“Whatsoever thy hand findeth to do, do it with thy might; for there is no work, nor device, nor knowledge, nor wisdom, in the grave, whither thou goest.”
So reads the inscription (Ecclesiastes 9:10) over the door of the “Pathology and Museum” block of St Bartholomew’s Hospital, a QMUL campus next to Smithfield Market. The only area of the building commonly accessed by QM students is the West Smithfield Library, unique in its ability to flood completely if a drop of rain falls within three miles. Despite this flaw, the library is beautiful, built-in 1872 to house the document collection of the medical school, I recommend making the short trip on the Hammersmith and City Line to visit it. Confusingly, the focus of this article lies in the building opposite the inscription, the Robin Brook Centre; through the doorway labelled “Minor Injuries/Outpatients” and up three flights of stairs there is a locked door behind which sits the Barts Pathology Museum.
A Medical Museum
First opened in 1879, the room behind the door is home to over 5,000 medical specimens displayed over three mezzanine floors. The building is Grade-II listed, which means it is protected as a historic monument of national significance. It was purpose-designed to display these specimens, and the elegant roof and fine ironwork on the balconies make a beautiful and well-lit space to look at them in. They include a variety of objects, from full adult skeletons to the tiny organs of children, and the oldest of them date back as far as the 1750s. Those specimens that are skeletal are mounted or hung, while the specimens with flesh remaining are pickled in various preservative solutions in jars.
The purpose of the museum and its preservation of the specimens was not for the education of the public, but rather for the students who studied at the hospital. Some publically accessible anatomical museums opened in the early nineteenth century, but they were mostly prosecuted and shut down after 1857 when the Obscene Publications Act began to be applied by courts to prosecute privately-owned displays of human remains. Afterwards, specimens were only allowed to be shown by medical professionals to students of medicine, who needed to observe examples of common or unusual medical ailments. Multiple universities and colleges hold such collections: King’s College London has the Gordon Museum of Pathology and the Royal College of Surgeons has the Hunterian Museum, both equally stuffed with human remains. The Barts Pathology Museum was the fourth largest of its kind in the UK, by the mid-1950s; the Gordon Museum, with around 8,000 specimens, was and remains the largest.
The usefulness of physical specimens in medical education declined as medical imaging advanced, and by the 1980s there was no purpose seen in the collection, once a central point of pride and attraction to students. By 2000 it was being considered for sale by the St Bartholomew Hospital NHS Trust, whose proposed plans included converting the building into a supermarket. Little money was spent on maintenance and so it decayed, with part of the roof collapsing and specimens rotting in their jars.
Some Things Never Change
The Museum was saved in 2010, by a grant from The Medical College of St Bartholomew’s Hospital Trust, and QMUL now employs a Technical Curator named Carla Valentine to look after the collection. Carla was a Mortician for eight years, notably assisting in the dissections of the 7/7 Bombers, and has a progressive attitude to the treatment of the dead. She describes herself as “having one foot firmly planted in the future of Pathology, and one firmly in the past”, got married in a graveyard, and in 2014 set up the World’s first dating app for those whose jobs involved dealing with the dead, “Dead Meet”, which has since shut down. While she should be admired for the stellar job she has done organising and labelling the collection, there remain some serious problems.
The Barts Pathology Museum is not fully open to the public. Firstly, it only admits visitors when it is hosting a particular event; they are normally about once a month, and generally not directly related to the collection specifically. I first got in to listen to a delightful performance by a jazz quartet, for instance. Secondly, you are not allowed to climb the stairs to look at the specimens beyond the ground floor. The reason for this changes, depending on which source you ask. The QMUL Pathology Museum “About” web page suggests that this is due to the level of restoration of the particular items: “repaired specimens on the lower floor, yet to be repaired specimens on the upper floors”. Display signs outside the museum and a paper, written by Carla Valentine, about the display of the dead, however, both indicate the real reason is legal. The specimens on the ground floor are older than 100 years (1919 and before, at the time of writing) and therefore do not require consent to display, while those on the floor above were collected and pickled more recently, and require the consent of the donor or a license from the Human Tissue Authority to display. As such, visitors to the museum are not allowed to see them except from a distance. Carla Valentine agrees with me that these rules do not make sense, although for different reasons. She suggests, they are thanks to a “paternalistic” attitude from elitist lawmakers, who wish to keep the public from learning about anatomy. I would suggest that the standard applied to specimens younger than a hundred years should apply to all of them: how can we ethically display the bodies of the dead to the public without the consent of those displayed?
The items in the collection are highly unlikely to have been given up consensually. Within the museum, there are a large number of body parts of children, not normally freely given up by grieving parents. The foetuses are particularly interesting, given that abortion was only legalised in the UK in 1967 after the majority of specimens were collected. Those preserved in the collection are likely to be from illegal abortions, miscarriages, or pregnancies that killed the mother. All of these are traumatic or highly distressing events unlikely to end in consensually allowing a doctor to pickle your child. As recently as 1992, NHS doctors were secretly removing pieces of children’s corpses for preservation without informing the parents – the Pathology Museum specimens are older and likely to have been subject to significantly less oversight.
One of the public displays from the early nineteenth century was initially reviewed extremely favourably in The Lancet, which was probably thanks to its brave engagement with then-modern scientific theories: it displayed “Niam-Niams”, allegedly men with tails from central Africa, representing an earlier stage of human evolution. The medical community in the nineteenth century harboured a variety of uncomfortable and now discredited beliefs about racial and biological hierarchies of men. The Barts Pathology Museum did not escape the influence of prevailing wisdom, in its specimens. There is a collection of skulls at one end of the Museum that is labelled by continent of origin, undoubtedly designed to teach the racist science of phrenology. Hung on chains on the opposite side is the “skeleton of a Negroid”. No part of this aspect of the Museum is engaged with by the labelling or layout. Rather, the racial theories present in the collection are not significantly challenged or interrogated.
If we are to visit and interact with Museum collections, they must be managed in a way that genuinely informs. This duty does not merely cover the famous and respectable areas of Victorian medical advancement, but also the grotty and offensive aspects that were held to be equal at the time. Part of decolonising and modernising museums has to include an interrogation of those who built the collection and their motives, not merely presenting their collections without comment, or with glowing praise of their pioneering medical research. It would be odd to visit the Bethlem Hospital Museum (Bedlam) and be presented uncritically with the chains and manacles used on the mentally ill, in the Victorian period, as though they were important tools used by pioneering psychologists. Not only does the Barts Pathology Museum feature specimens likely taken without consent – certainly lacking definite proof of consent – it also harbours dark relics of foul racist and imperialist attitudes. If the specimens continue to be displayed, they should be labelled appropriately and presented as such.