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The Organ Grinder

The living need the dead like never before, and Michael Mastromarino had a Dickensian scheme for supplying the parts.

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The last days of Alistair Cooke were painful and difficult—“what we all go through, really,” says his daughter, Susan Kittredge—but Cooke carried on with typical English fortitude. In his final public broadcast—“Letter From America,” No. 2,869—he made his deathbed sound positively cozy: “Propped up there against my usual three pillows and reluctantly having just finished a favourite bed book … I was feeling chipper enough to glance across at two bedside piles and hope for a perfect lullaby before drifting into sleep.”

When he died, in March 2004, he left his daughter 150 pounds or so of ancient flesh and bone. Kittredge, a Congregationalist minister in Vermont, was not unfamiliar with such things. She had prayed over many of them and had counseled parishioners never to cherish a corpse but to view it only as the empty vessel, a rather worthless item. Disposal, she explains, “is not something I’m inclined to spend a lot of money on, so I grabbed the phone book and started going through the Yellow Pages, looking for the best price on a direct cremation.”

She found a place in Harlem that advertised “the highest quality services at the lowest rates”—cremations for only $595. Kittredge remembers that “it was the middle of the night” when they came. Alistair Cooke was taken down from his Fifth Avenue aerie to a dim, decidedly gothic parlor at 115th Street. “They were just going to come and collect him and return the ashes in due course,” Kittredge recalls. But instead, there was a man waiting for Alistair Cooke, with a knife. He cared nothing for Cooke’s mind or manners. He had actually come for the body—that pale, wizened, cancer-ridden cadaver of a 95-year-old Englishman, stretched out now beneath the light in the embalming room.

It has never been safe to be dead. As Annie Cheney writes in Body Brokers: Inside America’s Underground Trade in Human Remains, “the cadaver trade has a long history in the U.S.” It began here in the late eighteenth century, when surgeons studying anatomy “enlisted the help of ‘resurrectionists’ or ‘ghouls,’ as body snatchers were known—a class of cagey, often desperate men.”

Grave robbery went out of fashion about 100 years ago, as states began providing anatomists with a legal supply of corpses (typically those of paupers) and people began leaving their bodies to science. Now, however, the dead are in demand like never before. It has been discovered that not only are human beings essentially the same machine inside but that we carry interchangeable parts, and the dead may be stripped of their parts much like old cars. Hearts and livers and kidneys receive the most attention because they save lives, but the same technology that has allowed for their transfer has also enabled the far more common transplant of tissue. Nearly every part of a corpse can now be put to use. For spinal fusions and the repair of fractures, bone is in greatest demand, but veins may be used for bypass in heart surgery. The membrane around the heart can reupholster the brain after neurosurgery, and the membrane around the muscles of the thigh can sling up sagging bladders to control incontinence. Tendons and ligaments can return mobility. Corneas can restore clear vision. Cartilage can help in facial remodeling. Dead skin can replace burned skin. And collagen can fill wrinkles, plump lips, revive youthful appearance.

The American Association of Tissue Banks calls it “a medical revolution,” but here is the sad part: “Many people who need transplants cannot get them because there simply are not enough to go around”—a mere 25,000 donors a year to supply more than a million tissue transplants. “The need to increase the number of transplants,” says the AATB, “is the responsibility of us all.”

The problem lies in persuading the living to give up their dead. Tissue may be harvested only shortly after death, explains Bob Rigney, head of the AATB, so “there’s a very small window in which we can act, and that is the very worst possible time for everyone involved.” Even if the deceased has signified consent on his driver’s license, many states, including New York, also require permission from the family—harvesters must face them, at the height of their grief, and ask for certain choice pieces of the loved one’s body. The case for organs is generally more compelling than the need for collagen and the like; families often answer no, which keeps supplies low and prices high.

Yes, prices: The sale of the dead is technically illegal, but the National Organ Transplant Act of 1984 authorizes tissue banks to recover “reasonable costs” for transport and processing—leaving it to the banks to determine what’s reasonable. Although all organ banks are nonprofit charities, and organ donation, with its higher stakes, is generally well regulated, tissue donation is another business entirely—governed by the Food and Drug Administration, which allows many banks to operate openly for profit. And the money to be made in human tissue—up to $100,000 a corpse depending on its use, according to Cheney—lures forth desperate men who don’t always abide by the rules.


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