WHEN I was a medical student elbow deep in the abdominal fat of my cadaver, and neck deep in the Latin names of body parts, I decided to visit a kosher slaughterhouse. I wanted to get some real-life perspective on all the anatomical terms I had been painstakingly memorizing for exams. And what better way to get perspective on anatomy than to learn how muscles become meat? Cattle and humans have similar anatomy, after all — the muscles just have different names. Cattle have the filet mignon, and we have the psoas major muscle. They have the rib eye, and we have the erector spinae.
I found a slaughterhouse in central New Jersey, deep in the state's industrial heart. The owner agreed to let me visit on the next slaughtering day. And ! it was in that kosher abattoir, among bearded rabbis, burly slaughterhouse workers and hanging slabs of meat, that a central insight of anatomy and histology would take shape for me. It was there that I would learn something about the border between our bodies and the rest of the universe.
On the crisp autumn morning that I arrived, the slaughtering had already begun. Rabbis with long gray beards and thigh-high rubber boots stood around a large wooden table examining mounds of shiny flesh. Black and Hispanic workers wielded huge motorized butchering saws and moved hanging quarter-cows along tracks in the ceiling. A steer was led into the building from the lot outside through a narrow chute leading directly onto the slaughtering platform. Chains were then fastened to its back legs and used to slowly lift the animal off the ground. Just as the front hooves left the! concrete floor a long, final "moo" built in volume and ec! hoed off the industrial walls. One swift slice of the rabbi's knife, a slick of blood hit the floor with a loud splash and the animal was dead before the echoes of that last moo had finally faded.
The rabbi wiped the blood off his long knife with a rag. A towering man high-fived him and said, "Rabbi, you're the best there is."
As the day went on, more than 30 living bodies were turned into meat. I walked among the hanging slabs and saw quarter-cadavers, recognizing the same orthopedics of muscle and bone that I had seen in anatomy lab. Underneath our skins, we and the cattle are both glistening red outlined in white, strung like puppets by the names of a dead language.
Just as anatomical dissection has its proper procedure, which medical students can find neatly laid out in textbooks, Jewish traditional dietary law, or kashrut, provides a guide to the proper kosher dissection of meat and diagnosis of its cleanliness. The basic rules of kashrut are simple and widely familiar: Keep milk and meat separate and avoid shellfish and pork. But there is another criterion that is less well known: severe pneumonia can make a steer no longer kosher. Therefore, an examination of an animal's lungs helps determine its cleanliness.
Pneumonia is an infection of the lungs and, in bad bouts, the infection can extend all the way to the lining of the lungs, which is called the "pleura." The lungs and pleura normally slide freely past each other as the lungs exp! and and contract with each breath. When the two surfaces are inflamed b! y pneumonia, however, they stick together like an unlubricated piston in its shaft. As the pneumonia heals, a scar forms at the spot where the lung got stuck — a band of white fibrous tissue attaching the two surfaces. The rabbis look for these "adhesions," each the footprint of past disease, and each a potential degradation of kashrut. According to Ashkenazi Jewish tradition, the number and size of these adhesions determine the grade of kosher. But most important, the rabbis must determine whether or not there is a hole hidden within the scar that reaches straight through the lung.
As a carcass hung freshly killed and cut open, a rabbi slid the lungs out of the chest cavity. His hand grasped the trachea as two fleshy lungs dangled below, and he walked over to the examining table. He placed an air hose into the animal's trachea and inflated the lungs with! a rush of air. They doubled in size like two large loaves of bread rising abruptly. The rabbi then cupped his hands around a scar tuft on the lung and filled his hands with water, being careful not to let any drain out. If there was a hole within the scar, air from inside the lungs would bubble up through the water, as when a mechanic investigates a flat tire for the puncture site. Such a hole from the outside to the inside shows the animal is not intact and therefore not kosher. These bubbles, then, are the diagnostic criteria for the rabbis.
And this is the heart of the situation: Kashrut's concept of cleanliness and health relies on the sanctity of the barrier between the inside of the body and the outside world. Maintaining cleanliness means keeping the outside out, much as people in many cultures remove their shoes before entering a house or a place of ! worship. When we breathe, air enters our lungs and whooshes all the way! down to the alveoli — but this is not truly inside the body. The air in the lungs is still continuous with the atmosphere and all of its dust, spores and smoke. The real threshold of the physical self is the lining of those deep alveoli where the body meets the atmosphere. The lungs are like the skin — a boundary with the rest of the world — but outside-in. A hole connecting the inside of the lungs to the pleura is a way for the dirt of the outside world to get in, truly inside, the body, and once that sacred barrier has been breached, innocence and purity are soiled.
It was in histology class that I learned about this sacred barrier between the self and the not-self. I learned it has a name — the "basement membrane." The basement membrane is a bundle of fibrous tissue that forms the foundation for all surfaces throughout the body. It en! cases every organ and tissue, and provides the flooring for all the lungs' alveoli. In short, it holds the body together, keeping the inside in and the outside out.
In pathology class I learned that transgression of the basement membrane has another name — "cancer." A tumor is an uncontrolled division of cells forming a mass, and benign tumors just grow and press against surrounding tissue without breaking through or violating any tissue planes. A malignant tumor, or cancer, on the other hand, does not respect boundaries. In determining whether a tumor is benign or malignant, pathologists look at a biopsy of the tumor under a microscope. They typically examine the basement membrane and search for tumor cells that have violated this sacred boundary — a necessary first step to invading blood vessels or lymph channels and spreading to distant sites in the ! body. For most tumor types, if a pathologist finds that tumor cells hav! e gained the ability to break through, then cancer is the diagnosis.
A violated basement membrane is a gold standard of cancer diagnosis for pathologists peering under microscopes, just as it is for rabbis looking closely for bubbling water in the abattoir.
In medical school I learned about how the body is held together and how it falls apart in illness. In the kosher abattoir I learned about the sanctity of those boundaries that keep both humans and animals healthy. The basement membrane protects every organism from the filth and infection of the outside world and the cancerous disease from within. It is the inviolate outline within which a healthy life is lived. Ultimately, every bout of disease — every violation of the basement membrane — leave! s a mark and makes up an individual's medical story. And when the body is opened, whether in the dissection lab or in the kosher abattoir, that story will be read. For what we all hold most strongly in common is precisely that which is most private and personal: our hidden insides and the story they tell.
Source : http://www.nytimes.com/2014/04/27/opinion/sunday/the-bodies-that-guard-our-secrets.html
