Dissecting 'Gray's Anatomy'

By Louis Bayard,
a novelist and reviewer
Tuesday, January 15, 2008


A True Story of Gray's Anatomy

By Bill Hayes

Ballantine. 250 pp. $24.95

"If anything is sacred," the poet and nurse Walt Whitman assured us, "the human body is sacred." And for 150 years, it has had a sacred text: a 6-by-9 1/2 -inch volume that, from its first printing, violated all principles of bookselling. Grabby title? Try "Anatomy, Descriptive and Surgical." Human interest? Only if you want to know what your spleen looks like. Or your nasal duct or your femur. And if it's hot-toddy prose you're after, then lap up this entirely characteristic sentence: "The fasciae are fibroareolar or aponeurotic laminae of variable thickness and strength found in all regions of the body." Not exactly a recipe for book clubs.

And yet this same text, better known today as "Gray's Anatomy," has never once gone out of print and, according to journalist Bill Hayes, "it has to date seen thirty-five editions in the United States alone. It has been translated into more than a dozen languages, been pored over by generation after generation of medical students, and sold millions of copies." And, we need hardly add, its title has been co-opted by a ridiculously popular nighttime soap featuring surgical interns who sleep with their bosses.

Whole generations of TV viewers might reasonably open this slender, thoughtful volume expecting the latest on McDreamy and McSteamy. They will instead find two real-life doctors who would have been forcibly removed from any medical-show casting call. One was too short, one was too gloomy, but they welded their differing temperaments into one of the world's great textbooks, a model of clarity and erudition and, yes, art.

Begin with Gray himself. Henry Gray, a young lecturer at London's St. George's Hospital, was commissioned in 1855 to write a manual of anatomy for students. Earlier manuals had been incorrect or incomplete, and because cultural taboos had long made dissection a crime, anatomy was still a young science. The time had come for a definitive text, and Gray, who knew a thing or two about bodies, was the man for the job.

Sadly, he couldn't savor his success: Smallpox claimed him at the age of 34. His papers were likely destroyed with him, but all contemporary accounts paint him as honest, industrious and mild -- everything fatal for a biographer. As a result, Hayes is forced to resurrect the forgotten partner in "Gray's Anatomy": Henry Vandyke Carter, the itchy-in-his-own-skin physician-artist who produced the book's 363 engravings. Carter's "great innovation," writes Hayes, "was to place the anatomical names right on the parts themselves, like street names on a road map."

The resulting illustrations are austerely beautiful, but Carter doesn't make much of a protagonist, either, even though his diary is squeezed for every possible drop of emotional color. The one scandal in his life took place in faraway India several years after the book's publication, and he finished his days in prestigious retirement in Scarborough, England, surrounded by a wife and two young children.

In short, none of Hayes's skill can make the creation of "Gray's Anatomy" more dramatic than it really was, and a reader may suspect that "The Anatomist" is really a magazine article promoted above its station. Ironically, though, the digressions that pad the book out to full length are also its saving graces. To enter into the proper spirit, Hayes spent a year taking gross anatomy classes at the University of California-San Francisco, and his descriptions of the experience evoke the legacy of Gray and Carter more forcefully than any dusty diary could.

It's not just the random facts that enchant. (Did you know bones are "pale rose," not "bone white"?) It's also Hayes's talent for making the familiar strange. "A tongue in profile," he writes, "does not remotely resemble the one you see in your bathroom mirror; it is far thicker and longer than you would ever expect. Beyond the pebbly portion at the back of the mouth, there is a full third you never see, which curves down into the pharynx, the top of the throat."

Like any good teacher, Hayes has a knack for metaphor. The still, close air in an anatomy lab is "like the gym of the dead." A lung is "a wet mound of gray taffeta," a kidney is "a pomegranate, whose leathery rind belies its jewel box interior," the hand is " a minefield of nerves" and a human head with the skullcap removed is "a nightmare cookie jar." Hayes is particularly struck by "the sound of skin being pulled off, a tearing sound, like old Con-Tact paper being torn from a shelf. With the removal of the skin, what remains on the torso is a lumpy coating of bright yellow fat. It does not just scoop off; it has to be either cut or plucked away with tweezers." Um, ew.

All laud and honor to Hayes, though. In perusing the body's 650 muscles and 206 bones, he has made the case that we are, as the psalmist wrote, "fearfully and wonderfully made" and that dissection has an aesthetic all its own. The act of carving open a body becomes, in this context, a perverse act of love, a desecration that consecrates "the extraordinary, the inner architecture of the human form."

© 2008 The Washington Post Company