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.
***
The Mary Roach list:
Fuzz
Grunt
Gulp
Packing
for Mars
Spook
Stiff