In the summer of 2016, a team assembled at the Royal College of Surgeons in London for one of the most special medical procedures: A post mortem (after death). But there is a difference in this post mortem: the team was specifically looking at how obesity affected the body. And the procedure will be filmed. It was a unique event and it raised a whole lot of ethical and practical challenges, including finding a body that could best illustrate the medical effect of obesity.
For this, the team had to become part of the transatlantic system for the movement of body parts. The TCS and BBC paired up and sent requests to science organizations for their ideal body size. Their answer was at the outskirts of Los Angeles, Science Care, where they received the bodies of their donors. In their lab the bodies are dissected and specific parts are removed before being dispatched all around the world.
Earlier this year, they contacted the BBC’s program team to say that they had a body that could suitable for the post-mortem. She was in her early-sixties, 165cm, almost 110kg in weight and she had recently died of heart failure. She was frozen on sight, carefully sealed, boxed and packaged for her flight to England. In order to qualify as a body part, an arm was removed. Every year, thousands of body donations pass through this facility. Each is vital to medical science. All post-mortems are tightly regulated to ensure body donors are treated with respect and researchers are carried out on them. Cameras are not usually permitted but BBC was allowed to film on this occasion and a special license was approved for the event. The production team worked closely with the human tissue authority, to ensure the filming preserved the dignity of the donor at all times.
Caroline Browne who is the head of regulation at the Human Tissue Authority explained, “The Human Tissue Authority is a statutory regulator which means we are kind of a watchdog. We have a very specific role which is set out by the law and that is to ensure the safety and ethical use of human tissue. So in doing that, we regulate through licensing and inspection to any organization that stores or uses body parts or human tissue. The BBC filmmakers recognized earlier on that it would be a very powerful program if they were able to show the effects of obesity on the inside of a body. The important message of the program is the life-limiting nature of obesity and the potential health problems.”
The surgeon knife slices the donor’s huge belly like cutting through butter, immediately exposing the yellow jelly-like substance that is fat. The examination showed striking evidence of the impact of obesity of the inside of the donor: Excess quantity of fat in the abdomen and dangerous accumulations around the internal organs.
“With every post-mortem I do, I learn something new.” said Carla Valentine, a senior Anatomical Pathology Technologist. “But I think in this situation with our post-mortem, not only was I learning, but the public has also had the privilege of learning the incredible secrets of the inside of the human body of what I would see on a daily basis.”
Dr. Michael Osborne, a consultant histopathologist is seen cutting up the lungs, draining the blood that drips heavily onto the stainless table. He held up the heart that is smothered in fat for the cameras and explained, “The blood vessel here is the aorta. This is the vessel that takes all the blood from the heart around the body. As you can see here, increased collagen deposition leads to stiffening of the arterial wall that can block the vessels which leads to heart disease.”
In addition to the educational purposes of the film, the donor has contributed to medical research in another way: a small selection of her tissue will be retained and used in medical studies at the Medical College of Royal Surgeons, helping students understand how obesity affects the workings of our most vital organs. The cameras faithfully followed the surgeon’s steps of weighing, cutting and sorting out the donors organs.
At the end of the post-mortem, the organs are put into a bag and placed inside the body. The cadaver is then stitched together. The donor is returned to the United States for cremation. Her gift; a valuable insight into how obesity, the greatest crisis in the future, that damages us on the inside.
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