October 2007

The Nation Reviewed

Written in the body

By Ashley Hay
Illustration by Jeff Fisher.

On a table of its own, in the pulmonary section of the Museum of Human Disease at the University of New South Wales, sits a solid-looking object, jet black but glistening as if it’s been sprinkled with some crushed jewel, some metallic powder. It’s an elliptical shape - or half an ellipse, flat on the side you see first, the side of its dissection - and it’s set in formalin, in a heavy perspex box. The rest of the room is filled with a fleshly collection, with arteries and lungs, skin and ovaries, and things tend to look distinctly animal. Unhealthy and diseased, certainly, but animal nonetheless - except for this jet-black shape, sitting like treasure on its own.

It’s not treasure, of course. It’s a coalminer’s lung, ‘dusted’, as the saying goes, with the very substance that was supposed to ensure the man’s livelihood. And dusted to such an extent that it seems his body - he was 55 when he died, and had spent 35 years working at the coalface - had been completely colonised by the stuff. It looks as if the coal transformed him, or rather this critical piece of him, into itself. The clinical history talks of the lung being “overexpanded, with widespread collections of carbon evident on the outer surface, as well as the cut surface”; the lung shimmers where its darkness catches light. This is the hallmark of pneumoconiosis, that insidious dust disease.

There are a lot of extraordinary things in the Museum of Human Disease, home to more than 2700 objects conservatively valued at over $2 million. There’s a leg, shin-through-to-foot, destroyed by cancer; an example of diphtheria; a nail-like horn, five centimetres long, that grew from someone’s elbow; an ovary with surprising but benign growths - a curl of golden-brown hair and a perfectly formed tooth. What’s most extraordinary, however, is how obviously the damage of disease is written across these bits and pieces of our bodies; if, as a smoker or a drinker, say, you could peel away the outer layer of yourself like the wrapping on a parcel, you would see clearly the black spots, the degradation of your lungs, the pock-like fatty nodules of cirrhosis in your liver. There would be no avoiding the evidence of what you were doing.

It’s something many visitors comment on, says Robert Lansdown, the museum’s manager. “Part of what we try to show people relates to the messages they see on television: two fruit and five vegetables, don’t drink, don’t smoke. And a common remark is that it should be compulsory for everyone to come here.” He points to a cabinet. “Up there is a smoker’s lung; all its air sacs have broken down. On the far left you can see it’s completely degraded, but throughout the whole organ you can see these holes. There isn’t a better anti-smoking message than that.”

The collection evolved alongside the university’s medical course from the early 1960s, and for many years was only accessible to medical students and visiting pathologists - mainly for teaching, Lansdown explains, rather than research. “This museum is about anatomical pathology, looking at the gross morphology” - or external structure - “of things. For a lot of students, this will be the last time they see the effect a disease has; when they’re practising they’ll be treating the symptoms.”

But the collection’s seclusion had two downsides: its original setting was a fairly uninviting place - pathology has something of a reputation for harbouring “strange-shaped jars of murky solution on dusty shelves, poorly lit,” says Lansdown - and it was in constant danger of being deemed redundant, because those not directly involved with it didn’t know what it was for. A decade ago, a decision was made to make the museum more accessible to the public, and in late 2005 it moved to new, purpose-built premises. In the past two National Science Weeks, its open day has been a hit. “We had over a thousand people in 2006,” says Lansdown. “The queue was hundreds of metres long. This year we changed things a little bit so we could offer people more experts to answer their questions, and more presentations. And we had about 450 people across the day.”

The museum’s more impressive year-round numbers - 8000 visitors in 2006 - come from community groups and schools from all over the state. “A lot of older people come through with the groups,” Lansdown says, “and they like to look at diseases they’ve had or their friends have had, or things they suspect they might have. And more than 35% of our school bookings come from rural and regional areas. We had one group who left Broken Hill at seven at night, drove 15 hours and stepped off their bus and straight into the museum.” For a lot of students, these visits become definitive: some join the museum’s volunteers; some decide to go into medicine. “It probably works the other way for some people too,” suggests Lansdown, “if they come here and find it’s not for them. Which is a good thing.”

Beyond the impact of seeing so many organs, so many bones, so many tumours, the astonishing thing is being able to read the case history, the literal provenance, of each and every piece in the museum’s collection. That glistening black lung belonged to a man who died in 1952, whose lungs - despite his 35 years down the pits - had looked completely clear in a check in 1948. (He died, as it happened, of an aortic aneurysm.) It “takes some thinking about”, says Lansdown, “to realise all the specimens have come from real people”.

Not too many new specimens come into the museum these days. A hospital might donate its entire collection to the university because it no longer has the resources to preserve it, but other more bureaucratic changes, like changes in legislation regarding human tissue, have made acquiring new specimens a lot harder. “And a lot of the conditions you see here are things that will probably be treated quite well these days,” says Lansdown, “so that if someone presents with that particular pathology they’ll get a good course of treatment, and your specimen will be no more.”

Like all museums this is a still and silent place, and there’s something of a reliquary about it. It’s not a place you’d pick to attract queues of curious visitors, whether they’re students, parents who’d like their children to have a better understanding of science, or Probus groups. Lansdown meditates on the impact of all the hospital dramas and reality shows that deliver complex surgery and traumatised bodies to our living rooms, inuring us to the sight of organs and infections: “things like RPA mean it’s a lot easier for us to have people through. It allays some of my concerns about how people might respond when I can look at what’s being broadcast to them on television.”

The museum is also an example of innovative engagement with science, an area in which Lansdown believes Australia desperately needs “some new ideas ... if people don’t think science is a real strength of theirs, they sometimes worry about coming to a place like this and not understanding what they’re seeing, what’s happened to a specimen. But things like this” - he places a healthy aorta, smooth and a clean creamy-yellow, next to a diseased aorta, scarred, thickened by plaque and a strange purplish-grey - “show them they don’t have to be concerned about that. They’re going to be able to see exactly what’s going on.” He tilts the two perspex columns to demonstrate the arteries’ differences: the muscular tubes are like nothing you’ll see on ER or House, but they’ll focus your thoughts on cholesterol more sharply than John Stamos or Hugh Laurie ever could.

Does he wish he could screen visitors for hypochondria? Lansdown laughs. “Definitely. And you do have to remind people that a lot of the patients lived with the conditions seen here, lived a long time, lived very happily. Some visitors look at things and start to worry about what might go wrong with them, and then you have to remind them that while there are a lot of things that can go wrong, things, remarkably, go right most of the time.”

Ashley Hay

Ashley Hay won last year’s Bragg UNSW Prize for Science Writing. Her last novel, The Railwayman’s Wife, won the Foundation for Australian Literary Studies’ Colin Roderick Award and the People’s Choice category in the NSW Premier’s Literary Awards. Her new novel, A Hundred Small Lessons, will be published this April. She lives in Brisbane.

Cover: October 2007

October 2007

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Losing the plot: the American midterms

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