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In September of 2022, archaeologists in Borneo announced the discovery of the
remains of a person who’d had their lower leg amputated,
possibly during that person’s childhood.
That person survived for several more years, as evidenced
by the leg having fully healed. The twist here: the remains
were 31,000 years old. The discovery was further
evidence that the practice of caring for our sick or injured
companions is way older than previously thought, and knowing
exactly how old can help us understand our ancestors’
capacity for compassion. The research team in Borneo
is pretty confident that the missing foot was an intentional
amputation because of the way the bones were broken,
and the way that the fractured bones healed.
And it all happened many thousands of years before the
previous oldest intentional amputation on record, which
dates to just 7,000 years ago. This tells us a few major things
about this group of people from 31,000 years ago.
One, they knew enough about the body to know when amputation was necessary and how to do it.
Two, they had the tools and skills to perform precise
surgical procedures. And three, they were also
willing to care for one of their group members while they
recovered from surgery, and for the rest of that person’s life as
a permanently disabled individual.
This, at its core is health care. So what is health care anyway? Well,
it’s more than just some people in white coats sticking
a patient with needles. Most narrowly,
health care is the organized system of direct support for someone’s physical acute needs.
Basically, “making them better”. But it's also considered
giving health care to accommodate someone’s permanent or chronic needs to allow that
person to live longer than they otherwise would without
care. And some of the
earliest evidence for the practice of health care is a lot older than you’d think.
We have evidence that health care is not even unique to
our species, which can give us insights into some of our
other hominin relatives and their capacity for care.
Remains from a 1.7 million year old site in the Republic of
Georgia called Dmanisi include the skull of a Homo erectus
individual with major gaps in their smile. The individual’s jaw shows evidence
that they had lost all but one of their teeth,
due to either disease or aging. While losing your teeth is
not great in the long run, the invention of tools like juicers
or blenders with more horsepower than a car
means that getting enough calories to stay alive is possible even without pearly whites.
However, Homo erectus was not quite so technologically
developed as we are today, which begs the question: What did
this individual eat? It’s debatable whether
this population would have been able to cook their foods at all.
But we know that this toothless individual lived for years
after losing their teeth since their sockets were closed over
in a process called resorption. So we know that they had
access to something soft they could get their gums on.
At the time, the soft foods that were available to them
would be things like bone marrow, brain tissue, or soft
plants, likely mashed or cut up using stone tools, which
takes extra time and energy to do.
So when it came time for this Homo erectus group to gather
for dinner, this individual’s need for specific foods was made
clear, and the group would have traded or given those foods
to this individual. And the whole group was
okay with this adjustment for years. That's a long time to be giving away
some of what were likely prime pieces of protein!
Now, we don’t know the extent to which this food sharing
happened, but it’s likely that the individual in question’s
needs were supported at least in part by their companions.
We also know that caring for sick and injured group
members is not unique to Homo erectus. Our evolutionary cousins the
Neanderthals went even further than Homo erectus in
providing care to group members.
By and large, Neanderthals in the fossil record have a lot
of injuries, more than we see in earlier hominin species,
suggesting that their lives were dangerous and survival in
their environments involved a lot of bumps and bruises. For example,
anthropologists discovered an individual from a site in Iraq called Shanidar who’d been
through the ringer.
He was either fully or partially blind in one eye, was
missing one hand and forearm, sported several leg and
foot deformities, and had both a degenerative joint disease
and hearing impairment. And somehow, he still
lived to be between 35 and 50 years old, which was the standard lifespan
for a Neanderthal adult.
He wouldn’t have been able to hunt or gather food as
effectively as his healthier companions, so it seems likely
that the only way he could have survived was if someone
was providing him food and assistance every day. Another individual from France showed
signs of tooth loss, arthritis in his back,
shoulders, and jaw, a fractured rib, and degeneration of his foot bones,
and he also lived to be a pretty normal adult age,
between 25 and 40 years old. Keeping both of these individuals
alive that long would have required managing
fevers, keeping them clean, and repositioning their joints as they
healed from their various injuries.
Plus, both of these individuals would have had limited
mobility for life, and their groups would need to help them
travel long distances as the group moved around. So it seems like Neanderthals had a
pretty high capacity for care. Which is not
surprising, in a species where as many as 80-90% of adults suffer
at least one traumatic injury in their lifetimes.
And they didn’t just support these injured group members,
they probably used medicine to treat their injuries too.
Tartar on the teeth of Neanderthals from Spain indicates
that they ate yarrow and chamomile, both of which are
extremely bitter and not pleasant to eat, but do have
medicinal benefits. So they probably
weren’t eating them for funsies or as a primary food source, since there were much
tastier things to eat.
Other Neanderthals’ plaque contained traces of poplar, a
plant that has lots of salicylic acid in it. Salicylic acid is the active
ingredient in aspirin, so these individuals may have been using it
as an early form of pain management.
And at the Iraqi site where archaeologists found Shanidar,
they also found a burial site where an individual appears to
have been buried with a whole bunch of medicinal plants,
including yarrow, cornflower, ragwort, and ephedra.
So these plants may not have just been useful, they may
have been important enough to these people to include
them in burials along with other grave goods. This isn’t the only interpretation of the site,
however. Some have argued that
the flowers may not have been put there by Neanderthals at all, and were brought
by rodents storing food.
Whether this “flower burial” represents a ceremonial
practice using medicinal plants or just a shared cave with a
hungry rodent, we do know that Neanderthals had a pretty
high-level understanding of many medicinal plants in their
environment. But this also raises a
pretty big question: Why was it so important to all these different
hominins to keep their sick and injured group members alive?
Some anthropologists think that these care behaviors
might have evolved to increase group survival rates in
societies where individuals were all super dependent on
each other. For example,
some foods need to be processed after they are gathered and brought to camp. So,
maybe your injured groupmate can’t hunt for elks,
but he can help crack nuts all day.
This ability and willingness to care for each other might
have allowed Neaderthals to move into northern areas
where there was more risk for disease, famine, injury, and,
you know, freezing to death, because providing health care
meant individuals actually had a chance to survive their
injuries. Of course,
it’s also possible that Homo erectus and Neanderthals just liked their friends
and family and wanted to keep them around longer.
Sadly, compassion and love don’t fossilize, so with these
species long gone, we probably will never know their exact
motivations for providing health care to each other.
But what we do know is that it suggests they had a relatively high capacity for empathy,
plus the cognitive ability necessary to take care of each other.
And in the end, compassion and empathy are what drives
most modern health care, too. So it sounds like individuals
have had the cognitive ability to take care of each other
for a long time. But the cognitive ability to work a computer is much newer.
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