At a recent alumni meeting, I was informed that my former school of medicine now holds an annual thanksgiving service for the family of body donors who ‘had given their last breath to the study of medicine’. How apt, how touching, how appropriate and how primal.
Working on a cadaver gives us so much and teaches us so much; much more that 3D imaging, more than plasticised models and more than virtual reality. Such standardised techniques would lead our students to believe that the anatomy of humans is standardised and uniform. Instead the universal medical response applies – ‘It varies’.
Tactile proof of the intense difference of one individual from another is presented to us with anatomy studies on cadavers. I remember the intense discussions we used to have over special coffees called cappuccinos which were then a marvellous novelty to us all. One such conversation with my university colleagues yielded the gem – ‘If you think people look different from each other on the outside, just wait until you see how very different they appear on the inside’.
Artificial presentations would also delude us into believing that it would be straightforward to locate, identify and isolate anatomical structures. Anyone who has ever dissected out or tried to trace the path of the brachial plexus definitely knows otherwise.
However, there is so much more to human dissection than mere knowledge. In some ways, it is an initiation into almost magical arts. Once we are guided to take a knife and plunge it into the skin of a cold, dead, naked human we are forever different. We are freed from so many taboos held by genteel society - they suddenly become irrelevant. From there on in we are obliged to accept death; we are obliged to no longer react to nakedness. We are expected to bypass the barrier of the skin and see what lies beneath.
From that day on, when we see people affected by trauma that breaches the barrier of their skin we are no longer just appalled or overwhelmed by gory, messy chaos. No, we see structures; depending on the area affected we see subcutaneous fat, tendons, muscles, fascia , bones and arteries amongst other things. It changes us. Once done, our values of decency and propriety are forever altered. Actions that were once unthinkable, even forbidden, are now routine. We now have the duty to undertake the intimate examinations of strangers without qualm or reaction but always with care and politeness.
However, society responds differently to us as well. The mother of one of my classmates reacted strongly when her daughter started anatomy. She insisted that her daughter use the shower in the outside bungalow and change her clothes before entering the main house. Cynics that we were, we, her colleagues, compared such actions to the ritual cleansings undertaken in ancient times by those who dealt with death. No other families reacted so blatantly but even so many were still uncomfortable with us as we were doing anatomy.
We were, and still are, suddenly treated differently by society, people are almost afraid of us - we do not follow taboos, we handle the dead, we keep secrets, we have secret knowledge learned from the dead.
Is this one of the reasons so many seek to belittle us, to condemn our knowledge as irrelevant, to promote treatments and systems that we decry? Who knows?
We are forever obliged to the body donors. They have educated us and changed us in so many ways. What they have taught us lasts our whole career and beyond. We could not be who we are without them.
Associate Professor Chris Hogan