In Episode 6 of Under The Knife, I take on an internet myth involving iron cages, old graveyards, and the undead. Check out our new video on the history of mortsafes in ‘Bodysnatchers vs Vampires’!
The last time I saw Paul Koudounaris, he was sitting, cross-legged, atop a small table in front of an old medieval church. He was regaling an audience with stories of demon cats, using language that was as colourful as the clothes he had donned. One of his slides featured a rendering of Da Vinci’s Last Supper, with a giant cat replacing Christ as the central figure.
After that experience, I thought I knew Paul well enough to conclude that he could do nothing to surprise me. And yet when his new book, Memento Mori, arrived at my doorstep, I actually gasped. The cover itself is a thing of extraordinary beauty. Its satiny binding is cobalt blue, and reminds me of the type of cloth in which Renaissance artists often draped the Virgin Mary. It is rare to find a book these days that could be considered a piece of art in-and-of-itself.
I washed my hands before holding it.
Over the years, I’ve come to think of Paul as a wordless storyteller. It is through his photographs that he tells a great many tales about the diverse ways in which humans, both past and present, have interacted with the dead. From the burial caves of Indonesia to the colourful celebration of the Festival of the Skulls in Bolivia, Memento Mori features photographs from more than 250 sites and 30 separate countries.
Flipping through the glossy pages of this extraordinary book, I begin to understand just how varied our treatment of the dead has been across time and space. But what of the similarities?
‘As diverse as their sources may be’, Paul tells me, ‘there is nevertheless a lot that is similar about a decorated skull from Tibet and the jewelled bones I photographed in Europe, for instance. Or an old Christian charnel house and a burial cave on Sulawesi’.
Paul—who has a PhD in Art History from UCLA—is nevertheless cautious about drawing too many parallels.
‘Judging on those external similarities invites ethnographic projection, which can often be highly deceptive. The underlying belief systems between all these cultures can be vastly different’.
One of Memento Mori’s most striking features is the flashes of colour which pop up throughout the book. To most Westerners—who are used to thinking of death with some degree of solemnity—the hot pinks, bright yellows and fiery oranges can be shocking.
‘That’s our context’, Paul says. ‘It’s the vision we’ve created. We’ve determined over the last century and a half that death is a one-way portal that indelibly erases a person from society… That makes death ultimately a lonely and tragic event. So, yeah, in our culture we think of it solemn terms’.
But this isn’t the case for all people, some of whom ‘conceive of death as an open door through which a dialogue is still possible’. For them, ‘the “dead” can be a very lively group’, Paul explains.
‘The first time that dichotomy ever really made a big impression on me was when I initially went down to the Fiesta de las Ñatitas in La Paz, Bolivia. All the European charnel houses I photographed in Empire of Death were still very solemn sites to me. Even though I later came to realize that they were once very lively, loving places, we had managed to project our modern Western solemnity on them. Down in La Paz, with the incredible beauty, colours, love, and general atmosphere of celebration the dead were being feted with, I realized very quickly how culturally conditioned I was’.
Was he surprised by this new, colourful way of treating the dead?
‘Not really. I think unconsciously I had been gravitating towards this vision for a long time, and that’s no doubt why I was seeking it out. It didn’t really surprise me as much as it liberated me’.
At the beginning of Memento Mori, Paul tells a story of a guide he met on his travels to Indonesia who, as a boy, slept in the same bed as his mummified grandfather. This man’s life has not just been shaped by his relationship with the dead; it has been defined by it. That got me wondering about how Paul’s own life has been affected by his interactions with the thousands upon thousands of the dead he has photographed.
‘I am sure that over time I will discover more and more ways that this has all affected me. One thing it has done, however, is impress upon me a sense of unity. Dealing with the dead has made me understand that no matter how different we think we are, we are all part of cycle that transcends place and time—whether you want to define it in spiritual or existential terms, there’s an underlying oneness, death makes all that very clear’.
Although Paul’s work focuses on the dead, the story he is trying to convey in Memento Mori is one of life.
‘I would have called it “Memento Vitae” if I could have, because it’s as much if not more about being a reminder of life as of death…In my parlance, death and dead are two different and very specific things. The dead are a group, those who have passed on. Death is the border between us and them. As such, it’s an intellectual construction that is culturally relative’.
‘This is something that I have a hard time getting some people to accept, but it’s true. Once you start realizing that the border is something more than just defining where life ceases, it becomes very arbitrary. Where do we keep the dead? How do we treat them? Do we allow them to still have a role to play within society, or is the space between us and the impassable? So the book is very specifically about places where the border is at its most passable, and that makes it as much about life as about death, or rather about the unity that I mentioned’.
In Memento Mori, you will not find the same level of historical and cultural contextualization that you found in Paul’s previous two books, Empire of Death and Heavenly Bodies. This book, more than the others, is a testament to Paul’s extraordinary skills as a photographer and as an artist. It is a feast for the eyes. With its heavy emphasis on images, Memento Mori invites the reader to gaze unashamedly into the world of the dead, and to find the beauty that lies within.
‘With the previous books, I felt frustrated as a photographer because the photos were captive to the text’, Paul tells me. ‘I never felt like their voice and their power were fully being heard. The text predicated which ones we would use, where they would go, how they would be displayed’.
With Memento Mori, Paul worked closely with the book’s designer, Barnbrook, first grouping together the photos in a way that made visual sense, and then adding text later after everything had been laid out.
‘Its approach is drastically different than the other two books. This time the photos do the talking, not the author. Because of this, I think Memento Mori is a much more beautiful, nuanced, and moving book’.
But what about the historical and cultural context? In Western society, we often have to intellectualize our interactions with the dead in order to avoid appearing voyeuristic. For instance, we can gaze upon body parts floating in jars as long as we rationalize that experience using a medical narrative. Flipping through the beautiful pages of Memento Mori, however, we must ask ourselves: is it possible to appreciate the dead purely from an aesthetic perspective?
Although Paul has his own view on this matter, he won’t tell me. ‘This question is central to the book. I want people to look through it and come up with their own opinion’, he says. ‘Letting people make that judgment is the very point of Memento Mori.
Memento Mori goes on sale next month. You can pre-order your copy by clicking here.
In Episode 5 of Under The Knife, I discuss the dark history behind anthropodermic bibliopegy, or binding books with human skin. Why was it done? And how exactly did tanners use human skin to create covers in the past?
I often write about rare medical disorders, but there is one extraordinary case which is so strange, that there is only one documented instance of it in medical history. It involves a man who was both a dwarf as well as a giant over the course of his lifetime.
Adam Rainer was born in Graz, Austria to average-sized parents in 1899. When WW1 broke out, Rainer tried to enlist in the army, but at 4’6.3’’ inches tall, he was deemed too short and weak. A year later, Rainer tried again, and although he had grown a full 2 inches, the army rejected him once more on the basis of his height. Standing 4’8.3’’ inches tall at the age of 19, Rainer was considered a dwarf, being nearly 2 inches below the cut-off (4’10’’).
Although he was short, medical reports from the period state that Rainer had abnormally large hands and feet for his height. When he first tried to enlist in the army, he wore shoes sized US 10 (EU 43). Three years later, his feet had doubled to a size US 20 (EU 53), though his height remained relatively static. To put this in perspective: US basketball player, Shaquille O’Neal, wears shoes sized US 23.
At the age of 21, all this changed.
Rainer (pictured right) suddenly began growing at an alarming pace. Over the next decade, he grew from just under 4’10’’ to a shocking 7’1’’. During this period, Rainer also began developing a severe spinal curvature.
What exactly was the cause behind this growth spurt?
Between 1930 and 1931, Rainer was examined by Drs A. Mandl and F. Windholz, during which time they discovered he was suffering from a condition known as acromegaly. In Rainer’s case, this was caused by a tumour on his pituitary gland which led to an overproduction of growth hormones in his body. This was the reason behind his strange appearance, for Rainer didn’t just have abnormally large hands and feet. He also had a protruding forehead and jaw, as well as thick lips set over widely-spaced teeth. Below are images of man with acromegaly – you can see the effects of this syndrome on his facial features as he ages:
The two doctors decided to operate despite believing the chances for success were small given the fact that the tumour had been growing for over a decade. A few months after surgery, Rainer was measured again. His standing height had remained the same, though his spinal curvature was more severe, indicating that he was still growing, albeit at a much slower rate.
Rainer’s health continued to deteriorate. He went blind in his right eye, and began suffering hearing loss in his left ear. Over time, his spinal deformity became so pronounced, Rainer was confined to bed.
He died, aged 51, measuring 7’8’’ – though some newspapers reported his height as 7’10”. He is the only man in history to be classified as both a dwarf as well a giant; and for me, he is a testament to the marvels of the human body.
After failing to turn on the microphone during a daytime shoot, I jump a wall to film a video in Ecton Graveyard in the middle of the night… all in an attempt to win your support for Under The Knife! If you’d like to make a donation to our project, please click here.
We’re also running a contest right now. If you subscribe to our YouTube Channel in the next week, you’ll automatically be entered to win this delectable chocolate raven skull by Conjurer’s Kitchen. Thanks, as ever, for your love & support.
In this special, festive episode of Under The Knife, we take on a Christmas classic and give it a morbid twist. Using the talents of Adrian Teal (artwork), Joel Mishon (animator), and the vocal stylings of Alex Anstey, this video is the first of its kind in our series. So sit back, relax and enjoy my rendition of `Twas the Night Before Christmas as you’ve never heard it before! Featuring myself as the dissected criminal (Thanks, Adrian!).
A boy, who looked ‘about Fourteen Years old’, had come into the hospital to ask ‘what should be done to cure him of many large Swellings on his back’. These growths—some of which had started to develop three years prior—were now as large as a ‘penny loaf’. Freke continued with his description of this horrifying condition:
They arise from all the Vertebrae of the Neck, and reach down to the Os Sacrum; they likewise arise from every Rib of his Body, and joining together in all Parts of his Back, as the Ramifications of Coral do, they make as it were, a fixed bony Pair of Bodice.
Freke ended the letter by adding that the boy ‘had no other Symptom of Rickets on any Joint of his Limbs’. 
What Freke was describing is a rare condition now known as fibrodysplasia ossificans progressiva (FOP). A mutation of the body’s repair mechanism causes fibrous tissue—muscle, tendon and ligament—to ossify when damaged (pictured right: torso of man suffering from FOP). Although FOP is not fatal, most die young, starving to death after their jaws freeze shut or suffocating when new bone develops, making it impossible to breathe.
Freke was the first to describe the condition in detail. However, a French physician by the name of Gui Patin may have come across FOP in the 17th century when he wrote to a colleague that he ‘saw a woman today who finally became hard as wood all over’. 
Today, FOP affects approximately 3,300 people worldwide, or 1 in 2 million. A more recent example showing the effects of the disease can be found in the Mütter Museum in Philadelphia. In 1938, a 5-year-old boy named Harry Raymond Eastlack broke his leg while playing with his sister. Shortly afterwards, bone growths began to develop on the muscles of the boy’s thigh. Within years, the condition began to spread throughout Harry’s body so that by his mid-20s, his entire vertebrae had fused together. In 1973, Harry died of pneumonia, just four days before his 40th birthday. By that time, his body had completely ossified. Even his jaw locked up, leaving only his lips to move. Before he died, Harry had agreed to donate his body (pictured above, both alive and after death) to the museum for further scientific research, where it continues to be studied today.
Given the rarity of the condition, I was surprised to find an 18th-century skeleton showing the tell-tale signs of FOP in the Hunterian Collection at the Royal College of Surgeons in London. And yet there it was, catalogued simply as RCSH/P 804.
I wondered: whose bones were these? And how did they end up in the hands of the anatomist, John Hunter (below), for whom the collection is named after?
It turns out that when the surgeon, George Hawkins, died suddenly in 1783, he left behind a collection of anatomical specimens that were then auctioned off. Amongst them was the skeleton of an adult male with an excessive number of bony outgrowths on his rather twisted frame. Hunter—always on the lookout for rare and unusual specimens—purchased the skeleton for the extraordinary sum of 85 guineas. 
Records at the Royal College of Surgeons describe the skeleton as belonging to a 39-year-old man named Mr Jeffs. Hunter’s assistant, William Clift, later reported that he had been told that the skeleton had been buried for seven years before it was procured, presumably by Hawkins. According to Hunter, this was ‘evident from the state of the softer parts of most of the bones’. 
Was this the body of the young boy whom had sought Freke’s help in 1736? If the boy was indeed 14-years-old, as Freke had guessed, that would put his death sometime around 1761. Add to that 7 years before his skeleton was recovered, and it is very possible the specimen now residing in the Hunterian Collection once belonged to the boy described in the letter.
Of course, like so many of the specimens residing in medical collections today, we will never be able to confirm the skeleton’s former identity. What I can say with some degree of certainty is that he must have suffered greatly in the 18th century. With no real way to manage his pain, everyday life would have been excruciating. It is also likely that he would have been unable to work at the end of his life. Depending on his financial circumstances, this could have been just as crippling as his debilitating condition.
Today, Mr Jeffs ‘stands’ next to Charles Bryne, the famous Irish Giant (right). Visitors to the Hunterian are often mesmerised by Byrne’s 7’7’’ frame, and rarely cast more than a fleeting glance at the twisted skeletal remains next to him.
Hidden in the shadows of something much bigger than himself, Mr Jeffs is to visitors what he likely was to surgeons in his day: a passing curiosity. His story, however, warrants further attention, for FOP remains incurable. There is still much to be learned from Mr Jeffs and his skeletal remains.
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1. Philosophical Transactions of the Royal Society 41 (January, 1753): pp. 369 – 370.
2. Qtd in Thomas Maeder, ‘A Few Hundred People Turned to Stone,’ The Atlantic (Feb., 1998). I cannot track down the original source for this quote; although I do know that most people incorrectly date this letter to 1692. Gui Patin died in 1672, and his letters were posthumously published in 1692.
3. L. W. Proger & J. Dobson, comps., Descriptive Catalogue of the Pathological Series in the Hunterian Museum of The Royal College of Surgeons of England, vol. 2 (1972), pp. 68-70.