The Lessons We Learn from Death: A Perspective on Cadavers in Medical Education

By Edrea Khong

The room feels sterile, a little chilled, tucked away in some mystical portion of the building. There’s an odd buzzing noise in the background, a quiet reminder of the infrastructure at work to make the room as pleasant as possible.  The students are hushed as they shuffle along quietly, filling the room with uncertainty, excitement, and most of all, curiosity.  Perhaps some sweat nervously under their long white coats, while others’ hearts beat wildly in anticipation of the coming lesson.  Others still may lounge casually, experienced and in their element. The occasional fainter is, apparently, par for the course.

Some students pay close attention to the instructors – make sure the vents are on, open the table slowly, take care that the collected fluid stays in the bag and not all over you, keep the vents uncovered, only expose parts you are working with, apply preserving liquids liberally after use, close up the table and lock it – the stream of instructions, though important and necessary, feels endless.  Most students are more worried about what lies inside the bag on the table and pray that someone else in their group has paid attention.

Clustered around the long tables, the warmth from the students’ bodies seems to slowly seep out towards another body, decidedly not so warm.  The students shiver, although whether from fear or excitement, only they will know. For many present, this is the first time they have seen a cadaver up close.

Does death still linger in the air?  Some might say yes.  It has a vaguely unnatural feel to it though, bodies carefully preserved in that moment for years. If medical students are expected to become accustomed to death, this is surely a good place to start.  When told that these cadavers are for educational purposes, there is a strange sense of dissociation that occurs, as if permission has been granted to lock away one’s feelings and emotions for the time being.  This is not to say that students are rude or intrusive, in fact quite the opposite.  There is a feeling of awe and utmost respect for those who have so bravely agreed to give all of their physical selves to science, so that medical students can learn the intricacies and wonders of the human body.  There is no other, better opportunity for this learning to happen.  No live human body would ever be opened and explored so thoroughly, and no animal exists whose anatomy is as comparable to a human’s as, well, another human.

It is a humbling privilege, this gift that medical students are given by strangers whom they will never truly know.  The students might concoct stories about the bodies they study, drawing inspiration from his or her old scars – battle wounds or surgical? – perhaps an old fleck of nail polish, a chipped tooth, piercings, or faded hair dye.  Although eventually somewhat desensitized to what can be a very emotional situation, the students still yearn for some semblance of a connection to the body in front of them.  They are all too aware that each person in that room is exactly that – a person loved and missed by countless people, who is proud of the things he or she accomplished, who maybe even holds regrets about his or her own life.  It is with these things in mind that students go about their dissections, their peeking and prying, their learning.  Carefully, even reverently.

Across the hall is another room which has a distinctly macabre feel.  Here are heads, hands, legs, hips, and more, all floating in jars of embalming fluid.  Lining other counters are hardened, preserved specimens, mostly limbs in which the deep muscles and ligaments of the forearm, hand, leg, or foot can be probed.  A strange sort of body parts graveyard, all handled with love and care.  Casual observers would likely be repelled by the students’ fascination with the eerie figures, and might call their sanity into question.  Some students initially feel the same way, yet once they immerse themselves in these studies they begin to enjoy the treasures which the rooms contain.

Long hours of frustration are spent here, trying to determine whether the piriformis is indeed visible from this angle, debating the differences between a tubercle and a tuberosity, or frantically decoding the fissures and foramina of the skull.  All this is done for that feeling of sweeping triumph when, after trying ten times and studying the flipbook for half an hour, one finally identifies all the features of a specimen correctly.  Sadly, this is often followed by a sinking feeling of despair upon starting the same vicious cycle again with the next specimen, with a hundred more to go.  Still students soldier on, doing their very best to become masters of anatomy and appreciate the marvellous wonders of the human body.

Some amusing phrases often overheard in this room include: “I wish I had a laser pointer.”, “Wow, that’s the nicest shoulder I’ve ever seen.”, “Come look at this brain, it’s my favourite!”, “This one has all the butt muscles.”, “Wait, that’s the back, not the front?”, “How on earth is this oriented?”, and perhaps most frequently, “They won’t be mean enough to put this one on the exam, right?”  Students really do develop an attachment to the specimens they have the privilege of learning from, even if much of the time it is a love-hate relationship.  Spending long weekend hours studying the specimens and sneaking in for one final peek between exams is the norm amongst this dedicated group of learners.  After finishing final exams, the students are left with a deep sense of gratitude for the lessons that these cadavers have taught them.

So what lessons do we learn from death?  In the case of medical cadavers, the lessons are much more than just understanding human anatomy.  We learn to try new things, to overcome fear, to explore.  We learn to familiarize ourselves with death, to remind ourselves to be compassionate and empathetic, to always be kind and respectful.  We learn to think about patients’ stories, to consider their pasts, to be curious about their lives.  We learn to work with each other, to learn from each other, to push each other.  We learn to be thorough, to be diligent, to be persistent.  We learn to remember our humanity, to celebrate life, to understand death.  We learn to check our pride, to be raw and honest in our studies, to be ourselves when we work.  Perhaps most of all, we are reminded of the immense privilege and responsibility we have as medical students and future physicians, and are challenged to show why we deserve them.  These lessons are arguably more important than knowledge of anatomy, as they shape the people we will become and influence the way we will interact with patients now and in the future.

Working with cadavers as part of medical education is an extraordinary opportunity that we should always be grateful for.  So thank you to those who gave their bodies to us and to the families of our donors who support our studies.

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