The Poppies of Terra #53 - Re-embodied

If you’re reading this, it’s thanks to an incredibly complex living matrix whose workings may well be largely, or at least in part, mysterious to you. Like me, you are embodied. (If you’re not currently occupying a body, email me immediately. And if you’re not alive and are somehow reading this, Sam Harris and Richard Dawkins would probably like a chat.) Most of us don’t spend much time pondering the structure that allows our very selves, and some would claim, is synonymous with those selves, to navigate the physical world. Unless challenged by illness or disability, we tend to be unreflecting about that which literally moves us. In her brilliant new book, Alive: Our Bodies and the Richness and Brevity of Existence, surgeon and award-winning author Gabriel Weston educates and simultaneously enlivens with her radical reframing and deeply humanizing approach to this subject matter. Never skimping on information, Weston nevertheless scalpels the tissue of typical pop science writing expectations to access a wondrous, sometimes shocking, corpus of subcutaneous marvels–and a few cutaneous ones too.  

Jason Allen-Paisant’s beautiful epigraph sets the stage: “Nothing makes sense until it makes sense in the body, till the body is present at the making-sense.” Through a baker’s dozen magisterial chapters–Dead, Bone, Genitals, Gut, Womb, Lungs, Skin, Breast, Kidney, Brain, Liver, Heart, Alive–Weston takes a delightfully unconventional approach to her exploration of the human body. As she states in the opening section, in which a woman’s corpse ends up as “nothing more than a shell, cavernous and rib-slatted as a clinker boat,” Weston has set out to write an “alternative anatomy,” one that blurs “the boundaries that usually separate science from art, rational from emotional, objective from subjective experience.” She does this by consistently shifting between three main modes: writing about ways that injury or disease have touched her and her loved ones personally, recollecting some of her experiences training to become a surgeon or being one, and providing scientific recaps, often enriched by philosophical and historical remarks, about the functions of the body parts and the organs she’s describing. The transitions are elegant, and help to keep everything nicely circulating. But the through line is clear. “Nothing thrills me more than the human body,” Weston declares, and after a few pages that sense of fascination is undeniable. After a few more pages, it is, thanks to the skill of her writing, contagious.

I am moved to relay some of the amazing facts in Weston’s book:

1. Through meticulous description, Weston reveals that the outer cortex of a living bone isn’t an inert shell, but is rather made of thousands of identical units called osteons, which have concentric layers rich with collagen and mineral salts arranged at right angles for maximizing tensile strength. The core of a living bone is packed full of red marrow, which produces over 200 billion blood cells–daily. Further, we learn that despite being the most solid part of our body, the skeleton is constantly shape-shifting through a process of bone remodeling where old bone is resorbed by osteoclasts and new bone is made by osteoblasts. 

2. Discussing genitals in the following chapter, Weston explains that until three months of fetal gestation all genitals are exactly the same. Even when male and female genitals start to diverge, the differences between them remain tiny, and the equivalent of the penis isn’t, lo and behold, the vagina, but the clitoris. The clitoris and penis develop from the same embryonic tissue, the genital tubercle, and share the exact same three columns of erectile tissue: two corpora cavernosa and a corpus spongiosum. As you can probably imagine, this territory is rife with cultural and sociological misunderstandings and appropriations. 

3. The gut, we learn, possessing “an internal surface area a hundred times bigger than the skin,” has recently been shown to be the  “largest sensory organ we have,” with an incredibly complex microbiome of viruses, fungi, yeasts, and bacteria that play a crucial role in our health. Swallowing food involves twenty different pairs of muscles, and in a commonplace example of our daily obliviousness to the machinery that maintains us, we do it more than 2,000 times a day, mostly without conscious thought. 

4. For renewal on a grand scale, the body has no other show like menstruation, where the uterus prepares for potential conception each month for about forty years. 

5. I never thought about it like this: the lungs are involved in some of our most intense personal experiences, from anxious breathing to sobs, laughter, and the sustained exhalation that pushes a baby into the world. 

6. The skin, “a meta-organ, without which all the others would literally fall apart,” contains heat, water, and a thousand different chemicals, while simultaneously protecting us against numerous external threats. 

7. The breast, remarkably, can transmute blood into milk, as building blocks from the mother's blood are taken up by the alveoli and converted into life-giving fluid. 

8. Our kidneys clean a staggering volume of blood–200 litres every twenty-four hours!–, with ninety-nine per cent of it being reabsorbed, and they contain two million tiny subunits called nephrons, where a sophisticated calibration of fluid and chemicals constantly takes place. 

9. The brain, though appearing solid, is an organ of “ultimate flux,” with information ceaselessly shooting between its different parts via trillions of synapses. 

10. If a large portion of the liver is removed, it can regrow entirely to its original size and function, not through stem cells but by the remaining hepatocytes swelling and multiplying. 

11. The heart is not just an inert lump but the “hub of a vast network” of 60,000 miles of arteries and veins, beating about 100,000 times a day and delivering 5,000 gallons of oxygen-rich blood.

It’s the way this information is packaged that makes Alive so memorable. Its richness as an introspective survey embodies the best that nonfiction has to offer: new perspectives birthed from an examination of data that’s initially detached and then poignantly re-attached to human happenings. 

This subtle feat is made possible, among other things, by Weston’s language usage. Tellingly, among some of the artists and authors named are renowned stylists Virginia Woolf and Emily Dickinson. Literal observations often take on layers of meaning and serve as springboards for reflection, as for instance when Weston writes: “Healthy skin isn’t a barrier at all, but a delicate semi-permeable membrane. Our soft and vulnerable selves may need protection. But we also have to remain open.” Consider too some of her arresting similes: the gut of a dead body “winding out in loops and endless ribbon-like lengths, thin as fingers, juicy as a mouthful of new gum,” the small bowel “plush as a shag-pile carpet,” the periosteum covering each bone “as a falconer’s glove does her hand,” or the confessional “secretly, I’ve always pictured the skin as a cake with two sponges and icing between them.” This image surely sticks in the mind: “Beholding a surgeon opening a patient’s face as easily as if it were a book, to remove a large tumour, knocked me sideways.” When discussing the heart, she quotes the late Jonathan Miller’s notion that “the reason Galen’s false anatomy of the heart took so long to be disproved was because of the lack of a satisfactory language for describing what was seen,” as the analogy of the heart to a lamp had to give way to that of a mechanical pump at the end of the sixteenth century. Agreeing with Miller’s take that for Galen’s model to be superseded by Harvey’s the right metaphorical equipment had to become available, Weston muses: “The truth of the body is as much about storytelling as it is about anatomy.”

I’m deliberately staying away from the more autobiographical sections, because I prefer not to spoil the human drama, as it were, and to leave those entirely in the author’s words. Weston’s academic background and path to writing Alive are also unusual, making for fascinating reading. All of this non-technical material vivifies things in incomparable fashion. I found this book a tour de force, or perhaps a tour de flesh. Weston’s prose gracefully and precisely evokes the biological idiosyncrasies, interdependencies, and constraints of our existence. In a time of increasingly depersonalized medicine and societal squeamishness, Alive is medicine for the soul, a rousing, sobering act of literary confrontation. No; it’s more than that. Going beyond the mere facing of the facts, Weston’s work is a display of personal, heartfelt incorporation.