Alexander Tsiaras

DATE January 29, 2003 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Alexander Tsiaras discusses his collection of fetal
images, "From Conception to Birth"
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Remarkable portraits of the fetus developing inside the womb have been created
by my guest Alexander Tsiaras. His new book, "From Conception to Birth,"
shows human development from the fertilized cell to the birth of the baby.
These images show us things we have never seen so vividly before, like the
development of the eyes, the vertebrae, the circulatory system and the brain.
Tsiaras creates these images with a combination of technologies. He uses the
latest medical imaging techniques, such as MRIs and CAT scans, and he has
created computer software that enables him to scan, enlarge, rotate and
enhance the images, leading to more clarity and detail.

He's part artist, part journalist, part scientist. An exhibit of his work
called From Conception to Birth is now at the National Museum of Health and
Medicine in Washington, DC. One of his photos was on the cover of the
November 11th issue of Time magazine, headlined Inside the Womb. His images
have been used on more than 80 covers of such magazines such as Life,
Smithsonian and The New York Times.

I asked him to describe what the fetus looks like after just 40 days.

Mr. ALEXANDER TSIARAS ("From Conception to Birth"): Well, a lot of people
think of it as being almost reptilian when you have this very long, you know,
curvy tail, which is really quite wonderful. And you're just starting to see
these little beautiful segmentations on the sides of the body that will
eventually become the neural endings and, of course, the vertebrae. So that
is exactly the same in pretty much all vertebrae, whether it's a chicken or
whether it's a pig or a dog. And that you really can't even tell the
difference. The vertebrae all start--you know, the ears start on the bottoms
of your shoulder and they migrate up. Your eyes start on the side of your
head. So there really is no real resemblance to kind of a little person. You
could look like a little dog, a little chick; they all look pretty much the
same.

GROSS: Including that little human embryos have a tail.

Mr. TSIARAS: Yes. Oh, quite a long tail. It recedes over a period of time,
and we always keep that little bit of a tail--it's called a coccyx--later.
But, yeah, there's this little tail that sort of recedes as the body sort of
starts to migrate down and sort of ...(unintelligible) really basically absorb
that entire vertebrae into the upper part of the body.

GROSS: And what can you see happening after 40 days as the human embryo
becomes more human-looking?

Mr. TSIARAS: It's actually--the demarcation point is the eighth week, and
that's why we go at the eighth week from calling it an embryo to calling it a
fetus. It's--all the organs are pretty much in place, the feet and the hands,
everything is pretty much defined. And now from eight weeks all the way up
until birth, you're really now just having kind of detailing and elongation.
So the real demarcation point here is really eight weeks.

GROSS: And at that eight-week point your book says that the embryo is still
only a half-inch long, weighing less than a paper clip.

Mr. TSIARAS: Yeah, it's tiny. It's tiny. That's the extraordinary thing.
It's very hard for people to get their sensibilities around the fact that
you're looking at such extraordinary detail from this imagery, being able to
watch the heart and the lungs and all the organs growing. But it is so small.
And this is the kind of extraordinary part of where these technologies have
come, that you have these kind of micro magnetic resonance scanners and these
kind of what they call confocal laser scanning microscopes. You have all
these kinds of new technologies that allow you to see into these imageries or
these tissues that are so tiny. And then you're talking away with this kind
of extraordinary detail. And then again with powerful computers and new
softwares, the ability to re-compile this is pretty unimaginable when you're
trying to conceive it abstractly. But then you look at the pictures and you
realize, `Wow, it's doable.'

GROSS: Before we get more into the technology that enables you to picture the
fetus, let's talk a little bit more about the fetal development. What does it
look like as far as you can tell when the fetus starts to differentiate for
gender?

Mr. TSIARAS: The fascinating thing is that you start to realize the kind of
architecture and design of the beginning of, you know, both male and female.
And one of the things you look at, you see the testicles and the ovaries of
the male and female look very, very similar at an embryonic period. And then
what happens is that the ovaries, which are now instilled with all these eggs,
but the male gender has basically the beginnings of what will be the--you
know, the beginnings of sperm-making tubes, starts to descend in the male and
then starts to ascend in the female. So these little vas deferens, which are
these kind of cords that connect the testicles to the rest of the reproductive
system for the male are very similar to the fallopian tubes in the female. So
at one point, you sit there saying, `Wow, it's just amazing.' One goes up,
one goes down, and the only thing that defines it is, you know, the X or Y
chromosome.

GROSS: And at what point does a fetus actually start to develop male or
female genitals?

Mr. TSIARAS: They start early on. In essence, of course, the gender is
defined immediately. You can start--if you look inside the tissue you can
start to see, you know, at six to eight weeks very clearly the ovaries vs. the
testicles. It's not until, you know, into the around 11th or the 13th week
where you can see it externally. That's why there's a certain period of time
where there's a little knob there that we refer to as the indifferent penis
because that could just remain the clitoris or it could become the penis. You
can't really tell from the outside.

GROSS: If you're just joining us, my guest is Alexander Tsiaras. And he did
the images in the new book "From Conception to Birth."

Now these images aren't exactly photographs; they're like visualizations. I
want you to describe a little bit the process of picturing the paper
clip-sized fetus.

Mr. TSIARAS: Sure. Yeah, that's been the biggest problem for a lot of
people, the concept that they look like photographs because in essence they're
images. But photography, in essence, photographs or records the surface of an
object from one direction. And visualization, or scientific visualization as
we refer to it, allows you to scan the tissue from many directions and inside
the tissue so that when you get these sequential slices of the inside and you
sort of pack them like slices from a loaf of bread and you put all those
slices all back together, you have the whole loaf. And, of course, inside the
loaf it's extremely complex.

Then we use all our mathematical skills to sort of try to figure out what's
going on in these tissues; I mean, how does the heart separate itself in value
from the lungs? Now we have the ability to actually separate objects from the
whole, and we call this segmentation. It's the Holy Grail of visualization to
be able to pull objects from the whole. In essence it's the same kind of
technology that we use later on, on people who have cancer, trying to separate
the cancer from the rest of the body, or whether you're trying to understand
the normalcy of our own development, trying to separate where does the kidney
begin, when does the liver start to develop, how big does it grow. And we
measure those throughout the development process in 3-D.

GROSS: So you're actually getting imaging from lots of almost microscopic
parts of the fetus and then reconfiguring it with the help of computers.

Mr. TSIARAS: Yes. And the scanners that we use are very similar to the kind
of scanners that you see in all hospitals, magnetic resonance or CT scans.
And we've all seen them sort of on the clipboards of doctors' light boxes.
This is just a kind of a research scan of looking at microscopic tissues but
using very similar types of technologies and very similar energies. Except
we're looking at very, very small specimens.

GROSS: So how come like when a pregnant woman gets an ultrasound of her baby,
it's this kind of ghostly image that you can project, you know, that it's a
fetus but it's a pretty hazy, unclear image. But when you're done, you have
this crisp, amazing detail.

Mr. TSIARAS: Sure. One of the things is that whenever you're trying to do a
lot of scans very, very quickly, one of the issues is that you want to use a
low energy that won't hurt the woman, that you can do many of these types of
scans and do them on the fly from many different directions. Ultrasound is a
spectacular technology for that. And that technology we're relying on more
and more into the future. It's getting better and better and better. But if
you really want crisp, crisp images, you have to use these kinds of
technologies at the moment that give you much higher detail, much higher what
they call signal-to-noise ratio and use a kind of different energy. Those can
only be used in research settings. It's extremely time-consuming to set them
up, and we're in the infancy of these technologies as well. Eventually these
kinds of technologies will overlap with the kinds of technologies that people
are using every day.

GROSS: These visualizations aren't taken from within a pregnant woman's
uterus. These come from medical specimens. Where do the fetus medical
specimens come from that you've used for your renderings?

Mr. TSIARAS: Some of them are from within the womb and others--but the
majority of the data is from the National Museum of Health and Medicine in
Washington. This was a project that was funded by the National Institute of
Health, and basically they have a repository, one of the largest repositories,
if not the largest, of embryonic development, and this is really actually
derived with the Carnegie Collection, which is just celebrating its 100th
anniversary.

GROSS: So these are--What?--like fetuses in jars or...

Mr. TSIARAS: They're embryos in a collection, yeah. They're embryos in a
collection. Basically they have all the critical information and then some of
these are put in scanners so that you can actually get a higher fidelity of
information from it, and also you know exactly what--you know, what you're
looking at because you have the external elements with which to match it
against.

GROSS: And how do these fetuses become medical specimens?

Mr. TSIARAS: This has been part of the collection for many, many years of
people who have been dedicated scientists who have been trying to understand
the developmental biological process or evolutionary biologists, so having
this archive or this repository is absolutely critical. It's not just the
embryological collection they have, but they have one of the largest
collections of brains and other organs. And this repository is now sort of
coming to life again with the ability to scan inside the tissues, whether it's
of the brain or whether it's of an embryo, and these repositories are critical
for us to not only understand developmental biology or how the brain develops
or how any body part, but also pathologies. So it's an absolute gold mine to
people trying to educate others about all processes of life.

GROSS: Are these fetuses from abortions, from...

Mr. TSIARAS: Oh, no, no.

GROSS: ...stillborn or...

Mr. TSIARAS: They're--none of them are from abortions. That is very clear.
The NIH and the federal guidelines on this are really, really stringent, and
we follow the guidelines to the, you know, letter of the NIH and the federal
laws. And so basically these are parts of collections and I'm not--you know,
I don't know the entire history of each specimen because there are so many
specimens and we only used a tiny fraction of them, and, again, one of the
things that we have to specify is that we do not deal with the collection
itself. We're of the software side of the development of this process. Where
you have always an--like, for example, if you think about astronomy, you have
people who make the satellites that go out and image the stars, and you have
other people who actually process that imaging. It's the same way in
medicine. You have those people who actually go out and image the human body
and then you have other people who will interpret it. We're the interpreters.
We use our science to interpret their science for them. So we really don't
have that much to do with the collection.

GROSS: My guest is Alexander Tsiaras. His visualizations are collected in
his new book, "From Conception to Birth." We'll be back after a break. This
is FRESH AIR.

(Soundbite of music)

GROSS: My guest is Alexander Tsiaras. He's created visualizations of the
fetus developing inside the womb. He uses the latest medical imaging
techniques such as MRIs and CT scans along with new software technology that
he helped create which enlarges and enhances the images.

You're a father.

Mr. TSIARAS: Yeah.

GROSS: When your wife had ultrasound when she was pregnant, how did the look
and the meaning of those images compare to the look and meaning of the images
that you're doing in your visualization work?

Mr. TSIARAS: Well, when we went to--we're older parents so we went in and had
amniocentesis--I use the word `we' lightly. But when--I went in with my wife
when she had amniocentesis. Of course, you have the ultrasound first. And
one of the things--you're looking through these images--for me, it was a kind
of a marvel because, you know, a lot of times you're looking at specimens that
you have no relationship to and then all of a sudden it's there, it's my son.
But what was--I was nearly knocked off my chair because all of a sudden the
technician is going down from the head on down and I saw this enormous cyst in
the left hemisphere of his brain. I mean, `Whoa! Wait a minute. What's
going on here?'

And the technician immediately tried to get--bypass it and say, `We'll call
the doctor in,' and all of a sudden the doctor comes in in a hurry. They're
not used to having someone really understand what they're looking at. I'm
seeing this, saying, `Let's go back up to the head,' immediately, and all of a
sudden we're rushed out, genetic testing and all that. And what happened was
that these new technologies--they didn't know whether it was an abnormality.
We had the test. There was nothing wrong. But all these new technologies are
just coming at us so quickly, we just don't know what they mean.

Right now we don't know what happened to that cyst. Did it just get absorbed?
Is that normal? Is that a part of the process that now we're only able to see
because we're starting to have these new technologies? So it made me more,
you know, steadfast about the idea that these technologies are more important,
getting more of this information down as quickly as possible so that people
really can understand what these things do mean. Does that mean that there is
going to be a pathology, or is there not going to be, so people can make, you
know, really important decisions about the development of their child.

GROSS: You and your wife must have been so worried from the time after that
imaging to the time she actually delivered. You had no idea whether your baby
would have a normal brain or not, a functioning brain.

Mr. TSIARAS: We were terribly frightened, yeah, because, of course, the
physician could not tell you anything. These are all new statistics, new
information to them. They just suspected that that--you know, that the cyst
would be absorbed. I couldn't understand how. I mean, it was really
enormous. I mean, it really took up the entire left hemisphere of his brain.
And the--he was born and he is absolutely fine. And he's two and a half now
and things are great. But we were scared to death and that's why I was
thinking, `Wow, this imagery--if we could actually just map this, that this is
a normalcy so that the next group of people who go through this will
understand clearly that this is just--you know, that the baby's gonna absorb
it over the next two or three months and this is just a kind of tissue
process.' That's why these kinds of technologies are important to understand.

GROSS: Has the visualization work that you're doing of the developing fetus
affected your thoughts on abortion?

Mr. TSIARAS: You know, it's a scenario that, you know, we try not to
go--because we try not to politicize this. We try to keep it in the area of
science. But I think I would have to say that it's modified my position.
It's like thinking of a photographer who goes to war and then comes back
totally unchanged. You would say that there'd be something about their
conscience that you'd be a little suspect of. In my case, when you look at
this and you marvel at it, all I'll say is that it has, indeed, affected me,
and it has modified my opinion. And basically, that's as far as I'll take
that.

GROSS: OK. Are you concerned that these photographs are going to be
politicized?

Mr. TSIARAS: The visualizations--because we're always making that correction.
They're not photographs. Yeah.

GROSS: They're not photographs. Thank you. Yes, right. Right.

Mr. TSIARAS: It's--well, I was worried about it for a long period of time. I
kept on thinking, `Wow, you know, there's a marvel here that we want to get
people to understand, and I think what they're going to try to do is make this
into a political football.' But then one day I just got up and I thought,
`Wow.' You know, `What's my problem? That's my job.' My job as a scientist
and as a journalist is to provide information, and that's what we're doing
responsibly. We're providing this kind of extraordinary information for
people to make a decision for themselves.

GROSS: Now one of the things you've been able to do using this high-tech
approach to visualization is to visualize the moment of insemination, the
moment when the sperm meets the egg. How did you manage to do that?

Mr. TSIARAS: Those images we worked with New York University School of
Medicine, in the in vitro fertilization program. It's wonderful, wonderful
stuff to see when you see, you know, just hundreds and hundreds of sperm
trying to get in there, and all of a sudden just one goes through and it sort
of breaks into the barrier of the membrane of the egg, and then everything
else is locked out. So when you think about this in a kind of a natural
process, that, you know, from the pistol, you know, of the game beginning, 300
to 500 million sperm are taking off, and only one of them will make it in
there. And it's a kind of a marvelous process, both the chemistry of what's
going on and just the sheer volume, the sheer numbers.

GROSS: Another amazing project you've done--you had a 1997 book called "Body
Voyage: A Three-Dimensional Tour of a Real Human Body." Now the actual human
body that was used as your specimen for this was a Texas man who was executed,
you know, after living on death row, and he wanted to donate his body to
science. And you ended up having access to it. How did you use his body?

Mr. TSIARAS: Well, that was a project that was funded by the National Library
of Medicine at the National Institute of Health. The male was about 15
gigabytes of data; the female was about 45. They did her in much higher
resolution. What you do is you take the data and you start to look at it and
you say, `I now have probably, from an anatomical perspective, the greatest
data set ever created.' And now we have to sort of start what we referred to
earlier, segmentation--starting to pull objects--separating the pieces from
the whole. How is our heart embedded in our chest? How are our lungs, you
know, developed around that? And then you sort of just start to pull the
pieces apart, and you start to sort of look at them like a jigsaw puzzle.
And, I mean, it's almost kind of like God's puzzle, in a way: `I'm going to
put these pieces back together. I'm going to put these pieces back together,
and I'm going to take a look at all the valves in the heart and then I'm going
to show people as to how we're actually taking apart and putting it back
together using this extraordinary data set.'

GROSS: So the body of this executed prisoner, who donated his body to
science--it was divided into, like, nearly 2,000 little pieces...

Mr. TSIARAS: Yes.

GROSS: ...so that you could visualize the whole thing in three dimensions,
like all the pieces of a puzzle, and then put them back together again?

Mr. TSIARAS: Right. Well, it comes back to that slice metaphor of the bread,
except in this case we call him `Carpaccio Man,'(ph) because he's basically
1,878 slices of very thin meat. And so that's--I mean, everyone had their
name. Some people called him `Prosciutto Man'(ph); some people called him
`Carpaccio Man.'

GROSS: Who did the actual slicing?

Mr. TSIARAS: It was a group out of Denver, the University of Colorado. A man
named Vic Spitzer created this kind of enormous cryomicrotome, which is
basically--it just sliced off one millimeter at a time, and then they
photographed the image below it and then sliced off one milli--also, they did
a CT scan and then also MR scans of him, so basically you had three data sets
to compare different kinds of energy. Because every time you use a different
form of energy, you get different kinds of readings. That's why when you look
at the stars, you may use sound and then sound will give you back a feedback
that's different. Light will give you--and there are all different kinds of
frequencies of light.

So when you use CT, for example, the denser the object, the more it will
absorb the radiation. So that's why whenever you look at an X-ray, the bone
is very, very bright, because it's the densest object and it takes in a lot of
energy. And magnetic resonance is very good on water, so that's why you see
so much soft tissue; it's very, very good. So you had three important data
sets that you could cross-reference, depending on the strength of the imagery.

And this is becoming more and more important now in medicine. They call it
multimodal imaging. Modality is the form of energy you use to scan, and multi
is meaning that you're using many different kinds. So when you're doing
cancer, for example, and you're scanning cancer, if you can use PET, then PET
will give you the imaging of where the cancer is, because it glows, because
the cancer uses so much more energy than normal tissue. But then the CT will
give you the kind of geography of the information. So all these technologies
are borrowed, and everyone steals from everyone else. I mean, in essence, we
steal from Hollywood, we steal from NASA; they steal from us. It's really a
wonderful kind of exchange.

GROSS: Alexander Tsiaras' visualizations of a developing fetus are collected
in the new book "From Conception to Birth." These images are also on exhibit
at the National Museum of Health and Medicine in Washington, DC. He'll be
back in the second half of the show.

I'm Terry Gross, and this is FRESH AIR.

(Announcements)

(Soundbite of music)

GROSS: Coming up, how documenting death rituals led to his work documenting
the development of life inside the womb. We continue our interview with
Alexander Tsiaras. And book critic Maureen Corrigan reviews "The Time of Our
Singing" by Richard Powers.

(Soundbite of music)

GROSS: This is FRESH AIR. I'm Terry Gross, back with Alexander Tsiaras. His
new book, "From Conception to Birth," collects his visualizations of the fetus
developing inside the womb. These pictures use the latest medical scanning
techniques such as MRIs and CT scans, along with new software technologies
that he helped create which can enlarge and rotate the images and enhance
their clarity and detail. One of his pictures was on the cover of the
November 11th issue of Time magazine, headlined Inside the Womb.

You function as if you had, you know, like Superman's X-ray vision. You see
beneath the surface of things; in this case, see beneath the surface of the
skin of our bodies. What's your motivation? Why did you want to do this when
you started doing it?

Mr. TSIARAS: Well, I had a--you know, a lot of people start in this because
they're, you know, PhD physicists; the others are radiologists. I had a very
kind of unusual beginning. I started as a goat herder. When I was 19, I left
the United States and I went back--my parents were shepherds in Macedonia, and
I wanted to go back and live the life that they had lived. So I spent a year
herding 2,000 goats on the Macedonian-Albanian borders down to Mt. Olympus,
and then I spent a year in my mother's village at the base of Mt. Olympus.
And I photographed and wrote my first book, which was published by Princeton
University Press, on ceremonies, ancient funeral and exhumation ceremonies
that date back almost to Homer.

And the Greeks really don't celebrate birth. We only celebrate death. We
only have, like, name days and everything is based around religious holidays
on the deaths of religious figures. And we have an elaborate ceremony in the
village that we mourn the dead every morning and every evening for five years,
and then for after five years, we exhume the bones. The more flesh on the
bones, the more sins the person committed during their lifetime; the less
flesh, the less sins. So when the village goes to, mostly women, exhume this
body, it's a very, very important moment for the members of that person's
immediate family, and they're hoping that there's going to be no flesh.

When I saw these women doing these kind of elaborate ceremonies and then
washing the bones in wine and water and wailing and singing these magnificent
dirges over them, I was thinking, `When I go back to the States, if I could
find something that had the kind of power of that imagery and the power of
these events'--and when I did come back, I really--it was hard. The only
places that I actually saw that kind of power were in X-rays. And there was
no way that I could really start to collect these files, because you'd, you
know, you're a civilian, you had no reason to be inside a medical archive.

So I visited my brother, who's chairman of the Department of Ophthalmology at
Brown, and he's an eye surgeon. And I thought, `Wow, maybe if I stay with him
for a while, they'll let me into the archives and I'll photograph a report,'
and, you know, it was very strange, because the thing is that all of a sudden,
I started to look at this eye surgery and I saw the first cut across the eye,
and I thought, `Wow, this is just like surrealistic art. It's like Dali.'

And as I started to make these kinds of records, then they did let me into the
archives and I started collecting these X-rays for my personal artwork,
because I'm principally trained as a painter and a sculptor. And oddly, I
started to become fascinated by the science of how the lasers were going
across the eye, and that sort of provoked me to learn mathematics and then
physics about how this light was going across. And then I started designing
my own cameras and lenses. One, I designed a lens that could photograph the
development of the egg, one of the first ones in an in vitro fertilization
program that became the cover of Life magazine. And then I designed an
endoscope that could photograph the development of the fetus from outside the
amniotic sac, which again became the cover of Life magazine.

So I had this kind of weird hybrid of science, art and journalism that was
going on simultaneously. And about 13 years ago, I decided to sort of
transfer that energy to the computer, because I saw that these X-rays and
these CT scans were making beautiful imagery. So I then learned UNIX and then
all the computer languages, C and C++, and it was easy to transfer the
algorithms of how you made light travel in these endoscopes and these
microscopes actually travel through virtual space, and then I started
designing these computer codes. So it's a kind of--now we're sort of
respected by the scientific community, the journalistic community, the art
community, and it all sort of works. Unusually...

GROSS: I just have to say that listening to you say this, I can think of only
one thing, which is how remarkably similar my career trajectory is to what
you've just described. Right. It is pretty amazing.

Mr. TSIARAS: I didn't know you were a goat herder, as well.

GROSS: Right. Right. Yeah.

Well, in listening to this amazing description that you've just given, one of
the things I want to ask you about--I want to go backwards a little bit--is to
when you were in Greece during your goat-herding phase, and you were watching
people exhume bodies as part of this ancient Greek ritual. I have to say--I
mean, the only way I can connect to that--and this is a very kind of gruesome
fictional way of connecting--is through, you know, body snatcher horror
movies.

Ms. TSIARAS: Mm-hmm.

GROSS: I mean, when I think of a body being exhumed, unless it's for strictly
medical or forensic purposes, all I can think of is like Boris Karloff. And
certainly, it seems like it would be a very unhealthy thing to do, to expose
yourself to a decomposing body of five years. I mean, it sounds almost
unthinkable to me.

Mr. TSIARAS: Well, it's--I mean, what happens in these rural regions is
people are, you know, extremely comfortable with death. When I told my
grandmother that in the United States, one of the things, especially in New
York City, people do everything they possibly can to avoid death; like the
following day, you know, someone wants to get back to work so they can forget
the death of someone close to them or, you know, try to get over it as quickly
as possible. My grandmother turned to me and said, `(Greek spoken),' `You
barbarians.' So their perspective on it is that you must pay homage to that.

In one way, they're extremely comfortable with the process of how it ends.
And I must admit, you know, a lot--to think about it abstractly, it sounds
like, you know, the paranoia of your own--the end of your own existence is,
indeed, frightening. But for them, they were extremely comfortable with it.
At least I found that a fascinating part of the process. They also have very
elaborate ceremonies in the sense that this ascendence to heaven can be
helped, like people are given dreams all the time. I remember my aunt seeing
her father very, very skinny in her dreams, pulling his belt very tightly and
he was totally emaciated, meaning that she then had to give food. So she
baked food for the next few days and brought it to his supposed enemies so
that that would help alleviate his sins so that his, you know, soul would
ascend a little bit more quickly, his flesh would decompose. So it's a lot
more elaborate than just basically going and doing the exhumation.

Of course, what happens to the bones at the end is that people put them in a
box with their photograph on it, and then they can actually bury it under
their home or they can put it in an Ashery. They don't want their enemies to
get to it so that they burn the bones.

GROSS: Who actually does the exhumation and the examination of the bones? Is
it the loved ones of the deceased, or are there, like, designated exhumers in
the community?

Mr. TSIARAS: Oh, there are designated exhumers. That was another fascinating
part. These women, most of them--principally, it's done by women, and most of
them are illiterate. But they were great anatomists. They knew every part of
the body, and they knew if there was something there, if someone was trying to
hide something, because sometimes their family members will see a piece of
clothing or something and it's almost like a sleight of hand or it's a piece
of tissue or something, so it just disappears underneath. But it's kind of an
extraordinary ceremony.

That's why one of the things, when I was mentioning earlier about coming over
to writing these algorithms, one of the first things I did was I wrote a
series of algorithms in code to scan my own head, and I did these virtual
exhumations as a kind of a new type of portraiture, which was odd that after
2,000 years of doing these kinds of ceremonies this way, the next generation
of exhumations was done on a $1/4 million supercomputer, but it's all done
virtually now.

GROSS: My guest is Alexander Tsiaras. His images are collected in his new
book "From Conception to Birth." We'll be back after a break. This is FRESH
AIR.

(Soundbite of music)

GROSS: My guest is Alexander Tsiaras. His visualizations of the fetus
developing inside the womb are collected in his book "From Conception to
Birth." He uses the latest medical imaging techniques, such as MRIs and CT
scans, along with new software technology that he helped create which enlarges
and enhances the images.

Now you were trained as an artist.

Mr. TSIARAS: Yes.

GROSS: And when you were younger, you worked with the sculptor George Segal,
who's famous for his plaster casts of the human body. And there was something
really ghostlike about George Segal's sculptures, because he would plaster
cast living people, but then he usually would not paint over the cast. So it
would be a perfectly lifelike rendering, but with, like, a white plaster
surface...

Mr. TSIARAS: Right.

GROSS: ...like a shroud of plaster.

Ms. TSIARAS: Mm-hmm.

GROSS: You, I think, modeled for some of George Segal's work.

Mr. TSIARAS: Yes, I modeled for a number of George's sculptures, and also for
Lucas Samaras. They were sort of two of my mentors. And it was great, and
they were great conversationalists, spectacular teachers, and it was one of
the kind of original--I remember one of the things that was so powerful was
the idea of how they released you from having to use anything traditional as
part of the materials that you needed to make art. And the power of their
ideas, you know, still to this day stay with me.

GROSS: Well, it must have been interesting--and since you're so involved with
anatomy now, but using high-tech imaging, it must have been interesting to
have started working with George Segal, who's also interested in the anatomy,
but he's just doing basic plaster casting.

Mr. TSIARAS: Well, George was much more interested in the kind of the
psychodynamic of the social circumstance and what kind of position you would
be sort of--the body and the mind would be frozen in at any point in time.

GROSS: Mm-hmm.

Ms. TSIARAS: You know, I'm interested in kind of the psychodynamic of being
able to see inside. Each one of these is sort of--is provoked by different
reasons, but you're sort of coming out to the same ends. If you take a look
at George, or if you take a look at a kind of classic movement, something like
abstract expressionism, you see that there's a period of time where Jackson
Pollock's work is reflective of a time in the sense that the atomic bomb had
just been dropped, but we had just won the war. So you felt this kind of
vulnerability and you felt this extraordinary power, and you could see that
all in kind of, like, Jackson Pollock's canvasses.

Now one of the things that I'm fascinated by is that after 9/11, people feel
vulnerable, but after the '80s and '90s and this kind of generation Y and
generation X, of people being totally self-involved, I think that probably one
of the next new art movements will be medicine. It'll be where science and
medicine--where people can now just go into malls and get scans of themselves.
I mean, from a vanity point of view, when you're going and you're looking
inside this, there's something about having this kind of ultimate portrait of
yourself, but at the same time, it also reveals vulnerabilities.

So I think that--and another element that's interesting is that probably 10 or
15 years from now, you're going to have these holographic records of yourself,
where someone will just touch on the liver and there'll be this
three-dimensional image of the liver, and that will be your patient record.
But also, artists will be able to use this information to do a new kind of
portraiture. So I think that maybe one of the big next art movements that we
may be in the forefront of is the ability to use this medicine meets science
as the next big wave of art.

GROSS: Hmm. Now when you worked with Lucas Samaras--my memory of Lucas
Samaras' work is that one of the things he did was take Polaroids and then,
kind of as the Polaroid was developing, manipulate the image...

Mr. TSIARAS: Right.

GROSS: ...by destroying it a little bit, by maybe moving his fingers across
the developing film so that...

Mr. TSIARAS: Right.

GROSS: ...the image was blurred or reshaped in some way. How did that
contribute, if at all, to your sense of what you wanted to do with imaging of
the body?

Mr. TSIARAS: Well, Lucas was, you know--pre-Adobe Photoshop. The ability to
actually manipulate an image like that was kind of extraordinary. In one way,
when I was working with Life magazine very closely, the kind of preservation
of the image was absolutely critical, and any kind of manipulation of it was
sacrilege because, in essence, that was the document. And when you then went
on to the other side of photography, or photography used as art, the ability
that the surface or anything could be done to the image was a tremendous sort
of burden off your back that you really--the idea was more important than the
preservation of the document itself.

So Lucas was liberating in the sense of the way he actually, you know,
manipulated the emulsions of those SX-70s, those early Polaroids, and it was
absolutely spectacular. Again, from a young artist's point of view, getting
rid of those shackles is one of the most important things, and that's why, you
know, working with these kinds of great artists, like George and Lucas, was
getting rid of shackles. It reminded me sort of a statement that my father
said once about saying--I had four brothers, and he said, `I want you guys to
all go to the best schools; not to find out how good you are, but to find out
how bad they are.' So the demystification, the getting rid of shackles,
whether they're psychodynamic or whether they're just about the material
itself is kind of important factors in your growth.

GROSS: I don't know if you're a religious man or not, but seeing how the body
is formed in its fetal stages and then being able to show visualizations of
the fully developed body and so on--I mean, the body is a really miraculous
thing. Has it made you think more about, like, a divinely inspired miracle,
or are you more into the almost technical aspects of it? I guess I'm
wondering if it's changed you at all, you know, in terms of your interest or
lack of interest in religion, spirituality, whatever you want to call it?

Mr. TSIARAS: It's hard not to spiritualize a lot of this. A lot of times,
most of the time, I'm thinking I'm seeing that wonderful line, `I cannot
conceive of my own existence. How can I conceive of something greater than
myself?' That's the way, a lot of times, I'm looking at this material, and
I'm sitting there saying, `Keep it simple because it's just so beyond your
imagination.'

But it's hard not to spiritualize it. When I was looking, for example,
through a microscope at the cornea, and you look at the body and you say,
`Every part of your body is made of collagen,' and collagen's this kind of
opaque, ropelike substance, and your hair, your skin, your bone--everything is
made of collagen. Except collagen changes into this matrix form in your
cornea. Only there does it change its structure, and because of that, it's
transparent; you can see. It's so perfectly designed a structure, it's hard
not to attribute divinity to it.

But you know, then sometimes, you know, you just sit there saying--you know,
there's that line by Woody Allen that says `I'm a teleological existential
atheist. I believe there's intelligence in the universe with the exception of
a few parts of New Jersey,' you know.

(Soundbite of laughter)

Ms. TSIARAS: So you run this spectrum when you're looking at this material
of total awe, of the divinity of it and then sometimes you just--you know,
it's just beyond you.

GROSS: Now that you are giving us your high-tech visualizations of what goes
on inside the human body, under the skin, or what the fetus looks like when
it's developing, are there certain things that you hope these images will
inspire us to think about now that we can see things that we've never seen
before?

Mr. TSIARAS: I think, one, is that it's--the process that we went through,
again--and I use this word over and over again, because it is the most
appropriate word--it's the `marvel.' It's the marvel of our own existence,
realizing the complexity of this process and the beauty of it and the respect
of human life when you recognize that the beauty of this machinery that
actually does, indeed, work. I think for us the marvel and the respect we
walked away from is something that we hope other people when looking at this
book.

We don't want to make this a kind of a soft sell of the book. We really want
people to understand also that this is very, very solid science in the sense
that we're using this as a comparison for the next generation of abnormalities
that can help OB/GYN and developmental biologists. But if you're just to sit
there, saying from a human point of view, it's respect and marvel.

GROSS: One last question. Remember you told us about the ultrasound that
your wife had when she was pregnant that revealed a large cyst growing in the
brain of your baby.

Ms. TSIARAS: Mm-hmm. Mm-hmm.

GROSS: What did you with that ultrasound? Have you kept it?

Mr. TSIARAS: Yes. Yeah. We have it as a--we have actually every ultrasound
in, basically, a kind of, like, a gallery of pictures of him throughout our
home. So they're sort of matched up against a lot of the pictures from the
book. So we're sort of thrilled. Now we see him--he's terrific. He's a
wonderful healthy child. So we just got lucky.

GROSS: Well, thank you so much for talking with us about your work. Thank
you.

Mr. TSIARAS: Oh, my pleasure. Thank you very much.

GROSS: Alexander Tsiaras' visualizations of the developing fetus are
collected in the new book "From Conception to Birth." These images are also
on exhibit at the National Museum of Health and Medicine in Washington, DC.

Coming up, book critic Maureen Corrigan reviews "The Time of Our Singing," a
historical novel about race relations in 20th-century America.

This is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: New novel "The Time of Our Singing" by Richard Powers
TERRY GROSS, host:

Novelist Richard Powers is known for tackling intellectually complex subjects
in his award-winning novels like "The Gold Bug Variations" and "Three Farmers
on Their Way to a Dance." In his latest novel, "The Time of Our Singing,"
Powers interweaves physics, classical music, the mystery of time and the
problem of race with real-life events. Book critic Maureen Corrigan says that
it's a soaring performance that contains a few flat notes.

MAUREEN CORRIGAN reporting:

All novelists play God, but nowhere are there divine delusions so apparent as
in historical fiction. `What if?' is the irreverent question historical
novels pose. What if the past were to be tinkered with? The big `What if'
moment in Richard Powers' sprawling novel "The Time of Our Singing" occurs on
Easter day 1939, the day when the great contralto, Marion Anderson, defiantly
sang to an audience of tens of thousands in front of the Lincoln Memorial
after she'd been barred as a black woman from singing in nearby Constitution
Hall. What if on that historic occasion, another young black woman, an
aspiring classical singer herself, and a German-Jewish emigre, a physicist who
ruminates over the problem of time, were to bump in to each other in that
crowd and against all the odds were to fall in love and marry? And what if
they were to have three mixed-race children who came of age in the 1950s and
'60s? And what if the oldest child were so gifted as a singer that he, too,
dared to cross over the barricades into the lily-white world of classical
music? What then?

"The Time of Our Singing" is nothing if not audacious as it charts the lives
of that mythical couple, Delia Daley and David Strom, and their children. It
also retells the 20th-century history of race relations in America by
revisiting some signature events: the murder of Emmett Till and the travesty
of his killers' trial; the march on Washington in 1963; the Birmingham
bombing; the LA riots and the Million Man March. Sometimes Powers succeeds in
restoring the shock of the new to the past. The set piece on Emmett Till is,
in itself, a searing 10-page defense of the value of historical fiction. But
other passages where the public and private intersect have a hokey,
`you-are-there' docudrama feel to them. Albert Einstein's visit to the Strom
household is one such episode of high fakery that disrupts the spell of
belief.

Ironically, such flaws actually safeguard "The Time of Our Singing" against
the charge that critics like George Will and Jonathan Yardley have leveled
against other historical novels like Don DeLillo's "Libra" or E.L. Doctorow's
"The Book of Daniel"; namely, that these fictions about the Kennedy
assassination and the Rosenberg case are so convincing impressionable readers
will swallow them whole as the truth. "The Time of Our Singing" doesn't pose
such a threat because it isn't as powerful, as seamless, as insistent as those
novels. It's a moving and very good, but not great book; a second-tier work
of historical fiction in the company of other strong second-tier novels, like
David Bradley's "The Chaneysville Incident" or Doctorow's own "World's Fair."

The main narrator of "The Time of Our Singing" is the Strom's second son,
Joseph, who's born to play second fiddle. Joseph is not as gifted musically
as his wunderkind brother, Jonah. Appropriately, he grows up to be Jonah's
accompanist. Nor is Joseph as filled with passionate intensity as his much
younger sister, Ruth, an irritating Johnny One-Note creation who eventually
joins the Black Panthers and denounces her classically trained brothers as
Uncle Toms.

Joseph's account of his and Jonah's musical education is compelling even to a
tin-eared reader like myself. It begins at home, where Delia and David
recognize that the world's relentless purifiers would come after their
mixed-race children and that for pure safety, nothing beat music. Jonah, the
genius, ends up devoting himself to early medieval music; trying to find the
origins of human sound before categories like race make their mark.

Music clearly is one of Powers' big metaphors here; a formal device for
keeping the multitudinous of his novel from spinning out of control. The
other big metaphor is time. And surprisingly, even though it's the more
abstract construct, it turns out to be the more effecting one. David Strom,
the boy's physicist father, is convinced of the existence of curves in time,
loops by which chronology doubles back on itself and every one and every thing
exists concurrently. The novel itself endorses this theory.

As Jonah and Joseph age and, sadly, come to regret their parents' experiment
in mixed marriage, as separatism, not integration, becomes the rallying cry,
Powers' novel keeps returning to that utopian moment on Easter 1939 when David
and Delia first meet across the color line and think, `What if?' Though the
novel that follows doesn't quite live up to its own ambitions, that recurrent
question is poignant enough to carry a reader along.

GROSS: Maureen Corrigan teaches literature at Georgetown University. She
reviewed "The Time of Our Singing" by Richard Powers.

(Credits)

GROSS: I'm Terry Gross.

We'll close with a song from "Chicago." The movie and its soundtrack are
hits. Here's a track from the 1975 original Broadway cast recording, with
Jerry Orbach of "Law & Order" fame in the role that Richard Gere plays in the
movie.

(Soundbite of "All I Care About")

Mr. JERRY ORBACH: (As Billy Flynn) (Singing) Is everybody here? Is everybody
ready? Hit it.

I don't care about expensive things, cashmere coats, diamond rings. Don't
mean a thing. All I care about is love.

Backup Singers and Mr. ORBACH: That's what I'm here for.

Mr. ORBACH: (Singing) I don't care for wearing silk cravats, ruby studs,
satin spats. Don't mean a thing. All I care about is love.

Backup Singers: All he cares about is love.

Mr. ORBACH: (Singing) Give me two eyes of blue softly saying, `I need you.'
Let me see her standing there and honest, mister, I'm a millionaire. I don't
care for any fine attire Vanderbilts might admire. No, no, not me. All I
care about is love.

Backup Singers: All he cares about is love.

(Soundbite of whistling)

Mr. ORBACH: (Singing) It may sound odd, but all I care about is love.

Backup Singers: That's what he's here for.

Mr. ORBACH: (Singing) Ba-ba-ba-ba-ba-ba, boo-boo-boo. Ba-ba-ba,
ba-boo-boo-boo. Honest to God, all I care about it love.

Backup Singers: All he cares about is love.

Mr. ORBACH: (Singing) Show me long, long raven hair, flowing down about to
there. When I see her running free, keep your money. That's enough for me.

(Soundbite of music)

Mr. ORBACH: (Singing) I don't care for...

(Credits)
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