The Time I Saw a 400-year-old Tumor

Instead of having class at Regent's on Friday morning, our group took a field trip to the Royal College of Surgeons. Our visit was actually a three-part adventure. Not only did we get to tour the Royal College of Surgeons, we also visited its two associated museums. It was a special privilege for us to see the first, the Wellcome Museum. This museum features thousands of human bodies and body parts, all of which have been donated for scientific study. The purpose of the Wellcome Museum is to provide those in the medical profession - primarily surgeons but also physicians and medical artists - with real visual examples of both normal and abnormal (pathological) human anatomy. It is not open to the public. Although the Wellcome Museum has quite an extensive collection it is fairly small, confined to one large room divided into several sections. These sections represent different regions of the body: the head, the thorax, the arms, the legs, the pelvis, etc. In each section are rows upon rows of dissected or partially dissected body parts suspended in preservatives in glass jars. In terms of normal anatomy, it was interesting to see how muscles attach, how soft tissue fits with bone, and how the circulatory system winds through the body. Much more interesting were the pathological specimens. There were cross sections of tumors in every body part imaginable, gangrene and infections, evidence of trauma, and examples of the effects of countless diseases and afflictions: syphilis, tuberculosis, pneumonia, gout, and hepatitis, to name a few. There was even a section on fetal abnormalities that included an example of conjoined twins. This collection was particularly fascinating to me because it dealt so much in fleshed bodies. I'm used to working only with bones, and seeing only the limited effects of disease on the skeleton. The skeleton can react to disease only by resorbing - eating away at bone - or deposition - adding bone on, whereas there are many different reactions of soft tissue that are much more diagnostic. We also had a tour of the Wellcome Museum by Martyn Cooke, head of conservation at the Royal College of Surgeons, who gave a lecture about a particular human specimen: the skeleton of a woman with FOP (Fibrodysplasia Ossificans Progressiva). This disease causes all the bones of the body to fuse with each other, severely limiting movement. The other museum we visited was the Hunterian Museum, a public museum named after John Hunter. In life, Hunter collected and preserved thousands of animal and human specimens. Like the Wellcome Musuem, these specimens are suspended in glass jars full of preservatives. Although most of the specimens have been transferred to new containers, all of them are John Hunter's original collection. There are skeletons and cross sections of many different kinds of animals, an entire collection of human fetuses, and even pathological human examples. In one jar, there is a 52 kg tumor that John Hunter himself successfully removed from a patient nearly 400 years ago. Also on display is the skeleton of the "Irish Giant," a 7'7" man with acromegaly. Examination of his skull shows a clear indentation of where a large tumor pressed on his pituitary gland, causing him to grow. The Hunterian Museum also houses a large collection of medical instruments throughout history, from the primitive to the horrifying to the very modern. The last part of our visit was a tour through the Royal College of Surgeons, lead by none other than Vishy Mahadevan. We got to see its state of the art teaching rooms, where surgeons attend workshops to learn the latest in surgical techniques. In the biggest room, there are eight fully equipped surgical tables, and one in the middle for the instructor. The video camera system allows anything at the instruction table to be broadcast onto flat screens above all the rest of the tables. We also got to see the "situation room" where surgical teams learn skills in teamwork, judged by a committee who watches through a two-way mirror. Although we were not allowed to take pictures inside either museum or the College, I don't think I'll soon forget the images of the massive operating room, the the thousands of dissected animals, or all of all those rows of body parts floating in glass jars. Links of the day Royal College of Surgeons: http://www.rcseng.ac.uk/ Wellcome museum: http://www.rcseng.ac.uk/museums/wellcome Hunterian museum: http://www.rcseng.ac.uk/museums/ FOP: http://en.wikipedia.org/wiki/Fibrodysplasia_ossificans_progressiva Vishy Mahadevan: http://www.rcseng.ac.uk/about/eagle-project-launch/phase-one/speaker-profiles/