Exploring our miraculous icky parts

Mary Roach calls herself the bottom feeder of nonfiction. The New York Times best-selling author delves into the crevices and alleys of life and the human body where few other authors explore. She plows through areas that make a reader wonder: What’s she thinking, and why does she want to go there?

Roach says, “I’m not, by trade or character, a spotlight operator. I’m the goober with a flashlight, stumbling into corners and crannies, not looking for anything specific but knowing when I’ve found it.” From talking to U.S. military special operations teams in Djibouti about diarrhea (in her most recent book, Grunt: The Curious Science of Humans at War) to detailing the human body as it decomposes (in Stiff: The Curious Lives of Human Cadavers), Roach’s motto seems to be: Who wants to write — or read — a boring science book?

For this special issue of Stanford Medicine on pushing the limits in biomedicine, Executive Editor Paul Costello spoke with Roach, a writer whose career not only exemplifies that notion but also encapsulates it.

Costello: What makes you so curious about areas of the human body where no one else ventures?

Roach: Well, part of it is no one else ventures there. The stuff that other people leave alone, I’m like, “I’ll take that.” Everybody has a certain amount of where they’re both drawn to something and repelled by it. And I’ll find a way, as a writer, to take them by the hand and say, “OK, yeah, this is a little repellent, a little grotesque, but come with me.”

Costello: Is the taboo also appealing?

Roach: When Grunt came out, the most common questions I was asked in interviews were about the flies and the maggots or the penis transplantation, the cadaver run-through. Those are the things people zeroed in on and they’re fairly gross, taboo and unsettling. Part of it is tapping into something most people are curious about. I don’t know that I’m special in the way that I’m able to bypass the normal feelings of revulsion.

Costello: Your first book, Stiff, was about cadavers. Doesn’t sound like a best-seller.

Roach: Stiff really got rolling through word of mouth because it was the combination of this topic, this seemingly dark world of cadaver research, but the tone of the book was humorous. People tended to talk to other people about it: “I’m reading this book. It sounds kind of gross, but it’s actually funny and kind of uplifting.”

Costello: I’m guessing you’re really trying to get readers to look at something they may find disturbing or gross and flip it around, making it endlessly human and thereby understood?

Roach: Absolutely. I think that people come to these topics thinking, “Oh, this is going to be disgusting and disturbing.” Sometimes I use humor, and sometimes I’m just very straightforward. There’s something about the straightforwardness of the writing that encourages people to step in.

Once they’re in, they start to learn all these things. They come away saying, “I thought this would just be gross, but it was really interesting and I learned a lot.” Anytime anybody learns a lot, particularly something about the human gut, like the colon, the rectum, the anal sphincter, this is a miraculous thing.

You hear a lot about the brain and the heart. People have a sense that these are miraculous, but not so much the nether regions or the inside of the nose, the nostrils, the tongue. The icky parts are just as miraculous, and people tend to overlook them. I’m the plumber.

Costello: Has any exploration changed the way you experience things or look at your body?

Roach: If you hold food or wine in your mouth and exhale through your nose, you’re sniffing in reverse. It’s called retronasal olfaction. You’re getting this whole other sensation. You’re experiencing all these vapors as they’re warmed and released in your mouth. People think, “Oh, you smell the aromas outside the body and on the plate or in the glass.” But you smell the aromas from inside your mouth, too. That changed how I experience my meals.

They come away saying, ‘I thought this would just be gross, but it was really interesting and I learned a lot.’

Costello: Before Grunt, I never considered diarrhea to be a national security threat.

Roach: Especially when you consider that the people who are the farthest out in the boonies, the farthest away from clean food and water are special operations teams.

They’re out in some far-off village eating goat that’s marginally cooked and not refrigerated, and water that may not have been treated. These people are doing the really high-risk operations, and they get hit at a tremendously high rate with really debilitating food poisoning.

Costello: I found it especially funny that one of the guys from special ops asked: “Why are you here? What’s this again?”

Roach: It was one of the stranger reporting challenges for me because on this base in Djibouti the special operations guys are off in a restricted zone. I don’t have the clearance to go in there. The only time they come out, my only opportunity to talk to them about diarrhea, is at mealtime when they sit down at this table. They come in. They’re often by themselves. They eat their food, then they leave. I had to march up to this man. He thought I was with the Naval Criminal Investigation Service. He thought he was in trouble for something.

I kept saying, “No. Actually, I’ve traveled all the way to Djibouti to talk to you about diarrhea.”

Costello: Why do people let you in their front door?

Roach: I expected military public affairs people to be wary, squirrely, turning me down all the time. In fact, they were the opposite when they heard that I was reporting on science and medicine, the military science that goes toward keeping people alive and putting them back together, rather than the weapons side of it.

That was not a threat to them. The approval was hung up for a while and I wrote to this woman. I said, “So, is there anything I can do? Do people have a problem with my approach or something I’ve written in the past?”

She said, “We don’t care about you. We’re concerned with Zero Dark Thirty. We’re concerned with special operations people writing memoirs and revealing things that are classified. We’re fine with you coming here and reporting about people who are repairing genitalia that are damaged in an IED explosion. We are fine with you writing about the problem of food poisoning out in Somalia or Djibouti.”

Costello: Are you ever traumatized or shocked by what you’re looking at?

Roach: Traumatized? No. I think the hardest part of Grunt, was sitting down with a man who’d stepped on an IED and lost part of both legs and part of his penis. Asking him to tell me that story, what was that like, re-creating that moment from the time he stepped on it clear through to when he made it back to the base. I’d never really spoken to someone who’d been through that.

I was really awed by him, and his courage, and what a decent person he was, and what an awful thing he’d been through.

Costello: In the intro to Grunt, you wrote: “I’m interested in the part that no one makes movies about, not the killing but the keeping alive.”

Roach: In its subtle way, it’s an antiwar book. I don’t hammer home any particular political point. … It was interesting to me to speak to these people and to come away with a far more nuanced sense of what it means to be in the military. There is no one military type. These people were extraordinary and very committed and very caring.

They’re folks who signed up for the military and spent their whole careers in it, but they’re not fans of battle or war.

Costello: Is there something you’re also trying to convey to the healers?

Roach: Yes. Thank you really is the message. Not just to military medical personnel I wrote about in Grunt, but also to NASA support teams reflected in Packing for Mars — the astronaut book. Whether it’s an astronaut, or a soldier, or a Marine, those stories of saving human lives and, even more so, just healing people and putting them back together. That story doesn’t get told enough, and I think that those people deserve a lot of recognition and gratitude.

Costello: What are the elements of storytelling and narrative for research scientists who want to tell their story?

Roach: The challenge for most research scientists, I think, is that the things they’re excited about and fascinated by are so dialed down, and specific, and complicated compared with what sparks the curiosity and interest of the average person who doesn’t have a background in bioscience.

I think they’re so far away from someone like me discovering, “Oh, this is how a bladder works. Stretch receptors, wow, that’s cool.” … So I’m the interpreter between the two.

Costello: So who are Mary Roach readers? Can you define them?

Roach: You know that scene in Being John Malkovich where he’s in that restaurant and everybody looks like John Malkovich? That’s how I picture it. Thousands of Mary Roaches.