Microcosm in a bottle.

As a young intern assigned to the pathology laboratory of a Catholic hospital run by a monastic order, I was ill-prepared for some of the routines. T:he nuns administered the place with exemplary efficiency. At each key post an overseer or coordinator (may the youthful levity of those who said "spy" be forgiven) saw to it that cleanliness, order, punctuality, and systematic avoidance of waste prevail throughout the establishment. Not that the vices that stand in opposition to these virtues held me in their grip, for as a newly arrived immigrant in the United States I was perhaps overly conscious of the need to produce a good impression through meticulous respect for the rules, but I still felt anxious and insecure.

One afternoon, upon the unexpected absence of a regular worker, I was put in charge of describing the gross appearance of the specimens removed at surgery and submitted to the laboratory. This is a daily routine, utterly familiar to pathologists: diseased organs, biopsied tissues, and even inert foreign bodies extracted from the interior of the body must be carefully inspected, weighed, measured, described, and sampled for microscopic examination in the manner most likely to document the existing pathology. The day's allotment of tumors and inflamed viscera had already been arrayed on the counter--spoils of the unending mayhem between scalpel and disease, daily enacted in sterile battlefields worldwide--when I caught sight of a batch of containers set aside. These were bottles identified as "products of conception" on the respective labels. I assumed this to be one more example of the unswervingly methodical ways of the good sisters: specimens of like character were grouped together to facilitate my task. These specimens were the first I chose to take care of.

"Products of conception" is common medical terminology that, for once, means precisely what it says: if there is reason to believe that a woman has conceived, and subsequently tissue exits her uterus spontaneously (in a Catholic hospital one is not likely to see any but spontaneous abortions), such tissue may reasonably be regarded as the product of the conception. The intervention of the physician may be required when retained remnants cause persistent bleeding and other complications. The surgeon scrapes off the interior of the uterus in the operating room, and sends all tissues recovered to the pathology laboratory.

Inside the tight-lidded containers there seemed to be blood clots. My duty was to scan them looking for evidence of placental tissue and, haply, an embryo or its parts. I was on the second or third specimen, reciting into the dictating machine the accustomed formula: "The specimen is received wrapped in saline-moistened gauze, and consists of multiple, irregular, crumbling fragments with the appearance of blood clots"--when I felt a tug on my arm. Behind me stood the "lab sister," clad in full monastic regalia head to toe, rosary at the belt and emblazoned insignias of her order on the large cloth that fell in front of the bodice; and she looked at me with a reproachful and impatient gaze from thickly bespectacled, cool gray eyes that dominated her gaunt face.

I turned to mush instantly. Mesmerized by her gaze whose strength seemed as if concentrated by the suppression of all other details in the wimple-framed head; unable to understand her speech, couched in a language still largely unfamiliar to me, I stood still, looking like the personification of the most abject idiocy. She ordered me away from the workbench, availing herself of peremptory gestures and the peculiar increase of voice volume and pitch with which some people address foreigners, as if convinced that conceptual impasse can be made to tumble, like the walls of Jericho, by the simple expedient of increasing sound volume I was obscurely conscious that I was at fault, but uncertain as to the nature of the gaffe. Nor could I see the road to atonement when I hesitated between addressing her as mother or sister, and between bowing, curtsying, or kissing her ring with one knee bent to the ground, as I thought the humble always did to those invested with the majesty of the church

I withdrew to respectful distance, as she motioned me to do, and thence appreciated the cause of her displeasure Products of conception are not surgical specimens like any others. Bloody, ill formed, insignificant, and clot-like as they seem to the viewer, they must be treated with special regard: not as castoff fragments of a perishable body, but as beings potentially capable of independent life and possessed of immortal souls. Truth to tell, most of the bottles had nothing but blood clots inside. In some, bits of placental tissue could be subsequently identified with the aid of the microscope. But somewhere in those bottles there could be a human embryo, a fully formed, albeit incipient human being, claiming for itself the rightful spiritual dues that the church magnanimously extends to all its brethren. Therefore a liturgical service was appropriate. And therefore I stayed away, looking contrite, while the "lab sister" prayed, and repeated invocations, and sprinkled holy water with a makeshift aspergillum over rows of glass bottles labeled "products of conception."

The lesson was not lost on me. I understood that the pathologist must handle certain surgical specimens that deserve/merit greater respect, compared to others, by virtue of an intrinsic metaphysical status. From then on, these specimens I would leave untouched, until after the nun assigned to the laboratory had performed the appropriate rituals. I was less clear as to the nature of these ministrations, their instrumentality and function. Because in the Catholic creed baptism is indispensable, I realized that the sister baptized the products of conception, and I could only reflect with sadness on the number of immortal souls to whom this benefit is denied. Every day, over 500,000 conceptuses live beyond the first week, and are thus brought to the very threshold of implantation in the maternal womb, but fully one-half are lost. Spontaneous abortion may then occur in 8 to 33 percent of pregnancies after implantation, as diagnosed by a sensitive hormonal method (assay of HCG, or human chorionic gonadotropin), often before the mother is aware of being pregnant. Later, when pregnancy is recognized clinically through physical examination, the incidence of spontaneous abortion is still 10 to 25 percent of all pregnancies.

But specific protocols, not metaphysical considerations, enjoin the pathologist to approach the products of conception with delicacy and circumspection. The experts are clear in their admonishments: use not formalin, which brutally hardens structures and alters their color, but sterile saline; and the containers should be well closed to avoid dryness. Gently tease the specimen under saline, and view it with a camera-equipped dissecting microscope, ready to photograph the slightest detail. What will you see? Crumbling, crimson-blackish blood clots, in which fibrin threads or bits of endometrium add an iridescent fringe. Often this is all, the products of conception having been previously lost. But patience and perseverance will bring future rewards.

On occasion you will come across a tiny, translucent sac, thin as a grape's skin and full of watery contents. The excitement of anticipation then seizes you: does a homunculus lodge inside? Incise the cover with infinite care, and a viscid fluid oozes out: an embryo is nowhere in sight. Empty, "anembryonic" sacs are not uncommon; either the embryo never formed or it was blighted very early in development and resorbed. Or else the embryo is there, but in a disappointing guise: looking like a tiny pale nodule in which it is impossible to distinguish front from back, top from bottom-"nodular" embryos are soon aborted--; or like a cylinder, up to one-third of an inch tall, in no way reminiscent of a living creature.

Sooner or later, though, the dissector will be rewarded: the bounty of an intact human embryo, at last. Such a specimen begins to be discernible with the naked eye at about twenty days postconception, when it measures 1 mm from crown to rump. At this time it has begun to curve, and soon will be C-shaped. Two to four days later it measures 2-5 mm and evinces rudiments of eyes, in the form of little black specks; cardiac activity may be discernible by ultrasonography. At twenty-six days the embryo shows rudiments of upper limbs, which are first like confused protuberances, then like fins. It is doubtful that anyone can prompt it to paddle away, as Hippocrates allegedly succeeded in doing, by immersing it in cold water. In truth, you cannot tell if you are looking at the 4 to 5 mm embryo of a bird, a mouse, a lizard, or a human: so great is the homogeneity that early life imprints on all creatures. Its look is distinctly amphibian. And it has a tail. At thirty to thirty-eight days the fin-like limbs show swellings for the hands (hand plates), and its whole size has doubled. Elbow regions become recognizable between forty-four and fifty-seven days; at the end of this time toes have sprouted and eyelids are well formed. The entire process of organogenesis is complete by the end of the eighth week. It lives on, calm and serene in the depths of the mother's womb "that other world, the truest microcosm" in the words of Sir Thomas Browne. Beneath the vault of its cavern, it is yet encapsulated in a system of membranes of "chorionic sac," only a restricted area of which develops into the placenta, the complex structure that permits close inter-digitation between fetal and maternal tissues.

An odd presence, the placenta, shares the fetal living space. Mark that it, too, is a living presence, since it can develop alone in the absence of an embryo. Little wonder that in many cultures this organ is viewed as the fetus's twin. Physiologists tell us that the placenta subsumes the functions of all the major organs before birth, thereby lending a certain air of scientific respectability to the wildest contentions of myth and folklore. The placenta is the fetus's "double"; not a copy of a developing human, but its shadow. It functions as a lung, since it establishes gas transfer before the fetus emerges to the ambient air; as an intestine, in absorption of nutrients; as a liver, for metabolism and detoxification; as a kidney, connected with regulation of water and the acid-base balance of the organism; as endocrine system, in secreting hormones; and so on. As its multifarious protection is plain, the myth-making imagination--Gaston Bachelard was fond of saying "the material imagination"--has no trouble seeing a simultaneous power to inflict harm. Consequently it becomes a universal concern to determine the best manner to dispose of this organ once it is expelled. An organ anatomically and physiologically tied to the fetus by the umbilical cord, and on a mystical plane capable of influencing its whole future life-course, must be handled with extreme care.

Anthropologists and ethnographers have yet to compile the entire catalogue of local customs for placental disposal. Here it is buried promptly, lest it trigger dreadful plagues; there only after elaborate ceremonies; sometimes under a tree, to ensure the fertility of the fields; other times near the homestead, to secure the undeviating attachment of the individual to family and country. Or else it must be placed in a pot and washed, as in some rural Thai communities, to ward off the baby from skin diseases; or in a tray bedecked with flowers and floated down the river, at night, to please the crocodiles, as in Java; or thrown into the sea to propitiate a bounteous harvest of fish, as in the Marshall Islands. Scholars surveying over 300 different cultures found that only 7 seemed unconcerned about the manner of disposal of the placenta.

Moored to the placenta by the umbilical cord, like a vessel to the pier, a fetus rocks to and fro, now rising, now falling, ever so slowly, in its watery environment. To the elementary imagination all that is liquid is water, and it is fitting that the embryo and fetus be suspended in this milieu, itself the seedbed of life. Two thousand years ago, Thales recognized water as the reservoir of all potentialities of existence; Christian writers, like Tertullian, saw in it "the seat of the divine Spirit," since to it alone among all primeval substances was given the order to produce living creatures (De Baptismo, III-V). Earth is solidity, the abutment for our bodies and the seat of our sustenance; air is immateriality and indefinite expansion; fire is pure energy, approaching us as welcome light and warmth, or as winddriven, hissing devastation. But only water is cradle. Only water can impart that total, warm caress that lulled us all into the hypnotic trance of prenatal life, where no thoughts of finitude and decay, no pangs of contradiction and want, intrude in the consciousness.

Yet the sign of water is both positive and negative. Life is bodied forth from water, but water can kill. The symbolism of baptism implies submersion into the life-giving waters of the sacred. It is regeneration through rebirth, but in order to be reborn one must die first: the old self dies, and the new self emerges to life. Water is at one time cradle and tomb.

Nothing symbolizes better the bivalence of nature than those bottles containing the products of conception, which one sees in pathology laboratories or in collections of natural history museums. The fetus is there suspended in a liquid, but this liquid is not the cleansing, vivifying water of its original existence: it is a fixative to preserve its structure in death. The membranes of the chorionic sac screen the developing being from noxious influences, but pathologic specimens tell us that sometimes they tear, and their torn strands float waving in the amniotic fluid, encircle the fetus, constrict its limbs and may amputate its parts. The umbilical cord conveys the nourishment to the fetus as it rocks voluptuously, languorously, in the bosom of its mother. But look at this specimen in a jar: in its listless wanderings the fetus has looped the cord about its neck, and fashioned a constricting "figure-of-eight" knot that squeezed out its lightless existence forever. About 3 percent of perinatal deaths are due to loopings, torsions, twistings, and other accidental entanglements. Did a maleficent deity think of both the protection and the danger? This proposition is discussed by Leibniz in his Theodicy (Part, 2,121, VI):

To deprive a man of his life by giving him a silk rope

knowing that he will use it to strangle himself, is as

much a murder as to stab him ourselves, directly or

through paid assassins. One does not will his death

any less in using the first means than the two others:

it seems, rather, that one wills it with greater malevolence,

since he is left with both the fault and the reproof

for his perdition.

The subtle philosopher concludes that this reasoning cannot apply to the workings of the Creator, but all his casuistry leaves us still doubting.

Popular accounts of conception and embryo-fetal development easily lapse into rapturous odes to the invincible powers of nature. Conception is often celebrated in Anacreontic stanzas where all is mirth, and hope, and rejoicement. It is well that this be so, for in the embrace of lovers about to become parents there is something like an obscure, formless yet insistent promise of immortality, so the Diotima could define man-woman love, in the Banquet, as "love and immortality." Eternity seems at hand. And when conception occurs, at the very instant of its realization when the flame of a new life is kindled, it seems as if countless sublime possibilities were suddenly mobilized, and the speed of the wheel of time accelerated. When the bottles of champagne are uncorked to salute an infant's birth, who will dare tell the celebrants that on the topmost froth of their drink there is a flavor of death? Who will tell them that the nectar of life comes dashed with flecks of death?

Perhaps no one has to say this. Each one, in due course, will come to realize the life-death bivalence of human existence. The lover who feels transfigured by the power of love salutes in himself "a new man," yet mourns the death of his former self. The parents who exult at the life of their child are thereby reminded of the passage of time, and handed an obscure premonition that a new generation approaches, like a tidal wave, to replace them. The mother who senses a new life stir in her womb also experiences dramatic changes in her entire body, and therefore a heightened sense of the precariousness and fragility of life. The scientist who scrutinizes the development of new life knows it for an incredibly complex welter of permutations, combinations, chemical reactions, and exchanges that must take place in an exquisitely orchestrated fashion. No trials are allowed: genes must be activated at exactly the right time, enzymes released as preordained, and all this under perpetually changing conditions. The slightest misstep, the most trivial omission, asynchrony or incorrect performance, and the price is death.

Nothing in conception and birth speaks to us about death, yet all in conception and birth speaks to us about death. The products of conception symbolize life's eclosion, its fruitfulness and unflagging, victorious increase. Yet the products of conception symbolize fruitlessness, shriveling, ashes, and death. Nothing in hope, life, love, and the future expresses death. Yet all in hope, life, love, and the future proclaims death, and nothing but death. l could conclude that, as in the American saying, the same glass is half-full or half-empty according as to whether the viewer is an optimist or a pessimist, respectively. Or I could invoke the Spanish verse: Todo es segun el color/ Del cristal con que se mira, claiming that "things take the same color as the viewer's colored glasses." However, these similes would be inadequate, because they imply that the expressions of nature are univocal, and the message is distorted by the interpreter. But I do not believe that the message of nature is one, which is made to sound gladdening when read by Doctor Pangloss and ominous when the scholiast is Doctor Gloom-and-Doom. Rather, the texts of nature are double, like palimpsests that may be read right-to-left or left-to-right, and each reading delivers a different and contrary meaning. Neither palindromes, in which the sentences read the same backward and forward, nor single texts that can be made subservient to the temperament of the reader, but twin texts, each as forceful and impressive as the other--and both equally truthful. We read the one most frequently, because we find it soothing; the other one brings no solace, but may be read in many objects around u s. I spotted it in formalin-containing bottles labeled "products of conception."

F. Gonzalez-Crussi, a pathologist at Children's Hospital in Chicago, is the author of several books, including The Five Senses (Vintage, 1989) and On the Nature of Things Erotic (Vintage, 1988). This essay is excerpted from Suspended Animation: Six Essays on the Preservation of Bodily Parts, to he published this month. [C] 1995 by F. Gonzalez-Crussi. Reprinted by permission of Harcourt, Brace & Co.