Keeping the Chiros’ and Cadavers Apart
How anatomy draws a line and the role of
one individual, anatomy professor Ceri Davies of Imperial College London.
The world of anatomical dissection has a history of preferring to operate away from public gaze. The potential for scandal and outrage when it comes to dealing with the dead is never far away. From the body snatchers of Victorian England to that of the Alderhay Childrens Hospital shock of the 80s and 90s where a pathologist was retaining children’s organs without permission, the anatomical sector has always held a nervousness around its manner of operation.
The desire to ensure that those donating their bodies for anatomical study be well cared for is understandable and should be supported. In the wake of Alderhay, the Human Tissue Act was introduced in 2004 and the Human Tissue Authority – HTA established as the regulator to oversee the act. The HTA covers a lot of areas, not just the anatomy sector, which is one of the easier elements of the regulators job. For the most part the HTA leave the sector to get on with it and make the decisions it feels are best for the sector itself.
However the current approach from the anatomy sector is to close the doors and keep them closed, with a clearly stated desire to prevent anyone except ‘Medical Professionals’ from accessing areas of anatomical study where the use of cadavers are concerned. Even where the professions involved are regulated, the same approach stands and personal feelings and viewpoints are permissible when decisions about who gets in are being made. The individuals given the power to decide who comes into the dissection areas are known as DIs or designated individuals under the Human Tissue Act. They may well have views inconsistent with current or even logical thinking but their decision is final. Most DIs who aren’t necessarily anatomists and often won’t be actively present very often in the lab, if at all, will be guided by their teaching and technical team.
One DI, Dr Ian Scott a pathologist from Nottingham, whilst unilaterally preventing me from running classes at Nottingham Hospital, made the bizarre suggestion that Chiropractors and Osteopaths ‘harm people’ and should not be given access to health resources such as the dissection lab that was bringing in thousands of pounds of income to the hospital. Apart from the statement regarding registered health professionals being unprofessional and frankly bizarre, his decision to stop my classes went firmly against the advice and recommendations of his teaching and technical team, who were overwhelmingly supportive of my classes and my work. Dr Scott, along with every academic who has ever let me into the DR, had never sat in a class of mine to actually listen, in spite of being offered a daily paid rate to do so, but still felt qualified to comment on me, calling my content and approach, “left field” and “inconsistent with current anatomical thinking.” I would totally agree, but how he would know is unclear. The irony of the harm claim, coming as it did from a pathologist, the very profession that was at the heart of the children’s organs retention, was clearly lost. It was apparent to me that he had been ‘got at’ by someone who had warned him off me. The world of anatomy and DIs is a small one and most people know each other. Any senior academic with another academic’s ear, would simply have to pick up the phone and this is most definitely what happened here. (Full story link to follow.)
One particular individual who has gone out of his way to prevent myself from conducting anatomical training for the wider field of allied health professionals, has been the Professor of Anatomy at Imperial College London, Professor Ceri Davies. The methods he has employed to do this have been rooted in consistent falsehoods and libellous statements, repeated at various intervals over six years and reinforced most recently by lying in person to a panel of The Anatomical Society, of which Ceri Davies has been intimately involved for many years. He has accused me of a criminal offence, blackmail, but has produced no evidence and has be
Whilst lying to one’s peers might appear a little desperate and unprofessional, this kind of action, supported as it has been by significant elements of the anatomical community, masks a bigger, more pressing ethical issue and places the anatomy sector in a tricky position moving forwards. The decision to ignore someone lying to their faces and find in favour of the person doing it, taken by the oldest anatomical society in the UK, The Anatomical Society put the sector out of step with both the desire and interest of the public at large. It is evident that people want to know more about their own bodies and that the complementary health sector want to become better trained and more accountable. Shutting people out of legitimate study is also out of step with the view and guidelines of the regulator the HTA.
This somewhat anachronistic approach, overseen by elderly white male academics who will happily close ranks around their own will no doubt cease at some stage. Anatomy hasn’t really changed much in over three hundred years and misses entirely the central tenet that it is incomplete at best and fundamentally flawed at worst. Flawed models exist in lots of areas of the world, but when the very basis for current medical thinking and total belief is based on a model that is demonstrably missing so many fundamental elements, the flaws become not only glaring, but life threatening. Faced with the evidence of this, it would be a foolish industry indeed that did not seek to change. Medicine can’t do it without Anatomy starting the ball rolling and admitting its gaps. Admitting ones vulnerabilities has always been challenging, but for the old guard who see nothing wrong, the very idea is preposterous.
Here’s a link to an article I wrote on this very subject for a Physiotherapy Journal.
The now real and enormous peril of antibiotic resistance will help the collapse and as is now clear, it will happen sooner rather than later. In the meantime the struggle to get relevant anatomy to those who want to see it continues. Aided and abetted by the anatomical sector from the top to the bottom, the UK has effectively shut its doors to cadaveric dissection for anyone except those deemed ‘suitable’, pushing these important activities overseas. Thus it has in the short term been successful in preventing anatomical knowledge being presented to a wider and engaged audience desperate to learn the type of anatomy that is currently not taught in any university or by any UK anatomist.
A repeated false assertion from Ceri Davies and one he made many times to the panel of the Anatomical Society, is that I have been prevented or stopped from undertaking dissection classes due to ‘my activities.’ This, amongst the myriad tissue of untruths is one of the harder ones to bear as I have not at any stage been criticised, complained about, censured or reported for anything I have ever done in a dissection lab and any claim to the contrary is knowingly false. His claim that Imperial College have ‘stopped my classes’ is also false. I have had no letter, email, phone call or any form of communication from any university or institution including Imperial College London saying that my activities have been stopped. The Anatomy department of Imperial College have refused me permission to run dissection and anatomy classes for Regulated Allied Health professionals, simply by ignoring my emails, but I have had no cited reason and at no stage has anyone except Professor Davies question my integrity, professionalism or content.
It is worth noting that Ceri Davies himself mentored and supported my dissection activities for many years, enabling me to dissect alone in the lab for hours on end, facilitating and assisting the taking of pictures, which he then saw and approved, for my book and generally being supportive and encouraging. As well as regularly teaching alongside each other in the dissecting room at Imperial College London, we would often dine together, either alone or with others. We attended exhibitions together and he was my guest for some excellent lunches and dinners on many occasions, including at Langan’s Brasserie, and Sweetings in the City of London, as well as attending a wine tasting he had been invited to as my guest.
All this was taking place over the course of eight or so years, when we were both teaching anatomy for manual and movement therapists under a company run Amanda Hermitage called Anatomy on Cadavers. Whilst Ceri Davies was. over the years, personally paid tens of thousands of pounds into his own bank account, it is not clear whether he personally profited from this in addition to his salary, or whether these payments were just resting in his account. In any event, he was very actively engaged in teaching the very people he now wants to exclude from dissection spaces. At the time, the issue of donor consent was not raised either and it was always my assumption that he would have checked that the donors had given permission for their forms to be used in these ways. Certainly many therapists benefitted from this knowledge and subsequently helped many of their clients.
Quite why his about face has been so dramatic, requiring him needing to create a web of falsehoods along the way is a complete mystery. I have written to him on several occasions apologising profusely for whatever it was I did to upset him, and have asked for meetings to sort it out. I have also requested several members of associations which we were both members of for assistance in mediating the situation, all to no avail.
I have suggested that he could be the architect of a wider interaction with the therapist world, credited with bringing a new wave of anatomical knowledge to a bigger audience, but this has fallen on deaf ears. The desire to keep “these people,” out of the dissection lab has seemingly provided a stronger motivation than the dissemination of knowledge.
Instead Ceri Davies has continued to present me as something of a stranger that he barely knew, lying to his legal department to do so and accusing me of criminal activity whilst presenting no evidence. He was even personally responsible for having a class of mine cancelled in Ireland whilst did not declaring that he had known me for many years. His claim that the decision was based on donor permission, the anatomy act and that the advice came from a panel, has not been supported by evidence. A freedom of information request showed that it was an email from Ceri Davies to the university in Cork that sounded the death knell for this class.
My class in Scotland that had been running for many years with the support and approval of St Andrew’s School of Medicine, was cancelled after a colleague of Davies, Gordon Findlater, was appointed as Inspector of Anatomy for Scotland. One of his first actions was to inspect my class, which he pronounced to me that he was satisfied with. His first words to me however were, “What have you done to upset Ceri Davies?”
In spite of his apparent satisfaction and after I had even given him a break down of my earnings in relation to it, he then took the unprecedented and distasteful step of questioning my motives around money in his report. This report was then given to the Scottish Sunday Express. The subsequent article was factual and at no stage criticised my work, my content or my approach to donors, but just mentioned that I happened to get paid for what I do. The timing and connection between Davies and Findlater seems eerily co-incidental, but sadly Ceri Davies refused to co-operate with a freedom of information request regarding his communications with Professor Findlater. This was on the grounds that he was acting as a private individual, in spite of all his communication being through an Imperial College email address with Imperial College as his cited address.
Over the coming weeks as and when I can find the time or the interest, I will be exploring more about the prevailing attitudes around anatomical dissection and publishing further details of how one Professor has gone the extra mile to contribute to the demise of a widely acclaimed anatomical class that benefitted many. Watch this space!
Objections. Myth vs Reality
There have been several objections to classes that have been raised over the years, all of which are easily countered. A few of them are listed below.
There is a shortage of cadavers available for medical training.
The reality is that there are more than enough cadavers donated in any one year to fill university dissecting rooms ten times over. The problem arises when those cadavers fall outside the range of ‘normal’ that is required for medical students to study anatomy. Too high, too obese, too much surgery, too thin, too many tumours, would all be reasons to reject a donor body and London alone rejects over 200 such donors a year.
For people such as myself, the reasons listed are not ones that concern me and my students positively relish the challenge of an abnormal donor to learn from. Whilst the insistence on ‘normal’ is understandable from a handling perspective, medical students are learning anatomy in an unrealistic situation, when all they ever see is ‘healthy dead people.’
My classes have always asked for donors who would otherwise be rejected by the university donor programme. As a result, St Andrews had the lowest rate of donor rejection of any Scottish University, allowing the final wishes of donors to be granted, simply due to the existence of my class.
The universities are too busy with their own students
There is always a thing called the holidays! My classes will use facilities that would be empty were it not for us being in them, using cadavers that would be rejected were it not for our class and paying thousands of pounds of lab fees into the bargain. The delegates will pay to stay in University accommodation and will inject money into the local economy. Our delegates clean the lab and all the equipment at the end of each day and we undertake a thorough deep cleaning of the lab at the end of the week.
We place all the cadavers, with every part audited, into coffins where possible and stand for a moment of reflection and thanks at the end of our time together.
There are no donor permissions for your classes
Hiding behind dead people is a pretty cheap trick and for the most part it doesn’t hold up. Ceri Davies has claimed that my class in Ireland was in breach of the anatomy act of 1832 in relation to donor consent and Dr Ian Scott similarly made exaggerated claims about donor permissions as an excuse to get rid of something he didn’t like, misrepresenting the Human Tissue Act and the law along the way. Neither of them were able to present anything factual in relation to the claims they made, simply because they were untrue. However this approach is always useful in creating a layer of fear amongst people about what the general public or the donors might expect.
In some cases, universities will just lie about not having donor permissions even when they have and this is something I have encountered on more than one occasion. Donor permission forms have in the past been generally vague as far as what donors will be used for, but in recent times have gone out of their way to ensure that all the bases are covered. They will generally state that donors may well be used for courses aimed at Allied Health Professionals, another term which is suitably vague enough to be all encompassing. In the case of Ireland, the antiquated 1832 act is still woeful in terms of how it gathers permissions, but that’s another story.
At the end of the day it’s the DI that has the ultimate say in whether a class can go ahead. How that DI is influenced or who they listen to along the way is another matter. The HTA doesn’t really care and let’ the sector police itself in this regard. As we can see, it leaves the process open to a potential abuse of power and allows for the old boy’s network to be fully operational. The likelihood of change in this regard depends, as so much does in the field of medicine, on death and or retirement!
There is no way to censure anyone out if they do anything wrong
Whilst medical students, surgeons and such like can in theory be struck off if they do anything wrong, this approach is backward. The assumption that wrong doing will take place is rooted in a lack of intrinsic respect that starts with the faculty. I have never at any stage had any delegate do anything wrong in the lab or show any disrespect to the cadavers, the university or the facility we use. The underlying principle that is instilled t every delegate from the moment they book on to a class, is one of respect for the donors. These are our teachers and have given their bodies for us to learn from. We are entrusted with their care and we treat them as if they were one of our loved ones.
Delegates will often be seen picking up tissue from the floor around areas where university students have been working. This is not ’tissue’ to us, but part of a donor and every part should be kept in one place. By contrast, stories of medical student misdeeds are common place when it comes to cadavers, a situation which in my opinion, is solely a reflection of the academic team involved.
Even the method of communication outside of the lab is discussed and addressed and there are protocols involved for every aspect of the class. Where students feel a duty of care to the donors, the university, the technical team and to each other, they take care to ensure that nothing happens that should’t. Need to seek redress is therefore eliminated by the absence of any inappropriate behaviour.
Staff are too pressed to supervise the delegates
Apart from generally paying for a lab technician to be present, the classes are self contained. We clean all our own equipment, wipe down tables and chairs and mop floors. It is the technical staff who are at the front line of most establishments. They keep an eye on us and what we do and are vigilant about any behaviour that is untoward. Every technician we have ever worked with has stated that the courses I run are better than any surgical training or university based anatomy class that ever takes place. They constantly comment on the respect, care and professionalism of the classes and welcome our return.
We nearly always have a collection to buy the ‘tech’ a drink or gift and these classes become the highlight of the technical year.
More to follow…