Little Shop of Horrors
Allen Tyler had a good job looking after corpses that had been donated to the University of Texas Medical Branch at Galveston. He stored them, chopped them up, packed and shipped the parts. Then he got a wonderful idea: he would start his own enterprise on the side. What's a few toenails among friends?
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He had first come to UTMB in 1962, as a sixteen-year-old high school sophomore. Back then, he worked at a sandwich shop at the university. He was a large, reserved teenager who had already developed a distinctive—some would say odd—personal style. He was sometimes seen walking to Galveston's Central High, the segregated black school he attended, in an ascot and a derby. In his junior year he bought a red-and-white Corvair with a red-leather interior. He read Ian Fleming spy novels and Esquire magazine. In 1964, while still in high school and making sandwiches at UTMB, he married a churchgoing woman ten years his senior who suffered from a serious vision impairment that made her legally blind. Upon graduation, when many of his classmates were going to college, Tyler settled into married life with his wife and new baby girl and searched for a job with better pay. A year later, he made the jump from the sandwich shop to the body lab.
Tyler did well at the new job and stuck with it. In 1975 he was promoted to the position of supervisor of anatomical services. He prepared the bodies for students, passed out the knives and saws, cared for the "natural curiosities" display (two-headed animals and the like), and kept the perfume of chemicals and decay to a minimum. Once in a while he received a particularly difficult piece of work: for example, a man who had fallen off a roof headfirst into some tar. But no gift to the program was wasted. And Tyler was scrupulous about labeling and sorting the bodies. He noted which bodies could be cremated en masse and stored in one of the large drums on hand, and whose cremains were destined to be returned to families. This was an important part of his job: Even though it is understood that a willed body will be cut up or dissected, some families still want to be assured that they will receive the ashes of their loved ones.
By the eighties, Tyler had done so well that the entire willed-body program was basically left in his charge. Working with a secretary and a lab technician, he went about his business in Old Red, the gorgeously ornate UTMB structure built in 1891, the year that UTMB opened its first session, with 23 students and 13 faculty members. He spent some of his time in the anatomy lab, which was on the top floor of the building. More often than not, however, he was in the cutting room or in his office, which was a disorganized jumble of papers.
Over the years, Tyler discovered the tricks of the trade: He learned that a body takes up to four days to defrost; he knew how to deal with the bodies' liquids; he learned to prep bowels and fix leakage. He familiarized himself with the organization of the students' lab: The red buckets with garbage bags under the tables were for skin and fat only; the other red containers were for scalpel blades and sharp items. Much of his job as supervisor also involved disarticulation, the process by which a body is cut up into its various parts so that it can be used most efficiently.
But the body-parts business was changing in several important ways. In the eighties Johnson and Johnson, Tyco, Boston Scientific, and other companies in the medical-technology business were inventing advanced surgical equipment at a rapid pace. Instruments facilitating their new methods of surgery required training courses. Some seminars used plastic organs and bodies, but often models were not adequate for training. As the number of seminars increased, so did the demand for cadavers and body parts. Since Texas had a surplus of bodies, Tyler found himself spending more and more of his time filling orders for fresh frozen heads, feet, shoulders, and elbows.
Meanwhile, prices were going up, putting Tyler in the awkward position of having to deliver the news to his customers. A disarticulated torso could fetch about $7,000 in the late nineties, but the price soon shot up to $9,000. On one occasion, Tyler received an e-mail asking, "Is $650 still the right price for these [full leg specimens]?" to which he responded, "Attached is listing to date. I will be doing another pair on Monday that fits your protocol, almost there as you can see, I predict less than two weeks, and I will be ready to ship. Unfortunately prices have gone up. The cost for a whole lower extremity is $813. Even the cost [of] knees [has] gone up ($500) also, however, I am holding the line to what I quoted you on the knees ($400 each)." None of this revenue was technically "profit," since by law it went directly back into the program to cover costs.
While demand boomed, the cremains from disarticulated parts became more and more difficult to track. If an arm was sent out of state and the family had requested the body's cremains, the arm had to be sent back to be with the rest of the body so that, for example, anything pertaining to Aunt Myrna would remain with the rest of Aunt Myrna. Eventually, her separately cremated parts would be boxed together and the family could receive her in total. The rising number of shipments of various parts to various places made cremation reassembly complicated, but Tyler appeared to be able to handle it.
In 1998 Allen Tyler's life changed. In the middle of a rapidly expanding body-parts market, he decided to go into business for himself. In the fall of that year, Tyler was contacted by an Italian immigrant living in New Jersey named Agostino Perna. Perna was one of a new breed of middlemen who both arranged medical seminars and training courses and did the less pleasant work of rounding up body parts. A middleman could make a low-six- figure annual income from services rendered, charging a group of twenty to fifty doctors $750 to $3,000 each per class. He could also make use of one body part several times and charge for each use, so an elbow left untouched in one course could be amputated from its arm and used in another class. Perna eventually founded three companies of which he was the primary stockholder: Innovations in Medical Education and Training (IMET), which coordinated conferences and arranged doctors' hotels, air flights, and course literature; Mobile Medical Training Unit, which supplied the bodies and on-site support technicians; and Surgical Body Forms, which designed latex models. Where he needed help was with the handling of cadavers and body parts. That's where Tyler came in.
At Perna's urging, Tyler became his consultant and guide through the body-parts transactions. Perna offered him all-expenses-paid trips to weekend seminars, where he was responsible for keeping the bodies in good condition, cutting and preparing them, and preventing their ripe scent from fouling the air. The two had a loose business arrangement with no set pricing, and Tyler would be paid anywhere from $600 to $3,500 a day. Tyler sometimes worked from seven in the morning to midnight. Often, he provided parts from UTMB. This was not against the law, but it was certainly unconventional and invited the possibility that Tyler could give preferential treatment to Perna in the form of easier access to parts and lower prices. "Let's say it may not be illegal," says Ronn Wade, the director of the Anatomical Services Division of the University of Maryland School of Medicine and a co-chair of the Anatomical Services Committee for the American Association of Clinical Anatomists. "The question is, Is it a conflict of interest? And if it's not a direct conflict of interest, does it have that appearance?"
The work with Perna was exciting and profitable. Tyler called an old friend one day and told him he was finally getting out of Galveston to see the world. "I'm flying out to California," he said. "I guess they have a program and I guess I'm suited for the things they are doing out there."
"Oh, that's great, Tyler," his friend said. "Get your camera, man. You're going to places I won't see."
Tyler sometimes got paid to be on call. According to Perna's deposition in the civil suit against UTMB, "If [Tyler] could not attend the course, he was still paid a consulting fee because he was on standby for me to call with questions." But his freelance work would go beyond simple consulting: 1998 was also the year he started his fingernail and toenail venture. The idea was this: He'd peel the nails off the cadavers and sell them, then route the checks to his home. There were potential problems. The corpses involved belonged to the UTMB willed-body program, and there are state laws against taking personal profit from the sale of parts. But who would be watching? "Right now there are more laws and regulations that apply to the interstate shipment of commercial commodities, such as cotton, than cover the interstate movement of human bodies or body parts used in medical education and research," says Todd Olson, Wade's co-chair of the Anatomical Services Committee.
And so Tyler began writing his invoices to Watson Laboratories, sending them nails, which they would use for tests with experimental drugs, and receiving checks made out to him. According to invoices released by UTMB through a Public Information Act request, between November 1999 and August 2001 Tyler received at least $18,210 from Watson from the sale of fingernails and toenails. Watson officials later told the Houston Chronicle that they believed Tyler had been turning the money over to UTMB. And UTMB officials in Galveston felt that they had had no reason to suspect that anything untoward was happening either, with toenails, fingernails—or more essential parts. Not, at least, until the incident in Riverside.
WHILE TYLER WAS DEVELOPING HIS new line of business, other anatomical specialists around the country were seeing similar opportunities in the expanding body-parts market. In 1999 an official at the University of California, Irvine, named Christopher Brown, who was overseeing the university's willed-body program, was fired on allegations that he had sold spines for personal profit to researchers in Phoenix for a total of $5,125. The Irvine story caused a stir in willed-body circles.
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