I had no idea there was a word for it before today, but there it was in front of me: the abnormal and the deformed, walls of skulls and eight-foot colons and the chair that the original “Siamese” twins had built for them. What I had heard, not inaccurately, billed as a “museum of medical oddities,” and had consequently driven a few hours to find, was the outwardly proper Mütter Museum in Philadelphia. Home of a collection intended to educate medical students on potential traumas, diseases and weirdness back whenever it was put together (shows how closely I was paying attention to the fine print… I’m guessing the 1800s), the dense, small space houses a woman turned to soap, a man whose muscles turned to bone, plaster casts of eyeball tumors, creepy things in formaldehyde, drawings of conjoined twins through time, a giant’s skeleton, and a comparitively mild exhibit on the health of U.S. presidents. In case you were curious, the most unnerving human anatomical possibility is a fully developed eyeball tumor. No contest. Eyeball tumor. Wow.
On the ride home, discussion found it’s way to the fantastic 1932 horror movie “Freaks.” The movie casts circus freaks in starring roles, highlighting their sense of community and the strange and awesome ways they manage or adjust for their abnormality. The thing that stayed with me the most (ok, after “one of us… one of us…”) was the opening title card. In setting the stage, it describes how the diseases and deformities on display in the film are rapidly being cured or corrected by medicine, and therefore the contemporary generation of a lot of freaks (I think pinheads were mentioned specifically) will be the last. These are words from a film released in 1932, so I can only imagine how much further along medical science and technology is today.
It is a fascinating, curious “problem” that society is faced with when it has the knowledge and the means to make abnormal people more normal. There seems to be a lot of hand wringing going on about how medical intervention to change a condition stigmatizes it, suggests that all must aspire to a “normal” ideal, and removes the impetus for tolerance as well as the contact based engine of it. So what justifications do we believe in for limits on the individual’s right to inhabit a body he or she chooses? Consenting adults are allowed a good deal of freedom to modify their biological raw material for personal reasons – tattoos, piercings, hair coloring, and makeup are common, but increasingly profound elective cosmetic surgery is also widespread and gaining in popularity. What societal goals should trump the individual’s control over the shape of his or her own body?
The fantastic thing about this question is that prior to very recent human history it was next to meaningless, because available technology for body modification was either inoffensive, gradual, or nonexistent: humans could adjust diet, clothing and exercise, and make only minor, temporary, and superficial changes beyond that. We can see this in the lives of the “normal,” who were straightforwardly living what they were handed biologically, and in the lives of those men and women who were born at significant remove from the human body’s averages, who were for lack of other options doing the same. Conditions present at birth that led to loss of bodily functioning, pain, and severe social barriers, conditions that narrowed potential employment, impaired the ability to have and raise a family, caused limited mobility or early death, these were dealt with as gracefully as could be managed, because humans had no technologies to offer them control over their own bodies. So we all went our merry ways, inhabiting the bodies genetic and environmental chance handed to us, and in most instances, couldn’t even imagine biological choice possible.
Today, I think it’s clear, both those born under the category of “normal” and those born with recognized variation from that norm, including variations that cause significant impairment, have more avenues open to them than ever before. We learn more about the shockingly extensive degree of choice a wealthy American currently has over his or her biological systems ever day, on voyeuristic television programming that reports exactly what new, completely optional surgery is being performed on those with the money to pay for it. We also hear stories of birth abnormalities being operated on successfully, of diseased being treated or cured, of the survival and in some cases long, productive lives of those who only a few years ago would have been doomed by their lot in the genetic lottery to extremely limited lives, or would not have lived at all. I doubt these stories, the cosmetic and the medical, strike many as two dimensions of the same trend, but it seems to me that the exact same thing is happening in both cases. Whether or not our current medical edifice labels a surgery elective or curative, what we are seeing is humans beginning to flex their new found ability to make transformational personal biological choices.
As many commentators have documented, there is a hugely fuzzy line between correcting biological “mistakes” and offering up the same technology for use in optional improvements. Medicine has learned, for instance, how to significantly extend human height for many, causing people who once would have had no say in the matter to chose to live lives as taller humans (the men and women receiving this treatment to date have to my knowledge all been of below average height). Where should we draw the line between those who are so far out of the mainstream when it comes to height that growing taller is classified a medical procedure, correcting a diagnosable flaw, and those humans who just really wish they were taller? What is the optimal human height range, outside of which you are allowed to resort to growth hormone therapy, and within which you are not? I have little sympathy for such distinctions. It seems unjustifiable to divide human beings from on high into those with different rights when it comes to biological alteration. It seems unjustifiable, actually, to limit acceptable biological alterations to those changes that bring people closer to human averages.
What about the man of average height who wants to be of above average, who dreams of a career in the NBA? What government bureaucrat has the right to deny him, when he’s willing to pay for the procedure and accept the risks? What societal “good” do we preserve by limiting freedom in this area? It would seem to be the same sort of exaltation of human “norms” and averages that disability advocates decry when it comes to treatment of those with divergent bodies. The expansion of choice will no double cause many who today are abnormal to seek normality, and this will no double have repercussions when it comes to societal treatment of those who chose to retain their nontraditional biology. But this is the same choice we will all have: a body which generally conforms to norms and expectations, or a body wildly divergent from them. To deny this choice to those born abnormal seems criminal and discriminatory; to deny this choice to the enormous pool of the medically normal but personally unsatisfied just seems impossible, not to mention unwise and cruel.
It will flow naturally, then, from medicine tackling mental impairment that artificial mental enhancement will become commonplace. Surgery and pharmaceuticals pioneered on those with below average capabilities will, once tested, become available to anyone looking for above average capability. If we’ve learned anything, its that the human appetite for self betterment is insatiable. We won’t stop at curing all known diseases. We’ll begin to view previously “natural” capabilities as woefully unsatisfactory, and this may happen in the blink of an eye, just as contemporary laptop computers outperform the fastest supercomputer in existence twenty years ago. We’ll also discover all the things we’d enjoy doing if only our biology allowed us, and then begin realize them.
So what will the world begin to look like when humans start exercising greater choice in their biology, be it conforming to or confounding anatomical averages? This choice, offered up across the board (if you can pay for it, and accept the risks, sign here) would level the playing field in a truly wonderful and profound way when we consider the maddening unfairness of a pre-1932 world filled with carnival freaks and others who, not by choice but by chance, found themselves far outside of the mainstream of human social and productive life. It’s terribly impolite to say it, but despite how beautiful we find human diversity, the fact that it is imposed by genetic selection causes a lot of suffering and loss of opportunity: only the beautiful can be beautiful, only the strong can be strong, some of us cannot experience biking along a river or watching great cinema or hearing great music, ever, and that’s just tough. The extension of basic human abilities – sight, mobility, hearing, memory – to those who don’t now have access to them would in itself be a glorious achievement. Cochlear implants and modern prosthetic limbs suggest how completely and how soon technology will allow this.
Of course, in other ways, the playing field will be less level than ever before. Our species will experience intensified biological segregation and inequality, which although well entrenched already thanks to substantial differences in diet, health care, personal grooming budgets and the option for cosmetic surgery, is today a pale shadow of what it will become. Billions will continue to struggle for basic nutrients and bodily function while several million will pioneer advanced stages of biological reinvention.
The separation of human bodies into new forms will not simply mirror wealth, however, as people will have wildly divergent goals. For many, optimal health and physical beauty will be something traditional, easily recognized, and familiar, probably a slight enhancement and exaggeration of the typical human form. Many will continue to adjust their music collections, social networks, travel plans and hobbies more avidly and carefully than their bodies, and more boldly; I can’t imagine that true adventurous biology will be a mainstream pursuit, at least not any time soon. But what of our minorities? Already many of us choose physical appearances at odds, in varying degree, with expectations or notions of beauty. Niche athletes in the year 2008, as we witnessed at the Olympics, have freakish and fantastical bodies finely tuned to whatever sport they have chosen, bodies that come in all shapes and sizes but that are unified in their high level of directed, intentional alteration. Many communities create and embody alternative notions of the desirable and the possible, modifying their bodies with scars, piercings, ink, amputations, dye, implants; there’s even that one guy with the ear in his arm. Tomorrow giantism and dwarfism will be chosen, not an accident of birth; gills, sail fins, scales, and wings will be both beacons of irrepressible, brash individualism and centerpieces for close knit communities of transhumans. I look forward to photosynthesizing skin, myself.
Anorexia in runway models, bulimia in figure skaters, and steriod abuse in professional athletes and entertainers all point to the extremes that some of us will go to in inventing new ideals for ourselves. Don’t kid yourself. Many of our fellow humans, in the coming generation, will craft and inhabit bodies that to our standards are downright grotesque. Some men will seek to imitate their favorite superhero; I can’t imagine not one person will attempt a giant green “Hulk” body. There will likely be women who continue to reduce their width and extend their height, in a feedback loop with their peers, to comic (and likely tragic) extremes. The consequences of limitless body modification on gender expression and sexual function are truly awesome to contemplate; speculation on what forms that will take would require another book-length discussion.
There will be inventions, hybridization, ornamentation, innovations artistic and functional (flying will undoubtedly be a rewarding and exhillarating experience), and whole categories of designed, biological change that are impossible to forsee. From cottage industy to recognized university degree, cosmetic body design will grow rapidly and transform millions of lives. The abberations, the choices a few will make that most or all other humans will look upon with disapproval and disgust, should be allowed, and even celebrated. They will represent the triumph of the mind over the dictates of biology, and represent a huge expansion in human freedom. There have always been giants, bearded ladies, human torsos, living skeletons; there have always been abnormal bodies, some (if we’re honest) unbearably grotesque. The crucial difference is that in the past, the people who had to live in and with those bodies had no choice in the matter. When everyone can be as average as they want to be, those who chose abnormality will not only profit themselves from living out their dreams, but will reward the rest of their species with continued, and expanding, human diversity. Diversity will be as beautiful and desireable as it has always been, only this time around, it will be created through human choices and not genetic whims.
A few other notes from today. Downtown Philadelphia is terribly clean and quiet, and stunningly dull: enormous windowless walls, hospitals and banks, a few beautiful old buildings and all too many terrifically ugly new ones. Waffle House is… beyond. It’s worth a six hour drive thinly disguised as a field trip to a museum of medical oddities just to sit in that butter-yellow box and gorge on waffles, hash browns, and bacon. What a world.