Ancient Bones That Tell a Story of Compassion

While it is a painful truism that brutality and violence are at least as old as humanity, so, it seems, is caring for the sick and disabled.

And some archaeologists are suggesting a closer, more systematic look at how prehistoric people — who may have left only their bones — treated illness, injury and incapacitation. Call it the archaeology of health care.

The case that led Lorna Tilley and Marc Oxenham of Australian National University in Canberra to this idea is that of a profoundly ill young man who lived 4,000 years ago in what is now northern Vietnam and was buried, as were others in his culture, at a site known as Man Bac.

Almost all the other skeletons at the site, south of Hanoi and about 15 miles from the coast, lie straight. Burial 9, as both the remains and the once living person are known, was laid to rest curled in the fetal position. When Ms. Tilley, a graduate student in archaeology, and Dr. Oxenham, a professor, excavated and examined the skeleton in 2007 it became clear why. His fused vertebrae, weak bones and other evidence suggested that he lies in death as he did in life, bent and crippled by disease.

They gathered that he became paralyzed from the waist down before adolescence, the result of a congenital disease known as Klippel-Feil syndrome. He had little, if any, use of his arms and could not have fed himself or kept himself clean. But he lived another 10 years or so.

They concluded that the people around him who had no metal and lived by fishing, hunting and raising barely domesticated pigs, took the time and care to tend to his every need.

“There’s an emotional experience in excavating any human being, a feeling of awe,” Ms. Tilley said, and a responsibility “to tell the story with as much accuracy and humanity as we can.”

This case, and other similar, if less extreme examples of illness and disability, have prompted Ms. Tilley and Dr. Oxenham to ask what the dimensions of such a story are, what care for the sick and injured says about the culture that provided it.

The archaeologists described the extent of Burial 9’s disability in a paper in Anthropological Science in 2009. Two years later, they returned to the case to address the issue of health care head on. “The provision and receipt of health care may therefore reflect some of the most fundamental aspects of a culture,” the two archaeologists wrote in The International Journal of Paleopathology.

And earlier this year, in proposing what she calls a “bioarchaeology of care,” Ms. Tilley wrote that this field of study “has the potential to provide important — and possibly unique — insights into the lives of those under study.” In the case of Burial 9, she says, not only does his care indicate tolerance and cooperation in his culture, but suggests that he himself had a sense of his own worth and a strong will to live. Without that, she says, he could not have stayed alive.

A child who suffers a moderate or severe traumatic brain injury (TBI) may still have substantial functional disabilities and reduced quality of life 2 years after the injury. After those first 2 years, further improvement may be minimal. Better interventions are needed to prevent long-lasting consequences of TBI in children conclude the authors of a study published in Journal of Neurotrauma, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

Frederick Rivara and colleagues from University of Washington, Seattle, and Mary Bridge Children’s Hospital, Tacoma, WA, and Children’s Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, describe the functional and quality of life outcomes of children who experienced a moderate or severe TBI when they were 0-17 years of age. In the article “Persistence of Disability 24 to 36 Months after Pediatric Traumatic Brain Injury: A Cohort Study” they follow up on a previous report that found improvement in some areas of functioning for up to 24 months. In this expanded study, the authors showed no significant improvement in the children’s ability to function, participate in activities, or in their quality of life between 24 and 36 months post-injury, and they suggest that a plateau is reached in the recovery.

"This important communication by Rivara and colleagues reinforces the concept that pediatric traumatic brain injury is associated with significant enduring morbidity, with recovery plateauing over time," says John T. Povlishock, PhD, Editor-in-Chief of Journal of Neurotrauma and Professor, VCU Neuroscience Center, Medical College of Virginia, Richmond. “This finding also reinforces emerging thought that pediatric traumatic brain injury must be viewed in another context, rather than the current perception that the course of such injury parallels that found in the adult population.”

A typical five-month-old infant has hardly figured out how to sit up yet — even crawling may be months away — but there are a few babies who already know how to drive. They’re steering their very own mobile robots. 

The robots are designed to allow babies with disabilities to move around independently, at the same age their peers might learn to crawl.  Whether they use robots or their own limbs, starting to move may be an important part of baby brain development, some childhood specialists think. Researchers don’t want kids with cerebral palsy or other movement disorders to miss out. 

"We think that babies with disabilities are missing an opportunity for learning that typically developing babies have," said Carole Dennis, a professor occupational therapy at Ithaca College in New York.