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The Lessons of Gross Anatomy Linger

Robert Saul, MD explains why the experience of learning human anatomy from a cadaver is an awesome one.

I recently received a notice for a 50-year reunion for college graduation.

What that signaled to me was a 50-year anniversary from the start of medical school.

Wow, a half of a century ago I started on my journey to become a physician!

That prompts two quick questions –

1) would I do it all over again?

2) Has it been worth it?

And the reply to both is a swift YES, but today I want to discuss briefly my initial journey and the awesome responsibility that medical students carry early in their careers.

 

For some admittedly selfish and some honestly altruistic reasons, I decided that I wanted to become a doctor, but I made the decision midway through college.

I spent the last two years of college glued to science books to get the necessary background credits and then crossed my fingers for the application process.  Getting into medical school was very difficult in the early 1970s.

I was initially waitlisted, and it looked like I would need to work in a medical setting for a year and then reapply.

The night before classes started (yes, about 12 hours before), I came out of a patient’s room in the local hospital to find the pre-med advisor from my college (Colorado College).

I had literally just changed a bedpan and was shocked to see him.

He said the Dean of Admissions (University of Colorado School of Medicine) had been trying to get in touch all night—there was a spot available in the morning if I still wanted it.

Well, I took it and have never regretted it since.

 

But then I needed to earn this honor.

Everyone enters medical school with their own unique circumstances, and then they are put through a relatively rigid curriculum to make sure that they capable to retain a mind-boggling amount of information and to use it in a distinctly humane manner.

 

Everyone enters medical school with their own unique circumstances, and then they are put through a relatively rigid curriculum to make sure that they capable to retain a mind-boggling amount of information and to use it in a distinctly… Click To Tweet

 

One of the first trials is a distinctive one to medicine—gross anatomy.

Gross is an unfortunate term given its often pejorative use. It is meant to distinguish the study of anatomy that is grossly visible versus anatomy that is only seen by the microscope (microanatomy). My medical school delayed the gross anatomy class until the second semester of the first year knowing that gross anatomy was potentially emotionally jarring for freshly minted medical students.

 

The experience of learning human anatomy from a cadaver is an awesome one.

When I say awesome, I mean it carries an awesome responsibility to be given the opportunity to learn the anatomical structures of the human body on someone who made this donation to help teach doctors-in-training.

The donor made the conscious decision that their body could provide a useful service beyond their lifetime. It was then our privilege to use this body in a respectful way and maintain our proper composure.

 

A cadaver donor makes the conscious decision that their body could provide a useful service beyond their lifetime. It is then our privilege to use this body in a respectful way and maintain our proper composure. Click To Tweet

 

If I am honest, it was difficult to maintain our proper composure at all times.

There were cadavers all around in varying states of dissection.

The smell of formaldehyde was at times overpowering and always lingered in our clothes after leaving the gross anatomy lab.

The overwhelming amount of knowledge needed to master the anatomy class was daunting and stress-producing.

Nervous laughter often broke out regarding the ability (or frequently the inability) to correctly identify certain structures.

 

I am sure that it seems very morbid to talk about such a topic.

Yet, now in retrospect 50 years later, I have an even greater respect for the donor that our group learned gross anatomy on.

She did make a significant difference.

Our cadaver (“Maude”) became our friend, our joint venture and at times our haunting reminder of the trials and tribulations of medical school.

My respect for her sacrifice has only grown through the years. She taught me so many anatomy lessons then, and those lessons have certainly lingered and morphed into life lessons over my career.

I suspect that she just thought that she was allowing us to learn anatomy.  We learned so much more about ourselves and others.

 

My respect for her (my cavader's) sacrifice has only grown through the years. She taught me so many anatomy lessons then, and those lessons have certainly lingered and morphed into life lessons over my career. Click To Tweet

 

I recently read an article by another physician about his gross anatomy experience.1

He shared similar thoughts about the humbling experience of being given the awesome responsibility of having a cadaver to learn human anatomy.

His descriptions demonstrate the great respect and eventual love that medical students have for their cadaver.  Yes, I dare say love.

His related experiences were so full of the empathy (em – within; pathos – suffering) for the donor and their family.

This is precisely the type of empathy that we seek as physicians-in-training and beyond in our careers and lives.

 

As I reflect on this experience, I am struck with comparisons to the movie, Saving Private Ryan.

As the army captain, Captain Miller (portrayed by Tom Hanks), is dying on the bridge, he leans over to Private Ryan (portrayed by Matt Damon) and whispers in a dying gasp — “earn this”.

I must admit it took me awhile to really understand the full magnitude of this request at his death.  He means that multiple lives were lost in an effort to find Private Ryan and to bring him home to his family (that had already lost their other sons in the war).  He means that Private Ryan needs to honor his fallen comrades with a life of service toward others.  He also means “earn this” in a much broader sense.

We all have a responsibility to each other.

 

Now what’s my point here?

It is my awesome responsibility to “earn this” opportunity to take gross anatomy, to respect this life of the donor and to use the educational experience in her honor and memory.

Though now clinically retired, I am forever indebted to the profession of medicine and how I have hopefully helped others and how so many others (colleagues and patients) have helped me. And I am particularly indebted to the early donor for my anatomy experience.

Though not alive, her contribution to our medical school class was certainly a “living” reminder of the good that we all can do.

Fifty years later, her contribution continues, and I thank her.

 

  1. Mathur M: Reflections: Cor Cordis. THE PHAROS Spring 2022, 31-32.

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