Body builders
Authors: Colin Martin
Journal: BMJ (2008)

I missed the vital clue provided by American author Bill Hayes—in the form of an indefinite article in the subtitle to his engaging book—that it would not be the definitive account of Henry Gray (1827-61). In his penultimate chapter Hayes explains why a biography devoted solely to Gray would fill only a slim volume.

Fascinated by human anatomy, Hayes has made excellent use of the sparse data available on Gray’s personal life, focusing his attention and research on Gray’s collaborator Henry Vandyke Carter (1831-97). A junior medical colleague, Carter illustrated what was eventually titled Gray’s Anatomy of the Human Body. It is really a biography of this book that Hayes provides, celebrating the 150th anniversary of its first publication in London in 1858, swiftly followed by the first US edition, and coinciding with publication of the 40th edition later this year.

Although the Royal College of Surgeons in London is currently exhibiting a selection of Carter’s drawings from its collection of his work (BMJ 2008;336:688-9, doi: 10.1136/bmj.39526.647176.DB), Carter’s contribution to Gray’s Anatomy has been largely overlooked to date. Hayes rectifies this. Luckily for him and us, Carter kept meticulous records of his own medical studies and his work as a medical illustrator with Gray. Diaries—begun in 1845 and recording his daily logistics, together with loose leaved “reflections” begun later—enable Hayes to flesh out the skeletal frame of Gray’s life. Carter’s letters also provided information. Hayes intersperses his story of their 19th century collaboration in Dickensian London with a lively account of his own 21st century study of human anatomy, at dissection tables in California.

“Something about the look on Gray’s face seized my imagination in a way that I can only compare—odd as this may sound—to love at first sight: an overpowering desire to get to know this man as thoroughly as possible,” writes Hayes, on identifying Grays’ dark-clad figure seated among two dozen white-smocked students in a group photograph taken at St George’s Hospital in 1860. “My course of action then seemed perfectly clear: I would come to know Henry Gray by coming to know human anatomy.” True to his word, he enrolled as an observer in undergraduate dissection courses at the University of California at San Francisco, assuming the role of a de facto demonstrator, among groups of younger pharmacy, physical therapy, and medical students.

Gray registered as a medical student at St George’s Hospital in May 1845, after which his stellar progress can be traced in official records of his examination results, awards, qualifications, and publications. By 1852 he was curator of the Anatomical Museum and a fellow of the Royal Society. Carter became an “articled student of medicine” at the Royal College of Surgeons; and in May 1848, three years junior to Gray, he too registered as a medical student at St George’s. Gray is first mentioned in Carter’s diaries in May 1849. On 14 June 1850 Carter offered to illustrate Gray’s On the Structure and Use of the Spleen, initiating their historic partnership. In 1855 he began the Herculean task of providing illustrations for Gray’s Anatomy: Descriptive and Surgical. Initially he drew them on paper, but later he began to draw directly onto the woodblocks from which the book’s engravings were printed, saving the time and costs of having an engraver transfer the designs.

Although a non-fiction writer, Hayes is enough of a novelist to breathe life into his dusty research into the lives of Gray and Carter and also to tell a parallel tale of self discovery, one that is based on his own experience of dissection. And what happened to Gray’s elusive personal papers? Hayes believes that they were burnt along with other contaminated household goods in 1861, after Gray’s early death from smallpox at the age of 34, to prevent the further spread of infection. There is also a denouement relating to Carter’s later career in India.

“Dissecting really has nothing to do with making things orderly,” Hayes concludes. “The order is already there, just under the surface. The anatomist only has to uncover it.” As his book demonstrates, the same might be said of writers, who use words rather than scalpels to expose our humanity.

“Something about the look on Gray’s face seized my imagination in a way that I can only compare—odd as this may sound—to love at first sight”