Book Reviews - Summer 2009

Gross Anatomy

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A physician's inside stories about the human body

By Richard McCann

June 1, 2009


Carrying the Heart: Exploring the Worlds Within Us, by F. González-Crussi, Kaplan Publishing, 291 pp., $26.95

Not long after being discharged from the hospital following my liver transplant, the surgical staples that had been used to close the wound—a “bilateral chevron incision,” as the surgeon put it, measuring almost 20 inches—began to rupture, one staple after another, due to severe abdominal ascites. It was a gruesome sight. It looked to me as if a gaping, bloody mouth had somehow opened on my belly. What did it have to tell me?

The doctor told me there was nothing to do but let the wound close on its own, through granulation. Toward that end, he told me I’d have to clean and pack the wound myself, despite its depth and size, irrigating it twice daily with saline and then stuffing it with sterile gauze. I hated doing this, though in truth my sense of horror was suffused with a kind of anxious fascination: I was reaching down into what I’d once seen described in a medieval medical illustration as “the region of occult things.”

That’s the region that retired pathologist and medical essayist F. González-Crussi examines in Carrying the Heart: Exploring the Worlds Within Us. In five rich but somewhat discursive chapters—“Digestive,” “Scatology,” “Respiratory,” “Reproductive,” and “Cardiovascular”—he chronicles how, from antiquity to modern times, the insides of the human body have been perceived, understood, and described by physicians and anatomists, as well as by philosophers, writers, and artists. Needless to say, there’s quite a lot of ground to cover here, even given the bans on human dissection that slowed the accumulation of medical knowledge about anatomy for more than a thousand years, at least in the Western world, from Galen’s anatomical demonstrations in the 2nd century c.e. to the publication of Vesalius’s De Humani Corporis Fabrica in 1543.

As a result, González-Crussi necessarily conducts each chapter as a quick tour. In “Digestive,” for instance, he covers the fanciful speculations and “egregious blunders” of the ancients (many of whom regarded the esophageal sphincter as “the king of viscera” and the stomach as “the seat of the soul”) through the later empirical researches conducted by 18th-century naturalists such as Abbot Lazzaro Spallanzani, whose experiments—performed first upon a falcon, and then upon himself—showed that digestion resulted neither from trituration nor putrefaction, as had been commonly believed, but rather from the secretion of gastric juices so powerful that they could “digest the toughest materials, such as tendon, the tanned leather used to make shoes, and even bone.”

Along the tour route, there are also numerous welcomed, shorter stops, in which we learn, say, that “the golden age of the clyster undoubtedly spanned the European 17th and 18th centuries” and that the 2nd-century philosopher Nikomachos believed that semen was “ejaculated in seven spurts during coitus,” as a result of which it was “perfectly ‘logical’ that there should be seven divisions in the uterine cavity and that the maximal number of births allowed by nature at one time should also be seven.” (Octomom, are you listening?) Most of the chapters then close with a biographical narrative: for example, “The Story of a Famous Poitrinaire” recounts the refusal of Frédéric Chopin’s lover, Aurore Dudevant, AKA George Sand, to believe he was consumptive. A notable exception is the chapter “Reproductive,” which ends with three stories, the first two concerning the penises of Napoleon and Rasputin, and the third concerning the holy prepuce of Jesus, of which “about a dozen medieval European sanctuaries” have at some time “claimed to have a fragment.”

All in all, González-Crussi proves himself a good guide, even if “the region of occult things” that I had hoped to visit sometimes seemed to be sharing space with a Ripley’s Believe It or Not! museum. Although Carrying the Heart advances no new argument and relays no new scientific information, González-Crussi does provide the pleasure of his own commodious intelligence, which includes a wide-ranging knowledge of literature and art as well as medical history. He has a charming, almost old-fashioned penchant for quoting from an exceptional array of literary sources, including Chuang Tzu, Rabe­lais, Shakespeare, Hawthorne, Lu Hsün, Pirandello, Thomas Mann, Simone de Beauvoir, and Fernando del Paso. Although his prose sometimes lapses into a florid grandiloquence, it is for the most part at once cultured and ardent. At times, he wonderfully illuminates illness by regarding it in its cultural context, as when he observes that the term premenstrual syndrome first appeared in 1953 “in coincidence with the pressures that compelled women to quit their jobs and stay at home.”

If González-Crussi were in fact a tour guide, that is, I’d stand beneath his red umbrella, at least for a while. Above all, he consistently proves himself a remarkable raconteur, with a seemingly endless supply of engrossing anecdotes. Who knew that the Aztecs believed that gold was the excrement of the sun god Tonatiuh, “who deposited in the earth his own waste as he passed through the underworld”? Who knew that from the 17th century to the early 19th century, “intra­rectal smoke insufflation”—blowing smoke into the anus—“was recommended not only for drowning victims but also as a measure against intestinal colic, incarcerated hernia, volvulus, and severe constipation”? Of course I often wanted more from González-Crussi—greater depth and rigor, for starters. But some­times, his anecdotes seemed almost enough, and I’d find myself reaching for the phone so I could ring some friend to ask:

Hey, did you know that Rasputin’s penis is reputedly on display in Moscow? Did you know that after having his mother murdered, Nero insisted that she be cut open so he could see the place where he’d come from?


Richard McCann is the author of Mother of Sorrows, a collection of linked stories. He teaches at American University and is working on a memoir based on his experience as a liver transplant recipient.


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