Source of book: Borrowed from the library
Note: Once again I have been forced to remove references to male genitals from this post, because it got flagged for a warning. The same is not true for female genitals, for reasons I do not understand.
There are very few authors for whom I have read everything they have written. I’m not sure how many they are - I guess I would have to go back and find all the ones who wrote one book and nothing else. Harper Lee ruined my streak posthumously - I haven’t read her new one, and it isn’t high on my list.
I am sure, however, that I have again read everything by Mary Roach. This is my third time. She keeps writing new ones, which is good, of course. There is always a sad feeling when I get to the end of her latest and know I have to wait for the next.
I have reviewed nearly all of her books, the only exception being Bonk, which was the first one I read. I actually was blogging back then, but I still cared too much about what Evangelical friends and family would think if I wrote about a book with sex stuff in it. Suffice it to say that those days are long gone. I haven’t been a church member for nearly a decade, am estranged from my parents, and most of the people whose opinions I once cared about have outed themselves as racist, misogynistic, and homo- and trans-phobic. So, my remaining fucks will be reserved for better things.
Replaceable You is a return to Roach’s fascination with human bodies. And, as she always does, she finds a way to participate in the things she writes about.
The book is about the things one can replace on humans. Or that we are working to figure out how to replace. She starts with some pretty mild stuff, like Tycho Brahe’s nose, and skin grafts for burn victims. Not that this isn’t fascinating, but you might need a strong stomach for the chapters on tissue donation and organ transplants.
Roach, of course, cannot be actually grossed out, as far as I can tell. She is game for just about anything that is merely unpleasant (as opposed to actually harmful or dangerous) or nausea-inducing. Watching the bones be removed from a corpse? Of course! Getting a hair transplant to her leg? Why not. Donating hair follicles for research? She’s a public citizen! And yes, of course there is plenty of talk about genitals. Because Mary Roach.
I’m not going to go through all the topics, but I do want to share some great quotes and quips. And footnotes, where she buries some of the snarkiest stuff. In case you wondered, yes she makes fun of the Elongated Muskmelon - I’ll highlight those.
Anyway, I’ll start with a bit of the introduction, “First Thoughts,” and a bit that triggered my memory. About dentures.
Roach cites a 2015 survey by Poligrip, and highlights a few fascinating statistics. Some are just sad, like the fact that a quarter of those with dentures were afraid to kiss someone.
But the one that stood out to me is that more than half of the respondents got their dentures when they were younger than age 45.
Yeah, that’s surprising. But I also recall that when I was a young kid, my mom’s parents both had full dentures. They couldn’t have been older than early 50s. Which, well, I recently hit that half century mark myself, and I can’t imagine having all replacement teeth. But it used to be more common. Even people like my grandparents, who lived long lives, ended up with bad teeth early.
These days, implants are far more common, thankfully.
Skin transplants make for an interesting topic. I actually knew a lot about this from reading a book about Dave Dave, a burn survivor whose case at the time was considered unsurvivable. Technology developed at that time has made for huge improvements in burn care since.
In both books, the various steps of skin transplantation are discussed, from the use of cadaver skin for protection during healing, to the thin shaving and growth of skin cells from the burned person to eventually re-cover the body.
Leave it to Roach, of course, to note that one part of the procedure reminded her of a shawarma shop.
And also to observe that the frozen grafts have stickers reminding staff “DO NOT MICROWAVE” for thawing them.
The chapter on hearts and blood was fun for a variety of reasons. I donate blood, so I appreciate the advances that have been made in anti-coagulation technology. On that topic, there is a footnote where Roach describes early blood donation (which is depicted in Dracula, by the way), which had to be direct from donor to donee.
Roach, naturally, describes the attempts at privacy as being “Blood bank glory holes.”
I also liked that chapter on genital replacements. She talked a bit about this in Grunt, because war has a tendency to blow soldiers’ d!cks off. This book looks more at the creation of vaginas, which typically is done for transgender and intersex women, but cancer patients have also benefited.
But it isn’t just vaginas. A lot of the use of intestinal tissue has expanded into other areas, because our guts are apparently very flexible and take well to repurposing.
The best quip comes regarding the case of the cancer patient from over a century ago, who insisted on a replacement vagina, despite the significant risks in that era, because she was sure her husband would leave her if she didn’t. The physicians - all men of course - agreed with her on that.
Roach’s response:
“And here we see how the anus can be used as a substitute for the male brain.”
Roach, no surprise, is a feminist who is affirming of sexual and gender minorities, and has no end of snark for sexist males. At the opening of a passage on the phallocentric approach to pen!s construction or reconstruction, she has this observation.
When cisgender male surgeons let their sexual worldview dictate their practice, it’s not only women who endure the consequences. Garcia has had at least four trans men who came to his clinic for a pen!s reduction because the excessive girth of their new phallus made it impossible to penetrate their partner.
She also notes a journal paper that explored the myth that nose size correlates to pen!s length. It doesn’t. “Big nose, big hose” is just a myth.
I’ll also note here my wife’s experience as a nurse. She has, naturally, seen and catheterized a great many pen!ses. She reports that when the female nurses get a guy with a huge one, the reaction isn’t positive. Usually, the comment is “ouch.” It’s not the size of the tool, it’s the skill of the one who wields it.
The chapter on joint replacement even ended up containing some great stuff about sex. The discussion starts with an article by Dr. Ban Saw, orthopedic surgeon. (Actually, his name was San Baw, but the letters were inadvertently switched in publication and wasn’t caught for years.
To head off speculation that Roach chooses her sources because of the names, she notes that the first choice for her interview was a person who, after the first contact, turned out to be the person Roach lost her virginity to.
She then, in a footnote, talks about it without revealing the name. This stuff is comedic gold:
A friend from high school and I, townies both of us, had gone to a frat party with the aim of choosing someone cute and “getting it out of the way.” Boom, done. The man spends more time inside the hips of a typical arthroplasty patient than he did in mine.
If you want to take a guess, she notes he is an orthopedist with the Mayo Clinic. She is 67, so he would have been presumably of similar age or slightly older. I’m heterosexual, so perhaps I am biased, but Roach is way hotter than any of the old guys in this list. (Hey, I have celebrity crushes too…)
The chapter about amputations was more interesting than I expected. There is the question of whether it is better to have a “natural” but strongly dysfunctional limb, or to cut it off and get a good prosthesis. In the case of feet and pain, the answer is often the latter.
Roach observes that most of us either have or will have a prosthesis at some point.
We all will, should we live long enough, be disabled.
This is a truth that I wish right wingers could understand. There is no point in looking down on the ill, the disabled, the unhealthy, and assuming they are at fault for their suffering. All of us will, unless we die young and suddenly, end up disabled. And sick. That is the progression of life and death. Better that we care for each other with love, and receive that care in our turn.
Roach also initially claims that she doesn’t have a prothesis, but then realizes that she does. (And so do I, by the way.)
Oh wait, I do. Without my artificial lenses, I’m legally blind. Ezra puts on a leg in the morning. I put on contacts.
I made it to age 45 with my natural eyes. But they have gone downhill pretty fast after that age. Without my glasses - and I have two different pairs, one for reading, and one for music and computer work - I couldn’t read, write, or make music. With them, I can read a Mary Roach book and write about it. And then go out and play a symphony.
There is a whole chapter on ostomies, which is quite interesting. As part of my professional practice, I have had clients with long-term ostomies due to a variety of conditions. One of my most stupid stories is about a client who applied for Medicaid due to disability, and the examining physician for Social Security entirely failed to note the presence of the ostomy. That’s malpractice level incompetence, likely driven by the pressure on SS doctors to deny benefits - the United States has as one of its personality traits a deep hatred toward the poor and disabled that leads to treating them with suspicion when they need help. Sorry, I could write a whole post about that.
Needless to say, we appealed the denial, had a hearing in front of the administrative law judge, who was appalled at the doctor, and granted coverage. I am proud of that case.
Anyway, Roach decided to attend the fundraising run for Ostomy Awareness Day.
“The Giant Inflatable Colon will be on-site,” he added. If you know me, you know that that is, for better or for stupid, the sort of thing that tips the balance. I booked a flight.
And now we come to hair transplants. Roach asked that some follicles of her head hair be transplanted to her leg. Just because. Unfortunately, it wasn’t successful. And worse, her donated follicles weren’t all that great at growth. Oh well. Her hair is still good where it grows, though.
This is the first of the appearances of the Elongated Muskmelon. The discussion is about the work to figure out how to use stem cells to create hair follicles. Although they in theory could make other things. Like sperm and egg cells.
Human “in vitro gametogenesis," should it make its way into practice, presents intriguing scenarios. The ability to generate eggs or sperm from, say, one’s blood cells, would present novel solutions for infertility. It would mean that gay and lesbian couples could produce offspring with genetic material from both parents. Also, in theory, a person so inclined - Elon Musk comes to mind - could use iPS cell technology to generate his own eggs, fertilize them in vitro with his sperm, and produce offspring with no genetic input from anyone else.
And yes, the Muskmelon is the first person who comes to mind in that scenario. I would myself very much prefer that this technology benefit gay and lesbian couples, rather than narcissistic sociopathic billionaires, but maybe that’s just me.
Oh wait, there is another Elon Musk bit. When transplanting hair, the best practice is to not make lines too even and straight.
“It’s a zone of transition. It can’t be too straight or too abrupt. You want some irregularity.” This is achieved by implanting follicles in a slightly meandering manner, a technique called “snail-trailing.” “And you don’t want to give a fifty-year-old the hairline of a twenty-year-old,” Chaffoo says. The name Elon Musk comes up.
I didn’t win the genetic lottery in a lot of ways. I’m okay with being short, but the allergies and the tendency toward illness are not fun. But I did get good hair. Which is ironic, because if I were to go bald, I think I would just shave it. It’s no big deal.
Speaking of stem cells, I love that Roach calls out the marketing industry for some serious bullshit.
Not long ago, walking through Target with his wife D’Amour stopped to examine a jar of moisturizer. It was on sale, but that wasn’t what caught his eye. It was the words WITH STEM CELLS. And there they were in the ingredient list: “apple stem cells.” D’Amour points out that the plant stem cells are found in the shoots and roots, not the fruit of the plant. While it’s possible to culture them in a lab, that’s unlikely to be the case in a cheap Target product. His guess is that the company just added some cells from apple stems.
This being Mary Roach, it is no surprise that butt enhancement makes an appearance in the book. And plenty of snark about male surgeons. After all, there is this whole paper about “what makes buttocks beautiful” - and the “scientific” method used to determine this apparently was a panel of plastic surgeons who “pointed out which buttocks they considered attractive and harmonious, and features on which this attractiveness depended.” As Roach says, “Oho!”
She then discusses the Golden Ratio, and talks about a website called “Math Is Fun,” which she says convinces no one. Oh well, I kind of like math. In moderation.
I want to end with a downer, unfortunately. The epilogue was written after Trump’s second election, and the DOGE cuts. Several of the programs she discusses in the book no longer exist, thanks to the cuts. This is unfortunately something that we are going to see increasingly as the Big Billionaire Bill’s delayed cuts kick in next year.
Already, my home county has lost its Alzheimer’s Disease Association and its associated adult day care that served so many of my clients - due to the cuts. I am thoroughly frustrated that local media dropped the ball on this when the bill was enacted, and still refuses to call out our local congressmen - David Valadeo and Vince Fong - who voted for it. And of course, Trump and his ghouls and goons.
People are going to suffer, and the US is going to continue to lose its scientific and medical infrastructure as the result.
And yes, I am so fucking furious at the people who voted for him. Even though, in the case of ADAKC, I suspect that a LOT of people who voted for Trump are now suffering after they essentially killed their own program. It’s beyond stupid, but here we are.
Things could have been so much better. And perhaps in another generation we can repair the damage so my children can have a decent life.
I’ll just end by pointing out that this all is a blazing example of how racism makes you stupid. And link to Jonathan Metzl’s excellent book, Dying of Whiteness - which is the perfect term for what we are experiencing.
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The Mary Roach list:
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