“In the end, people don’t view their life as merely the average of all its moments — which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life maybe empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.”
–Atul Gawande, Being Mortal: Medicine and What Matters in the End
To our donor,
The morning that we met was one most medical students eagerly anticipate as they embark on the journey that is medical education. Excitedly I put on my first set of scrubs, elated to look like a “real” doctor. Beneath my external façade however, I masked an underlying feeling of anxiety. How would I react when I saw you for the first time? Would I be fascinated by the working machine that is the human body? Would I faint? Would I suddenly realize I’m not cut out for medicine?
Our lab group gathered in a semicircle and stared intently at the cold metal table and electric blue, zippered bag in which you rested. As our instructor made a few, now forgotten remarks and unzipped the bag, we peered over the edge and saw you lying there peacefully with your identification tag intact on your right ear. This unusual way of identifying a human being as just a number made the experience feel cold and impersonal. Our instructor quickly covered your face with a “privacy cloth.” For weeks that was the last time we saw your face.
As we moved through each section of your body, dissecting away layers of fascia and removing major organs, I rarely stopped to think beyond the methodical cutting and scraping. While I had learned more in those few short months about the anatomical composition of the human body than many people have the opportunity to learn in a lifetime, I rarely stopped to think about you, the donor and person at Table 4. I did not know what your passions were or about the memories you had made throughout your living years; I did not know the meaningful story that was your life.
Just the other day I held your brain in between my two gloved hands. As I inspected the many sulci and gyri a realization came to mind: This was the organ that carried the facets of your personality, the struggles you faced, and the joy you felt. Prior to your final breath and allowing yourself to become a tool for education, you were a member of someone’s family, perhaps someone’s father or grandfather, a member of society. It was then that I truly began to appreciate the weekly six hours spent in lab, the countless nights studying and ultimately why every medical student has been required to take clinical anatomy since the infancy of medical education. Not only had I learned more about the human body than would ever have been possible from reading a page in a textbook, but I had also realized more about your story without ever having the privilege of conversing with you.
Over the course of four months we had inspected the various pathology that inevitably lead to your death. We learned that cancer had spread throughout your body, that your heart had to work harder than most, and that you had more surgeries during your life than our entire lab group combined. But we also learned that for whatever reason, you felt compelled to share your body and health struggles as an opportunity to allow students like us, discover how pathologic processes can lead to disease and how that impacts the complexities of the human body. One day, I know I will have a patient with cancer, who needs a kidney transplant, or requires a pacemaker and I will undoubtedly think of you as the first person in my capacity as a medical student, who experienced each of these health difficulties. As physicians, it our duty to look beyond the interesting and difficult problems our patients present us with and remember that every person we have the privilege of caring for is far more complex than the diagnosis they have been given or the ailment for which they are seeking help.
So to our donor, thank you. You gave me the opportunity to not only better my medical knowledge but also to gain a better sense of appreciation of the person beyond the pathology and acknowledge the moments that make each patient’s story, theirs. I will be grateful to you throughout the course of my career for giving our table the opportunity to become more educated and competent future physicians and simultaneously more compassionate, understanding, and patient human beings.