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AUTHORS NOTE ON THE NATIONAL REGISTER OF PATHOLOGICAL ANOMALIES



The National Register of Pathological Anomalies is federally funded and was formed in the late 1940s. It publishes bulletins to tax-supported pathological services and other interested parties. This information is restricted to describing unusual anatomical structures and functions found in the course of routine postmortem examinations.

There are a number of usual anomalies, and the NRPA doesnt concern itself with them. Quite a few people have their hearts located toward the right side of the chest, or are born without a vermiform appendix. Extra fingers and toes, and anomalous genitalia, are other everyday examples. One of the earliest things a medical student learns is that the details of any given human beings internal arrangements will be roughly similar to but teasingly different from the tidy diagrams in the textbooks. This happens without impairing the individuals general function as a clearly, understandably human and essentially healthy organism. Anatomy classes dispel any notion that God works with a cookie cutter. The idea they do create is that the mechanisms of life are both subtler and more determined to proceed than most people can imagine. In many cases, these anomalies are successful enough so that theyre never noted during the individuals lifetime. Since most deaths are not followed by autopsies, there are no reliable statistics on how prevalent all this might be.

What this does mean is that there are any number of individuals walking around who will respond peculiarly to conventional medical and surgical treatment, who might overcome what ought to be disabling or fatal injuries while succumbing to apparently minor accidents, or who might even be able to evade normal methods of restraint and punishment to name a few areas of intense interest to authorities charged with the maintenance of the public health and good order.

The NRPA publications concern themselves only with extreme cases. They also draw exact distinctions between kinds of extreme. There are what might be called man-made anomalies; defects almost certainly created by actions of various manufactured substances upon the individuals mother during her pregnancy. These, while not completely cataloged, are part of a distinct field of medical investigation thats keeping reasonable pace with the ingenuities of recreational drug use and the pyramiding effects of modern industrial chemistry. The NRPA describes apparent cases in this category when theyre found, and this reason alone suffices to make its bulletins widely studied. But there is another category.

Occasionally, an autopsy will turn up organs, or even systems of organs, that are truly unique and whose function, in fact, may not be understandable to the resources of the pathologist who discovers them. The NRPA is very quick to react positively in such cases. At once, it will give the examiner all the help and information humanly possible, and join in delving into the matter thoroughly. As a result of its reputation for this sort of help, always welcomed even by pathology departments that have been nominally well funded, the NRPAs twenty-four-hour phone number is kept very much in mind throughout all nations signatory to the cross-cooperation agreements fostered by the World Health Organization.

It should be understood that almost invariably, one mundane explanation or the other is finally found for the seeming anomaly displayed by the particular case. The NRPAs annual budget is drawn against funds made available by Congress to a parent organization. This form of second-derivative funding is common in cases where the parent organization is the Central Intelligence Agency, the Federal Bureau of Investigation, or the National Security Agency, to name just three. It hasnt been possible for me to determine the NRPAs parent organization.

AO stands for anomalous organs. Most NRPA files are headed with the AO prefix followed by a number coded to show the date the file was opened and predict when it might be closed. These files form the basis for most of the material in the bulletins, and are of unquestionable immediate value to medical specialists dealing with the results of human interactions.

A far lesser portion of the files is headed AO/LGM, in which the second set of initials in the prefix is said to represent less germane matters. Access to and use of these files is restricted to the top echelons of NRPA. An AO/LGM Notification at one time a slip printed on red paper, now an advice preceded by a special tone signal on the NRPAs computerized communications devices, which connect to God knows where is required the instant a new file in this category is opened. At NRPA, which is housed in a three-story red brick Georgian with a very nice little company caf'e under the trees in the backyard, theres an office joke that LGM really stands for Little Green Men.

A.B.



PART OF A REPORT LATER REMOVED FROM THE AO/LGM FILE ON NEVILLE SEALMAN | Hard Landing | PRELUDE TO EVENTS EARLY ON A MARCH EVENING