This feeling of loss and subsequent reflection revealed to me something fundamental about how I experience time in my own life. As I depart the anatomy lab, I stand on the shores of time’s river and gaze into the clear water’s surface. In it, I see a reflection of growth and of internal transformation — a reflection not of who I was but of who I have become. I emerge not only learned in anatomy but also with insight into the impact that individuals can have on one another.
On the first day of anatomy, we were reminded that this course was a once-in-a-lifetime experience and that we were privileged to be experiencing it. For those of us first-year medical students who might not pursue surgery nor experience physically interacting with and entering the human body again outside of surgical clerkships, the professors said this would be an intense time. We would peer into the spaces and structures that — on some level — make up every human being.
I am sitting in school / but I am also thinking of you. // Yes, I do / wonder how consciousness / wraps round and round / this hunk of meat, / how chunks of flesh / sustain your metaphysical feat.
I no longer feel alone the way that I did the first few weeks of dissections, because now I recognize that my peers were sectioned off at their tables also worried that they were losing their sensitivity, that they weren’t good enough to belong, and they didn’t know how to cut into a person. I wish that I had known what my classmates were thinking and feeling during the anatomy course.
Why would someone choose to donate their body to medical education? We have a dishonorable history in medicine of illicitly sourcing cadavers for dissection: robbing corpses from graves, murdering people for their bodies and salvaging the unclaimed dead from city hospitals and morgues. Today, we call the bodies we learn from “donors” instead of “cadavers” to honor their autonomy and personhood, their choice to be in the room.
It is the day before the first anatomy lab for the first-year medical students, and a single professor walks alone, up and down rows of tables laden with twenty-six naked, embalmed bodies. He silently shares a few minutes with the donors, a private thank-you. Soon the donors will be covered in white sheets, and the students will tentatively spill through the locked wooden doors of the labs, a rush of anticipation, teamwork, questions and learning. But right now, no one makes a sound. There is no buzzing of saws, whirring of the suction machine, or gentle clinking of hemostats and Metzenbaum scissors against the metal tables, no nervous laughter, exclamations of discovery or confused mumblings.
In the golden glow of a fall day, one hundred four first-year medical students parade
out of the medical center carrying boxes of bones to aide our anatomy lab studies. The crates
look suspiciously like instrument cases, perhaps the size of an alto saxophone, and it feels absurd
to march back to our houses a la The Music Man, knowing all the while that we are bringing real
live (well, dead) human skeletons into our living rooms, kitchens and coat closets. Mine resides
propped against a bookshelf in my bedroom. I only open it during daylight hours, and only when
absolutely necessary. For the next four months, as we visit classmates in their homes and
encounter the subtle black or brown cases they’ve tucked into the corners of their lives, the bone
boxes will serve as a reminder of the secret club that we all have newly joined.
Over the next four weeks, I will share a series of essays with you in which I tell some of those stories. This writing results from the work of a summer, supported by a Summer Research Fellowship in Medical Humanities & Bioethics at the University of Rochester School of Medicine and Dentistry, in which I interviewed nine first-year medical students, two third-year medical students, eight anatomy and medical humanities professors, two Anatomical Gift Program staff, three palliative care clinicians, two preregistered donors and one donor’s family member. Out of respect for their privacy, none of the people interviewed are named, and identifying characteristics have been removed.
A first-year medical student’s stress and anxiety begin to take physical form as she navigates her first year of medical school.
A loud cry as we enter the world. / A silent cry as we depart.
There were seven of us standing around the table as the attending surgeon debrided the infected fascia. The vascular surgeon came in the room and barked at us to identify the structures before us. “What’s that artery?” he interrogated us. “I’ll give you a hint,” he said, “there’s a deep and a superficial.” We named the sural nerve and iliotibialis band and the great saphenous vein. As we clamored around the table, I suddenly thought of the Rembrandt painting: The Anatomy Lesson of Dr. Nicolaes Tulp.
Allowing natural death gives the elderly and terminally ill the opportunity to control the end of their life, providing empowerment and a sense of peace during their time of uncertainty. This patient and her family’s forethought allowed us to provide medications to ease her pain and discomfort. When she closed her eyes for the last time, her body relaxed into the sheets, and I pulled the blanket up to her shoulders. Her family said goodbye, and then I began to perform post-mortem care.