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Until the early 17th century, scientists believed that the heart operated a bit like a lamp, warming blood that had been produced by the liver. In 1616, when the English physician William Harvey corrected this misconception and explained how the heart works, the audience at the Royal College of Physicians booed him. Why did it take so long for scientists to understand the heart’s real function? One possibility is that until the invention of mechanical pumps in the late 16th century, doctors lacked the metaphorical language to describe what the heart does.
“The truth of the body is as much about storytelling as it is about anatomy,” the writer and surgeon Gabriel Weston argues in Alive, an unusual and gripping book that she describes as an “ecumenical exploration” of her subject. An English graduate, in her early 20s Weston enrolled in a pioneering medical degree programme designed to encourage arts students to become doctors. She believes clinical medicine has much to learn from the humanities. When anatomy textbooks show organs and body parts in isolation, removed from the individual and their wider context, Weston believes they miss important truths. Bodies are, after all, not purely mechanical entities. And so Alive, a book that draws on science, history, philosophy and art, is as much about what our bodies mean to us, how they feel to us, as what they do.
The chapters – Heart, Bone, Genitals, Lungs and so on – offer plenty of detailed anatomical information. The reader will learn the name and function of our different layers of skin, what happens inside our kidneys, and how breasts turn blood into milk, but this information is enriched by Weston’s personal and philosophical reflections, accounts of pioneering surgeries, and digressions on medical ethics and the arts.
Alive is not for the squeamish. Weston sets the tone in the first chapter when she watches a dissection and describes, in characteristically vivid detail, how the pathologist prises the sternum from the chest using a chisel, which makes a “ripe plasticky noise, like clingfilm being ripped from a cardboard roll”. Hats off to anyone who can make it through her description of a penis being degloved. Yet Weston’s passion for her field is contagious. She describes herself as “astounded” by the beauty of our anatomy, and writes that whenever she leaves the operating theatre, she feels as if she is “stepping from sunshine into gloom, substituting astounding reality for a faded imitation of what life has on offer”.
Perhaps, like me, you’ll read this book and realise that your body was as vast and unknown to you as the deep sea. The heart is the hub of a network of 60,000 miles of arteries and veins. Cut out 50mm3 of brain and you’ll find inside 5m neurons, 50bn synapses, 22km of dendrites (the frilly bits at the ends of neurons) and 220km of axons (the long parts).
Alongside such mind-blowing statistics are perspective-shifting meditations on the role our organs play in our emotional lives. Consider the womb, and its monthly self-renewal. “Is this part of what it is to be a woman, this profound repeated lesson in being cleaved from oneself?” Weston asks. “And if so, does the womb not equip us beautifully to grasp early and head-on what all adults must learn sooner or later, that the way that identity is tethered to our physical being is much more slippery than we’d like to imagine?”
The chapter on wombs is partly told through the story of Weston’s four births. In “Lungs” we learn of how her father nearly died after puncturing his in a climbing accident, and in “Brain” she writes about her son developing a life-threatening bleed. These personal stories are interwoven with political ones: Weston writes of sexist breast surgeons, transplant waiting lists, of measuring scars in immigration detention centres, where the marks on a person’s body may bolster their asylum claim or undermine it. Between the chapters are short exchanges between Weston and her doctors discussing her pending surgery to fix a faulty heart valve, fear intermingling with frustration that will be recognisable to anyone who has found themselves on an NHS waiting list: “We aim to discuss your case in the next 6-8 weeks”, “Please can I have a copy of my finalised echo report in the meantime?”, “I’m afraid that hasn’t yet been finalised in the system.” One hopes a few NHS administrators will read it.
This bold, humane yet unsettling book makes a strong case for giving doctors more time to get to know their patients properly, and it will make you see your own body a bit differently, perhaps change how you feel in your skin. Just – and trust me on this – make sure you finish your breakfast before reading it.
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