by Sue Black
Also by Sue Black
All That Remains
Copyright © 2020 by Black Affronted Limited
All rights reserved. No part of this book may be reproduced in any manner without the express written consent of the publisher, except in the case of brief excerpts in critical reviews or articles. All inquiries should be addressed to Arcade Publishing, 307 West 36th Street, 11th Floor, New York, NY 10018.
First North American Edition 2021
First published in Great Britain in 2020 by Doubleday, an imprint of Transworld Publishers
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Library of Congress Cataloging-in-Publication Data is available on file.
Library of Congress Control Number: 2021930902
Cover design by Erin Seaward-Hiatt
Cover illustration: © Getty Images/ilbusca
ISBN: 978-1-951627-80-5
Ebook ISBN: 978-1-951627-94-2
Printed in the United States of America
For Tom.
My whole life seeming to start and end with you.
CONTENTS
Introduction: The Skeleton
PART I—The Head: Cranial Bones
1. The Brain Box: Neurocranium
2. The Face: Viscerocranium
PART II—The Body: Postcranial Axial Bones
3. The Spine: Vertebral Column
4. The Chest: Thorax
5. The Throat: Hyoid and Larynx
PART III—The Limbs: Postcranial Appendicular Bones
6. The Pectoral Girdle
7. The Pelvic Girdle
8. The Long Bones
9. The Hand
10. The Foot
Tailpiece
Acknowledgements
Index
About the Author
INTRODUCTION
The Skeleton
“Flesh forgets: bones remember”
Jon Jefferson
Writer
It is not only in our brains that the memories of our lives are laid down. The adult human skeleton is made up of over two hundred bones and each has its own story to share. Some will tell it willingly to anyone who cares to ask; others guard it jealously until a deft, persistent scientific investigator cajoles them into revealing their truths. Our bones are the scaffold for our bodies and they survive long after the skin, fat, muscle and organs have dissolved back into the earth. They are designed to be robust, to hold us upright and to give us form, so it is logical that they should be the last sentinels of our mortal life to bear witness to the way we lived it.
We are used to seeing bones as dry and dead, but while we are alive, so are they. If we cut them they bleed, if we break them they hurt, and then they will try to repair themselves to regain their original shape. Throughout our existence they grow with us, adapting and changing as our lifestyle alters. The human skeleton is a living and complex organ that requires feeding and maintenance through nutrients transferred from our gut via the vast arterial network that surrounds it, with the equally complicated venous and lymphatic networks removing all the debris.
Minerals such as calcium and phosphorus, and trace elements such as fluoride, strontium, copper, iron and zinc, are modelled and remodelled continuously into our living bone structure to create its solidity and rigidity. But if bone were made up solely of inorganic materials it would be really susceptible to fracturing, so it also has an organic component, collagen, which builds in pliability. Collagen, a protein, takes its name from the Greek word for “glue,” and it literally holds the mineral parts of bone together to provide us with a complex amalgam that maximizes both strength and flexibility.
We used to do an experiment in our school biology class which showed the respective functions of these two basic-level components. We would take two bones, usually rabbit thighs (often sourced from my father’s shooting expeditions), and burn the first one in a furnace oven to remove the organic element. All we were left with was the mineral part of the bone, devoid of all the elastic components that hold it together: essentially, just ash. The bone would momentarily retain its form until you picked it up, whereupon it would suddenly crumble into dust.
The second bone we would place in hydrochloric acid, which leached out the mineral component. What remained was a “rubbery” bone shape, drained of all the minerals that had given it its rigidity. If you squeezed this between your fingers it felt like an eraser, and you could bend it in the middle so that each end was touching the other without it breaking. Neither component, organic nor inorganic, is on its own fit for purpose; in combination, they work together to provide us with the backbone of evolution and existence.
While bones may look quite solid, when you cut them open, you can see that they consist of two quite different types. Most of us will be aware of this from the animal bones in our cooked meat or those our dogs chew. The thick, outer shell (compact bone) has a dense, ivory-like appearance, while its more delicate inner latticework scaffolding (cancellous, or trabecular, bone) resembles honeycomb. The internal spaces are filled with bone marrow, which is a combination of fat and blood-producing cells. It is here that our red blood cells, white blood cells and platelets are made. Our bones, then, are much more than just a frame on which to hang our muscles. They are also a mineral store, a factory for blood components and the protectors of our internal organs.
With bone constantly remodelling throughout our lives, it is believed that the human skeleton essentially replaces itself every fifteen years. Some parts are replaced more quickly than others: cancellous bone reforms more often, while compact bone takes the longest. Over the years we may have many microfractures in our cancellous bone, where individual struts can break, so these need to be replaced promptly before the whole bone collapses. This continuous housekeeping of our skeleton largely goes on without affecting the original shape of the bone. However, since modifications will occur when parts are damaged, or as age alters how we replace those parts, the appearance of our skeleton does gradually change over our lifetime.
What we consume to nourish our bones is therefore vital in enabling our bodies to continue to function to their optimal capability. Bone mineral density probably reaches its peak in our fourth decade. Pregnant and breastfeeding mothers in particular draw on those resources, and, as we get older, we all do, leaving our bones increasingly depleted and our skeleton more brittle. This becomes particularly marked in postmenopausal women, when the protective action of oestrogen ceases due to the reduction of hormones in the body. As oestrogen depletes, so the floodgates open: bone mineral leaches out of the skeleton and is not replaced, and the bones become more fragile. This may lead to osteoporosis, which leaves us vulnerable to fractures, usually in the wrist, hip or spine, but they can occur in any part of the body as a result of a fall or any kind of trauma. It does not have to be excessive: a fracture can be caused by the simplest awkward movement.
It is in our interests to ensure that we lay down as high a mineral content as possible in our childhood and early adulthood. While we are growing, milk is still seen as the best source of calcium, the most important mineral for our bones. This was the rationale for supplying children with free milk at school, which began in the UK after the Second World War and continues to this day in the case of ch
ildren under five attending nurseries. The other essential ingredient for healthy bones is vitamin D, which helps us to absorb the calcium and phosphorus they need. Vitamin D is provided by dairy products, eggs or oily fish, but the best source is the UVB rays in sunshine, which convert cholesterol in the skin into vitamin D. Deficiency can result in a variety of clinical conditions. It is in children that this is most evident. Babies who are permanently swaddled or young children who are kept indoors may develop disorders such as rickets, resulting in soft or brittle bones, which are most obvious in the lower limbs in the form of an inward or outward bowing of the legs.
Almost every area of our body, soft tissue and hard, can carry an echo of our experiences, our habits and our activities. We just need to know which tools to use to recover the evidence, decode it and interpret it. For example, addiction to alcohol is recorded as scars on the liver; a crystal meth habit in the teeth (“meth mouth’). A fat-heavy diet leaves its mark on the heart and blood vessels, and even on the skin, cartilage and bone, when the damage it causes results in the heart having to be accessed quickly by surgeons through the chest wall.
Many of these memories remain locked within our skeleton: a vegetarian diet is written into our bones; a healed collar bone may be a souvenir of that fall from a mountain bike. All those hours spent pumping iron in the gym are captured in increased muscle mass, and consequently in the enhanced sites of attachment of our muscles to our bones.
Perhaps these are not memories as we might normally define them, but they form an honest and reliable underscore to the sound-track of our lives. For the most part it will never be heard, unless or until it is exposed to the scrutiny of others, perhaps through medical imaging, or if we die unexpectedly and our remains must be examined by those charged with the task of trying to figure out who we were when we were alive and what happened to us in death.
For this task we need people who have been trained to recognize the music. It may be unrealistic ever to expect to extract a complete song, but sometimes all it takes is a snatch of the melody—a bit like one of those quiz questions where you have to identify a piece of music from the introductory notes.
The forensic anthropologist’s job is to try to read the bones of our skeleton as if they were a record, moving a professional stylus across them in search of the short, recognizable segments of body-based memory that form part of the song of a life, coaxing out fragments of the tune laid down there long ago. Usually this will be a life that has ended. We are interested in how it was lived and the person who lived it. We want to find the experiences recorded in the bones that will help to tell its story, and perhaps give the body back its name.
Within our discipline of forensic anthropology—the study of the human, or the remains of the human, for medico-legal purposes—there are four basic issues practitioners must address when confronted with a body, or parts of a body. Most of the time they will all be answered when the right person asks the right questions in the right way.
First of all, are the remains human?
When bones are found in unexpected circumstances, there is no point in the police setting up an investigation until this first question has been answered. Advising the police on the assumption that bones are human if they then turn out to belong to a dog, cat, pig or tortoise would be a very expensive mistake. The forensic anthropologist must be certain of the origin of the material in front of them, which means they must have knowledge and experience of the range of bones from common species likely to be encountered in the country where they are working.
As the UK is surrounded by sea, it is very common for the remains of all manner of creatures to be washed ashore on our coastline. Often these are of marine origin, so we have to know what all the different parts of a seal, a dolphin or a whale look like, alive or dead and decomposing.
We need to be familiar with the various characteristics of all of the bones found in agricultural animals such as horses, cows, pigs and sheep; in domestic pets, like dogs and cats, and wildlife—rabbits, deer, foxes and so on. While every bone in every animal is subtly different, there is a commonality to the form because it relates to function. A femur, or thigh bone, looks like a thigh bone, whether it is from a horse or a rabbit: there is just a big size difference and a bit of a variation in shape.
Between species which share a common ancestry, it can be more difficult to distinguish between their bones, for example, to tell whether a vertebra is from a sheep or a deer. There are few animal bones that should be confused with those of the human, provided the investigator has a basic knowledge of anatomy, but there are some to which even forensic anthropologists need to be alert. Human and pig ribs are very similar. The tail bones of a horse can look like human finger bones. The ones most likely to confuse us are those of species with which we share an ancestral link: other primates. This is not a problem that tends to arise very often in the UK, but one of the golden rules of forensic science is never to assume anything, and such cases are not unheard of, as we shall see.
Skeletal remains may be found on the surface of the land or underground. When bodies have been buried we need to take into account that this has been a deliberate act, and that it has usually been performed by a human. We expect humans to bury humans, but they also bury animals that are important to them, primarily pets. While people tend to bury pets where they like, often in their own gardens or woodland, we expect them to bury other people in the proper place—in a cemetery. So when we find a human above ground or buried somewhere unexpected, perhaps in a back garden or a field, there is a long set of questions to be answered about why this might be so. In short, there is an investigation to be had.
Secondly, we need to establish whether the remains are of forensic relevance.
A recently discovered body is not necessarily going to have been recently deposited, and setting up a murder investigation based on Roman remains is not likely to result in a solved case. On TV crime dramas the first question asked of a doctor, pathologist or anthropologist is always, “How long has he been dead, Doc?” This is not always easy to answer but, very crudely, if the body still has bits of flesh attached, if it is still wet with fat and if it smells bad, then it is likely to be of recent(ish) origin and so worthy of forensic investigation.
The difficulty arises when the bones are dry and all soft tissue has been lost. In different parts of the world, this stage will be reached at different times. In warmer climates, where insect activity can be voracious, a body can be reduced to a skeleton in a matter of a couple of weeks if left unburied. If it is buried, the rate of decomposition will be slower because the soil is cooler and insect activity restricted, and skeletonization may take anywhere between two weeks and ten years or more, depending on the conditions. In very cold, dry climates, the body may never completely skeletonize at all. This extensive range of possibilities does not impress the police, but the determination of the time death interval (TDI) is far from being an exact science.
Nevertheless, it is important to establish a reasonable cutoff point beyond which human remains are generally no longer considered to be of forensic interest. Of course, there will be some instances where, regardless of the passage of time, if bones come to light they may remain forensically relevant. For example, any juvenile bones found on Saddleworth Moor in the north-west of England will always be investigated as a possible link to the moors murders of the 1960s, committed by Ian Brady and Myra Hindley. Not all of the bodies of their victims have been discovered and both murderers have now taken whatever further information they might have been able to give us to their own graves.
In normal circumstances, though, if a skeleton belongs to someone who has died more than seventy years ago, it is unlikely that any investigation would establish the circumstances of the death, still less lead to any conviction, and so technically the remains may be considered archaeological. But this is a purely artificial demarcation, arrived at on the basis of the expectation of accountability in relation to a human life span. There
are no scientific methodologies that can enable us to be sufficiently specific in terms of determining a TDI.
Sometimes context can help. A skeleton found buried next to a Roman coin in a known archaeological hotspot is unlikely to be of interest to the police. Neither is a skeleton uncovered by stormy weather from the sand dunes in Orkney. But they all have to be investigated, just in case. A forensic anthropologist will make an early assessment and if that is not conclusive, we may send samples away for testing. Measuring the level of C14, a radioactive isotope of carbon, which is created naturally in the atmosphere, in organic matter such as wood or bones is a method that has been used by archaeologists to date their important finds since the 1940s. The level of C14 begins to decrease once a plant or animal dies so, basically, the older the bone is, the less C14 will be present. As this particular radioactive isotope takes several thousand years to disintegrate completely, radiocarbon dating will only help us when remains are five hundred years old or more at the point when they are analysed and won’t get us closer to modern times.
However, in the last century the human race has been the agent of disturbances in our radiocarbon levels through above-ground nuclear testing, and these have introduced manmade isotopes such as strontium-90, which has a half-life of only about thirty years. As strontium-90 did not exist before nuclear testing, if it is detected within the matrix of bones, it can only have got there during the life of the individual. So this can narrow down the date of death to within the last sixty years or so. However, self-evidently, with the passage of time, this methodology will cease to become effective. Never trust the pathologist on a TV show who says that the skeleton has been in the ground for eleven years. Utter twaddle.
Our third fundamental question is: who was this person?
If the remains have been confirmed as human and of recent origin, we need to find out who the individual was when they were alive. Our actual name is not, of course, written into our bones but they can often provide enough clues to lead to a possible identity. Once we have that, we can start to compare them with antemortem data, medical and dental records and familial biology. It is in identification that the critical scientific expertise of the forensic anthropologist is most frequently brought to bear. It is our job to extract the information held by the bones. Was this person male or female? How old were they when they died? What was their ethnic or ancestral origin? How tall were they?
