To study a body, first you had to dig one up. How medical students in Canada earned a ghoulish reputation
|Toronto Star 26 Oct 2019 at 03:15|
It looked as though Emeline Barnes had decided death wasn’t for her. More than a year after Emeline died of cancer, the soil at her grave was disturbed, and when locals near the Welland Canal removed the earth down to the outside shell of her casket in the summer of 1914, they noticed a hole. They also found a skull in a nearby field.
When the OPP inspector showed up in Allenburg, he had no way of knowing if the skull belonged to 57-year-old Emeline. He would have to open the grave to make a definite ruling, and it appears nobody wanted that — so the investigator filed his $5.70 expenses for the trip from Toronto, and the matter was closed, according to the investigation notes at the Ontario Archives.
Emeline’s son couldn’t shake the story. He’d been told the troubling details when the ship he worked on, the SS Scottish Hero, came up the lakes that summer. When he docked in Port Arthur he asked the police chief there for help.
“This man is very anxious that an Investigation be made as to the removal of the body from the Grave, as he claims it was removed,” the police chief wrote to the head of the OPP. “And that it was done by some Medical students.”
Although it’s mostly forgotten, medical students used to have a ghoulish reputation, earned by decades of grave robbing. Students needed human bodies to learn anatomy — and even when there was a legal means of acquiring them — the cemetery was often where they went. In the 19th century, stories appeared quite regularly in Canadian newspapers about midnight digging, footprints in the snow, vaults pried open, and “sorrowing relatives” demanding answers.
There was a snowy night in Montreal in the 1870s, when barking dogs startled the students who fled the cemetery with the “stiffs” in tow. The trail led to McGill University, where “the pieces were all found and given to the relatives, who reinterred them,” the Globe noted. In 1859, there was a woman buried in the countryside north of Toronto, only to vanish a few days later.
“There is no necessity for robbing graveyards, since sufficient subjects for medical purposes can be obtained in a legal manner,” wrote the Globe.
Through most of recorded history, dissection of bodies was outlawed. Amid epidemic disease and criminal violence in the Middle Ages, there was more pressure to allow it, which clashed with the prevailing Christian belief that the soul would not be resurrected if the body was tampered with, medical historian and hematologist Dr. Jacalyn Duffin writes in “History of Medicine.” So dissections were rare — performed on bodies of dead criminals in a “ritualized” manner once or twice a year.
By the 18th century, dissection was gaining more scholarly interest, but the public still thought it was a “vile act” done more for curiosity than anything else, she notes. As doctors discovered anatomical links to disease in the 19th century, it became “essential” to understand the human body, and universities began to offer programs.
With the advent of anesthesia and antisepsis in the mid-19th century, surgery was given a “tremendous boost,” Duffin writes in an email. Doctors required anatomical knowledge, but there were never enough cadavers. This created unsavoury situations.
The most famous case happened in Scotland, and it wasn’t grave robbing but murder.
William Burke and William Hare were Irish labourers who stayed in Scotland after working on canal projects in the 1820s. Later, Hare ran a lodging house where Burke lived. When another lodger died with money still owing for the room, Hare and Burke sold the man’s body to Edinburgh anatomist Dr. Robert Knox for £7.
Knox was “famed for his gory lectures” and the generous prices he paid for cadavers. As Burke and Hare surveyed the “wretched lodgers” they realized there was money to be made. But rather than waiting for death to occur naturally, they offered vulnerable people cheap liquor, smothered them, and sold the bodies to Dr. Knox. They killed 16 people.
When the police finally caught them, the doctor said he knew nothing of the crimes. Hare turned Crown witness, and Burke was sentenced to be hanged and publicly dissected in 1829. The dissection included a two-hour lecture before a crowd of thousands, and Burke’s skeleton is on display at the Anatomical Museum at the University of Edinburgh. A pocketbook made with his skin is at the nearby Surgeons’ Hall Museum.
As Burke and Hare were terrorizing Edinburgh, a Scottish engineer named John Mactaggart was travelling through Canada, working on surveys for the Rideau Canal. He was struck by fenceless graveyards and the way the locals in Lower Canada would stockpile coffins in their churches to await the spring thaw.
“Let those come to Canada who wish to study anatomy; here they have as many subjects to examine as they please; here resurrectionists may do their duty in the open day, and no one will scare them,” he wrote in 1829.
Montreal was particularly known for its cemetery “depredations,” and lucrative trade in bodies, and in the late 1830s, there was a supply of cadavers secretly shipped from Toronto across Lake Ontario in whisky barrels for Dr. John Rolph, Duffin writes. Rolph, a known reformer and associate of William Lyon Mackenzie, had taught medicine from his Toronto home, and was in temporary exile in Rochester following the 1837 Rebellion.
Amid these macabre stories, some governments created laws around how medical schools would obtain their “subjects.” In 1843, the Legislative Assembly of the Province of Ontario passed its anatomy act, noting it was impossible for medicine to advance without studying “every portion of the human economy.” The government decreed that bodies of the unclaimed dead in public institutions would be sent to medical schools, unless claimed by “bona fide friends.”
But the act didn’t stop the clandestine excursions. There was religious and moral objection to sending unclaimed bodies to medical schools, and grave robbing became something of a rite of passage for Victorian medical students amid the limited supply.
“As important as learning anatomy was finding your body,” says Scott Belyea, a resident in family medicine at the University of Calgary who wrote his 2012 master’s thesis at Queen’s on “A Century of Body Snatching” in Kingston.
In 19th-century Ontario, there was a short-lived medical school in St. Thomas, and schools in Toronto, Kingston and later in London. Most of what we know about grave robbing centres around Kingston, thanks to digging (in the archives) by historians like Belyea. It was only two months after the medical school was founded in Kingston that the first body disappeared from the local hospital in the winter of 1855. “This was to be the beginning of a long, often tumultuous relationship between Kingston’s medical pupils and the dead of her city,” Belyea writes.
Belyea documented more than 200 incidents between 1822 and 1920, like the time police discovered a decapitated corpse in the city only to have the body vanish midway through the investigation, or the medical student known as G., who was said to be “the prince of grave-robbers,” showing up at hospitals or morgues in “clever disguises,” to spin “mournful tales,” in his bid to spirit away the bodies of strangers.
The 1880s were particularly “frenzied” period. With limited preservation technology, there was a “real sense of urgency” for the students. Incensed locals knew to go to the medical school as soon as a body disappeared, so students started the dissections at home, or in a back shed, until the medical school was given the all-clear, Belyea says.
Wealthy citizens installed iron cages called “mortsafes” at gravesites, others made sure to keep a vigil, or placed heavy stones over the plot. When Sir John A. Macdonald was buried in Kingston in 1891, his coffin was surrounded by “immense slabs of limestone,” covered in cement, and topped by a “bed of concrete” that would take “days to penetrate,” Belyea writes.
The faculty didn’t ask many questions or criticize the students until the community anger became palpable, he writes. When cases made their way to court, they led to settlements and occasional fines, but typically, there was a “judicial unwillingness” to punish the medical students.
In a 1988 article in the Canadian Bulletin of Medical History, historian Royce MacGillivray mentions a “scarcity” of convictions in Ontario, writing that medical students and their agents would only take the remains, leaving jewelry and personal effects behind in a bid to appease would-be prosecutors, since the “dead body” was not seen as property. Some of the snatchers took pride in the way they could make it look like they’d never been there at all.
Adam Montgomery, a historian of medicine who runs the Canadian Cemetery History Twitter account, suspects there was a “lot more going on in Ontario.” He has come across newspaper stories in St. Thomas and Bowmanville, and a body-snatching hook left behind in a foiled attempt in Niagara-on-the-Lake, to name a few. He speculates many weren’t caught.
As the 20th century neared, medical schools grew and so did the demand for bodies. It was a constant source of tension as doctors tried to make the legislation more liberal by including the unclaimed dead from “lunatic asylums” while some MPPs tried to impose more restrictions on the “cruel exercise of power” on the poor.
At Queen’s Park, doctors dismissed such arguments as “sentimental,” and threatened that restrictions would lead to graveyard desecrations. Certain politicians suggested that there were “too many doctors just now.”
“A lunatic dying in an asylum has no mind more than an oyster,” was the cold assessment of Dr. W.B. Geikie, dean of Trinity Medical College in Toronto, in a 1888 bid to broaden the act. “The dissecting knife will not affect him.”
In a letter at the Trinity College archives, a Western University representative bemoaned the dozen of so unclaimed “paupers” buried by the London asylum every year: “We feel that they are material for the dissection room and we should not be deprived of it.”
The word “material” was common, and a “conscious attempt to distance,” Montgomery says. He sees the language as an attempt at professionalization, noting that 19th-century doctors were self-conscious about the profession’s earlier reputation of doing more harm than good, with leechings and bleedings.
If the language seemed callous, the photos were worse. One image of the 1895 anatomy class at Trinity shows young men standing around a cadaver with a smoking pipe in his mouth. Belyea found similar photos of 19th-century Queen’s medical students: in 1880, the class of medicine has scalpels and saws at the ready while one student plays cards with a skeleton.
“The anatomy laws applied most often to those disadvantaged by poverty or race,” Duffin writes, noting that the idea of body donation hadn’t yet taken hold, “especially when medical students were fond of joking about cadavers and skeletons and had themselves photographed with the specimens in disrespectful poses.”
The bodies of unclaimed dead were distributed by “Inspectors of Anatomy,” who were local undertakers. These men were often stymied by “bona fide friends” who were willing to intervene and bury the deceased.
Correspondence from 1909 at the Ontario Archives notes that institutions in Kingston were forbidden to “give up any bodies Catholic or Protestant” by the Archbishop. The priest at the Kingston Penitentiary was also unhelpful, the local inspector wrote.
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In 1909, James Connell, the dean of Queen’s Medical School, complained to the province that Kingston was not receiving its fair share of cadavers. According to the Anatomy Act, the local inspector was supposed to receive $5 for transportation costs, and the general inspector who oversaw the system in Toronto $2, but Connell alleged that “Toronto University” was paying up to $40 for unclaimed bodies.
“We are not prepared to enter into competition with our wealthy rival in bidding for subjects,” he wrote, asking the government to establish a “fair price.”
Edward Bayly, then lawyer for the attorney general, agreed that the current fees were “inadequate” and sent a strongly worded letter to the province’s local inspectors to find out what they’d been up to.
The letters came back on stationery that advertised fine chairs alongside embalming, since most undertakers were furniture dealers. They told Bayly they accepted anywhere from $5 to $32 for the “anatomical material.” Some sent cadavers to the general inspector in Toronto, some sent them directly to London and Toronto schools. The Norfolk inspector had no bodies because “our County Council constituted themselves bona fide friends of the inmates of our County Home and had all subjects buried on the farm.”
Alex Millard, the general inspector who was in charge of the whole system, told Bayly that $5 was hardly enough for the travel and trouble as the undertakers received a lot of “abuse,” especially in small towns, where the idea of dissection “is looked upon as a sacrilege.”
The Queen’s dean threatened to make the matter public: “The business is disagreeable enough when transacted in a perfectly legal manner,” he wrote, trusting that the government would spare them the “annoyance of publicity.”
The attorney general sent out a circular reminding the local inspectors of the rules. Alex Millard, the general inspector, died a few months later. He was buried at Mount Pleasant Cemetery.
One student on the top floor of the “Biological building” told the Star that “all feeling of repulsion” went away after the first incision. “We all became so keenly interested in the knowledge we were acquiring that we had no thought of anything else,” he said. “Tracing the course of the smallest nerves, picking out the different blood vessels, seeing how the layers of muscles fitted into each other, was so absorbing that we soon came to have an impersonal, purely scientific feeling.”
The unclaimed dead in Ontario are no longer sent to medical schools — people are buried by the municipalities where they died, unless they made prior arrangements to donate their body to a school. A spokesperson with the Office of the Chief Coroner of Ontario did not know when the practice was discontinued, but believed it was “decades ago.”
In her book, Duffin writes that body donation became a “new form of socially acceptable charity” in the latter decades of the 20th century. Ten schools of anatomy are currently listed on an Ontario government website dedicated to whole body donation .
In the spring of 2018, Bruce Wainman, the director of McMaster University’s Education Program in Anatomy , stood beside a table covered in white tulips and framed photos. There is a man wearing a kilt, a woman sitting on a beach, an older gentleman beaming in a bowtie.
When Wainman took over the program 14 years ago, he was anxious about the annual service of gratitude, but now he looks forward to this day.
Every spring, he and a few students speak at this service. In 2018, a midwife told the families of the donors that she had seen “the spark of understanding” in the eyes of her classmates when they saw something “for real for the first time” that made the hours of lectures and study make sense.
“I am sure that for many of you the decision was not an easy one,” she said. “I want to assure you that your loved ones are in the very best hands and that they are making a very real difference.”
It costs $500 to donate your body to McMaster, which covers transportation, the coroner’s fee and administration. The school makes no profit. Currently, there are around 60 donors a year, says Maureen Letang, the school’s bequeathal co-ordinator.
“We only want people who wanted to donate, that felt that was the last best thing they could do,” says Wainman, who is also the director of the surgical skills laboratory. Donors tend to be very pragmatic, altruistic people, he says.
Anyone can donate, and acceptance is determined after death; certain illnesses or causes of death can rule people out, and so does organ donation, with the exception of the eyes. Letang says donors can have a teaching term of two to four years, or 10 years. After that, next of kin can pick up their loved one’s cremated remains or have them interred in the McMaster crypt.
In contrast to other schools where students might perform full dissections as part of their training, at McMaster’s anatomy and surgical skills programs, the majority of bodies are dissected by experts in advance, so that students can see multiple examples of tissues, organs, and entire interconnected organ systems like the gastrointestinal tract. (Full body dissection still exists as an elective.)
“We always feel that the donors want to be of greatest use as possible,” Wainman says, noting the labs are “interprofessional,” with students in surgery, medicine, midwifery, science, kinesiology, medical radiation, occupational therapy and physical therapy programs, among others.
Wainman reminds students that the donor was somebody’s grandmother, grandfather, uncle or aunt, and they were cared for, and they played a big part in other people’s lives. He tells them if this is the first dead body they have seen and they “feel nothing,” or “feel like you could do what you like,” then they are “probably in the wrong profession.”
“I really feel the person who is deceased deserves our respect, and they deserve it not only morally and ethically, but also by law,” he says. Nearly all of the students are profoundly moved, but there are occasional people who act tough, like this is a “big joke.”
“We don’t put up with that stuff,” he says. He very rarely has to kick someone out, but he will usually have a long chat with a student.
It is “utterly different” from Victorian medical schools. “The attitude there was to harden the student, somehow to make them less caring and less sensitive to what’s going on,” Wainman says. “What an awful thing to do.”
Every year, at the service of gratitude, he stands in front of people he knows have had a hard year. “Part of me knows that obviously we can’t make it all better,” he says. “But hey, it’s better than it could be and that’s the way we look at it.”
After the service, they all release doves, and people do feel better, he says. The families know their loved ones are making a difference. For the medical students, and for Wainman, it is a small way of discharging the debt.