“A Tiny Red Hole”: Horrible Stories of Needles

Jan19

Sometimes the smallest objects can turn out to be the most useful. And the most frightening.
Who doesn’t feel at least a vague repulsion, a little shiver upon seeing a needle entering the skin?

You guessed it: this article is devoted to needles in bizarre clinical contexts. If you are among the 10% of the population who suffer from needle phobia, then you should skip this post… or maybe not.

Prehistoric Needles
An invention older than Man himself

Let’s begin with a little curiosity that isn’t really relevant to this article, but I find fascinating: pictured above is the most ancient needle ever recovered by archaeologists… and it’s not a human artifact.

7 centimeters-long, carved from the bone of an unidentified bird, this perfect needle (complete with an eye to insert a thread) was produced more than 50.000 years ago – not by proper Homo sapiens, but by the mysterious Denisova hominin: settled on mount Altaj in Siberia, these human predecessors are partly still an enigma for paleontologists. But this needle, found in 2016 from their cave, is a proof of their technological advancement.

Needles Under The Skin
The inexplicable delay of Western medicine

Going from sewing needles to medical needles was a much later conquest than you might imagine.
It shouldn’t have been that difficult to see how injecting a drug directly under the skin might be an effective kind of treatment. Norman Howard-Jones begins his Critical Study of the Origins and Early Development of Hypodermic Medication (1947) by noting that:

The effects of the bites of venomous snakes and insects pointed clearly to the possibility of the introduction of drugs through punctures in the skin. In primitive societies, the application for therapeutic purposes of plant and animal products through cutaneous incisions is practiced […], and the use of poisoned arrows may be regarded as a crude precursor of hypodermic and intramuscular medication.

We could trace another “crude precursor” of intramuscular injections back to Sir Robert Christison‘s 1831 proposal, suggesting that whalers fix a vial of prussic acid to their harpoons in order to kill whales more quickly.

And yet, despite of all these clues, the first proper hypodermic injection for strict medical purposes did not take place before mid-Nineteenth Century. Until then, syringes (which had been around for centuries) were mainly used for suction, for instance to draw the fluids which accumulated in abscesses. Enemas and nasal irrigation were used since Roman times, but nobody had thought to inject medications under the skin.

Physicians had tried, with varying results, to scar the epydermis with irritants and to deposit the drug directly on the resultin ulcer, or they sliced the skin with a lancet, as in bloodletting, and inserted salts (for example morphine) through the cut. In 1847, G. V. Lafargue was the first to have the intuition of combining inoculation with acupuncture, and to build a long and thick hollow needle filled with morphine paste. But other methods were being tested, such as sawing a silk thread, imbued in drugs, directly into the patient’s skin.

The first true hypodermic syringe was invented in 1853 by Scottish doctor Alexander Wood, as reported in his New Method of Treating Neuralgia by Subcutaneous Injection (1855). Almost at the same time, the French physician Charles Pravaz had devised his own version. By the end of the Nineteenth Century, hypodermic injections had become a widespread procedure in the medical field.

Needles In The Flesh
The bizarre clinical case of the “needle woman”

Published in 1829 by Giuseppe Ferrario, Chief Surgeon at the Ospedale Maggiore in Milan, La donna dagli aghi reports a strange case that began in June 1828.

A young 19-year-old woman, Maria Magni, “peasant, of scrofulous appearance, but with a passionate temper” was admitted to the hospital because of severe pain.
One April morning, the year before, she had found a light blue piece of paper on the ground which contained 70/80 steel sewing needles. In order not to lose them, she had pinned them on her blouse cuff. But Maria suffered from epileptic fits, and a few hours later, as she was working in the vineyard, “she fell victim of the usual spasms, and convulsive bouts. Under these abnormal and violent muscular movements […] she believes that she unwillingly pushed the needles she had pinned to her shirt through her right arm – which was naked, as is the case among our peasants – as well as through her breast”. The needles didn’t cause her any trouble until three months later, when the pain had become unbearable; she then decided to go to the hospital.

The doctor on duty hesitated to admit her, for fear she had syphilis: Magni had tried alternative treatments, and had applied “many varied remedies, catplasms, ointments, blistering drugs and other ulcerating substances, etc, with the intention of exciting the needles out of her skin”, but this only resulted in her body being covered by sores.
Enter Doctor Ferrario, who during the first 35 days of treatment submitted her to bloodletting for 16 times, applied more than 160 leeches to her temples, administered vesicants, frictions, decoctions, salts and various tinctures. But the daily epileptic fits were terrible, and nothing seemed to work: “all the physicians, stunned by the woman’s horrible condition, predicted an approaching and inevitable death”.

Upon hearing the story of the needles, though, Ferrario began to wonder if some of them were still sticking inside the young woman’s body. He examined her wounds and actually started feeling something thin and hard within the flesh; but touching those spots triggered some epileptic fits of unheard violence. Ferrario described these bouts with typical 19th-Century literary flourishes, in the manner of Gothic novels, a language which today sounds oddly inappropriate in a medical context:

the poor wretched girl, pointing her nape and feet, pushed her head between her shoulders while jumping high above the bed, and arched her bust and arms on the account of the spasmodic contraction of dorsal muscles […] she was shaking and screaming, and angrily wrapped her body in her arms at the risk of suffocating […]. There was involuntary loss of urine and feces […]. Her gasping, suffocated breath, her flaccid and wrinkled breast which appeared beneath her hirst, torn to pieces; the violence with which she turned her head on her neck, and with which she banged it against the walls and threw it back, hanging from the side of the bed; her red and bulging eyes, sometimes dazed, sometimes wide open, almost coming out of their socket, glassy and restless; the obscene clenching of her teeth, the foamy, bloody matter that she squirted and vomited from her dirty mouth, her swollen and horribly distorted face, her black hair, soaked in drool, which she flapped around her cranium […] all this inspired the utmost disgust and terror, as it was the sorrowful image of an infernal fury.

Ferrario then began extracting the needles out of the woman’s body, performing small incisions, and his record went on and on much in the same way: “this morning I discovered a needle in the internal superior region of the right breast […] After lunch, having cut the upper part of the arm as usual, I extracted the needle n. 14, very rusty, with its point still intact but missing the eye […] from the top of the mons pubis I extracted the needle n. 24, rusty, without point nor eye, of the length of eight lines.”

The pins were hard to track down, they moved across the muscles from one day to the other, so much so that the physician even tried using big horseshoe magnets to locate the needles.
The days went by, and as the number of extracted needles grew, so did the suspect that the woman might be cheating on the doctors; Maria Magni just kept expelling needles over and over again. Ferrario began to wonder whether the woman was secretly inserting the needles in her own body.
But before accusing her, he needed proof. He had them searched, kept under strict surveillance, and he even tried to leave some “bait” needles lying around the patient’s bed, to see if they disappear. Nothing.

In the meantime, starting from extraction number 124, Miss Magni began throwing up needles.
The physician had to ask himself: did these needles arrive into the digestive tract through the diaphragm? Or did Magni swallow them on purpose? One thing is sure: vomiting needles caused the woman such distress that “having being so unwell, I doubt she ever swallowed any more after that, but she might have resorted to another less uncomfortable and less dangerous opening, to continue her malicious introduction of needles in the body”.
The “less uncomfortable opening” was her vagina, from which many a new needle was removed.

As if all this was not enough, rumors had spread that the “needle woman” was actually a witch, and hospital patients began to panic.

An old countrywoman, recovering in the bed next to Magni’s, became convinced that the woman had been victim of a spell, and then turned into a witch on the account of the magic needles. Being on the bed next to her, the old lady believed that she herself might fall under the spell. She didn’t want to be touched by the young woman, nor by me, for she believed I could be a sorcerer too, because I was able to extract the needles so easily. This old lady fell for this nonsense so that she started screaming all day long like a lunatic, and really became frenzied and delirious, and many leeches had to be applied to her head to calm her down.

Eventually one day it was discovered where Magni had been hiding the needles that she stuck in her body:

Two whole needles inside a ball of yarn; four whole needles wrapped in paper between the mattress and the straw, all very shiny; a seventh needle, partly rusted, pinned under a bed plank. Several inmates declared that Maria Magni had borrowed four needles from them, not returning them with the excuse that they had broken. The ill-advised young woman, seeing she was surrounded and exposed […] faked violent convulsions and started acting like a demon, trashing the bed and hurting the assistants. She ended by simulating furious ecstasy, during which she talked about purely fictional beings, called upon the saints and the devils, then began swearing, then horribly blasphemed angels, saints, demons, physicians, surgeons and nurses alike.

After a couple of days of these performance, Magni confessed. She had implanted the needles herself under her skin, placed them inside her vagina and swallowed them, taking care of hiding the pierced areas until the “tiny red hole” had cicatrized and disappeared.
In total, 315 needles were retrieved from Maria Magni’s body.
In the epilogue of his essay, Ferrario points out that this was not even the first recorded case: in 1821, 363 needles were extracted from the body of young Rachel Hertz; another account is about a girl who survived for more than 24 years to the ingestion of 1.500 needles. Another woman, Genueffa Pule, was born in 1763 and died at the age of 37, and an autopsy was carried out on her body: “upon dissecting the cadaver, in the upper, inner part of each thigh, precisely inside the triceps, masses of pins and needles were found under the teguments, and all the muscles teemed with pins and needles”.

Ferrario ascribes the motivations of these actions to pica, or superstition. Maria claimed that she had been encouraged by other women of the village to swallow the needles in order to emulate the martyr saints, as a sort of apotropaic ritual. More plausibly, this was just a lie the woman told when she saw herself being cornered.

In the end, the physician admits his inability to understand:

It is undoubtedly a strange thing for a sane person to imagine how pain – a sensation shunned even by the most ignorant people, and abhorred by human nature – could be sometimes sought out and self-inflicted by a reasonable individual.

I wonder what would Ferrario say today, if he could see some practices such as play piercing or body suspension performances.

Needles In The Brain
A dreadful legacy

As I was going through pathology archives, in search of studies that could have some similarities with the Magni story, I came upon one, then two, then several other reports regarding an even more unbelievable occurrence: sewing needles found in the encephalon of adult patients, often during routine X-rays.

Intracranial foreign bodies are rare, and usually result from trauma and operations; but neither the 37-year-old patient admitted in 2004, nor the 45-year-old man in 2005, nor the 82-year-old Italian woman in 2010, nor the 48-year-old Chinese woman in 2015 had suffered any major cranial trauma or undergone head surgery.
An apparently impossible enigma: how did those needles get there?

The answer is quite awful. These are all cases of failed infanticide.

The possibility of infanticide by inserting pins through the fontanelle is mentioned in the Enciclopedia legale ovvero Lessico ragionato by F. Foramiti (1839), where the author includes a (chilling) list of all the methods with which a mother can kill her own child, among which appears the “puncturing the fontanelle and the brain with a thin sharp dagger or a long and strong needle”.

But the practice, properly documented in medical literature only by 1914, already appeared in Persian novels and texts: perhaps the fact that the method was well-known in the ancient Middle East, is the reason why most of the forty recorded cases were documented in Turkey and Iran, with a minority coming from Southeast Asia, Europe and the United States. In Italy there were two known cases, one in 1987 and the 2010 case mentioned above.

Most of these patients didn’t show any particular neurological symptom: the sewing needles, having been embedded in the brain for so many years, are not even removed; a surgical procedure, at this point, would be more dangerous than leaving them in situ.
This was the case for the only known occurrence reported in Africa, a 4-year-old child carrying a 4,5 cm needle through his brain. At the time the report was filed, in 2014, the needle was still there: “no complications were noted, the child had normal physical and mental development with excellent performance at school”.

Of course, discovering at the age of forty that someone – your parents, or maybe your grandparents – tried to kill you when you were just months old must be a shock.
It happened to Luo Cuifen, a chinese lady who was born in 1976, and who showed up at the hospital because of blood in her urine in 2007, and who discovered she had 26 sewing needles in her body, piercing vital organs such as lungs, liver, kidneys and brain. Her story is related to the discriminations towards female newborn children in rural China, where a son is more welcome than a daughter because he can carry on the family name, perform funeral rituals for ancestors, and so on. In Luo’s case, it was most likely her grandparents who attempted the infanticide when she was but months old (even if this theory cannot be proven, as her grandparents already passed away).

In more recent cases, recorded in Tunisia, China and Brazil, it was discovered that the children had respectively three, twelve and even fifty needles stuck in their bodies.

The cases of people surviving for decades with a needle in their brain are obviously an exception – as one of the studies put it, this is the “tip of the iceberg”.
A needle wound can be almost invisible. What is really disquieting is the thought of all those infanticides who are carried out “successfully”, without being discovered.

Sometimes the smallest objects can turn out to be the most useful. And the most lethal.

My gratitude goes to Mariano Tomatis, who recommended La donna dagli aghi, which he discovered during his studies on 19th-century magnetism, and which started this research.

The premature babies of Coney Island

Dec1

Once upon a time on the circus or carnival midway, among the smell of hot dogs and the barkers’ cries, spectators could witness some amazing side attractions, from fire-eaters to bearded ladies, from electric dancers to the most exotic monstrosities (see f.i. some previous posts here and here).
Beyond our fascination for a time of naive wonder, there is another less-known reason for which we should be grateful to old traveling fairs: among the readers who are looking at this page right now, almost one out of ten is alive thanks to the sideshows.

This is the strange story of how amusement parks, and a visionary doctor’s stubbornness, contributed to save millions of human lives.

Until the end of XIX Century, premature babies had little or no chance of survival. Hospitals did not have neonatal units to provide efficient solutions to the problem, so the preemies were given back to their parents to be taken home — practically, to die. In all evidence, God had decided that those babies were not destined to survive.
In 1878 a famous Parisian obstetrician, Dr. Étienne Stéphane Tarnier, visited an exhibition called Jardin d’Acclimatation which featured, among other displays, a new method for hatching poultry in a controlled, hydraulic heated environment, invented by a Paris Zoo keeper; immediately the doctor thought he could test that same system on premature babies and commissioned a similar box, which allowed control of the temperature of the newborn’s environment.
After the first positive experimentations at the Maternity Hospital in Paris, the incubator was soon equipped with a bell that rang whenever the temperature went too high.
The doctor’s assistant, Pierre Budin, further developed the Tarnier incubator, on one hand studying how to isolate and protect the frail newborn babies from infectious disease, and on the other the correct quantities and methods of alimentation.

Despite the encouraging results, the medical community still failed to recognize the usefulness of incubators. This skepticism mainly stemmed from a widespread mentality: as mentioned before, the common attitude towards premature babies was quite fatalist, and the death of weaker infants was considered inevitable since the most ancient times.

Thus Budin decided to send his collaborator, Dr. Martin Couney, to the 1896 World Exhibition in Berlin. Couney, our story’s true hero, was an uncommon character: besides his knowledge as an obstetrician, he had a strong charisma and true showmanship; these virtues would prove fundamental for the success of his mission, as we shall see.
Couney, with the intent of creating a bit of a fuss in order to better spread the news, had the idea of exhibiting live premature babies inside his incubators. He had the nerve to ask Empress Augusta Victoria herself for permission to use some infants from the Charity Hospital in Berlin. He was granted the favor, as the newborn babies were destined to a certain death anyway.
But none of the infants lodged inside the incubators died, and Couney’s exhibition, called Kinderbrutanstalt (“child hatchery”) immediately became the talk of the town.

This success was repeated the following year in London, at Earl’s Court Exhibition (scoring 3600 visitors each day), and in 1898 at the Trans-Mississippi Exhibition in Omaha, Nebraska. In 1900 he came back to Paris for the World Exhibition, and in 1901 he attended the Pan-American Exhibition in Buffalo, NY.

L'edificio costruito per gli incubatori a Buffalo.

The incubators building in Buffalo.

The incubators at the Buffalo Exhibition.

But in the States Couney met an even stronger resistence to accept this innovation, let alone implementing it in hospitals.
It must be stressed that although he was exhibiting a medical device, inside the various fairs his incubator stand was invariably (and much to his disappointment) confined to the entertainment section rather than the scientific section.
Maybe this was the reason why in 1903 Couney took a courageous decision.

If Americans thought incubators were just some sort of sideshow stunt, well then, he would give them the entertainment they wanted. But they would have to pay for it.

Couney definitively moved to New York, and opened a new attraction at Coney Island amusement park. For the next 40 years, every summer, the doctor exhibited premature babies in his incubators, for a quarter dollar. Spectators flowed in to contemplate those extremely underweight babies, looking so vulnerable and delicate as they slept in their temperate glass boxes. “Oh my, look how tiny!“, you could hear the crowd uttering, as people rolled along the railing separating them from the aisle where the incubators were lined up.

In order to accentuate the minuscule size of his preemies, Couney began resorting to some tricks: if the baby wasn’t small enough, he would add more blankets around his little body, to make him look tinier. Madame Louise Recht, a nurse who had been by Couney’s side since the very first exhibitions in Paris, from time to time would slip her ring over the babies’ hands, to demonstrate how thin their wrists were: but in reality the ring was oversized even for the nurse’s fingers.

Madame Louise Recht con uno dei neonati.

Madame Louise Recht with a newborn baby.

Preemie wearing on his wrist the nurse’s sparkler.

Couney’s enterprise, which soon grew into two separate incubation centers (one in Luna Park and the other in Dreamland), could seem quite cynical today. But it actually was not.
All the babies hosted in his attractions had been turned down by city hospitals, and given back to the parents who had no hope of saving them; the “Doctor Incubator” promised families that he would treat the babies without any expense on their part, as long as he could exhibit the preemies in public. The 25 cents people paid to see the newborn babies completely covered the high incubation and feeding expenses, even granting a modest profit to Couney and his collaborators. This way, parents had a chance to see their baby survive without paying a cent, and Couney could keep on raising awareness about the importance and effectiveness of his method.
Couney did not make any race distinction either, exhibiting colored babies along with white babies — an attitude that was quite rare at the beginning of the century in America. Among the “guests” displayed in his incubators, was at one point Couney’s own premature daughter, Hildegarde, who later became a nurse and worked with her father on the attraction.

Nurses with babies at Flushing World Fair, NY. At the center is Couney’s daughter, Hildegarde.

Besides his two establishments in Coney Island (one of which was destroyed during the 1911 terrible Dreamland fire), Couney continued touring the US with his incubators, from Chicago to St. Louis, to San Francisco.
In forty years, he treated around 8000 babies, and saved at least 6500; but his endless persistence in popularizing the incubator had much lager effects. His efforts, on the long run, contributed to the opening of the first neonatal intensive care units, which are now common in hospitals all around the world.

After a peak in popularity during the first decades of the XX Century, at the end of the 30s the success of Couney’s incubators began to decrease. It had become an old and trite attraction.
When the first premature infant station opened at Cornell’s New York Hospital in 1943, Couney told his nephew: “my work is done“. After 40 years of what he had always considered propaganda for a good cause, he definitively shut down his Coney Island enterprise.

Martin Arthur Couney (1870–1950).

The majority of information in this post comes from the most accurate study on the subject, by Dr. William A. Silverman (Incubator-Baby Side Shows, Pediatrics, 1979).

(Thanks, Claudia!)

A precariously balanced wonder

Nov11

An interview with a pathologist

Some days ago I was contacted by a pathologist who recently discovered Bizzarro Bazar, and said she was particularly impressed by the website’s “lack of morbidity”. I could not help but seize the opportunity of chatting a bit about her wonderful profession: here is what she told me about the different aspects of this not so well-known job, which is all about studying deformity, dissimilarities and death to understand what keeps us alive.

What led you to become a pathologist?

When I was sixteen I decided I had to understand disease and death.
The pathologist’s work is very articulated and varied, and mostly executed on living persons… or at least on surgically removed parts of living persons; but undoubtedly one of the routine activities is the autoptical diagnosis, and this is exactly one of the reasons behind my choice, I won’t deny it. Becoming a pathologist was the best way to draw on my passion for anatomy, turning it into a profession, and what’s more I would also have the opportunity of exorcising my fear of death by getting accustomed to it… getting my hands dirty and looking at it up close. I wanted to understand and investigate how people die. Maybe part of it had to do with my visual inclination, and pathology is a morphologic discipline which requires sharp visual memory and attention to macro and microscopic details, to differences in shape, to nuances in color.

Is there some kind of common prejudice against your job? How did you explain your “vocation” to friends and relatives?

Actually the general public is not precisely aware of what the pathologist does, hence a certain morbid curiosity on the part of non-experts. Most of them think of Kay Scarpetta, from Cornwell’s novels, or CSI. When people asked me about my job, at the beginning of my career, I gave detailed explanations of all the non-macabre aspects of my work, namely the importance of an hystological diagnosis in oncology, in order to plan the correct treatment. I did this to avoid a certain kind of curiosity, but I was met with puzzled looks. To cut it short, I would then admit: “I also perform autopsies”, and eventually there was a spark of interest in their eyes. I never felt misjudged, but I sometimes noticed some sort of uneasiness. And maybe some slightly sexist prejudice (the unasked question being how can a normal girl be into this kind of things); those female sexy pathologists you find in novels and TV series were not fashionable yet, and at the postgraduate school I was the only woman. As for friends and relatives… well, my parents never got in the way with my choices… I believe they still haven’t exactly figured out exactly what I do, and if I try to tell them they ask me to spare them the details! As for my teenage kids, who are intrigued by my job, I try to draw their attention to the scientific aspects. In the medical environment there is still this idea of a pathologist being some kind of nerd genius, or a person who is totally hopeless in human interactions, and therefore seeks shelter in a specialization that is not directly centered on doctor-patient relationship. Which is not necessarily true anymore, by the way, as often pathologists perform biopsies, and therefore interact with the patient.

Are autopsies still important today?

Let’s clarify: in Italy, the anatomopatologo is not a forensic pathologist, but is closer to what would be known in America as a surgical pathologist. The autopsy the pathologist performs is on people who died in a hospital (and not on the deceased who fell from a height or committed suicide, for instance) to answer to a very specific clinical inquiry, while the legal autopsy is carried out by the legal MD on behalf of the DA’s office.
One would think that, with the development of imaging radiology tests, the autoptic exam would have by now become outdated. In some facilities they perform the so-called “virtual autopsy” through CAT scans. In reality, in those cases in which a diagnosis could not be determined during the deceased’s life, an autopsy is still the only exam capable of clarifying the final cause of death. Besides direct examination, it allows to take organ samples to be studied under the microscope with conventional coloring or to be submitted for more refined tests, such as molecular biology. In the forensic field, direct examination of the body allows us to gather information on the chronology, environment and modality of death, all details no other exam could provide.

There is of course a great difference (both on a methodological and emotional level) between macroscopic and microscopic post mortem analysis. In your experience, for scientific purposes, is one of the two phases more relevant than the other or are they both equally essential?

They are both essential, and tightly connected to each other: one cannot do without the other. The visual investigation guides the following optic microscopy exam, because the pathologist samples a specific area of tissue, and not another, to be submitted to the lab on the grounds of his visual perception of dissimilarity.

In my experience of autopsy rooms, albeit limited, I have noticed some defense strategies being used to cope with the most tragic aspects of medical investigation. On one hand a certain humor, though never disrespectful; and, on the other, little precautions aimed at preserving the dignity of the body (but which may also have the function of pushing away the idea that an autopsy is an act of violation). How did you get used to the roughest side of your job?

I witnessed my first autopsy during my first year in medical school, and I still remember every detail of it even today, 30 years later. I nearly fainted. However, once I got over the first impact, I learned to focus on single anatomical details, as if I were a surgeon in the operating room, proceeding with great caution, avoiding useless cuts, always keeping in mind that I’m not working on a corpse, but a person. With his own history, his loved ones, presumably with somebody outside that room who is now crying for the loss. One thing I always do, after the external exam and before I begin to cut, is cover up the face of the dead person. Perhaps with the illogical intent of preventing him to see what I’m about to do… and maybe to avoid the unpleasant feeling of being watched.

Are there subjects that are more difficult to work with, on the emotional level?

Children.

Are autopsies, as a general rule, open to a non-academic public in Italy? Would you recommend witnessing an autopsy?

No, all forensic autopsies are not accessible, for obvious reasons, since there is often a trial underway; neither are the diagnostic post mortem examinations in hospitals. I wouldn’t know whether to recommend seeing an autopsy to anyone. But I do believe every biology or medicine student should be allowed in.

One of the aspects that always fascinated me about pathological anatomy museums is the vitality of disease, the exuberant creativity with which forms can change: the pathological body is fluid, free, forgetful of those boundaries we think are fixed and insurmountable. You just need to glance at some bone tumors, which look like strange mineral sponges, to see the disease as a terrible blooming force.
Maybe this feeling of wonder before a Nature both so beautiful and deadly, was the one animating the first anatomists: a sort of secret respect for the disease they were fighting off, not much different from the hunter’s reverential fear as he studies his prey before the massacre. Have you ever experienced this sense of the sublime? Does the apparent paradox of the passionate anatomist (how can one be a disease enthusiast?) have something to do with this admiration?

To get passionate, in our case, means to feel inclined towards a certain field, a certain way of doing research, a certain method and approach which links a morphologic phenomenon to a functional phenomenon. We do not love disease, we love a discipline which teaches us to see (Domine, ut videam) in order to understand the disease. And, hopefully, cure it.
And yes, of course there is the everyday experience of the sublime, the aesthetic experience, the awe at shapes and colors, and the information they convey. If we know how to interpret it.

Speaking of the vitality of disease: today we recognize in some teratologic specimens a proof of the attempts through which evolution gropes around, one failed experiment after the other. How many of these maladies (literally, “being not apt”) are actually the exact opposite, an adaptation attempt? Is any example of mutation (which a different genetic drift might have elected to dominant phenotype) always pathological?
What I really mean to ask is, of course, another one of those questions that any pathological anatomy museum inevitably suggests: what are the actual boundaries of the Norm?

The norm is established on a statistical basis following a Gaussian distribution curve, but what falls beyond the 90th percentile (or before the 10th) is not forcibly unnatural, or unhealthy, or sick. It is just statistically less represented in the general population in respect to the phenotype we are examining. Whether a statistically infrequent character will be an advantage only time will tell.
The limits of the norm are therefore conventionally established on a mathematical basis. What is outside of the norm is just more uncommon. Biology undergoes constant transformation (on the account of new medicines or therapies, climatic and environmental change, great migrations…), and therefore we are always confronted with new specimens coming in. That is why our job is always evolving, too.

I didn’t expect such a technical answer… mine was really a “loaded” question. As you know, for years I have been working on the concepts of dissimilarity, exoticism and diversity, and I wanted to provoke you – to see whether from your standpoint a mutant body could also be considered as a somewhat revolutionary space, a disruptive element in a context demanding total compliance to the Norm.

Ask a loaded question… and you’ll get a convenient answer. You’re talking about a culture demanding compliance to a social norm, I replied in terms of the biology demanding compliance to a norm that is established by the scientific community on a frequency-based statistic calculation — which is therefore still conventional. In reality, deformity appears in unexpected ways, and should be more correctly described following a probabilistic logic, and not frequency. But I’m beginning to sound technical again.

I have seen respected professors lighten up like children before some pathological wet specimens. The feeling I had was that the medical gaze in some ways justified an interest for extreme visions, usually precluded to the general public. Is it an exclusively scientific interest? Is it possible to be passionate about this kind of work, without being somehow fascinated by the bizarre?

There could be a little self-satisfaction at times. But in general there is sincere passion and enthusiasm for the topic, and that surely cannot be faked. It is a job you can only do if you love it.
All our discipline is based on the differential diagnosis between “normal” and “pathological”. I could say that everything pathological is dysmorphic in respect to the norm, therefore it is bizarre, different. So yes, you have to feel a the fascination for the bizarre. And be very curious.

The passion for the macabre is a growing trend, especially among young people, and it is usually deemed negative or cheap, and strongly opposed by Italian academics. This does not happen in other realities (not just the US, but also the UK for instance) in which a common element of communication strategies for museums has become the ability of arousing curiosity in a vast public, sometimes playing on pop and dark aspects. Come for the macabre, stay for the science. If young people are drawn to the subject via the macabre imaginary, do you think in time this could lead to the education of new, trustworthy professionals?

Yes, it’s true, there is a growing interest, I’m thinking of some famous anatomical exhibitions which attracted so many visitors they had to postpone the closing date. There is also my kids’ favorite TV show about the most absurd ways to die. I believe that all this is really an incentive and should be used as a basis to arouse curiosity on the scientific aspects of these topics. I think that we can and must use this attraction for the macabre to bring people and particularly youngsters closer to science, even more so in these times of neoshamanic drifts and pseudo-scientific rants. Maybe it could also serve the purpose of admitting that death is part of our daily lives, and to find a way to relate to it. As opposed to the Anglo-Saxon countries, in Italy there still is a religious, cultural and legislative background that partially gets in the way (we have laws making it hard to dissect bodies for study, and I also think of the deeply-rooted idea that an autopsy is a violation/desecration of the corpse, up to those prejudices against science and knowledge leading to grotesque actions like the petition to close the Lombroso Museum).

Has your job changed your relationship with death and dying in any way?

I would say it actually changed my relationship with life and living. My worst fear is no longer a fear of dying. I mostly fear pain, and physical or mental decay, with all the limitations they entail. I hope for a very distant, quick and painless death.

With your twenty years experience in the field, can you think of some especially curious anecdotes or episodes you came across?

Many, but I don’t feel comfortable relating episodes that revolve around a person’s remains. But I can tell you that I often do not wonder how these people died, but rather how in the world they could be alive in the first place, given all the diseases I find! And, to me, life looks even more like a precariously balanced wonder.

Kegadoru, gli idoli feriti

Aug6

Il quartiere Harajuku di Tokyo è famoso in tutto il mondo per le sue Harajuku girls, ragazze dai vestiti stravaganti, multicolori e inevitabilmente kawaii, sempre pronte a capitalizzare qualsiasi cosa faccia tendenza al momento. In questa fucina di mode alternative potete vedere sfilare sui marciapiedi decine di gothic lolita, oppure adolescenti vestite con abiti tradizionali mischiati con capi di marca, o ancora giovani agghindati come se fossero ad un festival di cosplay.

Una moda degli ultimi anni è quella dei kegadoru, ossia gli “idoli feriti”, cioè giovani donne che mostrano segni di traumi fisici, bendaggi e garze oftalmiche o di primo soccorso.

Forse stanno soltanto cercando di attirare l’attenzione dei maschi orientali. Ma in realtà ricoprirsi di bende o fasciarsi un arto come se si fosse appena usciti dall’ospedale è un modo di strizzare l’occhio ad uno dei feticismi sessuali più in voga in Giappone: il medical fetish ha infatti sempre occupato una nicchia piuttosto apprezzata nell’Olimpo delle fantasie nipponiche, e non soltanto.

In effetti esistono riviste erotiche specializzate sul tema, in cui belle e procaci modelle sfoggiano fasciature mediche, tutori ed altri apparecchi terapeutici o protesici. Cosa affascina il pubblico maschile in queste fotografie?

A prima vista sembrerebbe controintuitivo: gli evoluzionisti ci hanno sempre insegnato (vedi ad esempio questo articolo) che, seppur inconsciamente, scegliamo i nostri partner per la loro prestanza e salute fisica – segnali di maggiori chance che la procreazione vada a buon fine.
Ma in questo particolare caso diversi fattori entrano in gioco.

Innanzitutto, le bende. Le fasciature che costringono il corpo, nell’ambito feticistico, rimandano al bondage e alle sue corde, ma con tutta la portata simbolica del contesto clinico. E tutti conosciamo bene il potere di un camice bianco sulla fantasia erotica: il mondo della medicina, in virtù del suo focalizzarsi sul corpo, è entrato prepotentemente nel comune immaginario sessuale, dall’infantile “gioco del dottore”, all’icona pop dell’infermiera sexy, fino ai feticismi che trasformano alcuni strumenti medici in oggetti di desiderio (speculum, clisteri, ecc.).

In secondo luogo, il concetto di kegadoru fa leva sull’istinto di protezione. In questo senso, è un tipo di roleplay simile a quello che esiste, in ambito BDSM, nel cosiddetto rapporto Daddy/Little, dove il maschio è figura paterna e premurosa (ma anche severa durante le necessarie “punizioni”) e la femmina diviene una bambina, viziosa e incorreggibile ma oltremodo bisognosa di cure e attenzioni. Qui invece, la ragazza occulta parte del suo viso e del suo corpo sotto le bende, e questa sua “imperfezione”, oltre ad esaltarne la bellezza (attraverso il classico effetto “vedo – non vedo”), domanda premura e tenerezza.

Infine, i kegadoru hanno anche una chiara connotazione masochistica. La donna, in questo gioco, è molto più che indifesa – è addirittura ferita; non può quindi opporre alcuna resistenza. Eppure nel suo esibire le proprie fasciature in pose maliziose, come fossero un tipo particolare di intimo o una divisa fetish, sta evidentemente accettando e scegliendo il suo ruolo.

Tutto questo contribuisce al complesso fascino degli injured idols, che ha ossessionato almeno due grandi artisti: Trevor Brown (di cui abbiamo parlato in questo articolo) e Romain Slocombe, fotografo, regista, pittore e scrittore parigino che ha fatto delle ragazze “ferite” le sue muse ispiratrici. Ecco alcune delle sue migliori foto.

Trevor Brown

Apr12

L’artista inglese Trevor Brown è celebre per le sue opere estreme e macabre, che spesso affrontano temi difficili e spinosi. Trasferitosi in Giappone all’inizio degli anni ’90, ha goduto di una fama sempre maggiore mano a mano che le sue pubblicazioni raggiungevano un’ampia diffusione, e che le sue immagini venivano utilizzate per adornare copertine di album di vario genere, e pubblicate sulle prime pagine di diverse riviste famose.

I dipinti di Brown sono ispirati dagli scritti di Sade e di Georges Bataille sull’erotismo, ma ciò che li rende davvero unici è la commistione di innocenza e violenza con la cultura pop giapponese. Trevor Brown esplora diversi territori ritenuti tabù: la pedofilia, la tortura, il medical fetish (di cui è pioniere riconosciuto), il BDSM e altre parafilie.

Protagoniste dei suoi disegni sono quasi esclusivamente bambine sottoposte a vari generi di stress, torture o costrizioni. Eppure, grazie appunto alla forza con la quale l’artista riesce a fondere la sua sensibilità con la cultura giapponese, queste immagini crude e forti emanano un’aria di innocenza e di infantilismo che contrasta con gli aspetti più macabri. I colori pop estremamente accesi, i grandi occhi in puro stile manga, la limpida pulizia dell’immagine rendono i suoi dipinti delle specie di teatrini astratti, pure icone di repulsione e desiderio.

Alcune delle sue immagini più celebri esplorano il cosiddetto medical fetish, vale a dire il feticismo ospedaliero per le bende, le siringhe, gli strumenti chirurgici e ginecologici. L’ispirazione principale (dichiarata) per questo tipo di feticismo restano i romanzi di uno dei maggiori scrittori inglesi del dopoguerra, James G. Ballard (Crash e La mostra delle atrocità sopra a tutti).

Trevor Brown è anche affascinato dalle bambole create da sua moglie: da un certo momento in poi comincia quindi a inserirle anche all’interno dei suoi lavori. La bambola è un altro stratagemma efficace per creare quel senso di disagio e spaesamento che l’artista ricerca: simbolo ludico e infantile per eccellenza, viene qui posto in situazioni invariabilmente adulte, crudeli o morbose.

Eppure, per quanto macabri ed estremi, i suoi dipinti hanno sempre qualcosa di indefinitamente positivo. Le ferite, gli ematomi, le garze oftalmiche divengono quasi un gioco sensuale, perdono il loro alone di semplice sofferenza: rappresentati come oggetto feticistico, sembrano divenire orpelli quasi desiderabili. Sembra cioè che le stesse bambole se ne rendano conto, e si compiacciano ingenuamente che la loro bellezza venga esaltata da questi strani ornamenti.

L’apparente semplicità dei disegni di Trevor Brown nasconde una cura maniacale per il dettaglio, e un senso della composizione non comune. Grazie all’ibridazione fra l’immaginario infantile e quello feticistico, Brown riesce a interrogarci sulla natura sadica del desiderio, mettendoci a disagio con pochi, precisi elementi.