Ramblings on healthcare, medical education, and life with a spinal cord injury
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Memorializing a Gift in Death

One of the quintessential medical school experiences is gross anatomy. It’s one of the things people frequently ask about, and it’s possibly the one single experience that causes the most apprehension amongst newly-minted students. That first exposure to a cadaver is one that nobody will ever forget. Unzipping the protective vinyl bag, curling back the large sheets of plastic, and being confronted with the somewhat rubbery skin of somebody’s embalmed remains is at once both intimidating and awe-inspiring.

We’re first instructed to locate structures that can be felt externally, which begins to ease the transition to an increased comfort with the person who will teach us most about the structure of the human body. Feeling skin and bony structures, cool to the touch, is a good way to start. Eventually we must pick up a scalpel and make the first incision, opening the layers of skin that, up until now, have been all many of us have had any kind of close contact with on another human being.

Stories often circulate of the occasional student passing out upon their first experience in gross. Others may become light-headed or need to take a break. It goes to show how significant this experience is in the many rites of passage in medical school. Nobody in our lab fainted, although I’m sure there was some apprehension that was not vocalized – we were all new to each other at that point in the year, and I’m sure some were guarded.

Often, the apprehension that precedes one’s first foray into the gross lab is gone shortly after that first experience. Replaced instead by a growing familiarity and sense of purpose, and the realization that there is nothing to be intimidated by. Our purpose is clear: we are there to learn, and that is what we do as time goes on.

While we are told the age and cause of death of these, our first patients, we are not told their names. The process is intended to be anonymous, to ensure the respect and dignity due the donors and their families. So instead, many students name the cadavers. These were people who led full lives, and giving them a name, rather than just saying “our body,” helps to make the whole process more personal. These aren’t animals or science experiments we’re peering into, they’re people. I’ve worked in two separate anatomy groups, in different classes, and have learned a great deal from both Alfred and Herman.

Along with the names sometimes come stories of the lives people led. Alfred had tattoos that appeared to be of a military origin, so given his age, we came up with stories of him flying planes in the Korean War. And things he had done since then. Alfred led a good life, was a good man, and had some incredible experiences.

A few days ago, Case held a memorial service for the families and friends of those who donated their bodies to our education. These were people who chose not to be buried or cremated, but instead to have their remains preserved and then torn apart by young, eager students. People who, even in death, have continued to give. One can only imagine that in order to bequeath such a donation, the donor must have been incredibly selfless.

Despite looming end-of-year and board exams, a lot of the students came to the service to honor and remember those who had died, and convey our gratitude to the loved ones who were not able to bury those they cared so much for. Seeing those people, after spending an entire year in the lab, was truly stirring. If those who lay on our tables had not been real enough before, they could not be more so now. The lives of those we memorialized had ended, but their spirit continues to live on, through the people they loved, and now, through us and through every patient we will be able to treat because of what we learned from them. Seeing the attendants of the service was every bit as memorable and humbling as that first step into the lab. Probably even more so.

As my first year of medical school draws to a close, I think back on how much I have learned scrutinizing Alfred and Herman. This experience is neither replaceable nor quantifiable. Every time I locate the anterior scalene, palpate the sternal angle, examine a radiograph, or dissect the connective tissue around a mass or vessel, it will only be possible because of what I have learned and practiced in gross. Every patient I treat, every student I teach, every patient those people treat, and so forth. It quickly becomes clear just how exponential the reach becomes.

So to Alfred, Herman, every other anatomical donor, and all of those who have sacrificed so that we may learn, I thank you with all my being. In death, you continue to live on and have single-handedly touched and benefited more lives than any of us could ever imagine.

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