Anatomies: A Cultural History of the Human Body (30 page)

At the moment, robots amuse us because they look so unnatural in their mimicking of our actions. In the future, if the technological dreamers get their way, they will look so human that it will be no laughing matter. Uncanny Valley is the place where humans begin to feel genuinely uneasy at something’s ability to appear human when it is not. This ‘valley’ is, in fact, a trough in a line graph that plots human enthusiasm for robots against their increasing human likeness. The line begins high while it is perfectly clear that robots are just machines. But shortly before they become so realistic that we can no longer tell whether they are human or not, there is a dip – a stage when they simply appear very creepy. Other strange creations already populate Uncanny Valley – Ron Mueck’s
Dead Dad
, for example, with its pallid ‘skin’ and body hair, or the ultra-realistic dolls known as ‘reborns’ that women sometimes carry as a substitute for a baby that has grown up or one that never arrived. We are fast approaching the point where we will have to decide whether we are going to pass through Uncanny Valley and increasingly share our lives with such creations or turn back.

The Geminoid series of robots created by Hiroshi Ishiguro at Osaka University is perhaps at the pinnacle of human resemblance in robotics. Ishiguro’s latest version is fashioned after a Danish colleague, Henrik Scharfe, and comes complete with skin, hair, blinking eyes and a stubbly salt-and-pepper beard to mask its metal innards. Scharfe’s own recent published research examines how trust may be built in encounters with his mechanical alter ego. Such innovations may represent a departure from our comic-book expectations of what a robot should look like, but it is important to remember that robots were not originally envisaged as shiny metal helpers with square limbs, red eyes and wheels for feet. Nor did Frankenstein’s monster ever have a bolt through his neck. The first illustrated
Frankenstein
, an edition published in 1831, thirteen years after the original, shows the creature stunned and stupid-looking, but with perfect human musculature. The suggestion is of biological life, not some crude mechanical reassembly.

In general, technology has a habit of realizing our dreams in ways other than we imagined it would. We wish to fly? We don’t grow angels’ wings. We log on to Google Earth instead. Even an artificial heart looks more like a piston engine than a real heart. I was startled during one of my anatomical drawing classes when I caught sight of a piece of plastic pipe lodged in the tangle of blood vessels within the heart cavity of one of the bodies. The straight line and even colour of this surgical insert contrasted so starkly with the variegated colours and textures of the surrounding tissue.

Angels and robots help us to think about where the boundaries between human and nonhuman (or extra-human) truly lie. So, which is it to be? Unashamed technological add-ons, such as Jody’s limb? Technology made to look biological, such as robots with stubble? Or biology all the way? Our choices will depend on what we feel comfortable with, or perhaps on what we feel least uncomfortable with. It is notable that potential organ recipients currently prefer the idea of mechanical devices, while their surgeons prefer xenotransplantation – the transplanting of organs or tissue from nonhuman species. They like it because it allows them to continue working in the familiar medium of biological tissue. If the rest of us are disinclined to go along with them, it may be that the medical profession has only itself to blame, as we shall see in a moment.

The hybrid species that began to appear in decorated manuscripts, in bestiaries and as gargoyles during the medieval period – which included human features, especially arms and hands, as well as human eyes and faces, along with desirable animal attributes such as wings and tails – were not simply fanciful renditions of exotic species based on Chinese whispers, nor the excited celebration of biodiversity that we might easily take them for today. Instead, these hybrids between man and the animals sought to comprehend changes in man. Fantastical physical transformation was the pre-modern world’s way of exploring and coming to terms with actual psychological transformation. It is key to our understanding of these images to know that while a character’s external appearances may change, his or her identity is preserved. It is the same person, only in a different guise. The new guise reveals the new psychological state. It is the same as in Ovid’s
Metamorphoses
.
When Jupiter rapes Io, and Juno then punishes Io for adultery by changing her into a white heifer, she is still beautiful in her way, but is now revealed in her bestial character. She is still Io, and can recognize her father, but is sadly unable to tell him it is she, except by means of her cloven footprint, which leaves the letters IO in the earth. In Homer’s
Odyssey
, Odysseus’s men waste a year on their voyage back to Ithaca feasting at the house of Circe, who transforms them into pigs. In appearance and behaviour they are pigs, but their senses and memories are the ones they had as men.

Strict rules apply in tales of metamorphosis. Without them, it would not be clear quite what degree of change we should regard as remarkable and worth a story. These rules also provide a framework for moral philosophy. If a werewolf is, as we have seen, a man (with human eyes) in a wolf’s body, then he has the rights and duties of a man. Is killing a werewolf then to be considered homicide? Is a human-eating werewolf a cannibal? Reimagining a dramatic human encounter in ways like this may help to resolve a dilemma about how to deal justly (for the period) with the psychologically disturbed person who has committed a terrible crime, for example.

If psychological disturbance is one predicament where body and mind may no longer be in alignment, then xenotransplantation is another. In 1984, four-year-old Baby Fae received the heart of a baboon in an operation at the Loma Linda University Medical Center in California. The procedure was quickly decried as ‘improper’ and ‘unnatural’, although it was to pave the way for successful human organ transplants in children. The Ovidian rule here was that a baboon is sufficiently similar to a human child that the transplant operation was biologically worthwhile, and yet not so similar that sacrificing it for the purpose counted as murder.

It does not help to put us at ease, however, that the chosen animal for many surgical procedures is increasingly the pig, a creature that, as Homer reminds us, comes with an all too familiar cultural back-story. The animal reminds us of ourselves at our worst, with its gluttony and its promiscuity, and its naked, fleshy appearance. Scientists favour pigs over other species because they are close in size as well as in some important immunological respects to humans, because they breed rapidly, and because, being reared chiefly for food, they are less strictly regulated than other candidates such as apes and monkeys and raise fewer ethical qualms. In short, the pig taboo is weaker than the ape taboo. This preference seems ‘altogether peculiar from a lay point of view’, according to the medical anthropologist Lesley Sharp, because we also associate pigs with filth and defilement. If pork is still subject to dietary prohibitions in many religions, how can we think of inserting pig tissue permanently into the body? The pig’s very suitability in biological terms – its relative closeness in some respects to humanness – is also its problem in cultural terms.

In order to persuade the relatives of a human donor to consent to a transplant, the promotional message is often that ‘the lost loved one can “live on” in others’. It should come as no surprise, then, that people start to wonder just how much of an animal ‘donor’ might also ‘live on’ inside them. Research surveys yield some lively responses. One subject observed that it would be ‘a little strange’ to have the heart of a baboon. ‘Would I start baring my teeth and bottom?’ It is no surprise, either, to find that patients happy to discuss their heart-valve surgery often omit to mention the pig that is the source of the replacement valve.

If our fabled enthusiasm for crossover with other species seems to have deserted us just as it becomes a medical possibility, it may be because science has done itself few favours. We have seen ample evidence of medical pioneers’ readiness to use all manner of human and animal subjects in transplant experiments through the ages. But perhaps the most notorious modern innovator in the field was the pioneer of the ‘monkey gland’ treatment, Serge Voronoff, a figure whose bizarre exploits inspired some excellent satirical fiction, a song by Irving Berlin and a lethal-sounding cocktail of absinthe and gin.

Voronoff was born in 1866 in Russia, and pursued his investigations during a long career as a surgeon in France. But his inspiration came from Egypt. During an extended sojourn there in his thirties, he ‘made a great number of personal observations on castrated men’. These eunuchs looked prematurely aged in his judgement and seemed on the whole to die quite young. It was, he thought, ‘something more than a mere coincidence’ that men not so impaired continue to be sexually active in old age.

Voronoff reasoned that if he could graft tissue from young men’s sexual organs into old men, then it might prolong their life. There was ‘no question’ of his obtaining human testicles – that would be ‘a mutilation’, he noted with perhaps just a tinge of regret – but since livestock are often castrated, there was always ‘material’. He made his first experiments on goats and bulls, cutting their testicles into half-centimetre slices, and then introducing these into recipient animals’ scrotums. Slices were used in order to increase the surface of contact between donor and recipient tissue, thereby promoting vascularization, the formation of blood vessels necessary for the graft to take. The animals generally survived. Voronoff’s 1926 memoir proudly shows photographs of a bull named Jacky and the offspring he was responsible for producing after the transplant.

Before any actual prolongation of this animal’s life could be observed, however, Voronoff had moved on to human subjects. In his memoir, he rues the fact that volunteers are not allowed by law to donate single testicles – the remaining testicle would in fact come to do most of the job of both, just as a kidney donor’s remaining kidney does, and even as one half of the brain can do if the other is damaged. Instead, while the occasional unlucky accident may yield a windfall, he is dismayed to find he must have ‘recourse to apes’. In December 1913, Voronoff had successfully grafted a thyroid gland taken from a chimpanzee into a child with a hypothyroid condition. Six months later, he was triumphantly able to bring the child before the French Academy of Medicine. ‘Thanks to his graft all the symptoms . . . had disappeared and the child, which was previously so backward as to be almost reduced to the animal level, had recovered his intelligence and his normal growth,’ Voronoff wrote later. ‘The proof of this statement lies in the fact that four years later, when eighteen years of age, young Jean, whom I had known in 1913 as a poor little imbecile, having but a rudimentary brain and the body of a child of eight, was found suitable for military service and accomplished his duty in the trenches most gallantly.’ Emboldened by this success, Voronoff over the next decade carried out hundreds of grafts into human subjects of sex glands from apes, as well as at least one using human testicles. He also tried ovarian grafts in women, inserting the monkey ovaries by preference into the outer labia of the vagina, in an effort to restore hormonal function, if not the full capacity for ovulation.

By his own account, the method was a triumph. In 1923, for instance, an eighty-three-year-old English gentleman benefited from Voronoff’s surgery, ‘in spite of the fact that he had the recklessness to leave my nursing-home at Auteuil half-an-hour after the operation, in order to get back home by motor-car.’ By the time that Voronoff was recounting these achievements, the man was eighty-five and, to judge by the before-and-after photographs, in better condition than ever. Another English patient appears looking slumped and fed up in a picture taken when he was seventy-four; at seventy-seven, he is seen running in spats towards the camera.

Voronoff’s moment passed, however, and his death some thirty years after these experiments went almost without notice. He lives on in fictional creations such as the ambitious Dr Obispo in Aldous Huxley’s novel
After Many a Summer
, who hopes to exploit the longevity of the carp to prolong the life of his Hearst-like Californian employer, and the Moscow professor Preobrazhensky in Mikhail Bulgakov’s
Heart of a Dog
, who implants human testicles and a pituitary gland into a stray dog. The dog swiftly acquires the worst characteristics of both dog and man, thus satirizing the behaviour expected by the Communist Party of the ‘New Soviet’ citizen.

Serge Voronoff’s desperate mission reminds us that perhaps the greatest human extension of all would be an extended lifespan. Who would not opt for a few more years – or decades – of healthy life?

There are two powerful forces behind this thought, one of attraction, the other of repulsion. The first is the alluring prospect of continuing the increase in longevity enjoyed by humankind since the advent of modern science. The age at which we can expect to die has tripled during the course of human history. By 1750, a Swede (the Swedes have kept the best historical records of mortality) could expect to live to the age of thirty-eight. Since 1950, Americans have added an average of nine years to their lives. In Britain, life expectancy increased by almost two whole years during just eight years of the last decade. In most of the developed world, life expectancy now hovers around eighty years. This rate of increase is relatively constant, and there is debate about when – or whether – it will top out.

The second factor is of course the spectre of death. As the American surgeon and writer Sherwin Nuland observes, nobody these days is allowed to die simply of old age. National government health departments and the World Health Organization keep statistics that require a cause of death to be given in all cases. ‘Everybody is required to die of a named entity.’ It is obvious that this data is useful to healthcare planners and actuaries, who need to know the risks of mortality from medical conditions and accidents. But
all
deaths? What really underlies this drive to ascribe cause? What does knowing a cause of death
compensate
for? What does it say about the way we deal with death? Surely its effect is to make us think of death as an accident, as something that might be forestalled – perhaps even avoided altogether – if only we are careful enough. To die at the age of eighty-five, let us say, might seem to demand little explanation. And yet to die at the age of eighty-five as the result of complications after a fall – which happens to be exactly how Serge Voronoff met his end – invites a host of questions. How did he fall? Might that fall have been prevented? What were the complications? Were these avoidable? What if he hadn’t fallen? How much longer would he have lived?