It’s Actually An Interesting Process to Donate Your Body to Medical Science

cadaver
Photo Credit: Shannon Carabajal 

Disclosure: For those who avoid morbid light-heartedness and sarcasm, perhaps you won’t enjoy this post.

Over the last year and a half, since getting divorced, I’ve been getting my  “affairs” in order.  I don’t plan on kicking the bucket any time soon, but in case I do, I want things to be in place for my boys.  So, I’ve designated a power of attorney, set up an estate trust, gotten ample life insurance, and set up a living will and advanced directives…you know, adulting kind of stuff.

Having gone to about a billion funerals in my life, and helping plan a few, I realize how expensive and stressful funerals can be. Even the cheapest, absolute bare bones funeral home services and coffin package costs several thousand dollars.  Even cremation comes with a noticeable price tag.

In many areas of my life, I’m pretty frivolous and excessive.  But when it comes to me dying, I have always aimed to be as practical as possible.  Salvage what you can for those needing transplants, and let medical students hack away on the rest of me. Morbid as it may sound, I’ve just never been keen on being stuck in a box in the ground or set in an urn on a fireplace mantel somewhere.

I made my wishes clear to my power of attorney in the unforeseen event of my demise and may have daydreamed a tiny bit of how my earthly self might help further the causes of medical research.  That is until I talked with a local hospital marketing employee who told me that in Indiana, it’s actually sometimes more difficult than you would think to bequeath your freshly dead self to science.  I was really disappointed, both regarding my fantasies of my altruistic sacrifice, but also because my plans to make things super easy on my kids and family when I die shriveled up before my eyes.   Just to be on the safe side, I decided to look into the process, and here are a few random but interesting facts I stumbled across on The Google.

  1. You have to apply to donate your body, and…you might be rejected.  In general, having things like cancer, arthritis, or dementia won’t exclude your bodily donation from being accepted.  However, if you have a communicable disease, hepatitis, HIV, are taller than six feet, or weigh more than about 200 pounds, your chances of being selected to grace the cadaver table of a med school gross anatomy lab are slim to none.  Apparently, the embalming process adds another 100 to 150 pounds of weight to a corpse, making them wieldy to handle.
  2. Who would have thought that airline mergers would have any bearing on gifting yourself to a research institution? But it does. According to US Funerals Online, the changes in major airline companies have made getting donations to where they need to go more costly and cumbersome. If you’re concerned about the transportation industry ruining your post-mortem travel plans, consider pre-registering with a for-profit cadaver company to donate your body so you’ll know ahead of time what your options are.
  3. Donating your body to medical science isn’t free. In some places, like Indiana, where I live, there is a 24-hour phone line to call with inquiries about donating a recently deceased person. A quick phone screening by the Anatomical Education Program of Indiana University School of Medicine will determine eligibility for donation. If the family of the deceased requests it, the program will come pick up the body, use what it can, and cremate the remains.  If the family doesn’t want the ashes back 18-24 months later, there is a cemetery specifically designated as an eternal resting place for them..the ashes, not the family.  This is all done with no expense to the family.  However, it costs the School of Medicine significant funds to carry out this program.  But an added perk?  You can donate funds along with yourself when you die to ensure that the program will be able to afford to dissect you, for educational and medicinal purposes, of course.
  4. Supply of cadavers for research and medical school is low, even as many medical schools are moving away from using cadavers. In the past, it was legal to use unclaimed bodies as research cadavers. Perhaps you’ve even heard stories of grave robbers and body snatchers. Here’s an interesting bit of history and social injustice surrounding that. Now, in states like New York, years old traditions have been upended by new laws requiring explicit consent by family to use a body for research.
  5. Body farms – enough said.  A few years ago I started reading Stiff: The Curious Life of Human Cadavers by science writer Mary Roach. In one chapter she described exploring an outdoor scene where corpses lay in various degrees of decay.  I had forgotten all about the detailed imagery in her book until reading articles for this blog about body farms.  This is the less glorious side of donating one’s body to science.  Rather than be sliced and incised by a fresh-faced doctor wanna-be, bodies are laid out on plots of land so forensics specialists can learn about how bodies decompose over time and when exposed to the elements.  However, the noble side of body farms is they can help provide justice for victims of abuse. Also, on a lighter note, if you get rejected as a body donation by a medical school, you might be welcomed at a body farm.
  6. You might not be accepted as both an organ donor AND a whole body donor. Organ donors are more common than whole-body donors, and it seems more culturally accepted here in the United States.  But many places, like the Mayo Clinic, won’t accept a body for donation after organs have already been removed for other purposes.  So, another reason to plan ahead of time which rite of passage is most important to you?- transplants or research.
  7.  There are alternatives to traditional funerals and cremation through funeral homes. Apparently, there is a trend called “green burials“, which is legal in all 50 states, where one can be allowed to decompose naturally without the use of embalming chemicals like the carcinogenic formaldehyde.  There are 30 or so specific “green burial” cemeteries across the United States.  And unbeknownst to me, you can still be buried in your backyard on private land as long as proper protocols and rules are followed.  This sort of necessitates pre-registration as well to ensure all the necessary paperwork is filed before you die.  Finally, only seven states require that a funeral director presides over the comings and goings of a person who has died. In all the other states, body preparation and services can all be performed at home.   Kind of like a home birth…but the other direction.

In reading up for this post I found quite a number of humorous articles related to body donations, as well as sites of companies that ironically make money off of body donations by taking them and piecemealing body parts out to needy institutions.  But the overall lesson? Body donation is not always a firm guarantee, so deciding on a backup plan for your body’s final destination is a good idea.

As a last side note, consider setting up an advanced directive for how medical care should be organized in the event you can’t make decisions for yourself.  It’s not difficult, it sure helps healthcare professionals and your loved ones when hard, emotional choices are required, and it’s a good way to maintain your self-agency in death instead of letting the courts have authority over who makes decisions concerning you and your care.

 

 

Life and Death are Programmed Within: A Brief Reflection on Telomeres and Interdepedence

A few years ago, after just moving to the Boston area, I discovered that the Dalai Lama was going to speak downtown at TD Garden.  I wasn’t very familiar with the city yet or how to get around, but I hopped on a train anyway and made my way up to see him.  Until that time, I had read bits and pieces of his writings and listened to a few short YouTube videos that featured him being interviewed or teaching.

The stadium was packed when I arrived, drawing in crowds from all different backgrounds.  The funny thing is, I hardly remember a thing about what he actually said.  But what I do remember is that he basically made the throngs of people melt.  We sat still and quiet, hanging on to every word that he said, and giggling every time he laughed or made a joke. We didn’t just hear a talk by an amazing religious and political leader; we felt the presence of someone who was joyful, and compassionate and seemed to know something that most of the rest of us didn’t.

I fell in love with the Dalai Lama that day. He’s very high on my “People I desperately want to meet but there is very little chance of that happening in this life, gosh darn it!” bucket list.

I own several books written by the Dalai Lama, and was very excited to read The Book Of Joy, which records conversations between the Dalai Lama and his good friend, Archbishop Desmond Tutu, about what it means to live a joyful life.

the book of joy.jpeg

In one particular chapter, the Dalai Lama and Tutu discussed death and how we need to learn to face our own mortality, and the fact that things in life constantly change and cease to exist.  Here’s a short excerpt that caught my attention:

“In fact, as the Buddha reminds us, the very causes that have given rise to something, such as our life, have created the mechanism, or the seed, for that thing’s eventual end. Recognizing this truth is an important part of the contemplation on impermanence.” (p.165)

When I read this sentence, my mind immediately flew to cellular activity and little bits of DNA sequences called telomeres. When I think of telomeres, I envision health status or life remaining gauges that are common in video games.   Telomeres are short nucleotide sequences that “cap” the end of chromosomes in our cells to help keep them from effectively fraying or fusing with nearby chromosomes.  Another analogy here would be to think of those little plastic tips on the ends of shoelaces that hold the threads together to prevent splaying.

 

telomere
Chromosome highlighting telomere sequence

 

Telomeres can be lengthened with a special enzyme called telomerase, which is present during development in fetal tissue or in adult germ cells (think sperm and egg cells), or cancer cells. It is an important component of the “life-giving” cells, the ones that will reproduce and differentiate into new tissues.  In other normal adult cells, telomerase activity is diminished, meaning that telomeres will inevitably erode every time cells divide.  Ultimately then, each time a cell divides, it ages just a bit more.

Eventually, as a telomere shortens after repeated rounds of cell division, it reaches a critical length. This critical length affects a cell’s ability to divide and reproduce.  Certain tissues in our bodies “age” more quickly because of lots of cell division, like our skin and hair.

While telomere length is negatively correlated to aging (as length decreases, aging factors show increased appearance), shortened telomeres are not necessarily the primary cause of aging.  However, studies have shown that individuals with shortened telomeres have increased risk of things like heart disease or infectious disease. If you’re interested in reading a review of the subject, click here.

What I find intriguing about telomeres is how an old Buddhist saying reflects some biological truth.  A telomere is a seed or mechanism that is crucially involved in both life, and death.  Something that is needed for our development and growth (life processes) also inherently seems to program our length of life to some degree. Sure, we may be able to alter the timeframe a bit with lifestyle choices and staying away from copious amounts of radiation and things like that, but as of right now, we get what we get in regard to telomere length.  In other words, our death isn’t something that just “happens” to us because of external causes.  Death is inextricably part of the same processes that bring us life.

This all brings us back to the Dalai Lama and his reminder that all things that come into existence will end, and this is because everything is interdependent.  Nothing exists independently.

We, as Westerners, are often terrified by our mortality, and we do whatever we can to avoid it. But I think we can learn much about what it means to be human by understanding that nothing stays the same forever, and that the dying process is just as natural as living.  The key then, I think, is to learn how to go through both processes with meaning and joy.