From the pectoral region dissection on August 1 until our final practical in December, we have undergone one of the most intimate and transformative experiences in medicine: dissection of our cadavers. Shared by only the select few who have taken this journey in medicine before us, our cadaver donors—our first patients—have given us a glimpse of what it means to be a doctor.
Our donors are the first completely vulnerable set of bodies with which we will ever interact. Naked and defenseless, they exposed every millimeter of their bodies to us, showing not only what their insides looked like, but glimpses of who they were during their lifetimes. Willingly bestowing their hearts and livers for us to hold in the palms of our hands, our donors also showed us their tattoos, their last color of nail polish and the stubble on their chins. They showed us forms of themselves that not even their closest family or friends had the opportunity to know. We were able to see more of their physical bodies than they were ever able to see for themselves. I was humbled, witnessing the most vulnerable moments of these strangers, and I reflected on the enormous privilege we will have as future physicians.
The first lesson that my donor taught me was how to face fear. I remember that first day of lab when our anatomy professor was giving directions. I admit that I wasn’t really listening. All I could think about was the lifeless human body resting right in front of me. I was afraid of the unknown that awaited. I was afraid that I wouldn’t be able to do my donor justice by making use of every bit of knowledge that they could teach me. I imagine that I will again face this fear when I meet my first living patient one day.
For me, seeing my donor’s face for the first time was the most emotionally challenging. I remember when the gauze was accidentally misplaced one day in lab, exposing the face before anyone had the opportunity to prepare for it. It was then that I was reminded that the body that I had grown an ability to dissociate myself from was once a living person like you or me.
By the end of gross anatomy, we were all pretty good at disconnecting ourselves from the fact that we had completely mutilated a human body from head to foot. And, we understood that our actions always had the good intent of knowledge. But sometimes, we became numb to what our time in gross anatomy lab meant. Maybe we got frustrated by our inability to find a structure. Or maybe we became so immune to the experience that we found ourselves dreading having to go into a long dissection.
Unfortunately, I foresee this process of numbing as an option that will always be available as we become comfortable in our roles as physicians. The opposite may be true: the emotional arousal caused by seeing the cadaver’s face for the first time may mirror the potential attachment that we have for a special patient in our futures, one who reminds us of ourselves or of someone we love. Perhaps conscious introspection throughout this journey will help us to strike a balance between attachment and indifference for our patients of the future.
In the process of placing our hands into the very depths of another person’s anatomy, we have become a little more aware of the demands and the privilege that comes with this lifework that we have chosen for ourselves. These lessons represent only a fraction of what our first patients taught us. Some lessons just may never be appropriately put into words, and others may only elucidate themselves as we continue on this long journey to becoming physicians.
I would like to leave you all with one of my favorite quotes by Lao Tzu. I think it expresses the beauty in the powerful lessons that such lifeless bodies taught us:
“Thirty spokes meet at a hollowed out hub; the wheel won’t work without its hole. A vessel is molded from solid clay; its inner emptiness makes it useful. To make a room you have to cut doors and windows; without openings, a place isn’t livable. To make use of what is here, you must make use of what is not. “
Although our physical relationship with our first patients has come to a close, I hope we can always remember the lessons they taught us as we move forward to serving our patients of the future.