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Bodies for Science

2024/2/23
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The Pulse

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People
A
Angelina Wally
C
Clarissa Murray
E
Ernest Tallarico
J
Jennifer Adokabi
J
Joy Balta
M
Maiken Scott
M
Michael Saple
P
Patricia Kelly
S
Susan Kelly
T
Teresa Thompson
Topics
Clarissa Murray: 我作为宾夕法尼亚州人体捐赠登记处的负责人,主要负责在生者和死者之间建立桥梁,为医学院提供遗体。然而,我们面临着遗体捐赠数量不足的挑战,尤其是在疫情期间,捐赠数量大幅下降,导致医学生共享遗体,减少了实践机会。同时,我们还面临着来自盈利性机构的竞争,这些机构利用法律漏洞,通过广告吸引捐赠者,使得我们这些非营利机构更难竞争。尽管如此,我相信真人遗体是无法替代的,它们对于医学教育至关重要。 Joy Balta: 我是美国解剖学家协会人体捐赠政策项目的主席。疫情对遗体捐赠项目产生了重大影响,许多项目被迫关闭。尽管目前缺乏全国性的数据,但我们知道疫情加剧了美国解剖学教育中存在的问题,例如解剖学课时数的减少,这直接影响了医学生的手术技能和患者护理能力。此外,盈利性机构对遗体捐赠的承诺含糊不清,可能并不真正用于学术机构的解剖学教育。

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This is The Pulse, stories about the people and places at the heart of health and science. I'm Maiken Scott. If you're training to become a physician, your first patient is usually dead. First patient is a way people refer to the human cadavers that med students work on during anatomy class.

when they first learn how to make careful incisions and lay eyes on the beautiful intricacies, bones, muscle, blood vessels, organs, that make our bodies work. He's cutting the red night right now so we can have more space to actually go into the cavity.

Anatomy lessons are often filled with nervous anticipation, a sense of wonder, and surprises for the students. It's very lumpy. It being a heart. Like in textbooks, you know, everything has a very defined shape. That is not the case at all. Everything, I feel like, kind of...

It's the shape it is to fit in the body. Anatomy instructors walk around, offering advice and tips. For the students, it's an important learning experience as they peel back layers of tissue to get to the organs. Right now, we will be exposing the inside of the ventricle.

They were seeing the effects of illnesses, but also human resilience. The patient was 107 years old, and the patient is in pretty incredible shape at the moment of death. Our bodies can tell a story, even after death, of staying healthy and strong, or of hard work and stress that left its marks, of bad habits that hardened organs, shrunk blood vessels, or added layers of fat.

Bodies can teach valuable lessons, leading doctors and researchers to understand causes of illnesses and connections between different conditions. But getting human cadavers for this kind of work is difficult. On today's episode, donating bodies to science, how they are being used, why they are so important, and why people decide to donate their bodies. ♪

First up, how do cadavers get to anatomy class? How do they end up in research facilities to be dissected and studied? Med schools often partner with donation organizations, which have to follow certain rules and regulations. Currently, there is a shortage of bodies that is affecting med schools across the country. Donations were slow to start with, and the pandemic made matters even more challenging.

Grant Hill has this profile of a woman who is spreading the word about the value of body donation, all while being very careful not to break any rules. The Human Gifts Registry of Pennsylvania. The name sounds like some kind of weird consignment shop. In a way, it is. But when I walk in, I get the feeling I'm not supposed to be here, like a stowaway amongst a skeleton crew.

The registry doesn't get a lot of visitors. Not anymore. For security reasons, the agency stopped sharing its address publicly. Clarissa Murray welcomes me into her office anyway and briefly excuses herself for a blunt call with a coroner tracking down a body. I'm always...

On a daily basis, either emailing the coroner or medical examiner's office or talking to them. Here, Clarissa is the captain, heading a three-person team of state-sanctioned middlemen, a bridge between the dead and the living for the fifth most populated state in the country. Clarissa and her team provide bodies to health professionals in training at nine of Pennsylvania's most important educational institutions.

While the registry can educate people about their work, they can't directly solicit donations. Once somebody signs up, it's the registry's job to make sure the body gets to one of the institutions after the donor has died.

Clarissa joined the team over 20 years ago, following her stint as a publicist for the Swedish bikini team. Actually, during my interview, I said, hey, if I could sell the Swedish bikini team to Americans, I could sell body donations to people. Personally, the Swedish bikini team seems like a much easier sell. Back then, she got them on the Howard Stern show.

These days, Clarissa sends letters to hospitals, speaks at nursing homes or hospice care facilities to talk about body donation. Telling them, hey, you don't have to just cremate or bury yourself.

Legally, this is about as far as Clarissa is allowed to go. But luckily, some people don't need convincing. She remembers going out to lunch with a nun who got her whole convent to sign up with the registry. She said, I tell my congregation that

Burying your body is like burying food when your neighbors are hungry. And I thought that was like, I love that. I will use that for everything I say. If more people had this type of attitude, Clarissa's job would be a lot easier. Overall, the agency consistently falls below its yearly donation goals. Whole body donation is not something a lot of people think about or like to think about.

Plus, the program competes with other organizations, like organ donation programs, that are more visible and easier to sign up for. We're kind of like the second tier of donation because there is an urgent need for organ donors. The registry has a donation goal of around 900 bodies a year, but only ever gets to about 750.

This means fewer bodies for its member institutions and that students have to share. Less hands-on training for future doctors and health care professionals. And when the pandemic hit, things started to feel really dire. Our internship probably was cut in more than half.

of what we were receiving. The registry isn't allowed to process donors that potentially harbor infectious diseases, especially something that was then unknown, like the novel coronavirus.

In-person training was also mostly canceled. Med school morgues that typically held donated bodies were repurposed for overflow pandemic deaths. It slowed the registry to a crawl. We only get funding from the medical schools for each donor that we get to them, you know, and that's how the laws are created. So when it's cut in half, it's not like rent was cut in half for us or bills were cut in half, but our families.

Our income was cut in half. It was a complicated, frightening time. I was afraid that HDR was going to close under my watch.

And nonprofit donation programs across the country faced similar fears. This was the case at many institutions for a very long period of time, for over a year or two. Joy Balta is chair of the Body Donation Policy Program for the American Association of Anatomists. So lots of programs kept their programs shut down.

During this time, because we didn't really know what to do. At the time, Joy oversaw the body donor program at Ohio State University, a program about half the size of the registry. He dealt with the same problems caused by the supply and demand whiplash brought on by the pandemic.

Still, he says little is known about the effects nationally. This is an understudied research area. In 2016, the yearly supply of body donors for medical education in the U.S. was estimated to be about 20,000. Today, there's little data for a credible comparison. What we do know, Joyce says, is that the pandemic exacerbated existing problems with anatomy education in the U.S.,

For health professionals in training, the number of hours dedicated to anatomy was already well in decline before 2020. Joyce says it's had real-world effects. There's been papers talking about how the decline in number of anatomy hours is actually having direct impact on gaining skills in surgery, at patient care, at competencies in residencies. An average of about five students shared one cadaver prior to the pandemic.

Not ideal, but better than nothing. Now, the number of students is likely higher for each body. A recent survey found a drastic reduction in time spent training with cadavers. Clarissa Murray says the human gifts registry weathered the storm, thanks to steep cost-cutting. The agency is now close to supplying the same amount of donors as it had before the pandemic.

Still, the registry and other non-profit body donation programs continue to face headwinds, like competition from for-profit body donation companies that are owned by hedge funds. They can exploit legal loopholes, create slick advertising, and cover more financial barriers for potential donors.

Clarissa says it all makes nonprofit organizations like the registry less competitive. If you Google body donation, we're not the first that come up in the state, even though we've been here the longest. We don't have the monies to do that, to do the algorithm, to be the first on Google. While for-profit companies make guarantees that body donations go toward education...

Joy Balta says it's a vague promise, not governed by the same regulations as nonprofits. Education is a very broad term. So if you are learning something remotely related, that is education. So that's a very broad term. It's not necessarily saying anatomy education. It's not saying at an academic institution. In 2021, one woman learned this the hard way.

Where's the body? That is the question a Louisiana widow is asking tonight after she learned of her husband's public autopsy. 92-year-old Elsie Saunders believes she donated her husband's body to science, only to find out the for-profit company she had given his body to sold it for public dissection in front of a large paying audience inside a hotel meeting room in Portland.

The company claimed it had not known what the body was going to be used for. An official said technically no laws were broken. There was also a push to eliminate the need for body donations altogether. Greetings, organic humans. Kevin.

Nearly a decade ago, a company called Cyndaver Labs made a big splash on Shark Tank, showing off its flagship synthetic human cadaver. Cyndaver Labs designs and builds the world's most sophisticated synthetic human tissues and body parts, made from salt, water, and fiber, just like you and I. A single Cyndaver takes about 10 weeks to make and costs around $75,000 each. Not

not including refurbishments. A company representative told me Cyndaver posted record sales last year. But Clarissa Murray believes there is no substitute for the real thing, a real human body. And a recent conversation she had about her work made that clear to her once again. My primary care physician, when I told her what I do, she gets all teary-eyed. You know, she hasn't been to medical school in 30 years. And she said her cadaver, where she went...

had an anomaly with the nerve. And so she said, I believe he was in a lot of pain, but it was so deep down in his body that it was not something you could find with an x-ray or other ways of finding, but he was in pain and he probably asked for a pain medication.

But nobody knew that he had that until I saw it. So now she treats people with the knowledge that this thing can be hidden in your body, but nobody would know. That story was reported by Grant Hill. We're talking about Bodies for Science.

We just heard about a bunch of different rules that govern the process of body donation, and they're in place for good reasons. Anatomy lessons are tied to a troubled history, body snatching. In the late 1800s, medical schools needed bodies for students to dissect.

There were no scans at the time, no MRI machines, no way to look inside the body other than to get your hands on a cadaver and open it up. But cadavers were really hard to come by. Philadelphia was home to several medical schools, and body snatching turned into a scandal.

Several years ago, reporter Alana Gordon spoke about this with historian Michael Saple, who's written a book about anatomy called A Traffic of Dead Bodies. A body snatcher is a grave robber who takes a body out of a grave. They could also be called a resurrection man,

The body snatcher term is mainly associated with medical grave robbery. During the 17 and 1800s, these resurrectionists made a killing digging up corpses and selling them to medical schools. There are a few notorious examples of times when it became so lucrative that body snatchers actually murdered people in order to supply the anatomy department. ♪

Now that was the extreme, but doctors and students had a problem. They needed bodies to dissect, to learn. But there wasn't an easy way to get them, at least enough of them. And when you think about it, the experience was really important back then. You had Civil War soldiers returning from battle, the emergence of the ambulance, new surgical techniques. Contrary to nowadays, Michael Saple, that historian who's written about this,

says there was a huge stigma back then about being dissected for medical education or even being autopsied because how you were treated after death was really important. This is also a time in American culture where how you die really matters to people. And

If you're a poor person and you're saving money, the money you might be saving would be dedicated to your death. Dissection for centuries back was often listed as an added punishment to those sentenced to execution. The easiest bodies to snatch were those of the poor and vulnerable, who didn't have money for cemetery security or a protected grave.

These were African Americans, immigrants, those buried in potter's fields or who died in asylums and prisons. There was also an urgency to get bodies. Preservation science hadn't really advanced yet, so bodies would decompose fast.

In the early days, even students sometimes got directly involved in stealing them. Well, some of them get the bodies by going to the cemetery themselves to get them. Meaning, like, they just ask for them? No, meaning they go in the dead of night and they might bribe a watchman or maybe get a watchman drunk or maybe they just look for the moment when the watchman falls asleep.

then they bring in their wagon with their horse and dig and unearth the body and then away. That sounds horrific to me and I would imagine to a med student today. What was different then? Well, part of it was this is a rite of passage. First of all, imagine the medical students back then tend to be younger. It's a culture of camaraderie and bravado. You want to curry favor with the professor, bring the professor a body. Bring the professor an interesting body.

You want to curry favor with your fellow classmates? I got a body. They're impressed with you. You're a brave, strong lad. These students weren't always respectful in how they handled the bodies. And when the public caught wind of the unruly activity, riots would break out. Every medical school in the United States has a body-snatching scandal. Wow.

That was reporter Alana Gordon speaking with historian Michael Sapel. Eventually, those scandals led to legislation that created legal pathways to donate your body to science. Legislation that also ensures that bodies are treated respectfully. We'll put a link to Alana's full story on this topic on our website at whyy.org slash The Pulse.

This is The Pulse. I'm Maiken Scott. We're talking about bodies for science. Donated bodies are often the first human patients that med students come into very close contact with. And while they will likely always remember that first patient, they often don't get to know all that much about them. No name, no history, just an ID number hanging off of their foot.

Anatomy professor Ernest Tallarico wanted to change this because he felt that it led to a disconnect in terms of how precious this gift of donation really was.

At the time, he was an anatomy professor at Indiana University. I remember one of the students giving a name to her first patient. But this particular name was Mercedes. He asked the student why she chose the name Mercedes, and he was shocked by her response. Because she's going to enable me to buy a bunch of Mercedes.

And I was just, you know, taken back by that. And I thought that without knowing the name of the individual and knowing something about them, we weren't communicating the right ideas in terms of professionalism and training that we should be imparting to our students.

Ernest decided he needed to reframe how medical students think of these bodies. He came up with a method called the Tallarico Protocol for Human Gross Anatomy. Nicole Curry has more about this approach and its impact. Susan Kelly remembers her father as a gentle man, even-tempered and very loving.

His name was William Kelly. He was my rock, and he was one of the best men I've known in my lifetime. Susan grew up in Chicago with her father, mother, sister, and brother. Her dad was a family man. He always made sure that we had individual time together. We didn't have a car, and we

We would have to walk sometimes a mile or two to go to church or to the grocery store and we would talk the whole time. We talked about life and what dreams I had. I felt like my life is richer because we had these long talks. Susan says her dad and mother, Patricia Kelly, were polar opposites.

William was Catholic. Patricia was Protestant. William was calm and collected. Patricia was daring and bold. My mom's nickname was the General. She was a force to be reckoned with. And my dad loved it. Despite their differences, Susan's parents had shared values. He and my mom both thought education was, you know, like on the top of the list practically, besides God and family.

They valued education so much that when Susan's dad developed Alzheimer's in his late 70s, he decided to donate his body to science. He chose an anatomy course at Indiana University's School of Medicine. He made this decision after Susan saw a story about this program on the afternoon news. When you're sick or injured, you expect that your doctor will have hands-on training treating patients. It seemed different than a regular anatomy course.

This was in 2010. Well, they are hoping that more people decide to donate their bodies to science. CBS 2's Pamela Jones is here with... The anatomy course was designed and implemented by Ernest Jalarico. Medical students had to write letters to the families of those who donated their bodies throughout the course, only if the family was okay with it.

The letters were an effort to teach students that the cadaver they were working on and learning from was a human before being donated. That this cadaver was their first patient and they should treat it as such. William Kelly died in 2011. His body was used in a spring semester class. Three students were assigned to his body.

They began exchanging letters with Susan and her family. During that process, you're telling them things about your loved ones, you know, what he treasured and what a good dad he was. The students wrote often. One of them, Jennifer Adokabi, wrote more frequently. And Susan really clicked with her. They started talking on the phone.

They talked about her dad, their shared faith, and Jennifer's hopes and dreams as an aspiring doctor.

And on the really bad days, when Susan couldn't stop thinking about her father's death, talking to Jennifer was very helpful. She would encourage me to really just close your eyes and try to remember some of the things that were really good. Susan would do this a lot. At times, it made her laugh to think about the good days, like when Susan or her children were sick.

The grief Susan experienced was so heavy. Not only because her father had died, but because of the way he died.

Susan was her father's caregiver towards the end of his life. Alzheimer's is by far to me the most wickedly cruel disease. You know, he would like always forget that he had eaten and he'd eat more and eat more and be like, oh good, I'll put some weight on. And then he'd go for days where he's like, I already ate, I already ate, it's

Because you lose people a little bit at a time. But Susan says talking with Jennifer helped her process her emotions. It's very emotional in that you were recalling things, but it was also like grief counseling. Jennifer also enjoyed talking with Susan. It causes for you to have a shift in your emotions.

mindset on when you are reviewing anatomy. She was in the lab, dissecting William's body, learning about anatomy. The letters were giving life to a lifeless body. Sure, they can't say ouch or, you know, that hurts when you're doing this, but being able to understand that this was once a living and breathing human who, you know, created legacy. They have kids and grandkids

Even after the class came to an end, the family's friendship with Jennifer did not. Jennifer would go over to their house for family dinners, and she grew very close to Susan's mother, Patricia. She was just a very, very, very sweet and loving woman. And, you know, just speaking about her raising her kids and, you know, taking care of her family and then seeing that in action and

It was just nice to see how close she was to her family and how much they meant to her. And she meant a lot to me as well.

And that would have never have become if, you know, this program didn't exist. And this program continued to impact the Kelly family. This was more than donating your body to science. This was respecting the person that is being dissected, basically, you know. And when you get invested in learning who this person is, you're going to be called to more excellence, more compassion in your work as a doctor.

Two years after William Kelly died and donated his body, his wife Patricia became ill. She knew that she had maybe a year or two to live, so she asked Susan to set up a video camera and record a message for her. May 14, 2014. Dr. Ernest Tallarico, anatomical medical students and guests.

Patricia signed up to donate her body to the anatomy course, and she wanted the students to know the impact the program had on her life. She took them back to the day when the school had given a memorial service for the families of the donors. She shared every detail of this special day. And as we walked down the sidewalk, you know, saw all of these young people, and they all just separated and died.

and just seemed so happy to see us like they'd known us all their lives. And I think they did, in a way, from those wonderful letters. The service was held on the school's campus in a garden. And each donor...

and a rose. Family members were given different colored roses. It was a way of saying thank you for donating to the program. And Jennifer stood up to honor William in song. She sang Unforgettable by Nat King Cole and his daughter, Natalie Cole. Unforgettable And as they passed by me, they knelt down, they hugged me, and I still will never forget it. Excuse me.

But I felt like they were all my family. And they were so, so grateful for the donation of my husband's body. It was just a perfect ceremony. Everything about it was perfect. Each one of them was perfect. It was just exactly like a family ceremony.

is proud to be a part of. Patricia died from heart failure one year after recording this message in 2015. Jennifer is now an OBGYN in Columbus, Georgia, but she remains friends with Susan and her sister Pam. They check in with each other every now and then.

Indiana University discontinued this program in 2018, but Ernest Tallarico has since taken his method overseas to schools in Spain and Vietnam. And when the time comes, Susan says she hopes to donate her body to one of his programs. For The Pulse, I'm Nicole Curry. No name.

This is The Pulse. I'm Maiken Scott. We're talking about bodies and the lessons they can teach in medicine and science. Donated bodies are often used in teaching healthcare professionals about the intricacies of bones, muscles, and organs, but they do much more than that. For example, there's brains that we remove here in Illinois, and we send them to Case Western because Case Western does research on prion protein or mucous

mad cow disease in humans. That's Ernest Tallarico again, the anatomy professor who started the program we just heard about. He's now at Purdue University Northwest. Beyond anatomy lessons, he says donated bodies play an important role in research and often offer an opportunity to learn new things about rare conditions. There was a study that we did on a condition called hyperostosis frontalis interna,

Sounds like very complicated words and basically what it means is that the inner surface of the frontal bone, which makes up the front part of the skull, becomes remodeled. And instead of being very smooth, like it should be, it becomes very rough. It almost looks like the surface of the moon. You know, why does that happen? How far spread is it? We don't know. And it was the worst type ever recorded.

Right now, Ernest is working on a cadaver that has a condition that is so rare, only nine people in the world have been recorded to have it. In one of our current studies, we have a male anatomical donor, male first patient, who has four testicles instead of two. Me personally and my students, we'd never seen anything like this before. Didn't even know a condition like this could exist.

The condition is called polyorchidism. It's unclear why or how this condition comes about.

Ernest and his team sequenced the donor's DNA. Which is a very difficult task to do from an anatomical donor that has already been preserved with formaldehyde-based embalming solution. But they were successful. And we were able to find mutations in a couple of genes and then suggest a model as to how this occurred. Why is this important?

Number one, because the condition itself is rare and rarer in the age of this anatomical donor who was 96. I mean, to live 96 years and no one knows that you have this is pretty odd. So then the question is why? And what we found is that these accessory testicles

mimic lipomas, fatty tumors, which are fairly common along the tract where the testicles descend into the scrotum. So that alerts us then to patients who come in with lipomas to be aware, are these true lipomas or are these accessory testicles hiding or masking themselves, mimicking themselves as lipomas?

That's important because if they are accessory testicles, then this patient is predisposed to testicular cancer and they may have that. And doing this work, they found another mutated gene in the same donor. We found a second gene that was also altered in this donor and this gene affects the heart.

So we transferred over to research in the heart that we were doing, and we found that this gene weakens the structure that holds the cells together in the heart and results in a cardiomyopathy, a dilated cardiomyopathy. That's a disease that causes the heart chambers to thin and stretch and get larger. And then the question is, well...

Do cardiologists need to be aware of patients who are poly-orchids? Because if they come in, or if urologist comes in and this patient has more than two testicles,

Do they then have this other gene mutation that results in cardiomyopathy? Because it seems like there's an association between the presence of the two modified genes. Now, when people have a rare disease, are they approached by anybody to suggest maybe they could donate their bodies to science? Because it seems like

That's an area where a lot of advances could be made. That is a great question. And in the United States, it is illegal to actively recruit individuals for anatomical donation. In other countries, you can do that. In India, for example,

Sometimes those that are thinking about donation are given a stipend and then in turn when the time comes they donate their body. With the way the laws are configured in the United States, we are not able to do that kind of thing here in the United States. It is considered illegal. And I understand that because there were times

when bodies were obtained, not in the most moral or ethical fashions. So these rules and these guidelines are in place both to protect those who are thinking about anatomical donation and those that are using the bodies. But when researchers do get a chance to work on a body where a rare disease is present, it often pushes the research and knowledge forward.

And the more knowledge that we have, the more understanding that we have, this leads us to new ways of looking at the same condition, new ideas, new methods to develop for treatment, disease conditions, and maintenance of the healthy human body. And this helps us, it helps human beings, it helps society be more productive.

and for us to help each other. Ernest Tallarico is a researcher and an anatomy professor at Purdue University Northwest in Hammond, Indiana. This is The Pulse. I'm Maiken Scott. We're talking about bodies for science, what they can teach us, and what motivates people to donate their bodies for this cause.

If anything got people talking about anatomy lessons and what we can learn from looking at human bodies, it's the exhibit Body Worlds. It's been traveling the globe for more than two decades. It's the largest curation of plastinated human bodies in the world. The exhibit was created with the idea of influencing people to live healthy lives.

Last year it was on display at the Da Vinci Science Center in Allentown, Pennsylvania. At the entrance, visitors are greeted by a skeleton. It almost looks fake. But then next to it is a tutorial on dissecting a human body through a technique called plastination, which permanently preserves the body. The bodies in the exhibit are posed in different positions.

Some reveal layers of muscle and tissues, others show organs, and some display cases are just for one specific body part, like the large intestine.

As people go through the exhibit, they recognize this is real. All of it. I get joy out of seeing their reactions, whether it's cringing or not. High school science teacher James Miller loves to see his students take it all in. Oh, wow, that's the thing that we've been talking about in class, you know, the past couple months. And yeah, there it is. There's the real thing right in front of you. I think it's amazing. Like, I didn't know that, like, this was like in our body, in our organisms. I didn't know, like...

Like we had bone marrow. I didn't know, you know, our skeleton and people donate their bodies to science. For some visitors, it puts a personal experience into context, like this woman who was diagnosed with leukemia. And so I spent a lot of time in the hospital. I spent a lot of time getting procedures done and even things like bone marrow biopsies. I had four. And over here, there was a cross-section of the bones.

Body Worlds has been seen by more than 50 million people in 150 cities. It was originally created by German physician Gunther von Hagens and his wife Angelina Wally. One must also understand that the exhibition Body Worlds touches aspects of both life and death at the very same time.

She says people who are willing to donate their bodies to the exhibit can choose how and if they want to be shown. There are quite a few donors who just want to donate their bodies for scientific or educational purposes, but they don't want to be on the public display, which we absolutely respect. Marcus Biddle has this story of a woman who decided to donate her body to this cause.

When Body Worlds finally hit the U.S. in 2005, opening at the California Science Center in Los Angeles, it quickly became the hottest ticket in town. The museum opened its doors around the clock to accommodate more visitors and still couldn't keep up. But Angelina Wally says that the desire to see the exhibit was not motivated by morbid curiosity, and the reactions she overheard were deep and meaningful.

And I vividly remember one incident of a younger woman. She might have been in her end 20s or early 30s, and she started crying. She told Angelina that she had tried to end her life three times, but seeing the exhibit gave her a new outlook. She said, I always...

felt useless. But now as I see how intricately and wonderful the human body is made, I feel I have something very important, something very wonderful inside me and I promise you I will never do that again.

Teresa Thompson had a similarly profound experience. She was one of the lucky ones to snag a ticket. She already had an interest in human bodies. Back then, she worked as an autopsy assistant and a sports massage therapist. And she always had a passion for keeping her body healthy and functioning.

Even as a kid, Teresa was into eating healthy foods. One of her favorite hobbies was picking out fresh vegetables from her grandfather's garden. And she was selective about what she ate.

I could eat potatoes and oatmeal. I liked chicken for some reason, but it was when I ate super processed foods. Back then they had this stuff called Hamburger Helper, which was always in our house, and I'm like, I couldn't eat it. When she got to high school, she got into exercise. I joined the synchronized swim team. I was on the track team. I got healthy. I was running and doing everything that took a lot of strength. I just felt great.

so powerful in my body and that was such a good feeling. Teresa was living outside of Los Angeles when she heard about Body Worlds and given her interest in the human body and health, she decided to go. She was moved by the exhibit

And as she was leaving, she noticed handout brochures for anyone interested in donating their bodies. You could attend a meeting to learn more. There was probably in that room about 60 people, maybe. They talked about the process of plastination, and Teresa immediately signed up. There was no question because of my experience with my own body, as well as

seeing so much in other people's bodies through the sports medicine and also the autopsies. But there was another reason. Even though she had tried to take good care of herself, she was just starting to experience many health issues, all related to the time she had spent as a rescue worker at Ground Zero following the September 11th attacks.

And she described all of this in a letter she wrote to the Institute of Plastination. And at that time, I had left the East Coast and my breathing problems had been diagnosed. And so I just thought, well, you know, if I do end up living a little longer, there's probably going to be more stuff. She's also the only known 9-11 rescue worker to sign up for plastination to date. I had to have parts inside my sinuses removed.

because they were so jam-packed. As you can hear, my voice is not smooth. So a lot of us, we still to this day, we make jokes about our voice because we can make it go up. We're always like clear in the throat, you know, yeah, we're like a bunch of old smokers. She still remembers rushing to New York after the Twin Towers fell.

She was a volunteer firefighter in Fort Washington, Pennsylvania, and drove up the week of the attack. I drove really fast. Nobody was on the road at that point. When she arrived, lower Manhattan was engulfed in a cloud of smoke and toxic dust. She joined a fire station in midtown Manhattan whose job was going into the wreckage pile to search for survivors.

Going into the pile was a dangerous job. The debris was still smoldering days after both towers collapsed. The sound and the roar of the fire underneath us, it was still burning for a while. It's like our oxygen was sucked away from us. She volunteered for 12 to 14 hours daily for two months.

Each day, she had to shower for at least an hour to remove all the dust from her body. To this day, she's hypersensitive to most chemicals, even makeup.

She was once hospitalized for a severe allergic reaction that caused her entire face to swell. But it was the makeup I'd been using for years. I thought, gosh, I was never allergic to that before. But I had no idea that it was related to 9-11 at that point. When she moved to California in 2005 for pulmonary rehab, she could barely do breathing exercises because of the pain.

It just felt like something was scratching in there all the time, like a cat clawing at your lungs, you know, with the nails. Just scratch, scratch, scratch. So it hurt to breathe. Teresa has seen many fellow volunteers die from similar health issues. It's forced her to think about her own mortality every day.

When her time comes to be plastinated, she doesn't have a specific request on how her body will be displayed. But she still has her helmet from volunteering at Ground Zero, stuffed in a plastic bag inside her closet. She's ready to donate it. It would be nice to have an axe or, you know, something there having to do with firefighting.

She wants her body to showcase the danger of firefighting and the lasting effects of 9-11, and just how resilient and fragile human life is. When you see that much death, you live your life in the moment more. So perhaps my body might have something that people might be interested in. I'm kind of glad I made that decision.

To her, the bodies and body worlds, frozen in time, their insides out in the open for the world to see, had the power to teach a much larger lesson about how we treat each other, especially with tragedies like 9-11 in mind. 9-11 happened because of humanity. And I as well think that that's very important to hopefully have that in there, that this was a human tragedy.

responsibility and how it was plotted and planned to be so destructive. On the inside, we're not all exactly the same, but we are the same. The only difference it might be with a disease or something. Not the color of the liver, not the color of a bone, not the color of anything. So I've seen too much of that hurt people. And I don't like that.

And I feel that showing the body from the inside helps people to learn our similarities are much greater than our differences. For The Pulse, I'm Marcus Biddle.

That's our show for this week. The Pulse is a production of WHYY in Philadelphia. You can find us wherever you get your podcasts. Our health and science reporters are Alan Yu, Liz Tong, and Grant Hill. Marcus Biddle is our health equity fellow. Our intern is Jaden George. Charlie Kyer is our engineer. Our producers are Nicole Curry and Lindsay Lazarski. I'm Maiken Scott. Thank you for listening.