Anatomy.
(aired on All Things Considered July 9, 2003)

 

Up in the anatomy lab, four of us gathered in front of the blue bag. Inside it was the body of one of the people who willed their bodies to our medical school for teaching. As a team, we were going to cut this person apart for several days a week for eight weeks. We introduced ourselves, talked a little bit, got our tools out. One of us said, `I feel like we should say something.' We were all staring at the bag and someone said, `Thank you.' Then we all said, quietly, `Thank you.'

We unzipped the bag and pulled the cloth off the woman's chest. At our teacher's suggestion, we made the first cut as a group. Siobhan held her scalpel, while Casey and Payman and I put our hands on her hand and her wrist. Together, we pulled the scalpel down the midline from the manubrium to the xiphoid process, the location of which I had just learned the day before. And I thought, `Now we start to become doctors.'

For the rest of our careers, this body will likely be our most lingered over and explored landscape of a real human interior. We'll remember that we held this woman's sciatic nerve in our latex-gloved hands, running it back and forth. The nerve was the diameter of my computer's power cord. Every time someone starts describing the symptoms of sciatica, we will remember her sciatic nerve.

We cut open the fascia that surrounded her muscles, thick fibrous sheets that looked like white packing tape. We touched her bones. We cut her ribs and pulled the front of her chest up and out. We pulled her heart out, cutting neatly through the aorta, a vessel as wide as a garden hose.

The most terrible thing we had to do was to saw her head in half through the midline of her face, starting the cut at the tip of her nose. Because the blood was drained from her body, the process wasn't wet or gory, but it was shocking. And yet only a few moments after we finished cutting and pulled her head apart, we discovered the baroque chambers of sinuses behind her face, and one of us said, `Oh, cool.' And we all leaned in, our own heads peering in close, gathering around and inspecting this new, amazing view. `What's this? How does this work?'

She was our donor, our benefactor, one of our first teachers. We knew nothing of her biography. Some other groups tried to give a kind of life to their bodies, giving them fondly rendered old people's names: Agnes, Herman. And at some point Casey asked, `Should we name our body?' But Payman said no. I asked him why. He said, `She already has a name.'

Through most of the anatomy course, I thought that it was our bond with her particular body that was the important thing about our path toward becoming doctors, and I think there's some truth to that.

But as the final exam approached, groups of us came into the anatomy lab outside of class, looking at the other bodies around the lab in order to study. That one had a cleared neck dissection where you could see the ansa cervicalis actually looping around. This one's leg muscles were well-defined. This one had tumors that probably killed her. We pointed at parts of many bodies, quizzing each other for hours. `What's that? OK, so what's that underneath?'

All of these bodies became case examples, no longer individuals but illustrations of larger principles. No longer was this about our donor, someone we felt connected to and protective of, even as we cut her body apart. Now it was about muscles and nerves and vessels and organs. The memory of the individual bodies began to blur together, and our donor became simply the first of many, probably for better and for worse. It was really then that our anatomy class starting making us into doctors.

 

copyright 2003 joe wright