Article published Sunday, August 12, 2007
University of Toledo doctor turns flesh into plastic learning tool
Neuroscience professor pioneers technique to preserve organs, tissue
Since 1978 this tiny heart, not much bigger than a golf ball, soaked in formaldehyde.
That was the year its owner succumbed to a congenital defect that made its lifetime a sad and swift defeat.
Dr. Jeffrey Gold examines the heart, probes its sole ventricle — there should have been two — that did double duty for this infant gone nearly 30 years now. He notes the lacking connection between the heart and the lungs.
He examines the accordioned Dacron tube, as wide as a finger, sewn in to make up for nature’s missing connection.
About once a month, Dr. Gold — the dean of the medical school and 25 years a cardiac surgeon — meets Dr. Carlos Baptista in the Gross Anatomy Laboratory in the basement of the Block Health Science Building on the campus of the former Medical College of Ohio — today the University of Toledo college of medicine.
Together, the men work their way through bucket after bucket of tiny hearts like this one.
Dr. Gold diagnoses defects that killed these infants, noting the special features of each. Dr. Baptista takes note of it all, asks questions, makes comments, assuring that he thoroughly understands each postmortem diagnosis.
Then Dr. Baptista turns these hearts into tools. He is one of the pioneers of a process that turns organs and body parts into perfect, everlasting plastic.
Back in his office, the associate professor of neuroscience pulls a fist-size adult heart from a file cabinet.
“Hold it up to the light,” he instructs. He points to a small section of the wall that divides the heart’s upper chambers. Faint daylight glows through it.
“You can see how thin it is,” he says.
Suddenly it all becomes clear: Why children are sometimes born with a hole in this septum; why older people can develop a breach in this paper-thin shield.
“You are appreciating something we want students to see,” he says.
The heart is human and it is plastic, the product of Dr. Baptista’s science, and his art.
Students seeing Dr. Baptista saunter across the parking lot near the Howard Collier Building — his face too young for his 53 years and too young for the gray hair he’s had since his 20s — know he may be carrying a body part: a leg, a brain, a bucket of infant hearts.
He steps into the air-conditioned offices of a small out-building across East Campus Drive from the main campus, passes through a couple tall-ceilinged storage rooms before, finally, unlocking a tall gate. It is uncomfortably warm in this part of the building, not much cooler than the swelter outside.
This is his workshop: Three small windowless rooms with block walls. Many homes have larger bathrooms. The setting is positively unclinical. On the floor of one room are three large plastic tubs, the kind one might use to store toys. Dr. Baptista pulls back the lid of the first tub. Inside is a breast with an obvious tumor, there is a heart, there is a stomach, there are ovaries. The sharp smell of nail polish remover — it’s acetone — scrapes the back of the throat as it rises from the tub. Even the light switches in this room are special: They don’t spark. Acetone is flammable, explosive, toxic.
These tanks begin the process of turning body parts into plastic.
It’s an unlovely technique, but what brews here is education. These body parts will be touchable. They won’t smell. They’ll last nearly forever. And they’ll educate hundreds of students studying to be doctors. They’ll also form a lending library for cardiologists studying the defects that occur sometime in infant hearts.
Holding the small heart he examined with Dr. Baptista, Dr. Gold explains: “Think about the power for a surgeon or cardiologist to spend time looking at these things when you can handle them, look inside them, touch them, when you’re not in the operating room having to make critical life decisions in minutes.”
A simple process
The process of making flesh plastic is stunningly simple.
The organ or body part is dissected to show some interesting feature: the tangle of arteries in a hand, the blossom of a tricuspid valve inside the heart, or the hole worn away in an ulcerated stomach. Then, with many other organs, it soaks in acetone. Slowly, the acetone replaces any water in the tissues. It also turns body fat to liquid.
Next, the organ is placed in a vacuum chamber full of liquid silicone. The chamber is inside a large freezer kept at minus 13 degrees Fahrenheit. Every few days, Dr. Baptista increases vacuum pressure in the chamber. Slowly, the acetone is drawn out, replaced by the silicone.
Finally, gas cures the now silicone-impregnated specimen. Silicone molecules crosslink into a durable plastic in every cell.
“It’s precious. It’s like jewelry,” he says of these donated organs, now ready for classroom discussion.
“The process is very simple,” says Dr. Baptista, who taught himself how to plastinate organs in the 1980s while working as a professor in Brazil. “It’s simple in the manner that you follow instructions. Then the refinement, that is the art and the science combined. It is like cooking. Some people say they can cook, and they can cook. Other people can do the cooking very well. This process has this: You have to put in your art.”
A 30-year-old technique
The general recipe for turning organs to plastic is 30 years old. It was developed by Gunther von Hagens, the German anatomist who went on to create the traveling Body Worlds exhibitions, where flayed humans in exotic poses of dancers and runners display muscles, organs, and vessels for the inspection of the curious.
In those commercial displays, organs and muscles are brightly colored, injected with special dyes. But the medical school models for the most part are monochrome: gray after long years in formaldehyde or a yellowish color for fresher flesh.
The idea of preserving human remains is ancient. While Egyptians developed a mummification process as part of religious belief, there’s some suggestion that the knowledge of mummification — which included removal of the brain and internal organs — may have played a role in the development of medical practice.
“Even in Egypt … they were also doing surgery,” says Ronald Wade, who directs the University of Maryland school of medicine anatomical services division.
“They were doing brain surgery.”
Mr. Wade was among the first in the United States to plastinate body parts. He directs the state of Maryland’s body donation program, which distributes some 1,500 cadavers each year to medical schools.
“I grew up in a funeral home,” Mr. Wade says. “Death is my life.” It’s clearly a favorite joke. He said it a few times.
Mr. Wade says early efforts to preserve human remains for study arose with the Age of Enlightenment in the 18th century, as dissection became a part of medical education and the body-thieving practices of “resurrection men” a shadowy adjunct to physician studies.
By the early 1800s, Mr. Wade says, Scottish anatomist Allen Burns was experimenting with preservation techniques that had a great deal in common with preserving food. The University of Maryland now holds the Burns specimens.
Many of the preserved organs were cured in salt and sugar, ‘‘just like you would dry beef,” Mr. Wade says. “They dried them out, and they were very light and delicate, just like beef jerky.
“When I came to the University of Maryland, they were shown in cabinets. Some were stuck together because the sugar was starting to come out.”
Burns was fascinated with the vascular system and injected hearts with a kind of red mortar “almost like cement,” Mr. Wade says. “I have hearts he injected that are 8 pounds, 16-pound hearts. They’re hard as a rock. They’re also very delicate.”
On this background, plastination was a huge leap forward.
It came from methods used for preparation of microscopic slides, Mr. Wade said. Its creator, Mr. von Hagens, “took it macroscopic. If you can do this for little fishes, why not big worms?”
Another teaching tool
Although Dr. Baptista plastinates body parts for other institutions, which helps cover the cost of his tiny operation, the ones he does for UT come from the university’s anatomical donation program.
Every year, some 120 to 130 bodies are donated to the university, said Mark H. Hankin, PhD, the director of the program that began the year after the medical school’s 1967 founding.
Plastinated specimens won’t replace the tradition of training students with real human bodies, says Carol Bennett-Clarke, PhD and associate professor in neurosciences — where the anatomy program resides. Rather, such specimens offer another teaching tool.
“We actually don’t have any intention of replacing cadaver dissection,” she says. “Our real intention is to make it more time-efficient.”
She and Dr. Baptista used plastinated hand dissections to investigate how effective they were as a teaching tool.
One group of students performed a traditional dissection of the hand during a three-hour laboratory period. A second group studied predissected hands to learn anatomy.
Testing before and after the hand-anatomy laboratory showed that the two groups learned the material equally well. But the group using the plastinated specimens learned faster.
The research group selected hand dissection because it is a difficult thing to do.
“Students find that it’s particularly time intensive, and not really rewarding,” Ms. Bennett-Clarke says. “The structures of the hand are very, very tightly knit with each other. And it takes a very patient and somewhat skilled person to dissect.”
In the three-hour lab typically assigned for hand dissection, student success rates fall about 50 percent.
“Wasting three hours of time for a 50 percent yield, that’s not really time well spent for them,” she says. “There’s just an explosion of information we need to present to the medical student,” and in this instance, plastination squeezes in learning a little more efficiently.
Emerging from obscurity
Dr. Baptista has labored almost unknown in the neurosciences department at the medical school. Many others there have no idea that a UT professor has plastinated body parts in Toledo since 1987.
But there are signs his star is rising. Plans are afoot to take him out of the tiny rooms where he works and put him into a larger laboratory space.
It’s ironic that the University of Michigan visited him when it was establishing its plastination laboratory and now possesses far posher facilities and the full-time assistance of technicians. Dr. Baptista generally works alone.
Just last week, two other universities contacted him for assistance in plastinating specimens. Other professionals in the field know and respect his work.
Mr. Wade of the University of Maryland says, “There are very few people that have developed the expertise and experience in this process. Carlos is one of them.”
And if you’ve ever visited the Chicago Museum of Science and Industry, the plastinated sections of a head displayed there are his work. In fact, the head MRI that accompanies the display is actually an MRI of Dr. Baptista’s head.
“Who can say they have their head in a museum?” Dr. Baptista jokes. “Nobody could say that.”
Contact Jenni Laidman at:email@example.com 419-724-650