen Helgren: Like we put the donors on the table, and we kind of give a little thank you before the students come in. Right. And, you know, we might say a little prayer. We do what's in our heart as we prepare our donor for the class that's coming.

Ally Jarmanning: This is the way people expect to be treated after death, right? With respect and dignity. This is the treatment those who donated their bodies to Harvard Medical School hoped for.

Instead, some of them got the Cedric Lodge treatment.

They were allegedly chopped up, packaged and sold to collectors. Horrifying. This shouldn't happen — especially not at an institution of higher learning.

Except, there's a history here. Our nation's medical schools have a dark past. Closer to Cedric Lodge's Harvard than we'd like to think.

I'm reporter Ally Jarmanning, and this is Last Seen, Postmortem: The Stolen Bodies of Harvard.

Episode 4: The anatomy lab.

Ally Jarmanning: That reverence for the dead that Dr. Helgren and the folks at Quinnipiac have, it's a relatively new thing.

Let’s visit the earliest days of medical schools. The late 1700s, Harvard Medical School is founded. Back then, what set medical doctors apart from other healers — who treated the sick with herbs or prayer — was the study of the human body. Anatomy. The act of dissecting a cadaver and understanding what went on inside. As one professor wrote, "Anatomy is the charm."

Medical students were thirsty for this relatively new field of study.

Michael Sappol: You marked your ambition by saying, I'm going to really do serious anatomical study. And I have to dissect more than just the minimum.

Ally Jarmanning: Michael Sappol calls himself a historian of anatomy and death. He wrote a book: A Traffic of Dead Bodies.

Those ambitious medical students, especially those looking to get some extra-curricular instruction in, they needed to get their bodies somewhere.

Michael Sappol: Sometimes they violated graves or lied to, or stole or paid agents to get stuff. There's this kind of like black market, gray market where you pay the keeper of the poor house or the jail to give you the bodies and they cart them off to the medical school.

In some cases, you might even finance your medical studies by stealing bodies for the other students and the professors.

Ally Jarmanning: Voluntary body donations like we see at medical schools now didn't exist in the 1800s. In fact, there was a stigma around ending up in an anatomy lab. Only the poor or marginalized were subject to the indignity of dissection.

The rich had mausoleums and sturdy caskets to protect their bodies. The poor were lucky to get a burial at all.

Perhaps the most famous — and most overtly criminal — shady medical cadaver suppliers in the world were William Burke and William Hare.

Burke and Hare trailer: Edinburgh, 1828. The greatest minds came from all over the world. And so did these guys.

Ally Jarmanning: Comedian Simon Pegg made a movie about the pair in 2010.

Burke and Hare trailer: We just have to work out what the demand is for and then supply it. Get rid of the body before it starts to stink up the place more than you two.

Ally Jarmanning: Burke and Hare would kill at least 16 people and sell the bodies to a local anatomist. Ten months into their scheme, they were arrested. Hare flipped on Burke, and Burke was hanged. And perhaps fittingly, Burke's corpse was dissected and his skeleton is on display at the Edinburgh Medical School's anatomical museum. A pocketbook was made from his skin.

Scandals like that would eventually lead to laws that would give medical schools a legal way of procuring bodies. Though, not exactly in a way that would be palatable today.

Michael Sappol: Medical schools start pressing legislatures for laws legalizing the provision of body through unclaimed bodies, mainly from poor houses and jails.

Ally Jarmanning: Harvard professors were among those who lobbied for what became known as the anatomy act. And it passed in 1831, making Massachusetts the first state to have such a law.

But in America, there was another source of bodies.

Daina Ramey Berry: The domestic cadaver trade is a term that I came up with. Essentially, it is a trade in human cadavers that were being sold from plantation communities throughout the United States to medical schools for anatomical research, for dissection classes, for study of the human body.

Ally narration: Daina Ramey Berry is a historian and a dean at the University of California in Santa Barbara.

She wrote a book called The Price for their Pound of Flesh. It's an unflinching look at how enslaved people were commodified and literally valued, from birth to death.

Dr. Berry thought the last chapter of her book would focus on enslaved people's burial practices. How they honored their dead. But then she discovered that even after death, Black people's bodies were not safe.

Daina Ramey Berry: Their bodies were used for medical education. Their bodies were the foundation for our early medical schools across the United States and some of the largest medical programs.

Some of the schools would brag about, we have great subjects for dissection.

It was all across the United States. I mean, I found bodies that were being traded as far south as Texas and as far north as Maine.

Ally Jarmanning: She dug into the archives of medical schools, including at Harvard. And there was one document in particular that chilled her — and made her realize she needed to keep going down this dark rabbit hole.

The letter, from 1845, was tucked away in the correspondence of a physician who later taught anatomy at Harvard.

Daina Ramey Berry: Somebody had written to him and was asking how much it costs to sell a dead stiff N-word and says ones that are not all cut up and that you can't nose or smell a mile off because I know that's the only trade that you participate in.

I mean that was, that was the big break for me, the breakthrough for me that I had to keep going.

Ally Jarmanning: Dr. Berry published a couple of pieces in The New York Times exposing this dark trade in dead bodies. And the response she got floored her. She realized this wasn't just a slavery-era thing. This desecration of predominantly Black bodies, it continued for decades.

Daina Ramey Berry: I received over 300 letters and emails and a lot of people that wrote me were medical doctors and they would say, "I was trained in the ’50s, I was trained in the 1960s, and every single body that we used in our, at our institution was African American."

Ally Jarmanning: It's that not-so-distant history that may affect today's voluntary body donations. There are no official statistics, but anecdotally, most body donors are white. One study from the ’90s in Ohio found that 94% of the donor applicants were white.

Perhaps that's because white people don't carry the same historical skepticism, or legitimate fear, of the medical profession. And maybe that makes them more willing to donate their bodies.

Daina Ramey Berry: There's been a larger history of African American or people of African descent having distrust with the medical profession because of things like the Tuskegee syphilis experiment, because of the case of Henrietta Lacks.

Because of that, people are not as comfortable becoming donors, uh, and signing on for that.

Ally Jarmanning: Dr. Berry found racism was baked into the mindset of medical students and their anatomist professors. Black people were othered, and that gave white doctors some kind of perverse permission to steal or purchase those bodies.

And racism affected white doctors' reaction to what they found inside, what they wrote down in their notes that Dr. Berry read almost 200 years later.

Daina Ramey Berry: When they dissected a Black body, they were surprised to find that the insides looked the same. So there was a perception that the skin color meant that there was difference everywhere. Not just difference in the flesh, but difference on the inside. And I think that really brought that home for me.

I remember I had chills and I just sat with that record at the archive for a good while. Because it was in that moment that I realized, the amount of difference that people thought between the races was so profound that they thought that we weren't the same kind of human beings as one another.

Ally Jarmanning: After the break, how are today’s doctors reckoning with this past. They’re still figuring it out.

Ally Jarmanning: The biggest shift for medical schools and anatomy came to pass within the lifetimes of some doctors still working today: voluntary body donation.

Passed less than 60 years ago, the federal Uniform Anatomical Gift Act, was designed to provide a legal and ethical source of human remains for organ transplant and medical research. It allowed people to designate their bodies for donation. Before that, it was actually illegal to donate your body in most places.

The stigma around body donation and dissection began to wane as some patients trusted the medical profession more. And medical schools began to court donors, as the well of unclaimed bodies dried up the government began paying for burial costs.

Body donation became a viable or even desirable end-of-life option for many people.

But a more modern view of sourcing bodies for medical schools didn't necessarily change how the cadavers were treated in the lab.

Dr. Tom Champney: 40 years ago, we were taught to think of those individuals as kind of pieces of wood, or, you know, inanimate objects that you were just learning anatomy from, and not to think too much about them.

Ally Jarmanning: Dr. Tom Champney is a professor at the University of Miami's Miller School of Medicine. And he's a big proponent of what he calls the "ethical treatment of human tissues."

But that wasn't something he was ever taught. He remembers his early days of learning anatomy and the crass detachment most had.

Dr. Tom Champney: The attitude we were given is that this is something dead. You can work on it. You can do things to it. It doesn't really matter because the living thing that was in there is gone, right? So this is a piece of meat or, you know, an old piece of equipment or whatever, and you're just trying to learn from that.

Sadly, we never really considered who those individuals were, right? For whatever reason, it never occurred to us to think about them and what their lives were like, why they were there, etc.

Ally Jarmanning: In his career, he's seen slow change in how professors, doctors and students treat bodies. Many programs have pushed more humane treatment of the donors — only uncovering the parts of the body the students are working on, for instance. Most programs, like Harvard, have annual memorial services to recognize the donors for their gift.

And those who disrespect bodies have faced repercussions. A University of Pittsburgh medical student was criminally charged two years ago after others saw him sticking his fingers inside a donor's genital region and smirking. He later got probation and community service.

Dr. Champney is one third of a group that calls themselves the "Bioethics Unicorns." The other two are doctors Sabine Hildebrandt from Harvard, and John Cornwall from New Zealand. The cutesy name sprung from a presentation Dr. Cornwall put together, where he included some rainbow and unicorn clip art and said the group was mythical and unknown. The nickname stuck. They have business cards with it now.

Dr. Tom Champney: It's a kind of a nice way to talk about a topic that is not always as pleasant to talk about.

Ally Jarmanning: The three of them write and speak a lot about how the dead should be treated. And they've attracted more followers.

Dr. Tom Champney: There's been more of a resurgence in thinking about these individuals, and what their lives were, and how they have meaning, etc.

I and my colleagues have been trying to move that needle. To get more people to think of it that way, and to think of these as individuals in the lab and not as just objects to be worked on.

Ally narration: Still, Dr. Champney says there are some professors today who, in the name of safety, direct students to store their scalpel blade in the body’s thigh — like a pincushion. Not exactly something you would do with a live patient.

Dr. Tom Champney: They look at the donor as a scalpel repository, but to me it's, it's an inappropriate, um, reflection of the donor's altruism and the donor's humanity.

Ally Jarmanning: And Dr. Champney told me the law doesn’t really see human bodies as anything special.

Dr. Tom Champney: The egregious things like selling of body parts, or things of that nature, when those individuals are caught, they're usually tried for stealing property, right? They're not tried for doing something inhumane, or doing something unethical to that individual. They're charged because these individuals were considered property of the school or the university.

Ally Jarmanning: Just look at Harvard's Cedric Lodge and the other alleged body parts buyers and sellers. They're charged with interstate transport of stolen goods. Not humans.

Dr. Tom Champney: If he’d stolen a hundred computers from Harvard and transported them across state lines and sold those computers to other people, he would have been charged with virtually the same thing.

I think it in some ways stems to a legal belief, I don't necessarily know if this is an ethical belief, but a legal belief that once you die, you are no longer human and you're now property.

I would like to see that that expanded. That that there should be some middle ground where we treat deceased tissues differently than we teach that we treat old refrigerators.

Ally Jarmanning: To illustrate this point, Dr. Champney has a little poster he puts outside his office. He has a wonky name for it: the "human tissue ethical continuum."

On the far right of the page is a picture of Dr. Champney. He represents the "living human." To the left of him, is a living animal, a cute dog. Further to the left, a living insect. Then valuable art — the Mona Lisa. And finally, on the far left of the page is a pile of old appliances: washing machines and broken refrigerators.

He asks his students: where on this spectrum do you think donated human bodies should go? Should they be treated more like a living human — or precious art? Or broken down equipment?

Dr. Tom Champney: I am on one's far end into the spectrum, where I think human tissues deserve a lot of respect and dignity. But there is, there is a wide range, even amongst the anatomy community, there's a wide range.

Ally Jarmanning: There are few laws about how we should treat the dead. Really, there are no rules, either. Everyone is making up their own. Medical schools can create their own internal standards, but there's no regulation.

In Massachusetts, the state doesn't even bother to inspect medical school morgues. And once you own a body part you can do whatever you want. Skin can be turned into books by Jeremy Pauley. Skeletons can flank a Delaware living room. A skull can join your knick knacks on the shelf. It's all mostly legally okay.

Paul Micah Johnson: There is no federal law that bans buying and selling of body parts as long as they're not going to go into another human being.

Ally Jarmanning: FBI agent Paul Micah Johnson became the agency's go-to guy for human remains cases after he investigated a so-called body broker — it’s a company or individual that takes donated bodies, chops them up for parts, and sells the bones, tissues and tendons to others.

Paul Micah Johnson: When I first started, I, I certainly imagined, you know, cadavers and a group of medical students standing around a cadaver and learning the parts of human anatomy. There is still that, but that's a very small part of it.

Ally Jarmanning: The body parts marketplace — it's big. This podcast has focused on two tiny slivers of the demand: medical schools for student learning — like Harvard — and the oddities marketplace — the guys like Jeremy Pauley. We'd need many, many more episodes to address all the other ways human bodies are bought and sold and used.

A handful of states — including Massachusetts — have laws against buying or selling human bodies. But this patchwork of laws aren’t very well enforced. There's no national database of human remains — even for bodies donated today.

Paul Micah Johnson: There's much better tracing for a head of lettuce than there is for a human head.

We can trace a head of lettuce exactly to the particular farm from which it came and in all the steps in between. That's not required with human body parts.

Ally Jarmanning: All those brains in jars and skulls on shelves, there is almost no way to know their origins.

Paul Micah Johnson: If you stop for a minute and think about then where it came from, that's, that's the issue. We should be stopping to think. Did someone really want this on my shelf? Did they give consent for this?

Ally Jarmanning: Our understanding of what respect and consent looks like for the living in the medical world is relatively new. Remember those "bioethics unicorns" — those mythical anatomists teaching about respecting donor bodies? Well, the term bioethics — ethics in medicine — it didn't even exist until the 1970s.

Turning today's ethical and legal lens on the past can be deeply uncomfortable work. Controversial, even. Because a lot of this dark history, it's still around.

The people dissected or dug up, exist now as skeletons or organs in jars. They're now "historic specimens" — the stuff we see behind glass in museums. What are we supposed to do with all that?

Next time, on the final episode of Postmortem, I visit an institution trying to reconcile its past and today's norms. And I look at how they're wrestling with our more refined understanding of how to treat the dead.

Ally Jarmanning (on tape): Fetal skeletons from two months gestation to newborn infants. We have 1, 2, 3, 4, 5, 6, 7, 8, 9, 9 tiny skeletons.