Written in Bone

by Sue Black

  Admittedly, the foot does not have the full agility of the hand. As the foot has no comparable equivalent of the opponens pollicis muscle, the pads of the smaller toes cannot be brought together in a pincer action with the big toe as the fingers and thumb can, and the big toe therefore occupies a very different position from the thumb. But that aside, all the other equivalent muscles and bones are present to provide us with the technical capability to use the foot as a substitute for the hand should the need arise.

  History is peppered with the names of those who have shown that the loss of their hands as a result of illness, accident or congenital disability need not be a barrier to creative art. The celebrated fourteenth-century German artist and calligrapher Thomas Schweicker lost both his arms in a duel over the right to court a lady. The skills he cultivated eventually attracted the attention of the holy Roman emperor Maximilian II, who brought him to the royal court. One of his works, a self-portrait which was reproduced on his tombstone when he died in 1602, shows Schweicker writing with a brush held between the first and second toes of his right foot while using his left foot as a guide.

  In 1957, the British Mouth and Foot Painting Artists (MFPA) self-help partnership was set up by a small group of artists from Britain and eight other European countries who painted without the use of their hands. It is still going strong today. Christy Brown, famous for his book My Left Foot, later turned into an Oscar-winning film, was an early member of the group. Probably the best-known mouth-and-foot painter in the UK now is Tom Yendell, born a “thalidomide baby” without arms. He says simply: “I learned to adapt”—a beautifully succinct summary of the extraordinary capacity of the human body to reinvent, almost to reset. That as a species we can find the capability in our bodies to adapt to such an extent is nothing short of miraculous.

  But the big toe will, of course, always play second fiddle to the thumb in the majority of us fortunate to possess both. As the loss of a thumb will have a far greater impact on our daily lives than the loss of a big toe, the transplantation of the hallux to replace an amputated pollex has become a recognized surgical procedure.

  The first foot-to-hand transfer was performed in the UK in 1968. The patient was a woodworker whose thumb and first two fingers had been sliced off in an accident with a circular saw. The substitution of his missing thumb with his big toe successfully restored some of the dexterity in his hand. Surgeons will usually connect at least two nerves, along with the corresponding vessels, muscles, tendons and skin, and the transplanted digit, sometimes referred to as a “thoe,” has proved to be very effective compared with an artificial prosthetic which, however good, lacks the subtlety of movement and sensitivity of real skin and bone.

  These patients learn to do without their big toe, but for some, it would seem, it is a loss that cannot be tolerated. The earliest toe prosthetic we know of was crafted from three pieces of hinged wood and leather, with a carved and sunken nail. Nicknamed the “Cairo Toe,” it dates back to between 1069 and 664 BC. It was found in a necropolis west of Luxor, with the remains of the Egyptian mummy Tabaketenmut. Jointed in three places and constructed to fit its owner perfectly, it was likely to have been reworked several times as she aged.

  Tabaketenmut, the daughter of a priest, was probably between fifty and sixty years old when she died. Evidently she had suffered an amputation of her right big toe at some earlier stage in her life, perhaps, it has been suggested, due to gangrene or diabetes. Her foot had fully healed but for some reason she wanted to disguise the deformity. Was it simply vanity? It has been postulated that this was to aid her balance, but the absence of a big toe causes no significant problems in this department. Even a Pobble amputation (disarticulation across all the metatarsophalangeal joints, which removes all the toes) has limited impact on balance, walking or standing. It is only swift movements, such as running, that prove difficult. And, as a priest’s daughter, it is unlikely that Tabaketenmut was a sprinter.

  Of course, all manner of items were buried with mummies in Egyptian tombs for their use in the next world, so it is possible that the prosthetic was created solely for burial or ritual purposes to ensure that Tabaketenmut did not go to the afterlife incomplete. However, evidence of wear and tear, together with the probability that it had been altered more than once, suggests this was not simply a funerary adornment. Perhaps she just wore it so that her sandals fitted properly.

  Another, more recent, prosthetic right toe from Egypt, named the Greville Chester toe after the collector who acquired it for the British Museum in 1881, dates back to before 600 BC. This was made of cartonnage—multiple layers of linen or papyrus impregnated with animal glue—a composite more commonly used for the construction of mummy cases. As the Greville Chester toe does not bend it is likely to have been purely cosmetic. It has a cavity where the nail should sit, which was perhaps inlaid with a different material, either to make it look like a more authentic nail or maybe to show off an early example of nail bling.

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  The average length of a baby’s foot at birth is about 3 ins (7.6 cm). It will grow rapidly in the first five years of life as it must mature swiftly to take up its functional role. By the end of the first year it will already be nearly half the length of an adult foot and by the end of the fifth, it will measure around 6 ins (15.2 cm).

  Most children will have adopted a shaky bipedality by around ten to sixteen months, but a fully mature gait will not be mastered until approximately six years of age. The foot will keep growing until about thirteen in girls and fifteen in boys. Interestingly, although the upper limb and hand appear in the embryo before the lower limb and foot, it is the foot that reaches adult size ahead of the hand. This is because the requirement to develop a stable foot takes priority.

  Parents tend to buy that all-important first pair of shoes within six to eight weeks of their child’s first independent steps. We know, however, that to aid healthy development, the more the foot is left bare and unshod, the better. About 5 per cent of the population visit a podiatrist or a chiropodist every year with some foot-related complaint, at the root of most of which are poorly fitting shoes. Women are the worst offenders. They will often buy shoes for their aesthetic appeal, or to complete an outfit, rather than for comfort or health. Platforms, wedges, stilettos, winkle-picker toes, ballet flats, flip-flops and many other fashionable styles are all basically torture chambers for the feet.

  The long-term effects of ill-fitting or inappropriate shoes, and of activities for which the foot was never designed, can be sobering. My daughter once asked a chiropodist what were the worst feet he had ever seen and he replied, without hesitation, that they were the feet of an elderly ballerina, which looked like two plates of rice pudding. His words, not mine.

  There is a correlation between height and shoe size, with taller people tending to have larger feet. So it is no surprise that the biggest living adult feet in the world belong to an avid basketball player, Jeison Hernandez from Venezuela, who is 7 ft 3 ins (220 cm) tall. In 2018, when he was twenty-two years old, his left foot measured 40.47 cm in length and his right 40.55 cm (nearly 16 ins). He takes a US shoe size 26 (UK size 24). The smallest adult feet may belong to Jyoti Amge, a young Indian woman who is just 24.7 ins (62.8 cm) tall. Her feet are 3.5 ins (9 cm) long, around the same size as those of a one-year-old.

  The notion that small is beautiful as far as feet are concerned was, of course, taken to its most extreme by the Chinese custom of binding women’s feet, which persisted from the tenth century right up to the early years of the twentieth. Bound feet were at one time considered a status symbol as well as an ideal of beauty. Known as “lotus feet” and encased within wrappings and tiny “lotus shoes,” they were viewed by some as the most intimate and erotic part of a woman’s body.

  Upper-class women, to heighten their allure, would soak their feet, cut the nails and then bind the toes tightly into the sole of the foot. With the toes curled underneath, the foot would be pressed down with great force until the toes
and the arches were broken. Ultimately, the bones would heal in this abnormal position.

  The effect was to bring the ball of the foot and the heel together so that the middle part of the foot was raised. Feet were often unbound and rebound daily to remove necrotic tissue and bones might have to be rebroken if they were not healing in an aesthetically pleasing way. The tight binding resulted in poor circulation, infection and constant pain. Sometimes toenails would be removed entirely. And if your toes dropped off through gangrene, this was seen as a bonus. The perfect lotus feet would be no longer than four inches (10 cm), the foot size of an average toddler.

  It goes without saying that any form of locomotion was challenging for these women. So, too, was standing. We find it difficult enough to stand upright on our normal-sized foot pads for long periods of time. That is because it takes incredible co-ordination across our musculoskeletal system to stop us falling over. Workplace advice acknowledges that standing demands around 20 per cent more energy than sitting and recommends that we should not stand still for more than eight minutes at a stretch.

  If you try to stand on one leg for any length of time, it becomes very clear how precarious the balancing act of standing actually is. And if we add some inebriant into the mix, we lose our balance easily because this affects our ability to control the intricate co-ordination needed to maintain our equilibrium. When we are balanced, our line of gravity passes from in front of our spine to behind our hips, then just in front of our knees and ankles and down to a base of support between the feet that is just a few square centimetres in size.

  Sheathing our feet in socks and shoes for protection and warmth is a very human characteristic. For the anthropologist, these coverings can be most useful. Traditional natural materials such as wool, leather and skins have now been supplemented by the synthetic equivalents of the modern age. They all help to keep the component parts of the foot together, even when the rest of the body starts to disintegrate, as well as sometimes conserving them better. A shoe also makes it difficult for a predator to remove a foot. And if a body ends up in water, it can act as a flotation device.

  A strange series of events occurred between 2007 and 2012 in the Georgia Strait, which separates Canada from the US. During these five or six years, twenty separate feet, inside their shoes, were washed ashore. A shod foot can float for a thousand miles and the cold temperature of the water will turn the fat in the foot into adipocere, the wax-like substance formed by anaerobic hydrolysis, lending more buoyancy to the foot and helping to preserve its soft tissue. Some of these feet were matched to missing individuals, but of course the wild stories and imaginative myths that grew up around the phenomenon took the internet by storm.

  At the height of the frenzy, one bunch of students decided to stuff a decomposing animal foot into a sock, put it into a trainer packed with seaweed and leave it on the shore to be found. But as we all know, the human foot is not like any other, and it did not take the anthropologists long to rumble the hoax.

  People are lost at sea all the time—in boating accidents, plane crashes or other mass fatality events—or they may be deliberately buried at sea. As the body decomposes in the water it may naturally separate into its constituent parts. When a foot has its own buoyant vehicle to keep it afloat, it is not surprising that it will move with the tides and eventually be washed up on a shoreline.

  The UK has about 7,723 miles of main coastline (if you don’t count the islands), about half of it owned by the Crown estate. So finding isolated feet on UK beaches, and along riverbanks, the shores of lakes and lochs or in canals, is not unusual.

  One right foot, wearing a training shoe, was discovered in a river on the east coast of England, shortly followed, further upstream in the same river, by a left foot. Only this one was wearing a brown boot. The booted foot was traced to a man who had gone missing that same year, while the right foot in the trainer belonged to an entirely different gentleman who had disappeared two years before. His left foot was eventually identified as well after it turned up on a beach in Terschelling, one of the West Frisian islands off the north coast of Holland, having made its way across the North Sea.

  From single feet like these, forensic anthropologists can determine the sex (from the size, the presence of hair, and so on), age, height and shoe size of the individuals from which they have become separated and sometimes this information can be sufficient to create a broad identity profile that assists with narrowing down the possibilities. But on its own, it won’t be enough to pinpoint a positive, named identity.

  Interestingly, finding a single, isolated foot is generally considered insufficient grounds for opening a coroner’s inquest as it cannot be taken as indicative of a death. Although the severing of a foot is quite likely to be a life-ending event, it is, of course, possible for someone to survive such an amputation.

  It is rare for foot bones to be the only evidence in an investigation but I do remember one, long ago, when I was still working in London. The call came from a police officer in Cambridge, who had a case out in the fens relating to the remains of a Polish Second World War pilot and his aircraft. The pilot had been returning to the UK after a sortie across the North Sea in about 1944, if memory serves, when his Spitfire took a direct hit to its engine, which eventually failed as he passed over the east coast. He had no time to eject. His plane plunged nose-first into the flat wetlands, its wings ripping off, reducing it to a metal tube like a cigar case embedded in the boggy ground.

  The sites of these incidents are well documented and the authorities know where most of them are. Occasionally, bits of plane, or indeed of pilot, have come to the surface as farmland is ploughed year in, year out. This request came around the end of February, early March, as I recall, a time of year when farmers are starting to think about preparing their fields for the sowing of new crops.

  There is big business in wreck salvage, and a lot of money to be made from Second World War aircraft artefacts. The police were aware that salvage-hunters had been searching this area for a couple of years and the military knew there had been various small finds. But the prospect of unearthing an intact Spitfire fuselage, preserved by the fenland soil, would have made these fields a prime target for those perhaps more interested in their monetary value than in their historical importance or the sanctity of a war grave.

  It was one of these salvage teams that had contacted the police. They said that, while walking in the field where they believed this Spitfire had crashed, they had come across a bone which they thought might be human. They had left it in the field where they had found it, flagged by a marker. They realized it might be important and felt that it should not be moved.

  The police were suspicious. They’d had dealings with this group before, and knew they had previously found an aviator’s boot with some bones in it. They would not be surprised, they told me, if this bone (if that was what it was) had come from the same source and had little to do with the fuselage they were looking for. The salvage hunters were perfectly well aware that if human remains were discovered, there would have to be an archaeological and anthropological search and assessment of the site, which might well lead to a full-scale excavation, and an opportunity for them to claim the salvage.

  It was a bitterly cold morning when I arrived in a police car at the side of the newly ploughed field to walk the area with the search officers. An orange camping flag had been left in the field for us, marking the spot where this bone had allegedly been found. We headed there first, so that before we did anything else I could determine whether it was actually human.

  There was no doubt about it. It was a human left fifth metatarsal, the bone at the base of the little toe. What made me uneasy was that it was sitting on top of the soil, not partly buried in it; not even adhering to the wet earth beneath it. It was clean, with no sign of dirt, dust or mud. It looked as if someone had deliberately placed it there. We photographed the bone, lifted it and bagged it as evidence. Then, starting at the edge of the field, we worked o
ur way inwards, walking every drill of the ploughed area. We found no trace of a boot or shoe, no sign of any wreckage. Not even any animal bones.

  What we did find, within a radius of less than eight feet of where the fifth metatarsal had apparently been discovered, were another four small human bones, all from a left foot. When compared with the metatarsal, they all looked, from their size, colour and appearance, to have come from the same individual. But every single one of them was perched right on top of a plough ridge. Like the metatarsal, none were buried in the soil, and there was no soil sticking to them. In my view, they had simply been laid on the ridge to get our attention.

  The salvage crew, of course, professed to know nothing about this, or about where the bones might have come from. But if their intention had been to coerce us into an excavation, they failed. The police and the military authorities accepted my opinion that the bones had probably been left there on purpose for us to find and my advice was that these were not justifiable grounds for an excavation.

  I did suggest that they attempt to retrieve some DNA from the bones, in case it was possible to establish a match with any of the pilot’s relatives. But at that time DNA extraction was not as sophisticated as it is today, the bones were all very heavily weathered and the lab was unable to obtain sufficient genetic material. I think the remnants were buried as unidentified. And what was left of the Spitfire and the pilot remained, for the time being at least, in their quiet fenland grave.

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  It is not only the bones of the feet but my personal bête noir—those deplorable toenails—that can tell us something of the life lived. The toenails grow at the rate of about a millimetre a month (significantly more slowly than the fingernails) and it takes them approximately twelve to eighteen months to fully regrow. The average toenail, then, represents a record of perhaps the last couple of years of a person’s life, with the nail bed holding the most recent information and the tip of the nail the oldest. If you know what you are looking for, there is a tremendous amount that science can tell from that nail in terms of where a person lived and what they ate and drank.