From 2010-2011 I was a ‘Bright Ideas’ Visiting Fellow at the European Genomics Forum (EGF), University of Edinburgh. My aim was to explore and write factual or fictional accounts of some of the people whose tissues and organs came to be publicly exhibited in the Surgeons’ Hall Museum, Edinburgh.
As a contrast to these stories of past ‘donors’ I felt it was important to find out more about the way in which we now treat donation and collection of organs and tissues, for both teaching, research and transplant purposes. The stories of the people who responded are recorded in the EGF archive.
The great anatomy and pathology collections were initially intended as aids to teaching, but their purpose has changed with time (see the perceptive article, ‘Making sense in the pathology museum‘ by Dr Steve Sturdy, formerly EGF’s Assistant Director). The collections at the Surgeons’ Hall Museum (SHM) in Edinburgh date from the late 17th century and it is impossible not to wonder about the people – the ‘patients’ as Andrew Connell, the then Collections Manager, touchingly refers to them – whose organs and skeletons are in storage or on display.
These exhibits were ‘donated’ by human beings, each of whom had a life, perhaps in a town, on a farm, perhaps with a family and friends; or perhaps he or she was ridiculed and despised.
I had previously been shocked out of being a detached observer when I visited exhibitions and museums researching background material for my novel, The Embalmer’s Book of Recipes: at the Museum Vrolik in Amsterdam, the clatter of coffee cups being laid out for a conference, the loud talking and laughter of men repairing the heating ducts, the bright lights and chrome and glass of the display areas, suddenly clashed agonisingly with the contents of the jars – late-stage foetuses and neonates, each with some developmental or genetic abnormality. These specimens were once, briefly, sentient beings, brought into the world by their mothers, women of all ages and backgrounds, privileged or poor, who may or may not have had the sympathy and support of family or friends.
And so began my need to explore and write the stories of some of those people whose tissues and organs came to be publicly exhibited – in this case, in the Surgeons’ Hall Museum, Edinburgh.
Some of these ‘specimens’ were certainly obtained without the patient’s consent, and Andrew Connell’s musings (see “The Curator’s Reflections” ) helped me to understand why the patients might have been brought to such straits, in hope or fear or ignorance.
I was further helped in my hunt for information by Laura Brouard at the Lothian Health Services Archive in the University Library; by staff at the National Library of Scotland; and by Anne Carroll, archivist at Perth Library.
It was a special privilege to meet and spend hours talking with artist Joyce Gunn Cairns, who has drawn several of the exhibits at the Museum with great delicacy and empathy and allowed me to include her drawings and words. Poets Christine De Luca and Diana Hendry had also written about some of the exhibits – ‘Janet’ and ‘Andrew’ in particular – and to listen to them talk about their subjects was a great pleasure and gave new insights (and to hear Christine read in the Shetland dialect was an extra treat); they too have been happy for me to include their poems.
Part-way through my Fellowship, I organised a meeting that included a lawyer, a bioethicist, the curators, the poets, scientists, sociologists and writers and we had a very helpful and thoughtful discussion about my research and writing, and its ethical implications.
Finally, in February 2013, the EGF organised a well-attended ‘Tell them our stories‘ event for the public in the University’s Anatomy Theatre. The SHM’s Curator Andrew Connell and I both presented illustrated talks; poet Diana Hendry read her moving poem about ‘Andrew’, and actor Michael Flett gave an excellent and very funny reading of ‘Caesar’s story‘ (an extract from my ‘The stories of Janet and Caesar‘)
Steve Sturdy, 2006, Making sense in the Pathology Museum, in Anatomy Acts: how we come to know ourselves. Eds Dawn Kemp & Andrew Patrizio; Birlinn.
ANDREW CONNELL,Collections Manager at the Surgeons’ Hall Museum in 2011, talks about the Collection’s modern function.
“It’s like inviting people in and showing them round your house and what’s on your shelves – there are different hands exploring the collection in different ways. It brings out endless possibilities, like a kaleidoscope.”
“The first collection, which was very basic, not very good, was held in places like Infirmary Street and High School Yards. Robert Knox [1791 -1862] was made responsible for increasing the collection and for its move to new premises. He bought up Charles Bell’s collection and brought it up from London. Much of it was stored in Infirmary Street and in various corridors and cellars. Knox was also in charge of presentation and the collection was opened to the public from that time. So why would you come to see it?
There’s a nice piece in the Tansey & Mekie ‘History of the Museum‘:
‘Visitors of the lower classes, mechanics, sailors and soldiers have uniformly been quiet, careful and most orderly…visitors of the lower classes seem to take more interest in the specimens than those of the higher, many of whom, especially ladies, merely walk through the rooms without looking at the objects particularly.’
Probably they were embarrassed to show too much interest!”
“The original context of the collection – the organs and tissues – was objective.
It was for teaching, for learning anatomy, all of which was observation-based.
For more than 150 years this was its raison d’être.
The teaching role was more a fade-out process from the 1970s/80s – that was
the start of its serious demise. With the advent of desk-top viewers for slides
you had the ability to represent material in different ways. There were other
diagnostic tools such as X-rays. And in terms of fairness in exams – you can
use the same slide for everyone rather than trying to get several identical
specimens. A photo of, for example, a pulmonary embolism is more realistic,
in its fresh natural coloured state, than a greying specimen in a jar.”
” ‘Benign neglect’. That’s what I like to call it. We’re very happy to be a figure-
head for benign neglect. At first the collection was loved and cared for and
funded for teaching purposes. But the College is very reactionary, very slow to
follow trends, and the collection became semi-obsolete for such a long time.
But now, instead of using it to look purely at anatomy and pathology, we can
use it to look at the history of medicine, to tell a consistent tale about medicine, the medical personalities and pioneers, and also the context of the social history.”
“If we think about the patients who formed the collection – what was their life
What misfortune led them here, with what stoicism?
We have to think about the things people put up with – and how they were affected.
We aim now to bring out the ‘patient-based’ context – the humanity, and
human stories.This is where artists of all genres are important.”
“I started in the Chambers Street Natural History Museum, then I moved to
the University’s Department of Pathology collection. There was a certain
element of haphazardness – I liked working with my hands, and enjoyed fixing
things. Chambers Street was quite Dickensian, with the inventories still on
cards. At the University it was more hands-on, a very different collection – I
had workshop duties in anatomy and pathology, teaching duties such as
display sets for classes, and I repaired things.
Medical terminology? I made an effort, enough to get by on – but it was
‘shallow waters’. Don’t take my word for anything – you should demand a
“When I was in Pathology, Dr Black once handed me a poly bag with a kidney
in it, still warm. He just said, ‘Can you deal with this?’ There was a bit of a
confrontation. ‘Am I supposed to?’
For me, the first issue was mortality – this was somebody’s organ, used until not long ago. Yes, the kidney was ‘dealt with’, but I then came away from that experience with some issues.
In the Museum, it isn’t red, it isn’t warm – and you start becoming aware of
your own feelings in relation to these aspects.”
“The society we live in, we’ve become desensitised to death, it’s all neatly
packaged in boxes. So you don’t know how somebody will react to a museum
specimen. When people come round, I’m very conscious of their response to
the collection. I try to think, what’s right, what’s wrong, about having that
specimen on show? But the responses are deeply personal, a gut reaction,
I might be overly protective, overly cautious, of how we present things to people.
For example, we had Siamese twins – they were on display in an educational
context, with X-rays that showed how their bones were joined. But then I used
to hear people coming in and saying, ‘Where’s the babies in jars?’ They were
missing the point, it was just voyeuristic, they were treating it like a Victorian
“I want to get people to look without feeling distressed about mortality: to start
a reflective process that’s speculative – and they can then allow themselves to
go in different directions. I want people to use the collection as a locus for opening up, and contextualising in the way of social history.
There’s an inter-connectedness between people – the surgeons, patients,
pathologists, the family – and they’re all colliding and ricocheting in all directions.
The collection here provides the impetus for you to look differently, and to re-focus your thoughts and ideas.”
Maxilla, anterior segment of the coronal section of the head, injected, showing ulceration of the face resulting from a carcinoma of the air-sinus of the left. … Microscopically, re-examination confirms the presence of a tumour growth which is diffusely cellular and which might be a spheroidal-cell carcinoma or sarcoma.
(Specimen also listed as Bci6M38 – in the Charles Bell Collection, 1824)
“A section of the head of a patient who died in the Middlesex Hospital; when he first presented himself he had a large fungous Tumour which projected from the left side of his face, occupying the left side of the mouth, destroying the left side of his nose, and hiding the left eye. After some time, this Tumour burst, and ulcerated, and frequently bled, exhibiting all the features of Fungus Haematodes. The Tumour is seen to extend backwards and into the throat of the posterior nostrils.”
There is no date to indicate when the patient died. The patient’s head is part of the Charles Bell collection, and Charles Bell moved from Edinburgh to London in 1804; his Collection of anatomical and pathological specimens was bought by the Royal College of Surgeons Edinburgh, the removal of the specimens being overseen by Robert Knox in 1825. (Of course there is always the possibility that patient had died before Bell arrived in London, and that Bell purchased the head subsequently for his Collection.)
The ‘section’ of the man’s head is in a large cylindrical glass jar filled with preservative. Not only do we see how the Tumour has disfigured his face, but we may also – because his skull has been removed from the back – look inside his nasal and oral cavities, to observe how the Tumour has invaded the soft tissues. But if we are to remind ourselves that this was a person, not a pathological specimen, we should look instead at his face. The man has ginger stubble on his chin, and his hair is pale ginger too (although this may be an artefact of the preservative). His right eye is closed so that his expression – despite the terrible deformation of his features – appears peaceful.
We can ask many questions, all now unanswerable. He must have been born in the last years of the 18th century. What sort of a man was he and where did he live? What was his general physical and mental health like before the Tumour grew? How old was he when it first appeared? Did he ‘present’ himself at the hospital or did friends or relatives take him there? Where else could he have gone if the hospital had rejected him as an ‘incurable’? Was he relieved to be taken in by the hospital, or terrified lest his ultimate resting place would be in an anatomy museum? Did he assume he would die in hospital? How was he cared for? (There was no palliative care).
After the first shock of seeing a man’s head preserved in a jar – and shock at the idea of a man’s head being preserved in a jar – the overwhelming feeling is of sadness and sympathy; and sorrow that he was born long before medical care and surgery could have helped him.
From: Essays on the anatomy of expression in painting: Charles Bell, 1806; Longman, London.
Relaxation of languor, faintness, and sorrow.
The muscle which depresses the angles of the mouth is often accompanied in its action by that of the corrugator muscle which knits the eyebrows,and this again is combined frequently with the action of the central fibres of the frontal muscle.
The depressing of the angle of the mouth gives an air of despondence and languor to the countenance when accompanied with a general relaxation of the features, or, in other words, of the muscles. When the corrugator which knits the brows co-operates with it, there is mingled in the expression something of mental energy of moroseness or pain.
In sorrow, that general languor which we have now described pervades the whole countenance. The violence and tension of grief, the agitations, the restlessness, the lamentations, and the tumult, have, like all strong excitements, gradually exhausted the frame. Sadness and regret, with depression of spirits and fond recollections, have succeeded; and lassitude of the whole body, with dejection of face and heaviness of the eyes, are the most striking characteristics. The lips are relaxed and the lower jaw drops ; the upper eyelid falls down and half covers the pupil of the eye. The eye is frequently filled with tears, and the eyebrows take an inclination similar to that which the depression of the angles of the lips give to the mouth.
“WHY DO I CALL HIM GEORGE?” Joyce Gunn Cairns’ story
“I have a photograph of a family friend, George, as a young boy. He died in 1980, aged 61. George was born in 1918, with a hair lip and cleft palate, and the surgical procedure then was to provide him with a palate, and involved the removal of his top teeth and giving him a false plate. George came into my life when I was five or six years old, a year or two after my father died at the age of thirty-six. We lived at that time in the small mining village of Rosewell in Midlothian, and George was the village joiner. My mother and George became strong and lasting supports for each other, and my mother was grateful for his kindness towards us as children: always her first priority. She was glad of George’s steadiness of nature, and his offer to take us all out for a run in his car – still something of a novelty in the late 1950s. George continued to be a part of our life from then until he died, twenty-five years later.
Although I remember as a child noting something different about his appearance and speech, this awareness soon slipped away, and he became just George our friend, the man who brought us sweets and took us for picnics in his shiny car, fixing whatever needed fixed in the house. He never lived with us, but remained ‘part of the furniture’ when we moved to Bonnyrigg, only two miles distant. He lived in an old miner’s cottage in Rosewell, now gone and replaced: its interior remains in memory – coal fire, wee back kitchen, grandmother’s clock, outside coal sheds, horsehair chairs, all part of George’s solid, traditional and reliable ambience!
I can only remember one time throughout the years George was part of our life when I was reminded of his disability: I was in a shop with him and my mum, and when the woman behind the counter could not understand what he was saying and became irate, my mother gave this woman a lashing with her tongue. She, my mother, was very protective of George in this way.
When Andrew [Connell, Collections Manager] first showed me ‘George’ I felt a sense of shock on seeing his disfigurement. I was eager to draw him, but also felt apprehensive. However the more frequently I drew him, the less I seemed to notice his disfigurement; or if I did, it was never again with that same initial shock or recoil.
From the drawing you will see that there is nothing of the grotesque in my preconception of him. And so I called him ‘George’ in memory of my friend George.
There is something strangely moving about the way that love penetrates the surface appearance, just as it did for me with our dear friend.”
Joyce Gunn Cairns 2010
Portion of a child, showing congenital malformation of the Nose.
From a female aged 3 weeks, who died of asthenia.
There is a partial bilateral harelip and a bilateral cleft palate. A shallow vertical groove marks the frontal bone between the tuberosities. The nasal bridge is flat, and the nasal bones vertical or absent. The rest of the nose is small, the alae being merely indicated, the nasolabial furrows ill-developed, and there is congenital occlusion of the nares. The central part of the upper lip, the prolabium, forms a narrow pyramidal projection whose base meets each half of the upper lip to form a notch. Between the notches, which are symmetrical, the apex of the prolabium is pendulous. There is possibly a congenital absence of the premaxillary element of the maxillary bones.
Presented (by) Herzfeld, GMA
The baby girl has curly reddish-brown hair, and her eyes are cast down; her right arm has been severed just below the elbow, the left arm just above. Her torso has been severed in the region of her diaphragm. She is indeed a ‘portion’: preserved, sometime in the mid-20th century, in a fluid-filled jar, to show a cleft palate and a malformation of the nose and jaw.
She died three weeks after she was born, of ‘asthenia’ – generalised weakness of the muscles.
The shape and positioning of her head and body bears a striking resemblance to another exhibit in the Museum, the plaster head of a baby, partly ‘dissected’ to show its brain.
Was this deliberate?
Or, you might – as you become used to her features, when you have got past that ‘initial shock and recoil’ described by Joyce Gunn Cairns – see her as a work of art.
Frederik Ruysch (1638-1731), Dutch surgeon, anatomist and Konstenaar (artist), might have adorned her embalmed form with a necklace of blue-and-white beads, or small lace sleeves made by his daughter Rachel.
We can ask many questions: there is the ethical question of ‘parental consent’ about having one’s child used as a teaching specimen; the question whether creating such a specimen was justified for teaching/scientific purposes.
We can question why a half-torso is needed if the purpose is to show maldevelopment of the nasopharyngeal region.
We can also question why this preparation of a baby girl was donated by a female surgeon, the first female President of the RCSE, Gertrude Herzfeld.
Perhaps we could find some answers if we looked through the hospital’s and surgeon’s records, but that in itself would be unethical and in breach of patient privacy.
Let’s first of all consider Gertrude Herzfeld, (1890-1981): this is her Obituary from the British Medical Journal, volume 282, June 1981.
Miss Gertrude M A Herzfeld, who was formerly a consultant surgeon and a president of the Medical Women’s Federation, died on 12 May in her 91st year.
Gertrude Marianne Amalia Herzfeld was born at Hampstead, London, in 1890, and was educated at Edinburgh University, where she graduated in medicine in 1914. After house surgeon posts at the Royal Hospital for Sick Children and at Chalmers Hospital, Edinburgh, in 1917 she became a surgeon attached to the RAMC Cambridge Hospital, Aldershot, and from 1917 to 1919 was senior house surgeon at Bolton Infirmary.
After this she held many appointments as a consultant surgeon, being from 1920 to 1955 at Bruntsfield Hospital for Women and Children, and from 1920 to 1945 at the Royal Edinburgh Hospital for Sick Children. She was also surgeon to the Edinburgh Orthopaedic Clinic from 1925 to 1955 and a lecturer on the surgery of childhood at the university and a lecturer at the Edinburgh School of Chiropody.
Miss Herzfeld was chairman of the City of Edinburgh Division of the BMA from 1960 to 1962, a past president of the Medical Women’s Federation, president of the Soroptimist Club of Edinburgh in 1929, as well as more recent appointments such as vice-president of the Scottish Society of Women Artists since 1954, of the Edinburgh Cripple Aid Society since 1956, and of the Trefoil School for Physically Handicapped Children since 1964.
CVK writes: A remarkable woman has just died, full of years and memories for many generations of students. At the time of her birth her father went to business in a carriage. Gertrude always longed to be a doctor and this desire crystallised into surgery after a prizewinning career at Edinburgh University, which gave her an excellent training but retained its established hierarchical traditions. In the early days of the first world war a newly qualified woman with a German name did not find life easy; being the first woman to take a seat as a fellow in the Royal College of Surgeons of Edinburgh opened no ready gates.
Gertrude was a large woman in heart, mind, and build, and she saw fewer obstacles than others of her sex, because she knew what she had to do. At first her surgical patients were women only, but she soon established herself as an infinitely patient paediatric surgeon. None of her housemen could forget her great figure bending over a tiny neonate, opening and semi-constructing a blind cystic duct, easing a pyloric stenosis, or, later, apposing two raw edges of a minute cleft palate.
Her wards attracted patients with conditions that we had never seen as students. Before the days of chromosome determination, sex was mysteriously undefined in more children than we expected, and from all over Scotland they came for cosmetic repair and the difficult assessment of what course they were to follow.
This was done by a great deal more than surgery: infinite thought, getting to know the child, the mother, the surroundings – a psycho-somatic exercise in which Gertrude Herzfeld’s warmth and wisdom combined with her skill.
Students over half a century, undergraduate and postgraduate, will always remember the extra help and loyalty that Gertrude gave them; she never let us down in front of others, but quietly made it clear where we had erred; it was not a failure, but part of learning. She also taught the skill of loyalty to the general practitioner who sent us his patients. She understood.
Andrew Connell, Manager of Collections.
“On our first, superficial examination, all we saw was that the baby had a cleft palate. But we looked again, at the specimen, and at her notes – and saw that the girl had died at three weeks old, of ‘asthenia’, and that there were further complications in the nose and jaw region.
Let’s look at the possibilities:
What other incompatibilities, with life, does this condition bring? From Gertrude Herzfeld’s position, there is maybe nothing she can directly do (and the child is so malformed that she dies after three weeks).
Did Dr Herzfeld say explicitly that this specimen must go to the Royal College of Surgeons, did she emphasise this?
Was she even directly involved?
Maybe her name was just associated with the case. She may hardly even have seen it – the decision to preserve the baby was perhaps made somewhere else.
Herzfeld was a surgeon not a paediatric pathologist – she may not even have been to the post-mortem. She might have said, “I’d like someone to do a PM on this one, to find out what the internal organs are doing’: so the body goes off for autopsy.
In the Sick Kids hospital, the baby is taken to the PM room. And someone says, ‘This is quite unusual, let’s have it for the Museum.’
Then it comes here with the surgeon’s name on it.
Elsewhere the pathologist’s name might be on it, or on the histological slides in the records.
Since then (the baby could have died sometime in the period 1920-1950) there have been big changes in medical legislation and how records are kept. Records are now computerised, and there would be a field to complete for each person involved, surgeon, pathologist, histologist – all would be recorded, partly for litigation purposes. It would be easy to follow the ‘trail’.
Now, I’m just trying to think about why she should be here.
Is this demonstration of a cleft palate useful for teaching purposes? We missed the fact that the nasal bones hadn’t developed properly. Maybe that is why the specimen is here – is it unusual to have these two faults together? There aren’t any nostrils – what are the other implications for the respiratory tract?
Perhaps her preservation is also for posterity – the meaning might be ambiguous now, but in the future might give important clues.
So why the half-torso?
Why not the head, like ‘George’? To dissect that out takes time and skill.
What’s next easiest? To decapitate the body? But a detached head is probably more awkward, more offensive: it’s nastier.
What’s the next alternative? Dissect down to the shoulders – this too takes time and effort.
So why cut through at that plane, mid-torso, the arms as well?
The body could fit through a band-saw. This could have been the quickest method, chosen because it was the least unpleasant of the possibilities in order to present the specimen quickly.
Why not prepare the whole baby? It would be bulky and heavy. In an exam, a whole body might lead students to look for the wrong thing, in the wrong direction: ‘It’s got a boil on its bum’.”
On occasion, Andrew has had to change the fixative surrounding bottled specimens, including those of teratologically-deformed foetuses and neonates.
“Your eyes interpret things which aren’t true. A baby should be soft, it should be warm, babies are very tactile. But as specimens they are completely different. For example the weight, the fact that the body’s completely rigid, there’s no softness, no bending, no impression of your fingers on the skin. It’s slimy, almost like a fish, the texture is completely wrong. And they’re cold, very cold, almost like a rubber doll washed up on a beach. Something innate makes you feel the utmost respect. For example, if you need to put a needle through the ear, say, so as to fix the baby in position in the jar – it makes you cringe, it’s completely against nature, something unnatural.
I had to re-pot a dissected head that showed microcephaly – it was half external face, half internal dissection.
That was difficult because you can relate to a face, there’s the mouth, lips, teeth and all the rest.”
You can relate to a face: perhaps that’s why – once we have overcome our shock and intial revulsion – we can relate to ‘George’ and the cleft-palate baby.
Sometimes subjects cycled in and out of one’s life, entering without warning and remaining for a day or more, and then exiting again as though erased. This weekend dwarves and babies had pushed their way in, small but not the same, one group stalled by a malfunctioning gene, the other with genes that had yet to function.
Yesterday, coming off the motorway at a large roundabout, Lisa had seen banners draped along a fence on the far side of the road: ‘Car boot sale, Saturday and Sunday! Smokers welcome. Dogs welcome. Cross-dressers welcome.’ Delighted, she had circled the next roundabout and returned to drive slowly past. ‘Residents of Appleby welcome. Lap-dancers welcome.’ Chuckling, she had debated going in to see what was on offer for such an eclectic mix of customers, but the distant hills had a stronger pull, and she circled again and resumed her journey. As it contoured around the feet of Blencathra the road headed inexorably downwards into the bowl where the small town of Keswick nestled as though poured.
‘Chamonix of the North-West’. Who had said that, perhaps mockingly? She could not remember, but narrow streets were further narrowed by climbing-gear that festooned doorways and spilled out of shops, and there was an air of concentrated enthusiasm for the Great Outdoors amongst the ambling pedestrians. Serious walkers would surely be out on the hills at this time, late morning, Lisa thought: those remaining at ground level were the dreamers and the unfit, and people who lived here, going about their normal lives in this town that was not, after all, a theme-park; people who paused only occasionally to remind themselves that their horizons were unusually high, an undulating rim of rock and heather. It would be good to dream, to drift like a somnambulist … But the main street was crammed with market stalls and she quickly became distracted by local fudge and mint-cake, which she bought for her research group, and a display of woven rough-wool rugs.
‘It’s Herdwick, love,’ the woman said. ‘That’s its natural colour.’
Lisa remembered the grey sheep that Madeleine had shown her, the sheep with the kindly faces, and she imagined how this rug, with the variegated colours of lichen-mottled stone, would look in her own house. She pushed her fingers into the weave, feeling the strong wiry fibres; the woman pulled out a wider selection and spread them over the scarves and hats at the front of the stall, and Lisa dithered over the different shades.
The owner of the adjacent stall, which glittered with cheap brass and baubles, occasionally interrupted his patter to slurp from a mug of tea. His long bony nose dipped into the steam and after each gulp, he wiped it with his sleeve. He caught Lisa’s eye and winked.
‘I’ve been telling Beattie here to knit me a nose-bag,’ he said. ‘It gets that cold. But she won’t do it, dunno why.’
‘I keep telling you, Derek, I haven’t got that much wool to spare. You’d need a flock of alpacas to cover that one!’
Lisa laughed with her while Derek continued, ‘I thought I’d get one of those balaclava things with just my eyes showing but what with the war on terror and and all that I was scared I’d be waterboarded.’ He passed a hand-mirror to a girl who was looking at some ear-rings. ‘Here y’are, lass, use this mirror. “Mirror, mirror on the wall”. This mirror never lies, we’re all beautiful people here.’
‘He likes it ‘cos it makes his nose look small,’ Beattie whispered loudly. ‘Now, love, have you any preference?’
‘As long as it’s only me nose. Look at these necklaces now, did you ever see such workwomanship? All the way from the mountains of Tibet, these – Blimey! Any minute Snow White’ll be coming round the corner, too!’
Lisa looked round sharply at the change in his tone, half-knowing what she would see.
Two achondroplasics were browsing along the stalls. They could not have failed to hear Derek’s loud joke and the woman had stopped to examine a display of smoked trout with great concentration. The man, perhaps her husband, had glanced up and had caught sight of Lisa.
There was that awkward moment, the half-smile, the indecision that Lisa experienced on the very rare occasions when she met another achon. The mirror-image that she had forgotten about, that she felt had nothing to do with her daily life; the transient exasperation and the silent question, ‘Why should I greet you like a brother, sister?’.
‘Here come your friends.’ Derek was inexorable, but not unkind.
The small man’s crumpled, ridged face collapsed even more into a toothy smile. ‘No, hadn’t you heard? Snow White’s banged up in jail. We always suspected she was a paedophile, and she was lousy at housework, too. Hi there.’ He nodded at Lisa. ‘How’re you doing?’
‘Fine.’ Lisa smiled. Passing shoppers were looking at them covertly or even with the classic double-take.
‘Nice rugs. Come and look at these, Sheila, one of these would do very nicely for Johnnie’s flat. Johnnie’s our son. This is my wife, Sheila. I’m Terry, by the way.’ He held out his hand to Lisa. ‘Pleased to meet you.’
‘Hallo. I’m Lisa. They are attractive rugs, aren’t they? They’re made from the local Fell sheep.’
Beattie was looking at them in surprise. ‘Don’t you all know each other, then? I just assumed, well, that you were all together.’
‘Bit of a coincidence, isn’t it,’ Derek agreed. ‘Something of a rare breed, not often we see—’
‘We’re just like buses. You don’t see any for ages then three come along at once, eh?’
Derek roared with laughter. ‘That’s good. You wouldn’t like to come and help out here, would you – Terry, did you say? We’d make a good team, I reckon.’
‘We’re not that rare, you know. But I don’t know where we all hide ourselves, do you, Lisa?’
Lisa realised, unhappily, that Terry had evangelical tendencies: he would always be ready to ‘fight our corner’.
His wife had clearly heard it all before. ‘Terry, they’re busy and we need to go.’
‘If you reckon that one of us is born in every 20,000 live births, that should be about thirty new children a year with our sort of restricted growth. Our son is like us, of course. We knew he would be, and we were happy about that, weren’t we, Sheila?’
‘Thirty. That’s a lot,’ Beattie agreed, uncertainly.
‘But you don’t see them, do you? And it’s not just because we’re so small and escape your notice. It’s a mystery. But it just goes to show that you shouldn’t be surprised to see a few of us at one time in normal circumstances.’
‘I think I’ll take this one, I like the mixture of greys.’ Lisa raised her eyebrows at Beattie, who grimaced sympathetically.
Derek had been briefly distracted, helping two women choose a pair of candlesticks, but now he leant across the wooden bar that separated the stalls.
‘Colour. What about colour then? You three are white, but where are the black and brown ones? Don’t they have persons who are vertically challenged or whatever we’re supposed to say, too, or is it a culture thing? The wrong ’uns get left out on a hillside to die. Or get shut away.’
‘Derek! You can’t say things like that!’ Beattie was shocked, but Terry laughed.
‘In Brixton and Bradford? No, it’s a valid point.’
Lisa suddenly wanted to be far away, preferably soaring in tandem with one of the paragliders who were circling beneath Skiddaw’s peak. Counting out the correct money, she grabbed her parcel from front of the stall. ‘Sorry, I have to go.’
‘Join us for a coffee, Lisa. Sheila and I would be glad of your company, wouldn’t we, dear?’
For a moment the two women made eye contact. Eye to eye: the realisation was like a physical blow. Almost simultaneously Lisa understood that for Sheila and Terry this was unremarkable, routine. At home, in their kitchen, bathroom, sitting-room, at whatever time of day, they could see each other face to face and for them this was normality. Normal proportionate family life. And they had had a normal proportionate baby, who had now grown-up to be their size. Only outside their front door was the world a difficult and disproportionate place.
‘He means well,’ Sheila said softly. She could have been in her fifties; she wore a badly-fitting tweed coat and a knitted woollen hat from which grey curls escaped, but she stood within a shell of calm.
‘Yes.’ Struggling to hold the rolled-up rug, Lisa held out her hand. ‘But a friend is expecting me. Thank you.’ When Sheila took her hand to shake it, Lisa suddenly leant forward and not quite knowing why, managed to kiss her on the cheek. ‘Thanks. ’Bye, Terry. Enjoy your day.’
Lisa takes the slip-road that will lead her back to Liverpool. She is tired now and has been listening to music to stay alert. The density of the traffic is increasing now, and she needs to concentrate fully on reaching home, but for the first time the ‘home’ image seems empty and resonant with echoes. She imagines Sheila and Terry, playing with a tiny, short-limbed baby who is sitting on a Herdwick rug.
(C) Ann Lingard
(This is an edited extract from The Embalmer’s Book of Recipes (2nd edition, Littoralis Press, 2014). More details about the novel can be found on my website where there are also three short, amusing and thought-provoking videos made by Dr Tom Shakespeare and Professor John Burn, about achondroplasia.)
Museum exhibit GC 13687
Skeleton of Dwarf (female)
Skeleton of an achondroplastic
dwarf showing the typical
deformity of the skull.
Diminution in length of the long
bones. Deformation of the
bone ends with a tuberculous
lesion associated with marked
kyphosis at the level of T12
Presented to Professor Struthers (1823-1899) by a former pupil. It is seen that there is an acute curvature of the spine at the junction of the dorsal and lumbar regions.
“In 1922, Charles Cathcart, Conservator of the College Museum, recruited James Jack to help William Wardie, Technician, with the maintenance and remounting of specimens. He also acted as projectionist, displaying the glass photographic slides at lectures and talks.”1
“On the outbreak of war it was decided that the specimens in the Museum would best be saved from the risk of damage by storing them in the basement of the College. They remained there until 1943 when it was apparent that the risks of air raids were diminishing and it was desirable that the College activities should, at least in part, be resumed. During these years the only work conducted in the Museum was the repairing of damaged specimens by the one and only member of staff, James Jack. In addition Smith, the College Officer, and Jack undertook firewatching duties in the College buildings.” 2
“James Jack was a well-known, popular figure, who lived at No.7 Hill Square. In addition to working in the Museum, he helped the local newsagent on Saturdays by selling newspapers at the College gate.
It was said that ‘he brought to his task skill, hard work and always a delightful sense of humour’.” 1
“James Jack was an unusually small person, described popularly as a ‘circus’ dwarf. In scientific terms he suffered from chondrodystrophia fetalis (achondroplasia), a disorder of the growth of bone that is inherited. The abnormality affects stature but neither physical activity nor mental function.” 1
James Jack’s arrival is also attributed to Professor David Middleton Greig (1834-1936).
“In 1922 Greig ‘procured’ for William Waldie [sic] an assistant from Dundee – an achondroplasic dwarf, James Jack.” 2
“During his years of surgical practice in Dundee David Greig had been an ardent collector of pathological specimens, especially those relating to diseases of bone and abnormalities of the skull. …
Many stories are told about Greig and his collection, some of which have been related by his nephew Dr B S Simpson who recalls visiting the attic of his uncle’s residence in Dundee and finding the place full of this material. Some of the stories suggest that the collection was acquired with an unusual enthusiasm.
The actual number of items thus added to the Museum [collection] is difficult to ascertain but it ran to several hundreds and included 300 skulls.” 2
The Greig skull collection, boxed in the basement, and on display
“Initially Mr Jack was employed in a temporary capacity on a wage of 30/- per week, but he stayed with the Museum for over 40 years, eventually retiring in September 1964.” 1
“There was no question of Greig’s fascination for achondroplasics and there are in the College a large number of clinical photographs of the new assistant.”2
But, “James Jack long outlived David Greig and at a much later date, still working in the College, he pronounced: ‘He didn’t get me, and he’s deid‘.” 2
1. From the text accompanying James Jack’s photograph in the Surgeons’ Hall Museum