WORKING STIFFS

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Funerals for medical cadavers have become increasingly common of late. Natasha Lennard investigates the practice ...

Special to MORE INTELLIGENT LIFE

Last January more than 100 people gathered for a memorial service in an airy auditorium at the University of North Carolina at Chapel Hill. Clad in sombre dress, the audience dabbed moist eyes and listened to musical performances, speeches and poems written for the deceased. Half of those present had come to honour their family members; the other half—those who performed and read the poems—were paying tribute to people they had grown familiar with, but had never met.

The ceremony was organised by medical students who had spent the preceding months cutting open and peering inside these men and women in their anatomy lab. They wished to give thanks to the donors they never knew in life but came to know, quite thoroughly, in death.

Annual memorial services for cadavers have become increasingly common in America and Britain. “The services are a way to thank the donors and a way to thank their families for this tremendous gift,” said Kurt Gilliland, an adviser to first-year medical students at the university and an assistant professor of cell and developmental biology. “It is often the first time these students reflect on death, which is an unavoidable part of the profession they are entering.”

The memorial services mark a significant departure from the medical-school experience of yesteryear, when detachment and playfulness in the anatomy lab were acceptable coping mechanisms for students dissecting and eviscerating human flesh for the first time.

“Humour used to be encouraged,” said Mary Roach, author of the book “Stiff: The Curious Life of Human Cadavers”, which details the experience of donated corpses. “I’ve heard stories from earlier generations of doctors about how they would joust with the legs.”

Students are now encouraged to feel reverence and gratitude for their anatomy subjects. Dr Steven Abramson, vice dean for education, faculty and academic affairs at New York University’s Langone Medical Centre, believes that medical training now considers the human side of medicine in a way that it never used to. “It is part of a culture change,” said Dr Abramson. “When I was training as a physician, we never talked about our feelings when dealing with cadavers. I remember this huge football player walking into the anatomy lab and seeing the bodies for the first time. He collapsed and hit the floor. But now students express their feelings far more to their professors.”

Support groups and discussions about the emotions associated with working with a cadaver are integrated into the NYU anatomy course, Dr Abramson added. Now cadavers are presented to students as their first patients, a relationship that becomes profound from the moment the first incision is made. The Langone Medical Centre was also one of the first institutions to establish donor memorials.

Roach sees the shift as reflective of broader social trends. Anatomy courses that consider a student’s emotional education are further examples of an increasingly empathetic professional sector—one that understands the relationship between morale and productivity or effectiveness.

The practice of human dissection has long oscillated between concern for the corpse and the needs of the student. There is a record of physicians dissecting corpses in ancient Greece, but the practice was considered morally unsound. Use of cadavers remained prohibited throughout most of Europe until the 16th century, when in 1752 Murder Act allowed the bodies of executed criminals to be dissected for anatomical research and education.

By the 19th century the supply of cadavers from executions proved insufficient, resulting in a black market in corpses. Medical schools were willing to pay a high price for bodies, exhumed, murdered or otherwise. The notorious Burke and Hare murders, which took place in Edinburgh in 1827 and 1828, involved the serial killing of 17 people whose cadavers were then sold to anatomists. The resulting public outcry helped inspire the 1832 Anatomy Act, which increased the legal supply of cadavers for dissection by allowing doctors and students access to corpses that were unclaimed after death.

The use of human bodies for research has since been considered an acceptable necessity. But the recent emergence of advanced computer programs that simulate dissection has sparked some new ethical debate. The Peninsula College of Medicine and Dentistry in Britain, founded in 2000, became the first modern medical school to carry out its anatomy education without dissection. But most schools maintain that actual cadavers offer students crucial experience with their first human patients.

Fares Samra, an NYU medical student and the class president, vividly recalls his first experience in the anatomy lab. “It’s terrifying—a very strange feeling,” he said. “Most of the cadaver is covered in cloth, but you can’t escape the thought that it’s a dead person.” Yet he conceded that dealing with cadavers feels remarkably normal after only a short time in the lab. “It’s almost shockingly simple to forget what you’re doing. It becomes mechanical, separating a muscle from a vein—it’s not human," he said. "That’s why it’s so important not to lose sight of what’s been given to us.”

Samra fondly recalled the memorial ceremony he attended after his first year of anatomy. His class gathered in formal dress in a large NYU lecture hall. “We weren’t forced to go, but it was as widely attended as anything could be,” he said. "People read poems and short stories about their experiences. It was a really, really nice thing."

Following the ceremony, each student received a red rose. They then filed into the anatomy labs, where 20 cadavers were concealed in white zippered bags. “We placed the roses on our cadavers and were encouraged to write something to them—it gave closure to what was in some ways a traumatic and some ways an incredible experience,” Samra added.

Most medical schools across the country now encourage students to conduct some sort of memorial service for donated bodies. Only a few invite family members of the deceased to attend. This year, for the first time, students at UNC-Chapel Hill asked for photographs of their cadavers from when they were still alive. These images of smiling, happy people were displayed on a board during the service.

“Students gathered at the photo board and stood there for hours,” said Nancy Wang, the co-president of her class at UNC, who helped organise the ceremony. “The pictures showed them as so full of life. It was strange, but in a good way.”

Wang recognised the cadaver she had worked on immediately from a smiling photo the woman’s daughter had donated for the ceremony. “We had named her 'Addie' while working with her. But then her daughter was telling us about her mother, Fern. But it was a beautiful thing to find out who she really was, to see her smiling in the picture,” said Wang.

According to Wang, UNC honored 40 donors at the event, 30 of whom had family members present.

“I was very moved by the ceremony,” said William Tow, 73, a retired emergency medical technician whose wife, Judith, donated her body to UNC a year ago. “I said to the kids, ‘I don’t know which of you looked at my wife’s body, but I want to thank you all, and I hope one of you wins that Nobel prize someday.’”

 

(Natasha Lennard is a writer based in Washington, DC. Her last piece for More Intelligent Life was on the Creation Museum.)

Picture Credit: State Records NSW