Prior to writing the book, you spent a year attending gross anatomy classes at UCSF med school. What compelled you to want to do that?
Curiosity, plain and simple. I was curious to know how Henry Gray had performed the dissections for Gray's Anatomy and what it's like to work in an anatomy lab. That being said, I never imagined that I'd spend a whole year studying anatomy or, for that matter, end up performing full cadaver dissections. I simply planned to attend a few lectures and labs as background research for the book. But, by the end of the first class, I was hooked. I just kept coming back to the anatomy lab day after day and I blended in - I was like an anatomy Zelig.
Though my skills and knowledge definitely evolved over the year, to the point where I actually started helping med students with their anatomy studies, I never lost my sense of wonder. What are we going to dissect today? The foot, the brain, a kidney? What are we going to see--learn? Every lab was a chance to study something new.
Okay, I'm still fixated on the fact that you actually dissected cadavers. How did you handle that?
I think what you're asking is, Wasn't it gross or horrifying? Which is what most people assume. I never found it horrifying - everything was done with such respect, even a certain reverence, all in the service of learning. But I can't lie, sometimes it was gross - the smell more than anything.
You mean the smell of decomposition?
Oh, no. The cadavers are expertly preserved - they can last for years without much decay. Mostly, it's the overpowering formaldehyde fumes that get to you. Your eyes burn, you can get nauseous, headache-y, you come home and you can't get the smell out of your scrubs. But you also get used to it. And, you know what? It's nothing. It's a small price to pay for seeing something so extraordinary - seeing inside the human body.
What did you find most extraordinary about the body?
It’s all extraordinary! Narrow it down to a body part, and then I'll give it a shot.
Fair enough. Let's say...a leg.
A right or a left leg? No, I'm kidding. In the leg, one of the most incredible things to see is a joint - a hip, knee, or ankle joint, any one. Even in a dead body, a joint is a thing of beauty. They remain well preserved and they actually still work - you can manipulate the limbs to see exactly how a simple ball-and-socket joint, like that at the hip, works. It's mind-boggling. And after you see something like that, you see your own body differently - you have a different awareness of how you walk and run and sit and stand. This goes for all parts of the body, really. After studying anatomy, something as simple as taking a pee is never the same. You have this bank of images to draw upon, which illustrate exactly how the body works.
So, where or when did your fascination with the body originate? This is something that runs through all three of your books - Sleep Demons, Five Quarts, and now The Anatomist.
I guess the easy answer is I have a body, so I'm naturally curious about how it works. It seems normal to me. But I realize it's not necessarily normal - or let's say, ordinary. After all, you could be interested in anatomy yet have zero desire to take it as far as I did - to learn about the body by dissecting dozens of them. I certainly met plenty of med students who didn't dig it.
But, I think my fascination with the body runs deep. There are childhood influences, certainly: Being raised a strict Catholic and absorbing all the weird iconography of the church and taboos about the body. Also, my mom being an artist and exposing me to all this great figurative art - from Michelangelo to Picasso. My two best friend's dads were doctors, and so on. But, honestly, I would have to say AIDS probably had the biggest impact. I moved to San Francisco at the height of the epidemic, 1985, I'd just come out, and seeing these beautiful young men, men my own age, fall ill to this mysterious disease and deteriorate so rapidly, die - the body became something to fear, to an extent. Also I fell in love with a man who had HIV, and especially in the early days, we really had to do our homework and learn about the body and drugs and medicine, and so on. It was like a crash course in anatomy, and in fact, it was back in those early days of the epidemic that I bought a copy of Gray's Anatomy.
The book has been around for, what, 150 years now? Why has it survived? Surely, there were other anatomy books that never got beyond a first edition.
It's true, absolutely. Anatomy textbooks go back as far as the fourteenth century. And, in the late 1850s, when Gray's Anatomy was first published, there were plenty of competing titles in bookstores. But Gray's alone has survived; it's never gone out of print. I could point to lots of reasons - the book came out at the dawn of modern surgery and was geared toward surgeons; it was designed to be eminently practical; it was small and portable; and pure luck surely played a part. But I am convinced that the sole reason it - and not others - has survived for all these years is because of the pictures - the clear, elegantly drawn anatomical illustrations. They're timeless (unlike the original text, by the way). That is the reason that people browsing in bookstores still pick it up and buy it: the pictures. Artists especially revere the book. The painter Jean-Michel Basquiat cited Gray's as a major influence on his work, for example, as has Kiki Smith, whose work deals so seductively, so viscerally, with the body. Likewise, fitness icon Jack LaLanne credited Gray's Anatomy with teaching him everything he needed to know about the body, and that's more common than you might think. Physical therapists, massage therapists, fitness freaks, personal trainers, professional athletes, aspiring quiz show contestants, not to mention doctors and med students - they've all got copies of Gray's Anatomy at home.
But Henry Gray didn't do the drawings, did he?
No, and few people today know that. Henry Gray wrote the book, a considerable achievement itself, but a man named Henry Vandyke Carter - a fellow anatomist and surgeon in London - did the drawings. And for a mere 150 pounds, incidentally, whereas Gray received a higher fee as well as royalties that would benefit several generations. Now, speaking of that, one of the most thrilling aspects of writing The Anatomist was discovering a trove of Carter's diaries, letters, and papers, which I then used to piece together the story behind the making of Gray's Anatomy. It's a great tale.
So why wasn't the book titled Gray & Carter's Anatomy?
Actually, the book originally went by the very un-catchy title of Anatomy: Descriptive and Surgical. On the spine of the book and title page, though, Gray and Carter received equal billing. But that didn't continue. By the time the second edition came out, just 3 years later, Henry Gray had died of smallpox - he was only 34; Henry Carter had moved to Bombay, India, where he ended up teaching anatomy and practicing medicine; and the book, partly in tribute to Gray, whose death was so untimely, came to be called "Gray's Anatomy." As for Carter, he had nothing to do with the book at all after the first edition and, in fact, his name was not even included in later editions of the book. The volume I bought back in the 1980s didn't credit Carter. Like most people, I assumed that Gray had done the drawings himself.
What would you like people to take away after reading your book?
I've already heard from people who've read the book and one comment comes up repeatedly. They would never in a million years set foot in an anatomy lab, but through my experience they can enjoy it and learn about anatomy vicariously. That delights me. I'm reminded of a wonderful quote in the book from a student of anatomy back in 1620, obviously a very thoughtful young man: "Self-knowledge ought to apply not only to the soul but also to the body," he wrote. "The man without insight into the fabric of his body has no knowledge of himself." Isn't that lovely? I absolutely concur and, idealistic as this may sound, I hope that readers of The Anatomist will take away just that, a greater knowledge of themselves.
Causes Bill Hayes Supports
International AIDS Vaccine Initiative