Science
A UCLA doctor is on a quest to free modern medicine from a Nazi-tainted anatomy book
As Dr. Kalyanam Shivkumar pondered how to fix the human heart, he was given a gift laced with horror.
Shivkumar, a cardiac electrophysiologist known as “Shiv” to friends and co-workers at UCLA, was trying to better understand the intricate details of nerves in the chest. He hoped doing so might help him improve treatments for cardiac arrhythmias — aberrant rhythms of the heart — that can prove dangerous and even deadly.
A Canadian colleague sent him a set of anatomy books renowned for the beauty and detail of their drawings, but tipped him off that the “atlas” had an appalling history.
Shivkumar was aghast to learn it was the work of an ardent Nazi whose Vienna institute had dissected the bodies of prisoners, many executed for political reasons after Austria was annexed to Nazi Germany in 1938.
“Every time I open up that book,” he said, “my sense is revulsion.”
Shivkumar is a big thinker, an erudite physician quick with an apt quotation, whose Westwood office is stacked with Sanskrit volumes of the Mahabharata alongside books about late Bruins basketball coach John Wooden.
Dr. Shumpei Mori sets up a donated heart to be photographed at UCLA as part of the Amara Yad project to create new, ethically made anatomical images.
(Allen J. Schaben / Los Angeles Times)
As he waded into the scholarly debate over using the tainted atlas, the doctor bristled at hearing others praise its illustrations as “unsurpassable.” Much of the soul searching among physicians had revolved around when and how to use it. Shivkumar wanted to put those questions to bed.
“Could we be better?” he asked. “Could we not be making something that’s completely untainted?”
That question would launch Shivkumar on a quest that has lasted more than a decade and is expected to endure for years. He wants to surpass the anatomical atlas created by Dr. Eduard Pernkopf, a fervent supporter of the Nazi regime whose work was fueled by the dead bodies of its victims.
His passion project at the UCLA Cardiac Arrhythmia Center is called Amara Yad, a mashup of Sanskrit and Hebrew meaning “immortal hand.” The work has relied on the generosity of people who have willed their bodies for use at UCLA, as well as hearts that were donated but could not be used for transplant.
So far, Amara Yad has completed two volumes focused on the anatomy of the heart and is enlisting teams at other universities for more. The plan is to draft a freely available, ethically sourced road map to the entire body that eclipses the weathered volumes of watercolors from Pernkopf and honors the Nazis’ victims.
Anatomists have told him, “‘You’re crazy. It’s impossible. How could you ever surpass it?’” Shivkumar said of the Pernkopf atlas in a speech last year before members of the Heart Rhythm Society.
But “can it be beaten? The answer is yes.”
For decades, the origins of the Pernkopf Atlas were unknown to many who turned to its pages for guidance. Swastikas tucked into signatures of an illustrator were airbrushed out in later editions. Its history began to trickle out in journals in the 1980s.
When Dr. Howard Israel finally learned of its roots, he was horrified. Israel, an oral surgeon at Columbia University and self-described “very ordinary American Jew,” told the New York Times he had been relying on the book since he was a medical student.
‘’I felt stupid at using the book,” he told the newspaper, “that I could possibly have benefited from something that sounded so evil.” He and another physician enlisted the Holocaust remembrance group Yad Vashem and publicly pushed for the University of Vienna to investigate whose bodies were depicted in its pages.
The resulting probe found no evidence that the anatomy department under Pernkopf — who had ascended to become dean of the medical faculty at the University of Vienna in 1938 — had received bodies from the Mauthausen concentration camp, as some had wondered.
But the institute had been given at least 1,377 bodies of executed people, most of them sentenced to death for political reasons. Among the charges that led to their executions: “crimes of resistance” and “high treason.”
Using the bodies of executed people was “a centuries-old practice in anatomy,” preferred because anatomists could time their work swiftly after a scheduled death, said Dr. Sabine Hildebrandt, an anatomy educator at Harvard Medical School. What was new under the Nazis, she said, was the sheer number of executions.
The institute “was drowned in bodies,” and “the source for these bodies was mostly connected with the apparatus of repression of the Nazi regime,” said historian Herwig Czech, a member of the Lancet Commission on Medicine, Nazism, and the Holocaust, at a recent forum.
By the time those findings emerged, the publisher of the anatomy book had stopped printing it.
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1. A stack of volumes of the Pernkopf atlas on a shelf in Dr. Kalyanam Shivkumar’s UCLA office. 2. Erich Lepier, one of the Pernkopf atlas illustrators, repeatedly included a swastika after the cursive R in his signature. (Allen J. Schaben / Los Angeles Times)
Yet use of the atlas persisted. Hildebrandt said that a decade ago, dental students in her classes “were basically giving each other thumb drives with bootlegged copies of the head and neck.”
Other anatomical atlases exist, but these illustrations had especially fine details, including of the nerves extending beyond the brain and spiral cord. One survey of nerve surgeons found that 13% of respondents were using the atlas. Among those who have publicly grappled with it is Dr. Susan Mackinnon, a surgery professor at Washington University School of Medicine in St. Louis known as a pioneer in nerve regeneration.
“I used this textbook for years before I knew the history of it,” she said. “My brain is contaminated with that. I can’t undo that.”
Mackinnon sought ethical guidance. Rabbi Joseph Polak, a Boston University assistant adjunct professor of health law who survived the concentration camps as a child, said one dilemma involved a patient in excruciating pain.
Polak recalled that the patient had told Mackinnon that “if you can’t find the nerve to stop the pain, then I want my leg amputated.” The rabbi walked through Jewish teachings that applied to the ethical quandary and conferred with other experts, penning a set of recommendations called the Vienna Protocol.
Among his urgings to doctors: If you use these drawings, make it clear to patients where they came from.
The Third Reich wanted “to extinguish them and to extinguish eventually all memory of them,” the rabbi said of Holocaust victims, speaking at a recent forum about the atlas. But when a doctor tells patients about what happened to the people depicted in the drawings, he said, “they’re being called out of that darkness.”
Mackinnon now keeps the atlas locked away. In the rare cases she feels she needs to consult it to operate, she tells patients and co-workers about the man behind it. His firings of Jewish doctors. The grim details in its pages — shorn hair, emaciated bodies — that began to raise suspicions about its terrible origins.
The only reason to use it, she said, is to save someone from misery — and only if “nothing else will help you.”
“Could we be better” than Pernkopf? Shivkumar asked. “Could we not be making something that’s completely untainted?”
(Allen J. Schaben / Los Angeles Times)
Shivkumar said his goal is to eliminate the need to consult those pages at all. Inside UCLA’s Center for the Health Sciences in Westwood, he showed off a donated heart, prepped and ready for its close-up in a corner of the lab outfitted with a black backdrop and brilliant lights.
A spent heart normally wilts like a deflated balloon, but this one had been pumped with chemicals to imitate the fullness of life. The team first puts the organs to use in research, then carefully dissects them for imaging.
Bringing out a bisected piece of a heart, Dr. Shumpei Mori displayed how its inner architecture could be captured on camera, threading a catheter through the organ as a co-worker snaked in an endoscope.
“The internal structure is really fine and delicate,” said Mori, a specialist in cardiac anatomy who had jumped at the chance to do something new in the field.
“Even Pernkopf simplified the anatomy” in its drawings, Mori said. “What we are doing is more complicated.”
Dr. Shumpei Mori holds a detailed model of a heart. “Even Pernkopf simplified the anatomy,” he said. “What we’re doing is more complicated.”
(Allen J. Schaben / Los Angeles Times)
The camera is far from their only tool: The team has generated 3-D images to illustrate the dimensions of the inner structures of the heart; done CT scans to produce hand-held models; and used sophisticated imaging from a microscope to reveal the lattice of nerves connecting to the organ — part of the signaling system that Shivkumar calls “the internet of the human body.”
In another lab, Mori carefully unzipped a bag on a metal gurney to reveal the stripped-down interior of a cadaver diligently dissected over a year and a half, its rib cage cracked open like a weighty book. Shivkumar pointed out the pale web of nerves stretching up through the neck. Mori had painted them yellow by hand.
The human body might seem like well-traveled territory, but as physicians work to find less invasive ways of healing, such as attacking a cancer with ultrasound, Shivkumar said there is “a volcanic desire for this kind of information.” Snip the right nerve, he said, and you can avert the need for a heart transplant.
“Pernkopf never did nerves like this,” he said with pride.
Amara Yad is also an act of “moral repair” meant to honor the victims, said Dr. Barbara Natterson-Horowitz, a UCLA cardiologist and evolutionary biologist who helped support the project. The Nazi atlases “were like documents of death. The atlases that Shiv is creating are really living, interactive tools to support life.”
When Shivkumar decided to launch the project, he had been inspired by the words of USC emeritus professor of rheumatology Dr. Richard Panush, who had pushed to set the atlas aside in the library of the New Jersey medical center where he had worked, moving it to a display case that explained its history.
Panush said the old atlas should be preserved only as “a symbol of what we should not do, and how we should not behave, and the kind of people that we cannot respect.”
Doctors need to know that history to understand their own moral fallibility, Hildebrandt said. Physicians in Nazi Germany “still thought they were doing the right thing,” she said, even as they failed to see some people as human.
Rabbi Polak stressed that doctors at the time “had the deepest, most profound respect of the masses.”
Yet when the Nazis took power, “it turned out that a vast proportion of them were moral sleazeballs,” Polak said. “They were the first to join when they saw that it could promote their careers.”
Model hearts line a bookshelf at UCLA. The Amara Yad project is working with other universities to tackle other parts of human anatomy.
(Allen J. Schaben / Los Angeles Times)
Shivkumar said that beyond making new tools for physicians, the Amara Yad project is working with Oxford University to develop an accompanying curriculum that will explore ethical failures in medicine. Pernkopf’s anatomy book is only one example.
The history of the atlas “invites the contemplation of how doctors and medical scientists and anatomists are related to a regime,” said Sari J. Siegel, who heads the Center for Medicine, Holocaust and Genocide Studies at Cedars-Sinai. Thinking about it underscores that “medicine is political.”
“It can’t be divorced from the larger contexts in which it exists.”
Shivkumar, born to a Hindu family in the southernmost state of India, is used to people wondering why he became “possessed” with this project. He recalls first learning about the Holocaust from a photographer friend of his grandfather, a former newspaper editor once imprisoned for sedition against the British Empire.
He was 11 when the photographer showed him images dating to World War II, and it chilled him “to see that human beings could be so brutal to other humans.” As a child, his parents had told him they owed the world because their part of India was lucky to be long spared from such conflict.
In Amara Yad, we “get a rare opportunity in history to correct an unbelievably depressing stain that was placed in our field,” he told the Heart Rhythm Society.
It irritates him to think of the abundant resources that a Nazi had at hand to do this sort of work. “Imagine having five Shumpeis!” he exclaimed at one point, gesturing at his colleague who hand painted the nerves. At UCLA, the project has piggybacked on ongoing research and relied on donations. He is hoping to garner $500,000 annually to continue and expand the work.
But Shivkumar likes to quote the Emperor Ashoka on that point: “To do good is difficult. One who does good first does something hard to do. … Truly, it is easy to do evil.”
A disease that can cause neurological illness and meningitis in people, rat lungworm, has been found in wild opposums, rats and a zoo animal in San Diego County, indicating its establishment in California for the first time.
Researchers reported their findings in the journal Emerging Infectious Diseases, published by the U.S. Centers for Disease Control and Prevention. The authors, who include veterinarians, researchers and wildlife biologists, urged physicians and other healthcare workers in the region to consider lungworm infection when patients come in with nervous system disorders.
The discovery highlights “a notable expansion of the range of this parasite in North America,” they said.
The CDC website says the risk to the general public of getting this infection is low, but it can be deadly.
If ingested, the worms can cause severe headaches, stiff neck, the sensation of tingling or painful skin, low-grade fever, nausea, vomiting, coma and sometimes death. People who eat freshwater crab, prawns, frogs, snails and slugs are at greatest risk. However, people can also get the disease by eating un-rinsed produce that’s been slimed by a snail or slug, or eating a slug or snail that was chopped up in produce. The worms need moisture, however; if the produce is dry, the worms will die.
Domestic animals, including dogs and cats, are also at risk.
Officials with the California Department of Public Health were not ready to call the disease endemic, or established, in the state.
“Additional surveillance and testing will be necessary to determine whether the detections of rat lungworm in the animals evaluated in San Diego County represent an isolated introduction of the parasite or ongoing local transmission,” spokeswoman Elizabeth Manzo wrote in a statement to The Times.
The department said it is not aware of rat lungworm outside San Diego County, and has seen no human cases.
“However, the San Diego study affirms that the parasite can be introduced to California through movement of infected animals from endemic areas,” the statement said. “Because some species of snails and slugs present in California are capable of serving as hosts for rat lungworm, and the presence of the parasite in other parts of the state is unknown, it is advised to take certain food safety precautions. Persons should not consume any raw or undercooked wild snails or slugs, and should thoroughly wash all produce before consuming.”
The worms that cause the disease, Angiostrongylus cantonensis, are native to Southeast Asia. They’ve been found in the U.S. since the 1960s — including in isolated human and zoo animal cases in California — and are established in Hawaii as well as in much of the southeastern U.S.
It is believed they came overseas via rats on boats.
The worms favored environment is the moist, warm bed of a rat’s lung. When a rat is infected, the worms cause respiratory distress, priming the rodent to cough. Worm-filled sputum is then ejected into the rat’s mouth, and swallowed. The rat then poops the worms out, and animals such as slugs and snails eat the poop. When a rat eats an infected invertebrate, the cycle begins again.
Occasionally, another animal, such as a raccoon or dog, or a person, will accidentally eat an infected animal, or the slime of one, and contract the disease.
The discovery of the worm in San Diego County rodents and opossums was made by staff at the San Diego Zoo and a local wildlife rehabilitation center, Project Wildlife, which is run by the San Diego Humane Society.
In December 2024, a 7-year-old male parma wallaby, born and raised at the zoo, began showing concerning neurological behaviors: incessant head shaking, blindness, a lack of muscle coordination and paralysis in his hind legs. He was euthanized after 11 days in the zoo infirmary.
When zoo staff examined the body, they found six rat lungworms in the marsupial’s brain, along with a lot of damage.
Because the diagnosis was so unusual, zoo staff examined the bodies of 64 free-ranging roof rats that had either been euthanized in the course of regular pest control or found dead on the property. Two, a little more than 3%, had lungworms. Their feces had them too: “numerous live … larvae with coiled posterior ends.” The larvae, roughly 300 in each poop sample, were each about the size of a grain of sand.
Officials at the San Diego Zoo did not respond to requests for comment.
Curiously, at the same time the zoo investigation was underway, staff from Project Wildlife had been dealing with sick opossums brought to them from around the county. Tests of 10 dead animals showed seven carried the lungworms.
Many people and animals remain asymptomatic when they’re infected. Symptoms typically appear within hours or days after ingestion and can last up to eight weeks. The worms will eventually die.
Because the disease has so many varied symptoms, health officials say it can go undiagnosed and untreated. Health officials from Hawaii, where the disease is endemic, say if lungworms are suspected, it’s best to be treated as soon as possible — even before lab results come back.
The CDC too notes that treatment works best when the disease is caught early, and can consist of high doses of corticosteroids, lumbar punctures for symptomatic relief of headaches, and antiparasitic medications, such as albendazole.
Science
Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal
For months, former residents of the Pacific Palisades Bowl Mobile Estates have feared the uncommunicative owners of the property would seek to displace them in favor of a more lucrative development deal after the Palisades fire destroyed the rent-controlled, roughly 170-unit mobile home park.
A confidential memorandum listing the Bowl for sale indicates the owners intend to do exactly that.
The memorandum, quietly posted on a website associated with the global commercial real estate company CBRE, says that the Palisades fire created a “blank canvas for redevelopment” at a site “ideally positioned for a transformative residential or mixed-use project.”
“I just thought, oh my god, this is so much propaganda and false advertising,” said Lisa Ross, a 33-year resident of the Bowl and a Realtor. “How can they even get away with printing this?”
Neither the current owners of the Bowl nor the real estate companies listed on the memorandum responded to requests for comment.
The memorandum describes the current single-family residential zoning as “favorable” for developers; however, the city and mobile housing law experts have painted a different picture.
Fire debris at Pacific Palisades Bowl in January 2026.
(Myung J. Chun / Los Angeles Times)
“Multifamily and mixed-use development on this site is not allowed by existing zoning and land use regulations,” Mayor Karen Bass’s office said in a statement Wednesday, adding only low density single-family housing or reconstructing the mobile home park are currently allowed. “Mayor Bass will continue taking action and [work] with residents to restore the Palisades community.”
City Councilmember Traci Park also reiterated her focus on getting the mobile home park rebuilt and allowing residents to return, with a spokesperson noting she is not entertaining the potential for any rezoning efforts from a developer.
Zoning changes typically require a city council vote and are subject to the mayor’s approval or veto.
Beyond the zoning laws, the site is also currently governed by a state law requiring cities to preserve affordable housing along the coast and a city ordinance protecting mobile home residents against sudden displacement.
Spencer Pratt, a resident of the Palisades and an outspoken supporter of the neighborhood’s mobile home community, criticized the mayor and the owners in a statement to The Times. “It’s unfortunate that Karen Bass has not advocated for mobile home residents impacted by the fire,” he said, “and that the current owner of the Bowl is ignoring good faith offers from residents to buy the property.”
The mayor’s office disputed this, noting Bass recently led a delegation of Palisadians, including mobile home owners, to Sacramento to advocate for recovery. “Mayor Bass’ priority is getting every Palisadian home — single-family homeowners, town home owners, renters, mobile home owners.”
Los Angeles Mayor Karen Bass speaks during a private ceremony outside City Hall with faith leaders, LAPD officers and city officials to commemorate the one-year anniversary of the Eaton and Palisades fires on Jan. 7, 2026.
(Allen J. Schaben / Los Angeles Times)
Bass also advocated for the federal government to include the Bowl in its debris cleanup efforts; however, the Federal Emergency Management Agency ultimately refused to include it, unlike other mobile home parks impacted by the Palisades fire. Its reasoning: It could not trust the owners to rebuild the park as affordable housing.
Court rulings over the years found the owners routinely failed to maintain the infrastructure and worked to replace the park with an “upscale resort community.” Residents also accused the owners of attempting to circumvent rent control regulations.
After the fire, it ultimately took more than 13 months to begin cleaning up the debris.
Ross said she approached the owners with independent mobile home park developers who were interested in buying the fire-destroyed lot and letting residents rebuild within months. She also approached the owners with a proposition that the former residents band together to buy the park. She heard nothing back.
“They don’t communicate,” Ross said. “It’s a feuding family. That’s also why we had so many problems with maintenance and with upgrades in the park.”
Pratt, who is running for mayor against Bass, also called on private developers like Rick Caruso to step in and save the Bowl. (Caruso’s team noted his rebuilding nonprofit is looking into how to help residents of the Bowl.)
Ross is a fan of Pratt’s proposition. “We need those kinds of people — we need Rick Caruso. That would be great,” Ross said. To sweeten the deal: “I’ll cook for him. I would make him all his favorite dishes.”
A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.
A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.
A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.
HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.
While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.
Here’s what you need to know.
What is HMPV?
HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.
Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.
Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.
However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.
Why are we talking about HMPV now?
Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.
That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.
“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”
In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.
So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.
While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.
What are the symptoms of HMPV?
Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.
HMPV infection can progress to:
- An asthma attack and reactive airway disease (wheezing and difficulty breathing)
- Middle ear infections behind the ear drum
- Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
- Bronchitis
- Fever
Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.
What is the treatment for HMPV?
There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.
A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.
If symptoms worsen, experts say you should contact your healthcare provider.
How to avoid contracting HMPV
Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.
The American Lung Assn.’s recommendations include:
- Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
- Clean frequently touched surfaces.
- Crack open a window to improve air flow in crowded spaces.
- Avoid being around sick people if you can.
- Avoid touching your eyes, nose and mouth.
Assistant data and graphics editor Vanessa Martínez contributed to this report.
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