The Icepick Surgeon

by Sam Kean

  To give Ballou some credit, he did show the article to Marsh before publication to give him a chance to respond; he also showed it to the head of the geological survey. The survey chief penned an immediate reply, but Marsh took a different tack. He went to the University of Pennsylvania to get Cope fired from his teaching job and complete his financial ruin. When the university balked, Marsh doubled down and started digging up dirt on its president. Apparently he’d been embroiled in a sordid blackmail case, and Marsh threatened to expose him in the press if he didn’t comply.

  Despite Marsh’s machinations, Ballou’s story appeared on January 12, 1890. One historian aptly summed it up as showing “disdain for the laws of libel” and lacking even “the restraint of good taste.” Virtually everyone quoted in the article denounced it—albeit without retracting what they’d said about Marsh. (Rather, they objected to Ballou’s underhanded reporting methods.) Not that Ballou cared. Shamelessly, he simply gathered his sources’ reactions and worked them into another hot scoop. “The fur is flying,” he noted in a follow-up. “It is a very pretty fight.” Nice work if you can get it.

  Marsh’s rebuttal—cold, precise, and nasty—appeared a week later. He insisted that it pained him to expose Cope like this, but his rival had left him no choice. Cope’s charges, he claimed, were old, tired, and full of lies: “Should I attempt to give all the evidence which I have on this subject [of Cope’s perfidy], verily the Sunday Herald with all its supplements would not contain the half thereof.” (The pseudo-biblical language here was probably a dig at Cope’s Quaker speech, too.) The wickedest taunt came in answer to a charge that Marsh had plagiarized his work on horse evolution from a Russian scientist: “Kowalevsky was at last stricken with remorse and ended his unfortunate career by blowing out his own brains. Cope still lives, unrepentant.” Marsh wrapped things up by reminding the world, one last time, that Cope had put the skull of a plesiosaur on its tail twenty years earlier.

  In the end, the articles embarrassed both men. Rather than destroy an enemy, Cope merely created more of them, since no one trusted him now. Marsh looked petty and conniving in his replies, and soon lost his post as the geological survey’s paleontologist. From a wider perspective, the scandal also sapped the fury of their rivalry. Marsh was approaching sixty then and feeling his age. Cope, nearly fifty, was in even worse shape. His wife had left him due to his financial woes, and he was sleeping alone on a cot in his house, with only a pet tortoise and his nightmare-inducing fossils for company. Then he fell ill with kidney disease, and recklessly began injecting himself with morphine, formalin (a fixative for corpses), and belladonna (a.k.a., deadly nightshade) as medicine. These home remedies did no good, and he died of renal failure in 1897. As one historian pointed out, “An inability to discharge the poisons from his system had finally killed him.”

  Immodestly, Cope willed his brain and skull to a colleague who studied the neurological basis of genius. According to legend, Cope’s gift was also a posthumous challenge to Marsh: He was daring his nemesis to leave his own body to science in order to determine once and for all who had the bigger brain. Regardless of whether that’s true, Marsh didn’t take the bait. He died in 1899 and was buried in Connecticut. He had just $186 of his uncle’s fortune left; he’d plowed every other dollar into his beloved fossils.

  In one of the Herald articles, a geologist said something about Cope that applied equally well to both men. “If he could [only] be made to realize that the enemy which he sees forever haunting him as a ghost is himself.”

  For all their demons, though, it’s hard to overestimate the impact Marsh and Cope had on natural history. At the start of the 1860s, scientists worldwide knew of roughly a dozen genera of dinosaurs. Marsh discovered nineteen genera by himself, and eighty-six species. Cope added twenty-six more genera and fifty-six species,3 and wrote an incredible 1,200 papers overall. (This is supposedly a record among scientists; a list of his collected publications fills 145 pages.) And while Marsh won the species count, Cope’s ideas on dinosaur biology have triumphed over his rival’s. Marsh always viewed dinosaurs as the reptilian equivalent of himself—slow and plodding, an idea that reigned for a century. Nowadays, Cope’s view of dinosaurs—that they were quick and nimble, like him—seems closer to the mark.

  More importantly, Cope and Marsh brought about a Copernican shift in our understanding of life on Earth. Thanks to them, human beings now grasped, for the first time, just how thoroughly dinosaurs dominated our planet once, and for how long they did so—roughly 180 million years, six hundred times longer than the span of Homo sapiens so far. Late dinosaurs like Triceratops and Tyrannosaurus actually lived much closer in time to us today than they did to early dinosaurs like Stegosaurus, which died out 150 million years ago. This perspective also drives home the fact that, if not for a bit of luck and a big asteroid, mammals like us might still be an obscure taxon of little hairy things burrowing underground.

  The public benefitted from the rivalry as well. Marsh amassed so many crates of fossils that his successors were still unpacking them sixty years after his death, and his and Cope’s collections filled museums across much of the United States. Before the Bone Wars, no one except a few academics had ever heard of dinosaurs. Cope and Marsh made dinosaurs famous—the first thing every schoolchild begs to see at a museum. They did so not just by unearthing old bones but by putting them on display and stirring people’s imaginations with their writings. Consider this passage by Cope on pterodactyls, a relative of dinosaurs: “These strange creatures flapped their leathery wings over the waves and, often plunging, seized many an unsuspecting fish; or, soaring at a safe distance, viewed the sports and combats of more powerful saurians of the sea. At night-fall, we may imagine them trooping to the shore, and suspending themselves to the cliffs by the claw-bearing fingers of their winglimbs.” The man could practically see these beasts, in his dreams and otherwise, and like a true visionary, he imparted what he saw to the rest of the world.

  In the end, certain aspects of the Bone Wars have an illicit thrill to them—the double-dealing and sabotage, the defections and secret codes. Because no one really got hurt, and because science benefitted so much overall, we can chuckle about the sins of Marsh and Cope today. The same cannot be said for the next few stories, which take us into the twentieth century. The victims there weren’t cranky academics, but medical patients who’d put their trust in—and were betrayed by—the very people they’d been seeking help from: physicians who’d sworn an oath to Do No Harm.

  Footnotes

  1 While Leidy and Cope’s was the first complete skeleton ever mounted, it was not the first reconstructed model of a dinosaur in history. Based on some pitiful bone fragments, paleontologists in England had made some wildly speculative sculptures of several dinosaurs for a park in London in the 1850s. They were such a big hit that officials in New York planned to erect a similar set of monsters in Central Park—and would have, except that none other than Boss Tweed came along and destroyed them, then ran the sculptor out of town. For more on this wild story, see episode 6 at samkean.com/podcast.

  Incidentally, Marsh once mounted a skeleton of one creature (a rhino-like mammal called an “uintathere”) by using papier-mâché to make molds of its bones. For the papier, he got hold of the thickest, sturdiest material he could find: shredded U.S. greenbacks. As a result this beast was, perhaps literally, a million-dollar skeleton.

  2 Yes, yes, I know—save the angry letters. Technically, we should refer to the Brontosaurus (a lovely name) as the Apatosaurus (a clumsy name). But according to some scientists, Brontosaurus might be making a comeback.

  The mess over this name dates back to 1877, when Marsh conjured up the Apatosaurus based on some vertebrae and bits of pelvis. Two years later, he named the Brontosaurus on equally sketchy grounds, combining the head of a sauropod from one area with the skeleton of a sauropod from another. Although a few colleagues questioned this Frankendino, Marsh’s reputation kept the Brontosaurus alive until
1975, when paleontologists reevaluated several specimens and decided that Brontosaurus and Apatosaurus were the same beast. And based on the rules of scientific nomenclature, because Apatosaurus had come first, Brontosaurus was no longer valid. (The name Brontosaurus stuck around in part because museums were slow to update their displays, so the name lingered in the public consciousness.)

  However, according to some scientists, Brontosaurus might be a valid species after all! They’ve compared various old skeletons and say that Marsh’s original bone fragments are distinct enough from Apatosaurus to count as a separate species. So our beloved Brontosaurus might be making a comeback. Time will tell …

  3 To be sure, not all of Cope and Marsh’s dinosaur species are recognized today, especially not under their original names. Perhaps more than any other science, paleontology requires the constant lumping, splitting, and reclassifying of evidence, and new species flit into and out of existence all the time. Of Cope’s twenty-six genera, for instance, just three survive today. But no matter how you slice it, Cope and Marsh’s taxonomic records are astounding.

  7

  OATH-BREAKING: ETHICALLY IMPOSSIBLE

  Smoking bans. Organic farming. Food free of dyes and preservatives. What do all these health measures have in common? They were pioneered by Nazi doctors. That’s not what we normally think of when it comes to medicine under the Third Reich, of course, but the same fixation on “purity” that inspired those nostrums also inspired many of the barbaric experiments that made Nazi physicians infamous.

  The Nazis were obsessed with purity, and they feared that cigarettes, processed foods, and pesticides were contaminating the bodies of German citizens. The diabolical SS even bottled and sold mineral water. The Nazis then extended this notion of purity from individual bodies to the body politic, and grew obsessed with purging society of supposed poisons, especially Jews. (As Deputy Führer Rudolph Hess once put it, “National Socialism is nothing but applied biology.”) As a corollary, Nazi doctors concluded that running medical experiments on non-Aryans was not only permitted but a moral duty: the death of such “human material” would eliminate contaminants from society, and the insights gained would boost the health and well-being of the Volk.

  Examples of ghastly experiments under the Third Reich include: shooting people with poisoned bullets; transplanting limbs without anesthesia; rubbing sawdust and glass into open wounds to study healing; and squirting caustic chemicals into people’s eyes to change the color. At least 15,000 people died in such experiments (contra chapter three, Nazi anatomists never lacked for cadavers), and 400,000 more ended up crippled, scarred, or sterile. Many of those experiments would have been illegal on animals under Nazi law. But unlike monkeys, dogs, and horses, Jews and political prisoners enjoyed zero legal protection.

  Incredibly, many of these physicians had sworn the Hippocratic oath to “Do no harm” or something equivalent—the same oath that medical students swear today. It’s one of the oldest statements of medical ethics in history, dating back to the ancient Greek doctor Hippocrates, and it would seem to preclude exactly the sorts of atrocities mentioned above. So did Nazi doctors feel they’d violated this oath? Not at all. The Hippocratic oath focuses on the behavior of doctors and is largely silent about what’s best for patients; it simply trusts doctors to look after them. Which is all well and good in a normal ethical landscape. But in 1930s Germany, a collectivist ethos took hold—a crude utilitarianism that ignored individual rights and promoted the “rights” of the race instead. Physicians bought into this ethos as much as anyone: As one historian noted, doctors “joined the Nazi party earlier and in greater numbers than any other professional group.” As healers, they especially relished Nazi rhetoric about “curing” society’s ills and eliminating “cancerous” Jews, gypsies, and homosexuals. In other words, doctors simply shifted the meaning of the Hippocratic oath from “Do no harm to patients” to “Do no harm to society,” and acted accordingly. As one of their number bluntly put it, “My Hippocratic oath tells me to cut a gangrenous appendix out of the human body. The Jews are the gangrenous appendix of mankind. That’s why I cut them out.”

  Altogether, nearly half of German doctors joined the Nazi party, and their work casts a shadow on medicine to this day. Beyond the lives cut short, there are several diseases and syndromes still named after Nazi physicians who gained their knowledge illicitly. More pressing, scientists remain split over what to do with the data from experiments on unwilling prisoners—data that’s unquestionably tainted but that could nevertheless save lives today.

  To be clear, most Nazi medical research deserves to be buried and forgotten. There’s zero medical value in, say, sewing identical twins together, as Josef Mengele once did. Even calling such work “medicine” seems obscene.1

  Not every case is so simple, though. In one series of experiments, Nazi doctors forced prisoners to guzzle seawater day after day to see how long they survived. In related work, they held people down in vats of ice water with thermometers in their rectums to study hypothermia. In still other work, they locked people inside hypobaric (low-pressure) chambers to determine the effects of extreme altitude (70,000 feet). SS chief Heinrich Himmler personally requested some of this research, and there’s no question it was barbaric. In the seawater study, patients got so thirsty that they began licking the floor after it was mopped for drops of moisture. In the low-pressure study, people tore their hair out in a futile attempt to relieve the pressure imbalance inside their skulls. People in the ice baths sobbed in pain as their limbs froze inch by inch; a few begged to be shot rather than endure another minute.

  But the doctors had a logical if ruthless rationale for running these experiments. Pilots were often exposed to low pressures in airplanes; sailors often got marooned on desert islands without fresh water; soldiers often suffered from exposure in the winter. Doctors wanted to know what these troops were going through physiologically, and especially how to save them. With the ice-water baths, for example, they attempted to revive people as soon as their core body temperature dropped below 80°F. Different ideas included intense sunlamps, scalding-hot drinks, heated sleeping bags, and booze. They even plucked some bewildered fellows out of the ice baths and dropped them into bed with prostitutes, who tried to get their blood flowing the old-fashioned way.

  Nazi doctors hold down a prisoner in ice water during a series of barbaric experiments to study hypothermia. (Courtesy of the U.S. National Archives and Records Administration.)

  And here’s the thing. For obvious reasons, no doctors since the 1940s have run similar experiments. One doctor studying hypothermia in the 1990s, for example, decided that he could not ethically lower people’s core temperatures past about 93°F; anything below that was guesswork. As a result, the Nazi data is the only data we have in some cases on reviving people in extremis. Which is a problem, because the Nazi data sometimes contradicted the prevailing medical wisdom. With hypothermia, the old prevailing wisdom held that people should be warmed slowly, with their own body heat, by wrapping them in blankets or something. Doctors felt that this slow approach helped avoid shock and internal bleeding. But Nazi doctors found that passive warming like that didn’t work.2 Warming people rapidly and actively in hot water saved more lives.

  So should modern doctors ignore that finding, due to the unethical nature of the data? Imagine a loved one—your child—falling through the ice on a river. You pluck her out, but she’s barely breathing. She has blue lips, and her body temperature has dropped well below 93°F. Which revival method would you choose? The ethical but theoretical method, based on guesswork? Or the tainted Nazi method based on real data?

  You could make similar arguments in other cases. In fact, some doctors maintain that saving lives today is the best way to make the victims’ sacrifice mean something. And while some observers have questioned the quality of the Nazi data (it never went through peer review, for one thing), in many cases the German researchers were internationally recognized experts who k
new what they were doing and set up their experiments carefully. For instance, it’s common knowledge that you shouldn’t drink seawater. German scientists therefore feared that forcing inmates to drink it would cause stress and other psychosomatic responses, which would confound their results. In response, the researchers masked the seawater’s taste, making it seem far less salty. This allowed them to isolate the physiological effects of seawater alone. That’s deceptive and vicious, but it’s sound science.

  To be sure, there are strong arguments against using Nazi data, too, both practical and moral. With the ice-water research, the inmates were often sickly and emaciated, so rewarming treatments that failed with them might still work with healthy people. Using the data could also implicitly excuse the atrocities. We should no more allow the use of improperly gathered medical results, the thinking goes, than criminal courts should allow the use of evidence seized by crooked cops.

  For what it’s worth, the American Medical Association, among other groups, has said that using the data might be ethical in certain circumstances—provided that there’s no other way to get the information, and that anyone citing the Nazi research makes it clear that atrocities took place. Emphasizing the atrocities could even help remind us that we’re not as far removed from barbarism as we like to think.

  Ultimately, sixteen Nazi physicians were convicted of war crimes at the Nuremberg Doctors Trial after World War II, and seven were hanged. During the trial, American physicians and lawyers formulated ten ethical guidelines for research on human subjects, now known as the Nuremberg Code. Unlike the Hippocratic oath, the Nuremberg Code emphasizes patients’ rights. Patients must give their informed consent to participate, and doctors need to take steps to minimize suffering and warn them about possible side effects and dangers. Moreover, the code states that doctors can run experiments on human beings only if there’s a real medical need for the experiment and only if there’s good reason to think the experiment will succeed.