This is a repost of an article I wrote for KevinMD. I hope you enjoy it. After a week of medical school orientation, followed by two weeks in the classroom studying cellular organelles and biochemical pathways, our class was finally going to start the centuries-old rite of passage that is human gross anatomy. For many students, it will be first time seeing a dead body. The anatomy lab is where future surgeons will make their first cut with a scalpel, without the pressure of life and death. It is where the ability to visualize organs and spatial relationships within a living body will be honed. It is also the place where medical students begin, for better and for worse, to become desensitized.
On the morning of the big day, professors lectured us, trying to prepare the class to walk into a cold room full of 30+ dead bodies. We were shown pictures of cadavers, videos on proper dissection techniques, and given rules and regulations of the cadaver lab. However, as is often the case, hearing about an experience is not quite the same as living it.
Our first round in the anatomy lab was smartly scheduled in the afternoon, hours after lunchtime. Although most students claimed to be excited (only one friend admitted to being hesitant about the whole thing), the locker rooms were very quiet. Before every laboratory session we use this locker room to change into scrubs, white coats, and close-toed shoes that will end up so stained, and smell so strongly that they will never be worn anywhere else. After changing, it is only a short ride up the service elevator to the cadaver lab.
As you walk into the lab, it is impossible not to notice all of the sealed black body bags sitting on stainless steal tables. The lab is a huge white room and also extremely cold. This is due to the constant current of cool air blowing through the room to prevent smells from stagnating. There are large orange “biohazard” buckets under each table that will be used to retain bits and pieces of human skin, fat, connective tissue, and other body parts that become separated from the cadaver over the course of the year.
On day one, after my dissection team of 3 is assembled around the table, we unzip the bag, and finally meet “our” body. He is an elderly gentleman, not skinny or particularly overweight. He is laying face up, although a sheet covers most of his body. During this first lab session we must flip our cadaver onto his stomach into the prone position. Honestly, I think this is done to make us appreciate the term “dead weight.” We then learn some surface anatomy on the back, finding bodily landmarks that can be felt through the skin, before sealing the bag back up, and quickly leaving.
Cutting begins a day later. Our list of muscles, nerves, and blood vessels to find and identify has been printed and laminated to prevent oil from body fat from soaking through it. My medical school, like most others, starts dissections on the back of the cadaver for two main reasons. The first being that it takes time and practice to become good at dissecting, and the chances of destroying the large muscles of the back are fairly low. Secondly, a cadaver’s back is one of the more impersonal body areas, thus protecting a medical student’s innocence just a while longer.
The hours seem to fly by in the anatomy lab. It takes a lot of time to cut through skin, remove fat, find the borders of muscles, and carefully dissect out delicate nerves and blood vessels. Entire afternoons are spent finding a handful of structures. For the first time in my life, I have cramps in the muscles of my hands. Luckily, my lab group develops a bit of a system. While one of us uses the dissection guide and illustrated anatomy atlas to be the “navigator” of the body, the other two cut, probe, and search the cadaver for familiar ground. Along the way we are constantly confronted with surreal moments. Hours into lab, while skinning the shoulder area, I realize I have been resting my forearm on the back of my cadaver’s head. I start to notice tattoos, nail polish, scars, or even pacemakers on cadavers around me. One of my lab partners says, “cool” as she flexes the finger of our cadaver by pulling on a tendon in his wrist. And it is cool.
Nothing about this experience is normal, yet it has become routine, as I spend two afternoons a week with my cadaver and will continue to do so for the next 6 months. Honestly, I haven’t had much of a reaction to being in constant contact with a physical reminder of death…at least not yet. Most days in lab, there just isn’t enough time to reflect on what I am actually doing. There is always more to do: more structures to find, or other cadavers to see for a different perspective. I think staying busy helps. As you probably know, medical school is full of “type-A” personalities. So when our professors tell our class that we will be tested on identifying structures from each cadaver, we can push aside thoughts of death, and the fact that these structures once belonged to someone’s grandmother or father or child.
That’s not too say that medical students are heartless or that the system is churning out apathetic physicians. Lab groups become attached to their cadavers. For instance, you’ve probably noticed I have been using the possessive “our” while referencing my group’s assigned cadaver. Most groups name their cadaver, and we use a sheet to modestly cover up areas of the body that won’t be dissected that day. We were lectured on the importance of respect and confidentiality towards our cadavers, but I think it was largely unnecessary. Our medical school class realizes what a sacrifice and gift that the donors of these bodies have given to us in furthering our education. Therefore, respect is always given to these cadavers. I sincerely hope that my donor’s family knows how much he was helping me learn, because seeing illustrated diagrams and attending lectures is no way to master this complex subject.
Within weeks of starting medical school, I take part in a tradition that has helped train thousands of physicians before me. Anatomy lab is a part of medical school that all physicians remember and have strong feelings about. However the act of dissecting cadavers sets me apart from 99% of my family, friends, and peers. Never is that more evident than on the phone with my mom trying to describe my day. I often will say that anatomy lab was “good” or “pretty uneventful today,” because I just don’t know what or how to say anything else. I guess you have to be there to explain what it is like to hold organs in your hands, to physically follow the path of nerves down the arm, or to spend hundreds of hours cutting apart another human’s body.