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Built to Last

Built to Last

Bones by Roy A. Meals

   In his engaging and fascinating book about bones — their cellular composition, growth, regeneration and role as a masterful “recorder of Earth’s history and human culture” — Roy A. Meals takes only 18 pages before citing the 1928 spiritual “Dem Bones.”

Employing the wry humor with which he enlivens this thoroughly scientific but far-from-stodgy book, the orthopaedic surgeon notes that if only songwriter James Weldon Johnson (1871–1938) had possessed anatomy’s devotion to Latin names for body parts, “We likely would be singing, ‘The tibia is connected to the patella, the patella is connected to the femur…,’ instead of ‘shinbone connected to the knee bone/knee bone connected to the thigh bone….’”

Meals (HS, surgery; orthopaedic surgery, 1973–78), a professor of orthopaedic surgery at UCLA and former president of the American Society for Surgery of the Hand, notes that bone, which serves the dual purpose of protecting internal organs and enabling creatures to move, has “spectacular” ability to grow and repair itself — thereby surpassing stone, brick, metal and wood as “the world’s best building material.”

Meals divides his book into two parts, both superbly illustrated. Part One, “Concealed Bone,” covers all aspects of the role of the bones in our bodies.

Nine chapters cover bone’s unique composition and varied structure; its “life and relatives”; what happens when bones break; bone’s other failings and who can help address them; bone surgery through the ages; six orthopaedic giants (some fairly recent); orthopaedic innovations; picturing bone (early anatomical artwork, X-rays, CTs, MRIs); and the “future of concealed bone.”

Meals also enriches his narrative with some typically amusing bone trivia. For example, while noting that 206 is the “widely accepted number” of bones in the human body, he points out that there is actually some variation among individuals. Many people have 24 ribs, for example, but others have 26. Babies are born with around 270 bones — but some slowly fuse together, such as in the skull.

“There are also wrist and ankle bones that sometimes for no good reason fuse with neighboring bones, further complicating our count,” notes Meals, who lived in Turkey for two years and has traveled extensively in the Middle East, Europe and Africa, to expand his knowledge about the historical and cultural aspects of bone.

In Part Two, “Revealed Bone,” the seven chapters maintain Meals’ lively pace, recounting such matters as the “business of bones” — for example, how grinding them up produced valuable fertilizer; “beguiling bones,” such as those that became the medium or subject of artworks; and the future of what they yet may reveal. “We have barely scratched the surface regarding what old bones have to teach,” he writes.

He also explores the future of “Concealed Bone,” envisioning the potential for successfully “tweaking the body’s cells and molecular messengers to grow a missing arm or leg”; improved medications to prevent and treat osteoporosis; and developing “custom hardware for fixation of difficult fractures.”

Some of these wonders may face pushback, notes Meals, author of the blog About Bone. “When I think about how controversial genetically modified foods are,” he writes, “it is a brave new world indeed to contemplate the time when molecular biologists can tweak our genes to have stronger bones, tougher cartilage and hearts that are not such prima donnas.”
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