Point of View
It was the clatter of engaged student voices that surprised me. Instead of the quiet, somber space I expected, perhaps reflecting the dark tones of the magnificent Eakins paintings, The Gross Clinic or The Agnew Clinic depicting medical students observing a dissection in a theater. In contrast, this was a large and brightly illuminated room with 34 teams of four students working under close faculty supervision to study the remains of persons who chose to make vitally important gifts to medical science by donating their bodies to our School of Medicine. The study subject of the day was the human forearm.
The bodies on the dissection tables, resting in open plastic bags and identified only by age and cause of death, many with their faces discreetly draped, at first seemed to me more like plasticized models than human remains exhibiting a range of morphologies. I could barely detect a very faint odor of formaldehyde in the cool room. High definition video monitors above the tables illustrated forearm structure that gloved students used to guide their progress. The bodies wore cloth mittens and foot booties purchased by students, my host said, because the high surface to volume ratio of these extremities would otherwise cause them to dry out. Listening, I thought to myself that physics students might find this example more memorable than traditional discussions of this ratio.
Given the opportunity by my faculty host and standing by the side of the student team at one of the dissecting tables, I could just begin to appreciate the complexity of the revealed anatomical structures. I saw, for example, that a nerve running the length of the forearm was as thick as a rubber band, not at all like the filament that I had envisioned. The students were completely engaged in the task, taking turns with the dissecting instruments. At a nearby table, the chairwoman of our department of anatomical sciences was demonstrating a technique to an attentive student team.
A typical body might remain in the laboratory for several months as the dissection progresses through stages, organ by organ, structure by structure. Dissected remains are placed in an individual storage container for eventual cremation to be returned to families requesting them. My faculty host told me that at the year’s end there is a memorial service that deeply appreciative students attend honoring those persons who contributed their bodies.
An observer could only be impressed by the intensity of student engagement in the process. Unlike too many undergraduate labs, I observed no passive students. It was apparent that this first-year medical school class, perhaps 50% of whom were women, regard this course as an important introduction to a life in medicine and research. Very few students drop out because they find the subject not to their liking and, given the engagement and motivation levels of the students I observed, I was not surprised to learn that the pass rate is very high. As the visit ended, I thought the deceased persons and their families would be pleased if they could see how these medical students and faculty members organize and conduct themselves in an activity so important in the education of future physicians and medical scientists. If more citizens knew about laboratories like this, perhaps many might be encouraged to donate what, as my host said, are priceless gifts to the science and practice of medicine.
Perhaps the future will see a national discussion of the importance of body donation as well as the development of more effective plans to obtain donated organs for transplant. Until then, teaching scientists and science educators can mention the importance of anatomical dissection to undergraduate students, arrange a visit to a medical school, and enrich their own understanding of a science pioneered by Galen and Vesalius marking the beginning of modern medicine, nearly 2,000 years ago.
Lester Paldy (lester.paldy@stonybrook.edu) is Distinguished Service Professor Emeritus in the Department of Pathology at Stony Brook University in Stony Brook, New York. He was JCST Field Editor from 1982 to 2008.