Anatomy 101

And then you make the first incision....

          A critical part of medical school for first year students is anatomy lab. Although the specifics of how the course is constructed may vary from school to school, one thing is the same: this is where medical students must dissect a cadaver. That's a dead human being.

          I cannot describe how excited I am for medical school. I will finally get to study the things I have been interested in for years. The waiting game will be over. I won't have to force myself to memorize the intricacies of general chemistry. Instead, I will finally learn human biochemistry, disease, and diagnosis. As excited as I am, though, I have to admit to having a lot of apprehension about dissecting a cadaver.  While I have to admit they make it look really cool - and somehow weirdly sexy - on NCIS, I don't think that's quite how it's going to be.

See?  They make it kind of awesome.

          It's not that I think it will be gross or that I'm afraid I'll react badly. I know myself well enough to know that's not the case. I have enough experience from being an EMT and viewing surgery to know that the sight of blood and the weird things inside us don't gross me out. In fact, whenever someone I know has an injury or scar or something, I usually ask if I can see it or even touch it.

          It's more about the fact that the cadaver was once a person and how that relates to my own hang-ups with the concept of death. The cadaver was someone's baby once, somebody's friend, sister, brother... maybe even mother or father. In all likelihood, somebody once loved that person that I will be cutting to pieces.  And that's sad.  It's so sad.

          It's also the idea that the person was once alive... and now they're not. A moment came and went where life met death, and now the things that made them who they are have gone, leaving behind just a body. A shell. I guess on some level it raises the idea of my own mortality and that of those I love. Without exception, we will just be a body one day.

          Then the last idea is that I feel guilty. If I were to suffer an untimely death, I am a registered organ donor, but I don't see myself ever donating my body to science. This person did that. They were willing to have their body cut apart and have all the different layers of tissue exposed and scrutinized after their passing, a sacrifice that I am unwilling to make.

          I have often thought about how I can honor my cadaver, some kind of symbolic display to offer respect to the person it once was and the sacrifice of their body.  This is one of those times I wish I was religious.  It would be so simple to do a quick cross and maybe offer a little prayer.  What can I do, though?  Maybe tell the cadaver thank you or something?  Then again, I don't want to spend my days talking to the cadaver like NCIS's Ducky.  Maybe when I get there whatever I'll need to do will come out of me spontaneously.

          At medical school interviews, the tours are typically run by students.  They are usually very informal, allowing the opportunity to ask a variety of questions. I never miss this opportunity to ask what the student's first time with the cadaver was like.  To my surprise, I haven't met anyone who had a problem with it.

          One student told me he had been nervous about it, but that it all happened too fast to have time to worry about it.  They went into the lab, and within a few minutes they were making the first cuts.  He was never given a moment to realize it was a person, and I have to wonder if the anatomy instructor purposefully handles the class that way.  That was kind of helpful to me.  I am nervous about it, but I feel like adding some urgency to the situation would be toward my benefit.

          Another student told me she was fine with it, but another student in her class had some difficulties.  Apparently she started to get naseous, so the teacher gave her the afternoon off.  I have looked up cadaver experiences online a little bit, and from what I understand teachers are on the lookout for students who are having trouble with it during the first few class sessions.  That's definitely really good news for some students; I'm sure a fair number of kids get a little queasy from it.  Personally, I'm just worried about how I will feel about it.

          Conversely, I know some people who are excited about it.  One student I volunteer with thinks it will be really exciting to learn anatomy with a human body.  I can understand the excitement, but his verges on disrespectful without quite going over the cusp, and I have to admit that it kind of bothers me.  I can understand excitement about getting to learn relevant anatomy on the best model possible... but it's still a human being.  Or at least it was.  Another student who works with us has worked with a cadaver.  She explained that it wasn't very stressful; you just have to compartmentalize your feelings.  I have to admit I'm not completely sure what that means.

          The final viewpoint I got is from my old advisor at Cornell, a clinical psychologist for whom I have great respect.  He told me that some students have trouble with it at first, but during the adjustment period, duty wins out.  You work the cadaver because you have to, even if you're struggling with it emotionally.  After a while, he explained, you just get used to it.  He told me the same students who struggle with it early on will be eating a sandwich with one hand and examining the cadaver with the other just a few months into medical school.

          I think this both helped me and scared me.  It helped me to know that I would, in all likelihood, become comfortable working with the cadaver.  The scary part, though, is that it sounds like the comfort comes from being desensitized to what you're doing, and I don't want that to happen.  I want to be a doctor, because I truly care about people and truly and deeply want to help people.  I know that medical students are supposed to suffer massive, testable losses in empathy over their four years of school, and that scares me.  And I don't want it to start on day one, with my cadaver, before I even get to meet my first patient.