The Anatomist: A True Story of Gray's Anatomy

  • Bill Hayes
Ballantine Books: 2007. 272 pp. $24.95 0345456890 9780345456892 | ISBN: 0-345-45689-0

We've all heard of it. Many of us have flicked through it in a bargain book shop. It has gone through more than 30 revised editions on each side of the Atlantic and has sold more than five million copies. Gray's Anatomy is surely one of the world's great books. But, as Bill Hayes discovered in researching this publishing marvel, evidence of how it came about is scant.

Illustrated anatomy texts had been in circulation for more than half a millennium when Gray's Anatomy was published in 1858. Its author, English surgeon Henry Gray, aimed not to produce an enduring classic, but to improve on the passable text books he had used as a student at St George's Hospital Medical School in London.

The medical curriculum's recent expansion and the increasingly widespread use of anaesthesia provided a fertile context in which to launch a fresh anatomical text book. Arguably Gray's most significant innovation was to focus on surgical anatomy, ensuring that his book would remain useful to medics long after they had entered the professional world. This commercial formula has proved buoyant ever since.

From its first reviews, critics were struck by the clarity and functionality of the atlas's pictures. Such fare had long served to objectively analyse the body in ever finer detail and to remind scientists, doctors and patients alike of its subjective and emotional resonance. Gradually the rigorous demands of the former squeezed out the opportunity to indulge in the latter.

Neck arteries, illustrated by Henry Vandyke Carter, from the 1858 edition of Gray's Anatomy.

Gray's Anatomy effectively marked the end of the road for the troops of playful cadavers that had, in earlier volumes, cavorted with props and danced as only the dead know how. Here instead images shied away from the notion of style altogether. The book offered a set of pictures that students and professionals were supposed to look through rather than at, into the realities of nature that they revealed. Recently, medical thinkers have begun to ponder what was lost when the two approaches were separated, and whether a third way — medical humanities — should now be cultivated.

Gray's bible of medical understanding emerged from his collaboration with another Henry. In June 1850, Gray, the project's instigator, invited the more junior Henry Vandyke Carter to supply what became the iconic illustrations. Even before their inspiring collaboration, Carter prophetically declared: “Two persons are generally concerned in every fact, one discovers part, the other completes and corrects.”

The emotional tension in anatomy: layers of a dead body stripped to better understand life.

Of Gray, we know very little — even the year of his birth is contested. Luckily, various archives reveal much more of Carter's life and work. The illustrator probably inherited his aesthetic abilities from his father, the practising Scarborough artist Henry Barlow. Carter headed south to pursue medical studies in London and took to anatomy with a passion, spending whole days dissecting. The combination of his skills as a draftsman and the depth of his anatomical knowledge recommended him to Gray.

The inspired collaboration lasted for just one project. By the time the work was published, Carter had moved to Bombay; here he clocked up an extended spell in research and administration at the Grant Medical School, ending up as its principal. Hayes is as concerned with character as career, and his lively prose provides much insight into Carter's colourful but failed romantic entanglements. But we never really get much insight into just what made Carter's drawings so compellingly distinctive.

The Anatomist also concerns the progress of a third anatomist: Hayes himself. Early on in his research, Hayes was determined that he too should learn through scalpel and cadaver as well as lecture, library and archive. Some of his most memorable writing describes the dissection classes he attended in San Francisco. We are treated to a selection of fascinating anatomical snippets about, for example, how to trace evidence of the sealed hole in the fetal heart through which the mother's blood enters; or how to find the kidney in a cadaver; or that blood flowing out of the heart is first used to feed the heart itself; or, best of all, a structural analysis of how the Queen manages to deliver such a uniquely restrained wave.

These sections allow Hayes to do what seemingly every writer must these days: he tells us about himself. Those tempted to skip over these fashionable journalistic passages might actually profit from lingering over them. It is here that Hayes really comes to grips with the emotional tension inherent in anatomical studies: the way in which layers of a dead body can be stripped away so we might better understand life.

An important work of medical history The Anatomist is not. It is, though, an enjoyable contribution to the burgeoning field of medical humanities, skillfully bringing together past and present, objective facts and speculations, in a provocative meditation on a text book that might well still be helping shape young medical minds in another 150 years.