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Our Cadavers, Ourselves

My cadaver has pink fingernails. I saw them on the first day of class, after we pulled back the white plastic sheet with the number “22” scrawled on it with permanent marker, and cut away the damp cloth that had been covering her cold skin. Her arms were folded across her chest, and on her fingers was a sparkly, ballet-pink polish, not chipped or peeling despite having been there for the 13 months since she’d died. I don’t know why it’s there. I don’t know if she painted them thinking she was going to survive to enjoy it, or if she was someone who always wanted to look her best, even in death.

Thus was my introduction to gross anatomy, that rite of passage that separates medical students and physicians from those who have never had a look at what goes on under the skin. It’s the class in which we take apart the human body to figure out how it works, not unlike the time when, as kids, my brother and I cut the fur off of our Furby toy to expose the underlying wires and plastic. I’d dreaded the class ever since interview season, when, clad in my suit and completely inappropriate footwear, I was thrust into a foul-smelling anatomy lab with my fellow interviewees, to see what it was like to be a real live medical student. The shock and revulsion almost made me question my entire decision to become a doctor.

In many ways, my dread was warranted. I never quite “got used to” anatomy the way older students told me I would, and I certainly never forgot that the person I was dissecting was just that — a person, formerly alive, whose name and personality I know nothing about, despite knowing exactly what her left renal vein looks like as it crosses her aorta on its way to her inferior vena cava. I’ve grown strangely attached to her over the last few months, which might be natural given the amount of time I’ve spent with her. She was a larger woman, but every time a professor or fellow student makes a comment about her weight, I find myself getting offended and angry, as though someone has judged and insulted a dear friend of mine without bothering to learn anything about her.

For the first month, I didn’t know what her face looked like. Out of respect for cadavers and students alike, her head was covered with cloth until we began dissection of the head and neck. When we pulled it back, she looked peaceful, calm and undeniably human, despite the grayish undertone of skin lacking blood to perfuse it. That’s the face I try to keep in my memory, even though it didn’t look that way for long; within a few weeks, it had been skinned, excavated, and, eventually, cut entirely in half, hacked through by my dissection partners and me with a rusty saw.

The only thing I know for certain about my cadaver’s life, when her heart still sent blood coursing through her arteries and ions still electrified her nerves, is that she suffered. On the first day of class, I saw the hernia in her abdomen, her viscera pulling through it like a baby on the verge of being born, likely a complication from the surgery that left a scar running down the length of her abdomen. I saw the way the ovarian cancer that killed her had wreaked havoc on her organs, leaving her intestines thickened and stuck to one another, her liver so teeming with metastases that when we tried to lift it up it all but disintegrated. I hope she had family around, that they comforted her when she felt weak, that she maintained an attitude as bright and sparkly as the polish on her fingernails. I hope, but I’ll never know.

Despite taking up just seven or so hours per week, I find anatomy lab leaking into the rest of my life. I dream about it frequently; sometimes about my cadaver, up and walking around like a living human, but with the leathery skin of a preserved body and a stiff, robot-like gait reminiscent of the rigor mortis I’ve always known her to have. During our unit on limbs, I dreamt about cutting off my fingers, to donate to somebody else who needed them, and woke up frantically flexing and extending the digits of my left hand, just to make sure I still could. The smell of the lab, and, no doubt, my actions while I was there, digging through parts of the body that nobody was ever meant to see, seeps into my every pore, and my post-lab showers leave me scrubbing my skin, Lady Macbeth-like, trying to remove a smell that might at this point be entirely in my imagination. Out, damned formaldehyde.

The course has made me consider my own body in a new way. I have a newfound appreciation for my kidneys, my tiny, unassuming kidneys, lying in my abdominal cavity and dutifully keeping my entire self healthy and steady. I find the human body more impressive, more wondrous, now that I’ve seen its inner workings. It doesn’t make me disbelieve in evolution, but in a way, allows me to understand those who do — how else could something so beautiful and complicated possibly have been devised by a series of random events?

I sometimes think about what it would be like if my body were the one being dissected, my identity reduced to a table number and an age at the time of death. The students would see my missing appendix, but they wouldn’t know that the operation to remove it was the reason why I decided to become a doctor. They’d see my spine, abnormally curved and crooked — “kyphotic, lordotic, and scoliotic,” a professor would tell them — but they wouldn’t see the bulky, plastic-and-metal back brace I wore during my preteen years, as though I wasn’t already awkward enough. They’d see my whole body, naked and defenseless, as a tool for learning about biology, but they wouldn’t see all of the rest — the adventures it took me on, the late nights it saw me through or the torture it inflicted on me when I was a teenager and didn’t think my body looked the way it should. But, they’d also see things I’d never know about myself — maybe an unusual branching pattern in my abdominal arteries or maybe a missing tendon in my hand.

Although anatomy ends next week, I won’t quite be done with my cadaver — later we’ll dissect her brain, which I’m sure will inspire a whole new set of existential crises and complementary nightmares. And, while I’ll be glad not to feel the stench of fixative in my hair or worry about which foramina the branches of cranial nerves go through, I’m sad to be finished with the course, to accept that the body my donor gave has served its purpose, that it can finally be cremated and returned to her family. I hope they know how much she taught me, and how my future patients will benefit from the knowledge I gained from her. I hope that’s what she thought about when she decided to donate her body, and maybe that it gave her comfort when she was nearing the painful end of her life. And, when her family gets her ashes, I hope that gleaming among the gray dust that used to be her flesh and bone, there are small, sparkling flecks of pink.

Image sourceOrgan Donor by Edward Allen Lim licensed under CC BY 2.0.

Leigh Finnegan (3 Posts)

Contributing Writer

Perelman School of Medicine at the University of Pennsylvania

Leigh Finnegan is an MS3 at the Perelman School of Medicine at the University of Pennsylvania. She graduated from Georgetown University in 2013 with a degree in English and mathematics. She enjoys cooking vegetarian food, running on the Schuylkill River Trail, and watching unhealthy amounts of television.