June 2007 | Back to Table of Contents

Editor's Note

The Complex Life of Bones

Bones are so simple. After all, they’re merely our scaffolding, the frame that holds up our vital organs, the studs and joists that give us form and need carpenters called orthopedists when they break. They get moved by muscles and tendons, but otherwise they just sit there, hard, immobile … simple.

The apparent simplicity of bones is a ruse. I remember my revelation in medical school when I discovered the teeming world of osteoblasts and osteoclasts breaking down and remaking bone and interacting with parathyroid hormone and vitamin D to regulate the body’s calcium and phosphorus. Today, the intricate secrets of the physiology and biochemistry of bone are slowly being further decoded, leading to insights about osteoporosis and rickets (see pp. 26 and 36).

Orthopedic surgeons are now more like artists than carpenters, fashioning new structures to replace or repair worn or damaged bone and cartilage (see p. 41). They are also inventors, dreaming up devices to patch or pin broken bone. Orthopedics isn’t just plaster anymore.

And bones have a wider and deeper metaphorical place in our language. They can represent our center, as in “chilled to the bone” or “I feel it in my bones.” Yeats invoked them as the core of understanding—“He knows death to the bone/Man has created death.” They can be the quintessence of fatigue when we have “weary bones” as Cardinal Wolsey did in Shakespeare’s Henry VIII—“An old man, broken with the storms of state/Is come to lay his weary bones among ye;/Give him a little earth for charity.”

Bones as a symbol of death and the dessication that afflicts the body after death have a genealogy dating to the Old Testament with Daniel encountering “dry bones” in the desert. Bones are frequently all that’s left of a body after postmortem decay, so we see walking death with skeletons on Halloween and Hamlet speaking to his father’s “canoniz’d bones hearsed in death.” Shakespeare envisioned his own grave after his body had lain for decades and so penned his own epitaph: “Good friend, for Jesu’s sake forbear/To dig the dust enclosed here./Blest be the man that spares these stones,/And curst be he that moves my bones.” Like Daniel divining from his dry bones, modern-day forensic anthropologists uncover clues from bones in criminal cases (see p. 12).

Since bones give our bodies rigidity, we say the courageous and strong have backbone and the cowardly and meek are spineless or boneless, a metaphor that the paragon of acidic wit, Winston Churchill, employed to skewer an opponent in 1931, when he compared him to the Barnum and Bailey circus performer, the Boneless Wonder.

And ever since Adam gave up his rib to make Eve, bones have represented the epicenter of our being that we share with our mates. In Paradise Lost, Milton paraphrased the Bible when he wrote “Flesh of flesh/Bone of my bone thou art, and from thy state/Mine never shall be parted, weal or woe.”

So bones and the people who fix and examine them are a complex tale told in part in this month’s issue. Those simple two-by-fours that hold us up are really elaborate organs that lead complicated physiological, biochemical, and metaphorical lives.

Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at
cmeyer1@fairview.org