Saturday, January 6, 2018

'The humanity of our cadavers'; Med students give somber thanks to donors



Fasciculo di medicina, Venice, 1493 (Metropolitan Museum of Art)

     I've begun writing another long-form medical story for Mosaic—my fourth. Which always puts me in a good mood. I'm not a medical writer, but find such stories challenging to report, and fun to write. Nothing focuses your attention like a corpse, and if you can't find a way to make such a story interesting, then you're in the wrong business. I've always liked this story, for its juxtaposition of the physicality of the cadavers with the spirituality of the ceremony. Though the heads, flayed apart like ghastly flowers, took some getting used to. 

     The ceremony is in 10 minutes, but the exam is tomorrow. So rather than idly wait to honor the former tenants of the bodies they have been dissecting for the last 10 weeks, 145 first-year students at the Loyola University Chicago Stritch School of Medicine are busy, crowding around 18 cadavers in the brightly lit room, poking and prodding, using the remains as fleshy 3D road maps to the densely packed, vastly complex systems of veins, arteries, nerves, ducts, glands, muscles, tendons and other elements that make up the human body.
     "Probably a genioglossus of the tongue," says Andrew Hantel, gently lifting a stringy beige mass of flesh atop the neck of a cadaver, its skull gone, the trisected head peeled back like a banana skin.
     "Where is the horn of hyoid?" asks Wes Barry, referring to a bone that supports the tongue.
     The class is "Structure of the Human Body," better known as gross anatomy, for centuries the cornerstone of a doctor's education (the name has nothing to do with disgust; "gros" is French for "large"). For most of that time, medical students had to use stealth when acquiring bodies to dissect, plundering fresh graves and bribing officials at pauper's hospitals.
     Stritch gets its bodies in a far more direct manner, paying $1,500 apiece to the Anatomical Gift Association of Illinois.
     While books and computers are helpful—entire human bodies can now be explored online —it isn't the same.
     "We have a lot of computer resources," says Dr. Frederick Wezeman, director of gross anatomy at Stritch. "But the actual experience of dissection is elemental to the learning of medicine. Nothing can really replace anatomical dissection by the student."
     Students in olden days had a habit of treating cadavers irreverently, placing them in comic poses—playing cards or smoking pipes—and photographing themselves clowning around with them.
     That's taboo today. The practice at Stritch—and many medical schools worldwide—is to conduct ceremonies of thanksgiving to those who donated their bodies, though the actual beneficiaries are not the donors but the students, who hopefully will become better, more caring doctors when confronted with living patients.
     "We try to keep the students focused on the fact this is a human being, as opposed to just an anatomical specimen," says Dr. Wezeman.
     "The students understand that these cadavers aren't just meat," says the Rev. Jack
O'Callaghan, senior chaplain to the medical school, who enters the room just before 8:30 a.m., when the cadavers are covered with white shrouds.


'THESE SILENT TEACHERS'
     The ceremony begins with Sister Brenda Eagan, director of the university ministry.
     "The first time you gathered in this anatomy lab, everyone looked nervous," she says. "That was Oct. 12, and you gathered here to bless and thank these silent teachers for offering themselves."
     She is followed by Dr. Wezeman.
     "Someone, some time ago, before you arrived here as a medical student, after thought, prayer, conversation, reflection and emotion but with full intention, made a decision on your behalf," he says. "You thus became a beneficiary of a gift from a total stranger. . . . We hope you will always remain appreciative for this gift."
     The 23rd Psalm—"Though I walk through the valley of the shadow of death"—is read, and a pair of students, Mona Patel and Dan Micheller, offer reflections.
     "We must not forget to recognize the real contributors here, which are these respectable bodies before us," says Patel. "Their one altruistic act has changed many things about us. . . . I wonder if they knew that they are gifts that would not only allow us to open a body full of anatomical structures, but a whole new chapter into our personal development. . . . I value that this stranger, whose real name I will never know, has allowed me to examine, palpate and learn from his human body. . . . What I really would have loved to do is hold my cadaver's hand and say a sincere 'Thank you.' "
     "It's been 10 weeks since we first set foot in this anatomy lab," says Micheller. "Ten weeks since formaldehyde became our scent of choice. Ten weeks since the beginning of our remarkable journey. Ten weeks since we unzipped those white plastic bags, lowered the wet sheets and were introduced to our traveling companion and true anatomy teacher. . . . Take a moment to think about the things we get to do every day—from feeling the unique texture of lungs, to peering inside a human heart—things others can only imagine. In this process, it's easy to view the cadaver as a biological specimen, however, at the same time, minor details—bright pink nail polish, whiskers on an old man's cheek—remind us of the humanity of our cadavers."
     While these students avoid the mockery of bygone days, they are still students, and do indulge in a bit of gentle lightheartedness by naming their cadavers—Gertrude, Sally, Mildred—"old people's names," explains one, apt since the majority of donors were elderly.
     As soon as the ceremony concludes, the sheets are drawn back and the students return to studying—in the morning, they'll confront these same bodies, with numbered tags marking structures they will identify—or fail to identify.
     "Where's the inferior laryngeal artery?" asks Drew Benjamin.
     Emil Fernando expresses a sentiment that isn't surprising in students who, having crammed to learn each strand of a human body, are now confronted with the real thing and required to name any given part.
     "Everything looks the same!" he exclaims, gazing hard into the jumble of flesh.

        —Originally published in the Sun-Times, Dec. 23, 2009

8 comments:

  1. If you're not interested in having a traditional cemetery burial, you may wish to state in your will, body to be donated to medical science. Another way to give back to the community, a recent celebrity to do so was Larry Lujack.

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  2. I've done that, but people should be aware that there is a cost now (there didn't used to be - they just came and picked up the body). Now the donation has to go thru an undertaker to prepare death certificate, pick up/deliver the body, etc. I'm not totally sure all that "etc." entails, but it costs now - about $900. I remember this column and have since made plans and prepaid to donate my body. It's kinda of nice, and a little weird, to know more about how it works.

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  3. My uncle passed away last year and had his body donated to Western Michigan University. They covered all costs of transport, certificates, and cremation. Once a year they hold a nice memorial and reception for the families of the deceased to give thanks for the gift they received. It's a ally great program WMU has set up. Very respectful.

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    1. I wish we'd known about that when my brother died. We had to pony up $500 for a funeral home to deliver his donated body.

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  4. Neil,

    I do not know what "Mosaic" is. Out of print? No longer published?

    Is the ceremony you describe unique to Loyal Med or would there be a similar one at Northwestern or Chicago?

    If the question is not appropriate for the blog page, tell me about Mosaic at ristow@mac.com.

    Thank yo.

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    1. https://mosaicscience.com/

      https://mosaicscience.com/people/neilsteinberg

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    2. There's some interesting information about the changing relationship over time between medical students and cadavers in the book Stiff: The Curious Life of Human Cadavers by Mary Roach. The whole book is pretty well-written and fascinating, although I may never have picked it up on my own (read it with my book club).

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    3. Re: that Steinberg page from Mosaic that Coey linked to: "A no. 1 best-seller among recovery books on Amazon, it is being published in paperback in September 2017."

      Neil, I see from your bio on EGD that the paperback has actually been pushed back again, to June, now. Which I imagine is a good thing. Don't know if that sentence from your bio on Mosaic is something you'd bother having corrected, or not...

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