Mind over matter

It wasn't the promise of saving lives that kept me attending an EMT class, but my will to witness the mystery of life in a bifurcated head.

By JC Hallman

Read more: Brains, Life

Photo: Catherine Michele Adams

Nov. 1, 2006 | I'm a reader and a writer, so I guess I'm used to the idea that deep down inside of things there is generally a kernel or a nugget of something, a theme or whatever. Meaning. You can talk about it, you can sense it; it's there. But that's not the beginning of all this. The beginning is when that stopped being enough for me and I wound up in Mike's class. People who traffic in ideas are famously underpaid, so money rears its head here, but I don't think it's uncommon, either, for writers to long for the kind of work where one's hands get dirty, where the sense of offering something up to humanity isn't so remote. I was broke; I was bereft. So I thought maybe I'd become a paramedic. Help people, get paid. Two birds, one stone.

Mike had been a paramedic once and now he taught the classes you took to become a paramedic at the hospital complex that dominated employment in Iowa City. Emergency medical technician certification comes in a variety of levels or degrees, and it's all vastly more complicated than it really should be. Emergency medicine traces its history back to morticians riding to accident scenes in hearses. That's why old-style ambulances all look like hearses painted white. They are.

I enrolled in the basic class. It was dispiriting almost from the beginning. The class actually spent its first few days figuring out how to avoid helping people, navigating the tricky legal contours of implied and expressed consent. And even when we talked medicine, it was glory that won out, the cheap thrill of deciding when to run red lights and turn on the siren. Maybe that was the beginning of my disillusionment with EMT training. I didn't feel like I was helping people. You got your hands dirty, but as a whole the thing lacked a kernel or a nugget that you could point to and say, here it is, this is why I do this, here is its life. The only reason I didn't drop out was the bifurcated head.

Among the extracurricular goodies Mike had arranged for us in the EMT-basic course was a field trip to the hospital's cadaver lab. Pictures in books did not do justice to anatomy, he told us, and sometimes he would digress into monologues about the bifurcated head, a dissection specimen illustrative of something. Mike liked talking about the head. He thought it was fantastic. The head for him had stopped being a head at all -- it had veered away from what the rest of us thought of as heads.

I was interested, neurologically and philosophically. If once upon a time, I thought -- say, with the Greeks -- man had staked his faith on the idea that his core self, his identity, his soul, had matter and was made up of something like smoke (Homer), caught in his chest, somewhere just left of center, or fire (Leucippus, Democritus), warming the pleural space between the triple-lobed right lung and the slick forever-bulging pericardium, and if that whole theory had then been razed by Aristotle, then what had happened was that philosophy had been set on course for the harebrained notion that the human brain, hugely intricate and flabbergasting in its engineering, so fantastic and persistent that it still represents a frontier, that surely this thing, or maybe a gland wrapped inside of it, amounted to something that could be labeled sacred or spiritual, or at least crucial. But it didn't. The bifurcated head disproved all that. I began to think of the bifurcated head as the one real meaning of my time in EMT training.

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The hospital employed 14,000 in a town of about 40,000 people. It was the largest teaching hospital in the world. It was its own city, really. It was a hospital with three piano lounges.

The day of our field trip arrived. To get to the cadaver lab we had to descend through an old section of the hospital, what had once been its operating arena, where obsolete gurneys stood forgotten in the hallways and the walls wore toggles for gases that kept people going through the hopeful gamble of anesthesia. Mike guided us down twisting corridors that conformed to the hospital's herky-jerky history of expansion. "Is anyone leaving a trail of bread crumbs?" he said once. Then, after a few steps, "Can you imagine how many people died in this hallway? Thousands."

We examined the corridor with reverence. The local ghosts stayed quiet. We filed down a flight of stairs, then another, and now the hospital began to look suspiciously morguish. In the air hung a faint chill and the phantomy expectation of formaldehyde. We were all nervous and the class started to joke about the cadavers. We plotted to stick some organ or other in our coats and produce it later, in the cafeteria, probably. We imagined what it might be like to actually be one of the cadavers and to be miraculously alive somehow with people fiddling around inside of you. The Bifurcated Head had us on edge, and the human reaction was to slip back toward adolescence, where the only proper response to a thing's being kinda gross was to exalt in it, to exceed its grossness if at all possible.

The doors to the cadaver lab were unmarked. We snapped on latex gloves and cellophane aprons before we pushed through. Inside was roughly what you, too, have probably come to expect: 30 or 40 bodies covered over with white sheets, spaced apart from one another like tables in a pool hall. A brown extension cord hung overhead for each, meant for lights or recording devices or cutting appliances, and a weathered "Gray's Anatomy" stood near each body on a small podium. A few skeletons hung about like Halloween decorations someone had forgotten to take down, and bright red disposal bins marked with biohazard symbols stood everywhere. A row of shelves against a wall held saws and mallets, an array of tools plain enough for a Mennonite and of as broad a variety to take down a barn.

The cadaver lab employed a full-time mortician, Mike said, in introduction. The facility had a state-of-the-art crematorium. The cadavers themselves were embalmed twice -- once when they died, and again here. I knew from a little research that deeded body programs sometimes got themselves into hot water, as in winter 2004, when the director of the willed body program at UCLA was discovered to have profited $700,000 from the sale of "knees, hands, torsos and other parts" to individuals for private research. A middleman had been arrested as well, making the whole incident something like a drug bust. Before UCLA, similar enterprises had turned up in Texas in 2002, and U.C. Irvine in 1999, and a Tulane official had once been caught selling bodies to the Army for explosives research. Just last week a half-dozen funeral directors, caught up in a scam run by a disgraced dentist, pleaded guilty to yanking body parts out of corpses without families' permission. Historically the furor over these incidents is short-lived, and the result has usually been that violating universities get their bodies from another university from then on. There's no discussion of who the customers were, and a thriving shadow industry of parts isn't hard to imagine.

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