Pam Poulakos and Irene Hombs don’t want to be buried when they die. A standard cremation won’t do, either. The sisters from Milwaukee, Wisconsin, have discussed their end-of-life options at length, and ultimately, they want to serve the greater good.
They’ve decided to donate their bodies to science.
“I'd much rather be used for medical research than be buried,” Poulakos, 64, tells Mental Floss. “We're not going to be using our bodies anymore anyway, so they might as well use it for whatever they need.”
They, in this case, are the staff and clients at a Portland, Oregon-based company called MedCure, which is one of seven non-transplant tissue banks accredited by the American Association of Tissue Banks. These facilities oversee the donation of whole bodies (as opposed to organ transplants) and ensure they end up in the hands of scientists and medical professionals. One of the largest national organizations of its kind, MedCure has been around since 2005, connecting researchers with about 10,000 body parts annually.
These deceased donors help to save lives. Medical students dissect cadavers to learn about anatomy. Researchers use them to study diseases like Parkinson's and Alzheimer's. Surgeons use corpses to refine new procedures like face transplants. And cadavers have even aided the advancement of surgical robots.
Yet corpses can be hard to come by: An estimated 20,000 Americans donate their bodies to science each year, which equates to less than 1 percent of the 2.7 million Americans who die annually. Put simply, the demand is far greater than the supply.
Heidi Kayser, MedCure’s director of donor education and outreach, says this is partly because body donation programs aren’t as well-known as organ donation programs. "A lot of people want to give. It's a matter of awareness and knowing that it's an option," she tells Mental Floss.
Donating to a non-transplant tissue bank like MedCure is just one way of leaving your body to science, though. While MedCure is a for-profit business, non-profit tissue banks provide an alternative. Universities and medical institutions across the country also accept "anatomical gifts" for research and teaching. Then there's the site known as the "Body Farm" in Tennessee, which helps forensic researchers study how cadavers decay.
In short, there are a variety of ways to continue being useful—even long after you're dead.
How were cadavers used in the past?
While body donation programs are fairly recent, cadavers have been used for various purposes since ancient times—though for much of human history, the donors probably wouldn't have been too happy about it.
King Ptolemy I, ruler of ancient Egypt, was the first world leader to allow the dissection of corpses, according to Mary Roach, author of the 2003 book Stiff: The Curious Lives of Human Cadavers. Although mummification was also happening around the same time for religious reasons, the purpose of dissection was strictly scientific—to learn about human anatomy. Early physicians cut open the bodies of executed criminals; more gruesomely, Greek physician Herophilus is said to have dissected live criminals.
The practice of dissecting dead convicts was also common in Europe from the 14th century to the early 19th century. But because there weren’t enough executions to provide medical professionals a steady stream of corpses for study and training, grave robbing emerged as part of a lucrative black market. Body snatchers, at least in Great Britain and America, could be hired for a price—and sometimes the scientists themselves rolled up their sleeves and started digging. “Extreme measures ensued,” Roach writes in Stiff. “It was not unheard of for an anatomist to tote freshly deceased family members over to the dissecting chamber for a morning before dropping them off at the churchyard.”
Body snatching only began to decline after the British government passed the Anatomy Act of 1832, which allowed medical schools to use the unclaimed bodies of people who had died in prisons or workhouses. Still, donating one’s body to science at that time was considered taboo at best, and eternally damning at worst. (Many Christians of the day believed that dissected bodies couldn't be reanimated, and that believers would therefore be denied any chance of resurrection.)
Some scholars believe the English philosopher Jeremy Bentham (1748-1832), who supported the Anatomy Act, was the first person to donate his body to science. Bentham didn’t want to pay burial fees to the Church of England, which he considered “irredeemably corrupt,” so in his will, he asked to be turned into what he called an "auto-icon"—essentially a preserved and dressed skeleton—now on display at the University College London. In addition, Bentham arranged for a public dissection of his corpse attended by eminent scholars.
The military has played an important role in the use of corpses, too. In the early 1800s, both the French and Germans used corpses to test out weapons and assess the damage. Later, in 1893, surgeon Louis La Garde of the U.S. Army Medical Corps received orders to pepper corpses with bullets for the purpose of trying out a new .30-caliber Springfield rifle. “[Corpses] were to be suspended from a tackle in the ceiling of the firing range, shot at in a dozen places and with a dozen different charges (to simulate different distances), and autopsied,” Roach writes.
In the 20th century, automobile manufacturers also began using bodies to test their products. It started in the 1950s, when many car manufacturers assumed that nothing could be done to make serious crashes survivable—and an experiment by Wayne State University researchers proved otherwise. The researchers dropped a corpse down an elevator shaft to see how it would handle blunt force trauma, and learned that the human body can be remarkably resilient. They discovered that a human head, for instance, can handle 1.5 tons of force for a fraction of a second without sustaining any injury. This experiment paved the way for similar tests, and by 1995, Wayne State researcher Albert King estimated that the use of cadavers in car safety tests helped save 8500 lives per year.
Some car manufacturers and branches of the military still use corpses—as opposed to dummies—in crash tests. “There’s a lot of things done in the realm of safety,” Roach tells Mental Floss. “You want to make sure a car is safe for occupants, or a car seat or an automatic window isn’t going to break somebody’s fingers, or a helmet is going to protect someone’s head. You can’t just give it to someone and say, ‘Let’s see how this works for you.’”
However, Roach says using actual bodies in experiments is expensive and cumbersome—“You can’t just go to Cadavers R Us and pick one up the same day”—so most car companies now try to avoid it. Yet cadavers are still occasionally used in trauma tests, particularly by the military, because they're more effective at revealing the outcome of certain impacts, like battlefield wounds.
Of course, military and industrial uses are rarer. Medical research and surgical training still remain the most common uses for donated bodies—and the practice of dissecting cadavers continues to save lives, not to mention improve the quality of care for living patients.
How does body donation work, and how do you register?
Non-transplant tissue banks aren't allowed to sell organs for transplant purposes. However, they are permitted to facilitate the sale of whole bodies or other human parts for research or educational purposes.
And in order to fulfill those needs, the companies need willing participants. Here’s how the donation process works, using MedCure as an example: Donors have the option of pre-registering with MedCure while they’re still alive, although donation can also be arranged by a deceased individual's attorney or next of kin. After filling out an online form to express interest, the prospective donor receives a welcome packet in the mail, which explains the entire process and includes consent forms that must be filled out. Once that’s done, nothing else is needed from the donor until they die or are placed in hospice care.
At that time, MedCure conducts a medical screening and background check for “risky behavior” to make sure an individual is eligible to donate. People with a history of IV drug use or recent incarceration aren’t eligible because they’re considered a higher risk for disease transmission. If someone’s application is rejected, they (or an authorized individual) will be told why they can’t donate.
Once an accepted donor has died, MedCure will come pick up the body from most states, at no cost to the donor or their family. (The exceptions are New Jersey, North Dakota, Minnesota, and Arkansas, which have stricter state laws regarding the transport of unembalmed bodies. People in these states who are interested in donating their bodies may opt for a program that's a little closer to home instead.) Blood samples are also sent to a lab to ensure the body doesn’t have infectious diseases like HIV or Hepatitis B or C, which can pose a risk to researchers.
The next step is deciding which research project a body is best suited for. Right now, robotics are driving the body donation industry, according to Rachel Mulligan, MedCure’s director of laboratory operations. New and improved surgical robots are constantly being developed, and some medical devices are tested out on cadavers in order to prove to the FDA that they're safe. In addition, many orthopedic engineers and researchers prefer to test their implants on cadavers to make sure they fit properly, according to MedCure. Most of the research is conducted in one of MedCure’s private labs located across the country, but the company will occasionally deliver human specimens to a recipient, such as a university.
Other organizations, like the Memphis-based non-profit Medical Education & Research Institute (MERI), provide similar services. MERI offers a door-to-door delivery and temperature control to preserve the human tissue. Likewise, the non-profit United Tissue Network, based in Norman, Oklahoma, works with shipping services that specialize in transporting tissue. In general, many of these tissue banks—both for-profit and non-profit—let donors sign up directly with the organization.
Critics of the industry say it's lightly regulated, with no federal law dictating how these businesses operate. Some so-called body brokers have suffered scandals over forgoing quality control or failing to return the cremated remains to families. In November 2017, reportedly amid larger scrutiny over the industry, MedCure's offices were raided by the FBI, but no charges have been filed.
Kayser says the raid occurred because the FBI was "investigating the industry as a whole." She highlighted the recent case of Arthur Rathburn, a Michigan cadaver dealer who was sentenced to prison last year for renting and selling infected body parts.
"[Rathburn] had a number of organizations he tried to procure from. MedCure was not one of them, but our name was in his files," Kayser told Mental Floss.
It's worth noting that many accredited tissue banks object to being lumped into the same category as unaccredited "body brokers." Rather, they emphasize that they’re selling a service: matching customers with cadavers that meet their criteria for crucial research needs.
What happens to bodies after they've been donated?
Although the staff at MedCure doesn’t typically find out how their clients’ research is applied, they sometimes get to hear gratifying stories. One of their clients, for example, was a surgeon who used cadavers to practice a new technique for transcatheter aortic valve replacements (TAVR)—a minimally invasive procedure that involves making an incision, often in the leg, and using a catheter to deliver the heart valve replacement to the chest cavity. After racking up enough practice, the surgeon found a candidate who was deemed too high of a risk for open-heart surgery. The TAVR procedure was successfully carried out, saving the patient’s life. “That’s what excites us and keeps us going,” Mulligan says.
When one of their customers is done using a cadaver—whether at one of MedCure's labs or a facility that's been vetted, like a university lab—MedCure collects the body once again and cremates the remains. A family can opt to receive their loved one’s ashes or have them scattered at sea, all free of charge. For some people, the cost savings are reason enough to donate their bodies. Cremation services typically cost upwards of $600, while traditional funerals (with burial) cost about $7000 on average.
“Cremation is on the rise, but at the end of the day, cremation is relatively expensive,” Kayser tells Mental Floss, explaining that for some people, the motivation to donate is a combination of frugality and charity. “Whole body donation is free to the donor, and they’re contributing to the advancement of healthcare. A lot of people do want to leave a lasting legacy. They don’t want to die in vain.”
Of the seven American accredited non-transplant tissue banks, the majority offer free cremation and shipping services. MERI's partner company, Genesis, even gives donors the option of having their ashes interred in a mausoleum in the Memphis area.
These services also alleviate some of the pressure associated with planning a traditional open-casket funeral, since embalmed bodies cannot be accepted into whole body donation programs. If the family does wish to hold a memorial of some kind, they'll have several weeks to plan it while waiting for their loved one's cremated remains to be returned to them.
As for the donors, this process may also help relieve the fear of financially burdening their loved ones after their death. For Poulakos and Hombs, that was a major motivation for pre-registering as donors—and for convincing several other family members to sign up, too. "It's stressful and awful when someone dies,” Poulakos says, “[but] you make one phone call and not only is it taken care of, but it's done with dignity.”
Can I donate my body to a university instead?
For people who like the idea of donating their bodies to science but don’t feel comfortable going through a company, university programs are another viable option. Many universities across the country—including Harvard, Columbia, and Yale—have “willed body” or “anatomical gift” programs. The donation process and acceptance criteria are pretty similar to that of non-transplant tissue banks, but some might not offer the comprehensive services that for-profit companies offer, like free cremation and transport of the body and cremated remains.
The other big difference is that instead of aiding research, you’d be helping future surgeons, dentists, anesthesiologists, radiologists, and other physicians learn about anatomy while honing their craft. “Nothing equals the human body for teaching both normal and abnormal anatomy,” Columbia University writes on its website. “This experience cannot be replaced with books or 3D computer programs.”
The work being done in the classroom isn’t cold and clinical, though. At Yale, students are taught to refer to the body they’re dissecting as a “donor” rather than a “cadaver.” And many universities, including Columbia and Yale, hold an annual memorial service to honor the donors whose gift helped advance the field of medicine.
Both students and the donor’s family are invited to participate in the memorials, and students at some schools are encouraged to contribute kind words or a song. Roach attended one such memorial while writing Stiff and called it a touching moment. “Students talked about the gratitude they felt toward those cadavers that they’d spent the year with. Some had written songs or poems. It was very moving,” she says. “It made me want to donate.”
However, she thinks the willed body programs at many universities aren't publicized enough, so few people know they exist—and believes that there’s a great opportunity to spread the word in a fun, lighthearted way. “I feel like they could really get out there more and try to encourage people to donate. Harvard Medical School should have a T-shirt that says ‘I’m going to Harvard’ and on the back it says ‘Harvard Willed Body Program,” she jokes. “They should own it.”
Can I donate to the "Body Farm"?
At first glance, being left to rot in a field might not seem like a dignified way to go, but the crucial work being done at the University of Tennessee’s Body Farm—officially the Anthropology Research Facility—is enough to attract a sizable number of living, pre-registered donors. About 5000 people, to be exact.
Here, corpses are brought to decay naturally in shallow graves, plastic bags, and maybe even a car trunk. It looks like a crime scene, but the end goal is the opposite: to make it easier for investigators to bring murderers to justice. “Pretty much anything a killer might do to dispose of a dead body the researchers at UT have done also,” Roach writes in Stiff.
Experiments at the Body Farm allow students and law enforcement professionals to study the body in different states of decay. Various biological clues—degrees of bloat and decomposition, certain isotopes, and the number of flies and beetles hanging around, for example—all paint a picture of how long someone has been dead. One recent project, for example, involves looking at the ways in which fat in the bone breaks down over time. This, too, helps investigators determine the time since death.
As the first human decomposition center in the world, the Body Farm was a pretty novel concept when it was founded by anthropologist Bill Bass back in the 1980s. Today, there are at least eight other body farms across the U.S., according to Lee Meadows Jantz, associate director of the Forensic Anthropology Center, which encompasses the original Body Farm at the University of Tennessee.
When the center receives a donated body, they document it, photograph it, list any scars or tattoos, and weigh and measure it. Blood, hair, and fingernail samples are taken to help facilitate future research, and the body is placed in a cooler until it’s needed for a project. Once a body is brought out into the open air, it's left there until only the bones remain. And yes, in case you're wondering, it does smell. A lot. "I’ve been doing this for over 30 years and it still stinks," Meadows Jantz tells Mental Floss.
The bones don't go to waste, either. They're collected and logged into the university’s skeletal archive, which helps illustrate how bones decay over time. The oldest ones in the collection belonged to someone born in 1892.
Their center receives 100 cadavers each year on average. To get the process started, interested donors must simply fill out forms that are available online. Many donors find the Body Farm an interesting concept, and they want to help out however they can, according to Meadows Jantz. “I actually met with two of our pre-registered donors [last year] and I think they’re just fascinated by forensics. Both of them are retired EMTs,” she says.
Roach, who has done extensive research on all forms of whole body donation, says she understands that rotting away under the watchful eye of college students might not be everyone’s first afterlife choice. However, she feels that donating one’s body to some scientific pursuit is a noble legacy to leave behind—and it’s one she personally plans on pursuing.
“I saw a woman who, as a dead person donating her organs, saved three lives. You can’t usually do that kind of a heroic thing while you’re alive,” Roach says. “You look at your options as a dead person: you’re going to rot in the ground, you’re burned up and cremated ... or you can do something useful.”