https://doi.org/10.36866/pn.59.21

Austin Elliott (AE) A couple of years ago you appeared in Gunther Von Hagens’ televised public autopsy. How did you first meet him and get involved with that?

John Lee (JL) I went along to see his Bodyworlds exhibition, which I thought was excellent. I was particularly interested by the reactions of the other people visiting – children and adults of all ages – who were enthralled at the opportunity to find out something more about their own bodies. I arranged to meet Von Hagens and discuss the exhibition with him, and during this conversation, he mentioned that he was thinking of carrying out a public autopsy and asked my opinion on it. I said that it could be a valuable thing to do, but was unlikely to be permitted. When Von Hagens went ahead with the public autopsy, he contacted me and invited me to participate. Initially I declined, for a whole variety of reasons, mainly political rather than educational. But in the end I decided that the benefits would probably be worthwhile, so decided to take part.

AE When did the idea for Anatomy for Beginners come up?

JL Following the autopsy both Channel 4 and Von Hagens were keen to do something further involving showing the public anatomy, and various discussions were held over the next year or so. Although some of these involved me, at that stage I thought that someone else would probably be better placed to help with the series. However, political pressures and personal choices meant that none of the people I suggested were in fact able to take part. A different production company subsequently got involved and the idea came back to me a relatively short time before the series was due to be filmed. Following detailed discussions on the aims of the series and how it would be carried out, I agreed to participate. I was then closely involved in the planning stages, as well as in the actual filming.

AE Where did the bodies for the series come from?

JL Von Hagens runs an extensive body donation programme, in which people who have seen his exhibition or who wish to donate their bodies for educational purposes, contact him and leave their bodies to the Institute for Plastination in Heidelberg. These formalities are carried out in accordance with German law and involve full consent for educational dissections and post-mortem display of their bodies or body parts. Body donation seems to be quite popular, since Von Hagens has accumulated several hundred bodies over the last few years and has many more people queuing up to donate theirs.

AE Could you have made the series in the UK?

JL I think that this is very doubtful. Even if it were theoretically possible under existing regulations (which is probably not the case), any UK anatomist who attempted such a series would have extreme bureaucratic and political pressure placed on them not to go ahead. It seems to me that the current attitude of the authorities can be summed up as being closer to ‘anything for a quiet life’, rather than ‘is this suggestion worthwhile and would it produce some benefit’.

AE Were the bodies that were used fresh or preserved in formalin?

JL Two of the bodies were fresh. Not fresh in the sense that they had only just died – the deceased individuals had been stored frozen and were then thawed for the dissections. These unfixed bodies were used for the programmes on movement and on circulation and respiration, because carrying out some of the demonstrations that we performed required pliable tissues. The remaining two bodies, those used for the programmes on digestion and reproduction, had been perfused with formalin and were therefore fixed. Fixation makes the body tissues much firmer and was necessary both for preserving the gut and also for allowing dissection of the small and delicate tubules of the male reproductive system in particular.

AE The audience in the series were applauding politely, but some wincing was apparent at times. Did you have to make any cuts because anyone ran for the exits?

JL No, no-one ran for the exits. In fact I felt that the televised audience reaction shots were not really representative of the audience response. Television people like to introduce a bit of drama into the proceedings in the editing, but in fact the audience sat quietly and intently during the 3-4 hours it took to film each programme. Their interest was reflected in the sensible and thoughtful questions they asked in the (mainly non-televised) question and answer sessions that we ran immediately following the dissections. Many of those in the audience had in fact enrolled in Von Hagens’ body donation programme.

AE Was it all live or did you have to do more than one take? Did the cameramen have to have especially strong stomachs?

JL The series was filmed live. We had worked out a running order for each programme – in other words the general order in which we planned to carry out the dissection, use the props and explain what was going on – but apart from Von Hagens’ initial introduction, there was no script and no autocue. We occasionally had to repeat a point or show something slightly differently in order for the director to get the right shot, and we sometimes paused the action for technical reasons while the dissection was progressed or while the cameras moved. But basically the feeling of it was that of giving a demonstration lecture to an audience, though with cameras and paraphernalia doing things in the background. I must say that I thought the cameramen, and indeed the entire crew, were exceptionally professional, since this was the first time that most of them had ever seen anatomy. In fact, this gave the production something of a buzz, since most of the crew were as fascinated by the proceedings as the studio audience.

AE In the shows you seemed to be talking mostly about physiology, rather than pathology. Was this intentional?

JL In a general sense, it always seemed to me at medical school that anatomy, physiology and pathology were the three cornerstones of medicine: what it is, how it works and how it goes wrong. In planning the programmes we felt that simply showing anatomy would make little sense to the audience unless we tried to explain something of what it is for. This then inevitably leads into some thoughts about how things go wrong. In trying to figure out what to talk about, I tried to pick things that were simple to explain, but also sufficiently common that many people would have had direct or indirect experience of them.

AE You trained in medicine, then did a PhD in muscle physiology and subsequently specialised in pathology. Do you think pathologists are ‘medical physiologists in disguise’? People usually say that anaesthetists are the physiologists within medicine.

JL The specialty of anaesthesia certainly does show what can be achieved by clear-headed applied physiology. As a pathologist, I think of myself as a specialist in disease and disease mechanisms. I certainly think that a good understanding of basic physiology is necessary to be an effective pathologist. It’s not so much that pathologists are medical physiologists in disguise, but rather that their job is to study perturbed physiological systems rather than controlled normal functioning.

AE Do you think anatomy/physiology/pathology is best ‘brought home’ to the public by a live show? Or by something like Von Hagens’ Bodyworlds exhibition?

JL I think both are valid methods of education. An exhibition allows people to go round at their own pace and to go into things to their own level of detail. On the other hand, a television series reaches a very wide audience (between 1.5 and 2 million for each of the four programmes) and has an immediacy which is difficult to achieve in any other way. The studio audience validates the experience for the television audience. And, as we all know from attending demonstrations of whatever subject, there is something about seeing the real thing that especially draws and holds the attention.

AE A couple of things that stood out for me were pulling the tendons to clench the fist and the inflation of the lungs – physiological bits of anatomy, I guess.

JL Yes, it has been interesting talking to people who saw the programmes. Many people found those parts fascinating, but in fact there has been a wide range of items highlighted by different individuals on the basis of personal experience or interest. Personally, I was interested to see the skin being removed as a whole organ and also to see the oesophagus dissected from behind, among other things. We tried to include items that would interest people with no experience of anatomy, but also some which would not have been seen by even experienced anatomists.

AE You mentioned above that the show could probably not have been done in the UK for legal reasons. There was a lot of objection to the public autopsy and to Von Hagens’ Bodyworlds exhibition at the time. Indeed, even the British Medical Association was rather ‘anti’, judging from some of the commentary on Channels 4’s Bodyworlds website. Do you think attitudes are changing? Do you think that regulations governing dissection and anatomy in the UK are too restrictive?

JL I think the response to this series was fascinatingly different from the response to the public autopsy. There was hysterical outcry over the autopsy which was followed by a rather sheepish silence when the sky did not fall and many people found the programme interesting. Remarkably, although Anatomy for Beginners showed vastly more dissection than the autopsy, it seemed to hardly rate as news. I think that this represents progress of a sort. On the whole, it seems to me that the general public are far more grown-up about the whole subject of anatomy than many of our politicians are. Current UK regulations are extremely bureaucratic and these will be added to by the work of the Human Tissue Authority which is being set up as a result of the recent Human Tissue Act. Although some of the ideas behind this and other legislation related to bio-medicine is perfectly sensible, there does unfortunately seem to be a tendency in the UK to legislate first and not bother to try and think about how it will actually work or affect things until afterwards. I personally do not believe this is good for medicine, science or society as a whole. Incidentally, we also wrote a new website to accompany the series which can be found at:
www.channel4.com/science/microsites/A/ anatomy/

AE Is this sort of ambiguity of the British towards anatomy new? After all, the Hunter brothers used to do public demonstrations in the 18th century, but after the revelation that Robert Knox’s anatomy teaching lectures in Edinburgh in the 1820s had used the bodies of Burke and Hare’s murder victims, there was public outcry.

JL That’s right, it wasn’t a good start. The bureaucracy started then, and ever since the British authorities seem to have had difficulty in reaching well thought out and proportionate responses to issues involving bodies. That this carries on to this day is shown by the institutionalised hysteria in response to, say, the Shipman case, among many other examples.

AE We now have medical schools in the UK with little classical anatomy or dissecting room teaching, and even one medical school with no dissecting room at all. What do you think about this? Did you ever discuss it with Von Hagens, who used to be a medical school anatomy teacher in Heidelberg?

JL Yes, there has been a strong tendency over the last decade or two to remove real practicals and replace them with second class substitutes. There are many reasons for this, though not many of them have much to do with whether this is good for education. Personally, I think that it is extremely worrying that medical students in many medical schools now do little or no anatomy dissection, do not attend autopsy demonstrations and perform few real physiology or biochemistry practicals. It is often stated that students can get this knowledge just as well from books or from computer simulations. I simply don’t agree. It seems to me that this attitude is very similar to that which led to the intellectual bankruptcy of medieval scholasticism. In my view, it is very important for students to see and do things for themselves if they are really going to appreciate what practical scientific subjects are about. I think that I would feel cheated as a student if I was aware how little real practical experience I was getting in many science disciplines at modern universities. Von Hagens is obviously passionate about teaching anatomy and I think holds similar views.

AE One science writer I know said she found Von Hagens a bit self­consciously ghoulish, dissecting in his fedora hat and so on … What do you think about this?

JL Yes, many people find it difficult to get beyond the hat and the German accent. People vary in how individualistic they like to be in presenting themselves to a wider audience. Personally, I think that interesting subjects speak for themselves and would rather people concentrate on the subject rather than other paraphernalia, which are really just a distractor.

AE Still on the same topic – to people with knowledge of 20th century art, Von Hagens’ personal chosen visual style – hat, sleeveless jacket – is very reminiscent of the German artist Joseph Beuys (recently the subject of a major retrospective at the Tate Modern, 4 Feb-2 May 2005). Do you know if this is deliberate? And why?

JL No idea. I suppose it’s possible that this simply represents a local style, in the same way that almost everyone in the UK seems to be wearing black at the moment.

AE Finally, what did you hope that Anatomy for Beginners would achieve? Do you think that it realised its aims?

JL I think my hopes for the programmes were simply that they would reach a large audience, interest them in anatomy and help them to think more realistically about their bodies. In particular, that it would allow them to see for themselves important truths about the way we are constructed and to do this in a way which would have a much greater impact than simply seeing a picture in a book. Judging from the audience figures and the overwhelmingly positive response, I feel the programmes did achieve this. If people were left with some arresting images and new ideas that have stayed in their minds as a result of the series, then that is essentially what education is all about.