Hello to all,I’d like to ask all of the experienced medical students/docs out there just how bad it really is to do the lab dissection of a human corpse. I’m not worried about the sciences, but this topic really gives me pause. I love all facets of Biology, but truthfully, had trouble with the frogs and the fetal pig. Can’t imagine doing it on a human! How long does the course last in med school, and how did you get through it? Did it give you nightmares? I have to say that this topic is the only thing that dampens my enthusiasm for med school. Thanks! Siobhan
Initially it definitely feels uncomfortable. For a couple of reasons you get used to it. First of all, you just get used to it and the surreal becomes commonplace. Secondly, you are under pressure to learn a whole lot in a short time and so you dive in to try and learn everything you need to know. Third, it is fascinating and awe-inspiring to see so much of the human body in this way. Fourth, schools promote respectful treatment of the donor bodies; at GWU they were occasionally referred to as “Your first patients.” There was always a tangible sense of appreciation for the gift these people made so that we could learn.
Back in the day, before I considered being a doctor, I used to think that I’d happily donate my organs but no way would I ever consider donating my body for use in a medical school. Now, I think I would. It is an awesome gift.
I highly recommend a book called “First Cut: A Season in the Gross Anatomy Lab,” name of author escapes me. He follows the first-year class at ?Emory (I think) and describes what they learn and how. I loved it.
Mary
http://studentweb.med.harvard.edu/jmw16/html/anatomy.html
is my reflection on my own experience of this. (Including an older student named Siobhan in the story, too.)
It’s harder for some than for others. But it’s also really really incredible, and I would say indispensable. It’s different than some other gross stuff you’ve had to do because (hopefully) it inspires a sense of reverence that is unique.
It is sometimes quite off-putting, sometimes upsetting; but most people get through it one way or another and I think almost everyone feels as if they get something out of the experience.
joe
I was worried about this, too.
We had a “Meet and Greet” session before our first lab. We met our lab partners and our cadaver. We were encouraged to examine the body, to look at the hands and face (the most personal parts, it seems). This really helped me. Most cadavers at our school are older people. I was concerned that I would either know the person (having worked with older people in the area) or that the person would look like my Grandma. It turned out that we got the youngest person- late 30s.
You’d think this would be creepy, being so close to my age (33). But it actually helped me to relax. It was like a breath of fresh air and I knew things would be okay.
Most of the cadavers at KCOM are directed donations. All body parts are saved and identified by number, and our cadavers are cremated after the course is finished. Families can then receive the ashes. A few families even come in person to get the cremains, and some even ask about the class (one even wanted a tour of the lab!). I certainly would consider donating my body to a medical school, especially after being a med student. I can’t imagine not getting the wonderful hands-on experience of human dissection in medical school.
As far as the actual dissection, it’s fine. We spend time grumbling about our cadaver’s lack of body fat (he was fairly fit) and how difficult it is to find fascial planes.
I wonder about the things that led to his demise and how happy/miserable he might have been. Mostly, we worry about finding everything and REMEMBERING what things are named. Not to be disrespectful, of course.
We start dissection next week. Today I went in to spend some time alone with our donor’s body (“cadaver” just does not seem right), thanks to our anatomy instructor. My father died very recently, and I did not want to see my next dead body for the first time when there were another 100 people in the anatomy lab.
In our lab, the head, hands, and feet are covered until later in the course. This made it much easier for me to look at the body. The smell, the color, and the texture are very un-lifelike; they are not even like a dead body. Also, the lack of fluid had made the skin on the breasts, for example, crumpled like paper, which seemed very unreal. I found the pubic area very disconcerting; I wanted to cover up the woman.
I spent my time thinking about what this person had done in her life, noticing features of her body like her abdominal scar, perhaps from a cesarean. I found myself trying to connect with her in some way, but there was nothing there to connect to; there was nobody there. It was an interesting experience of thinking that perhaps really, at that stage, the spirit has completely left the body and all that is left is a physical shell of material. I think this distinction will make it much easier to cut the body next week.
Here is a link to the book on amazon if you would like to look at it a bit closer:
http://www.amazon.com/exec/obidos/tg/detail/-/031219546X/104-5881417-5978330?v=glance
E Lynne
Very good question. Some med schools, like mine, have prosected cadavers. We don’t dissect, other people do. We just go in and examine them. Also, we only uncover them as much as we need to, we keep the rest of their body covered. If we are looking at the thorax, their heads and lower bodies remain covered. It is quite respectful really, and even though people are working furiously in there and not thinking deep thoughts about the people they are examining, respect, awe and appreciation pervade.
We had a chaplain available the first day of lab, and we have full-time counselling staff as well.
We were told that some of our donated bodies were people who, in stating the reason they donated, said they just wanted to go out an MSU Spartan! How’s that for school spirit?? I find myself cheerily saying “Well thank you sir” before moving on to examine another. It is a spontaneous thing, not a conscious thought. The magnitude of their donation pervades, even though things go so hard and fast you don’t really have time to contemplate or think deep thoughts about it.
I have classmates who will never “get used” to it. That’s OK too. I wouldn’t want them to.
Hi there,
It wasn’t difficult at all to dissect a human body. Once you start looking for structures and putting everything together, dissection is great fun and a superb learning experience. I also loved putting the muscles into compartments and figuring out their origins and insertions. I also loved exploring the anatomical variations in ducts and vessels. Gross Anatomy/embryology was one of my favorite courses. Except for the formaldehyde that permeates everything that you encounter, dissection is totally awesome.
Natalie 
Just yesterday there was a story on NPR about the anatomy lab for 1st year med students at University of Maryland. Here is the link to the story.
http://www.npr.org/features/feature.php?wfId=3924247
Jill
I remember reading about virtual dissection [interactive software] being used in some med schools. Is that correct?
Here’s another article on anatomy lab:
http://news.bostonherald.com/localRegional/view.bg?articleid=44897
As several have already said, it is a bit odd at first, but almost everyone gets fairly objective about it fairly quickly. No one in our class passed out on opening the body bags. A few people felt a little queezy because of the smell and effects of the formalyn, and the school provided respirators to anyone who wanted.
I suspect there will be disagreement on this, but there is something about working for the parts; digging and discovering on your own, that enhances the learning I think. It is so much more real than computer dissection.
Good luck with it - It is a unique and very priveledged thing to be able to do.
Steve
Hmmmmmm…how do you elaborate on this? Let me preface this with the fact the most folks become a physician for some variation on a humanitarian theme. So, dissecting another human being appears rather incongruent. But, I adamantly feel that this process is critical in the process of becoming a physician. Yes, prosections, simulators & models are improving - but they simply cannot supplant the tactile knowledge you acquire from having been there & done that.
That said, the art of coping with a human dissection is the beginnings of the development of your ability to objectify a situation. When dissecting, you become so focused on the fascinating aspects of what you are doing that you forget that your project was someone else’s Aunt Minnie. Don’t get me wrong, anytime you think about it - at least you should - you feel a deep & sincere appreciation for these people’s donation of their remains. But, during the process - it becomes a project. To facilitate this, either accidentally or intentionally, the more “human” parts are usually covered: face, hands & feet. You will be surprised at which parts are so inexorably human that you cannot objectify what you are doing. For me, dissecting the hands, feet & head/neck were the most difficult from an emotional perspective.
OK…I mentioned this was the initial stages of the evolution of your capacity to objectify. Why is this pertinent &/or valuable? Well, when the poo-poo hits the fan…emergent or critical situations…you, as the physician ABSOLUTELY MUST maintain an objective perspective because YOU are the (or a member of) the decision making body. Meaning, you guide the resuscutation process or are managing critical phases of care where a loss of the objectivity can have severe & negative implications on the outcome. More simply put, if someone is dying on your table in the ED & you’re focused it being Aunt Minnie or the cute little kid next door YOUR judgement will become impaired & that is when mistakes are more likely to be made. At such a critical juncture, this is where mistakes can be least afforded.
I fully acknowledge that this is in contridiction to most folks concept of the humane physician & for practitioners in roles where these sorts of situations are uncommon, this ability is less useful. However, I assure you that in the course of your education & training - this skill will serve to sustain your own emotional health AND potentially improve pt outcomes.
Of course, there is another side to this. In my humble opinion, an equally important & difficult to master skill is the ability to know how & when to shelve this clinical disassociation. Afterall, we are all human & as physicians, serving other humans, we must not deny or hide our own humanity. But, we must protect our own humanity for our own sanity, preservation of those we love & for the benefit of oour pts.
Loosing patients, esp those you’ve cared for over a duration of time, alwasy hurts at some level. If you have lost capacity to feel this - then you’ve been doing this too long & are burned/burning out.
Conceptually complex, yes…very hard to delineate w/o sounding callous, cold & uncaring. But these sorts of survival skills are also the root of the dark humor that not only will you witness; but most likely also participate in. These are things said & taken as humorous about situations that would under normal circumstances would be viewed as horrific. Again, it is part of objectifying the situation to maintain objectivity & preserve the self.
I would love to hear comments/feedback on my post
Dear Dave,
Thanks so much for your heartfelt, eloquent reply to my question about human dissection. The points that you raised are truly the difference between nursing, and being a physician, at least for me. As a nurse, I never could forget that I was working with someones “Aunt Millie”, and the families,as well as the patients, were always uppermost in my mind whenever I rendered care. I found it very hard to learn to be objective, and professionally distant, and consequently ran into some trouble as a nurse with burn-out. I would think of patients and their families at home, on my days off, out hiking in the woods, that sort of thing, so my own emotional distress was rather high when things didn’t go well for my patients. And that is what truly scares me the most about the human cadaver…I will indeed know that this person was someone’s wife, mother, sister, and I will start to grieve for this family’s loss.
However, you, and others, are telling me that it isn’t so, and I find that comforting, and something to hold on to to get me through the experience, should I make it that far. Sincerely, Siobhan
Hi there,
I did a pathology fellowship between my second and third years of medical school. This fellowship included spending some quality time in the DC Medical Examiner’s office and the Northern Virginia Medical Examiner’s office. My first autopsy was a 1-day-old child who had been found dead by her mother the day after her birth. When I heard that this would be my first forensic autopsy (with a pediatric forensic pathologist), I thought that I was not going to be able to get through this. It turns out that as I carefully searched for the cause of this child’s death, I realized that the best that I could do for the child and it’s family was find a cause for this tragedy at all cost. There isn’t much of grieving process when you are looking for pathology or, in the case of gross anatomy, structures. Your job is to find what you need to provide the best care for your patient. In both cases, it’s not the body that you are caring for but the patients who will benefit from your systematic study of this body post mortem. You will use all of your powers of observation and reasoning to find structures and apply their locations to patients who are living. Sure, you are grateful for the gift of this anatomical donation but your future patients will only benefit if you use this donation properly. In terms of the forensic autopsy, the grieving is to be done by the parents and families and the work at finding a cause of death of is to be done my me, the forensic pathologist. It was a stark but great learning experience that I keep with me at all times. In the 40 or so forensic autopsies that I assisted with after the first, I always kept in mind that I am looking for information and I have one shot to get it right.
Natalie 
After 2 weeks of dissection for our class, there is a marked difference between the “it’s a great learning opportunity” students and the students who are having strong emotional reactions to the experience.
Those of us who are having strong reactions seem to share the experience of having had people close to us die when we were present. Those who have been through anatomy lab before, or who have worked in organ donation, as EMTs etc., seem to be much more detached and to see it as a learning experience.
I think that, in the first 2 weeks of med school, both reactions are completely fine. I feel I am learning a lot by learning how to manage my own natural response to death.
What is most difficult is having the people in the second group disparage the others’ emotional reactions. It is particularly difficult when a 20-something says, “it’s no big deal, the person was “old”, they lived a good life, they wanted to give their body…” Some of our donors died of cancer when they were only 50 or 60, and I don’t see this as a wonderful end to a good life.
I see the marks of aging on the body, I see those same marks beginning on my own body, and I feel my own mortality every time I look at that cadaver.
I saw our cadaver at the grocery store tonight.
Well, not HIM, actually, but someone who looked a lot like him. I was taken aback for a second.