The Hastings Center Report

July - August 2014

Vol. 44, No. 4

Highlights

Editor's Podcast

This podcast player requires theAdobe Flash plug-in. You may also download the MP3 file via the podcast feed.


Subscribe

Order the Hastings Center Report
Unexpected Lessons from the Anatomy Lab
Medicine
Colleen Farrell, 12/14/2012

Unexpected Lessons from the Anatomy Lab

(Medicine) Permanent link

We put on navy blue scrubs, plastic aprons, goggles, and gloves and walked into the anatomical dissection rooms for the first time.Three other first-year medical students and I gathered around our assigned table on either side of a black body bag. We unzipped the bag and then peeled away the white sheet that covered the back of the old man whose body we would be studying.

I ran my gloved hands along his skin and realized, to my own surprise, that I wasn’t going to faint, or throw up, or cry. Instead, my classmates and I used a brown Crayola marker to draw an incision line down his spine. With this elementary line as our guide, we cut through the skin of his back and separated it from the underlying muscles. The more I could see of the muscles, arteries, and bones, the more fascinated I became.

On that first day, the questions that had occupied my mind all summer – Is it possible to harm someone who has died? What relationship does a lifeless body have to the person who inhabited it? – were distant thoughts. What I hadn’t anticipated was that, for better or worse, changing into scrubs, holding a scalpel for the first time, and using an entirely new vocabulary for the body parts I’ve known my whole life would simultaneously distance me from the human significance of anatomical dissection and pull me closer into the culture of medicine.

But those earlier questions were really just below the surface. During our second day in the anatomy lab, we were to study the arms.To ease our task, we needed to rotate the man’s arm. There was no way to do this but by clasping his hand and turning it. Because I happened to be standing alongside his hand, this task became mine. Clasping his hand felt eerily similar to holding the hand of a loved one. But it was unmistakably lifeless.

Though my mind was supposed to be focused on identifying the biceps brachii and cephalic vein, I could not stop thinking about his hand. I imagined a loved one holding it as he lay in the hospital before his death. I imagined him throwing a small grandchild up in the air and catching her in heaps of laughter. I wondered if he had played golf or the piano, or if he liked to cook.

While these may seem like pleasant thoughts, the juxtaposition of the image of a man full of life with the reality that I was dissecting his dead body brought me to a halt. I could hardly reach the end of our session without falling apart. Some of my classmates have told me this is why they don't let themselves have these thoughts at all. 

That night I dreamt that I was having dinner with a good friend. After we ate, we walked around the streets of our neighborhood, which happened to be filled with strung lights, live music, and laughing children. As I was recounting the dream to myself I realized that there was one odd detail: my friend had been missing her hand. My mind immediately flashed to the image of the cadaver’s hand.  Just as I had wondered what he had done with his hands in his life, while in my sleep I had seen my friend without her hand and wondered how she would lift her daughter, touch her husband, or simply peel an orange.

As I was getting ready for school the next morning, I felt haunted by what we were doing, seeing, touching. I didn't know how I could possibly go back to the lab, how I could cut into the man's body again. But somehow, I did.  Somehow, in the days that followed, when I held the man’s heart in my hands, the sense of awe and excitement I felt on that first day returned.

Anatomical dissection is not intended to promote empathy. We are not required to talk about how we feel afterward. This is our first experience when we must focus strictly on the task in front of us while with a “patient.” We have a schedule to stay on and structures to find. Expose the brachial plexus. Saw through the clavicle.

Before beginning medical school, I thought that the proximity to death in the anatomy lab would paralyze me. I was scared, and continue to be scared, of the suffering and tragedy that we will see in the hospital. But the anatomy lab has given me something else to be wary of: how quickly something that was once emotionally wrenching and deeply disturbing can become so normal.

During our first days of school, our faculty told us that we would need to learn appropriate detachment. If we get too wrapped up in our patients’ lives, we won't be as good doctors, nor will we be able to function personally. We wouldn't be able to learn what we need to learn in the anatomy lab if we were constantly considering the moral and human questions anatomical dissection raises. However, as we detach ourselves from those questions we risk neglecting them altogether.

A few weeks after I had been so affected by holding the cadaver’s hand, a classmate told me that he found the anatomy course to be dehumanizing at times. This casual comment struck me because, though I had had that same feeling previously, in just a few weeks time that thought had become distant. I realized how easy it was for me to become more detached than I wanted to be.

Though I will probably never dissect a human cadaver again, the lessons I take from the experience will likely come to bear in the clinic time and again. Just as with anatomical dissection, the sickness and suffering that inhabit any hospital may at first give me nightmares, but then someday seem normal. And yet in completely detaching ourselves from our patients we risk treating them as mere bodies rather than whole people and losing the parts of ourselves that made us want to be doctors in the first place. Therefore, we must search for ways to reinforce our human and moral engagement with our work. While we knew just where to look to find the brachial plexus, this search will likely be more meandering and more surprising, but certainly no less important.

Colleen Farrell is a first-year medical student at Harvard and a former research assistant at The Hastings Center.

Posted by Susan Gilbert at 12/14/2012 10:11:46 AM | 


Comments
thank you
Posted by: chenghuiaa123456@163.com ( Email | Visit ) at 5/15/2013 1:46 PM


your article is nice , and it is useful for me , thanks
Posted by: mikelong123@outlook.com ( Email | Visit ) at 7/1/2013 10:51 AM


Really impressed! Everything is very, very clear, open is a description of the problem. It contains the information.
Posted by: makexiao0327@gmail.com ( Email | Visit ) at 7/4/2013 3:23 AM


I wish to know more about this because it actually catches my attention. Keep on posting valuable information about this dude ! Thank you so much for sharing.
Posted by: makexiao0327@gmail.com ( Email | Visit ) at 9/4/2013 11:03 PM


Thanks.
Posted by: cansuok@hotmail.com ( Email | Visit ) at 9/26/2013 8:57 AM


I do have some kind of respect and appreciation for the great effort you put into your writing style, keep it up and getting better all the time.
Posted by: zxmsixsu@sharklasers.com ( Email | Visit ) at 12/20/2013 2:38 AM


I can't imagine how hard it is to be opening a dead body and still be able to get this interesting learning while in the moment.
Posted by: jason.santamari@gmail.com ( Email | Visit ) at 1/25/2014 11:36 PM


Dear Colleen Farrell

Just wanted to tell you that the article was very interesting. Thanks for sharing!
Posted by: alexstening@gmail.com ( Email | Visit ) at 2/5/2014 7:11 AM


The specific Infinity automobile insurance provider started in 1955 because the Dixie Insurance carrier. Infinity Insurance policy has advanced drastically ever since then, and today has 1900 workers along with has consumers in 43 Us all states.
Posted by: johnlaw827@yahoo.com ( Email | Visit ) at 3/3/2014 6:41 AM


With plenty of jobs inside finance, many freshers brain towards a qualification in finance so that you can join a giant corporate residence or grow to be an purchase banker.
Posted by: johnlaw827@yahoo.com ( Email | Visit ) at 3/3/2014 6:41 AM


Living of being married planner is not any doubt any glamorous a single, albeit frantic. If that you are one, in order to see how your thinking, when carried out, bringing people happy laughs on every person's faces, can be a real enjoyment.
Posted by: johnlaw827@yahoo.com ( Email | Visit ) at 3/3/2014 6:42 AM


I like it when my bags are very well-looked-after - for why I don't put them on the floor! I hate it, if my bags are durty!
Posted by: cindyholt9@yahoo.com ( Email | Visit ) at 3/13/2014 11:19 AM


I seem to acknowledged too that their bags seem fresh (even the ones on display) are in fresh condition. enjoy sanfo!
Posted by: cindyholt9@yahoo.com ( Email | Visit ) at 3/14/2014 10:54 AM


purchase the bag asap or it's going to wearisome you to keep this one. Don't about remembering a website to look over the new one and make sure you may then happy with it pointed out leaving.
Posted by: kateh159@yahoo.com ( Email | Visit ) at 5/30/2014 5:19 AM


The best developer in the world.
Posted by: rodneysingle716@hotmail.com ( Email | Visit ) at 6/13/2014 3:13 AM


People talk, walk, eat, sleep online, it's a world that is pacing at the highest speed towards an unknown land of their own and there is no end to this race.
Posted by: hyderali.urgetech@gmail.com ( Email | Visit ) at 7/22/2014 2:32 AM


It is no surprise that the city has growing crime rates. Lots of homeowners are considering home security systems in Dallas to protect their valuable belongings and a lot more importantly their loved ones.
Posted by: hyderali.urgetech@gmail.com ( Email | Visit ) at 7/22/2014 2:32 AM


The reason rashes on skin are of significant importance is because rashes cause extreme discomfort and aggravation to the one suffering from it, unless it is treated in a proper way.
Posted by: hyderali.urgetech@gmail.com ( Email | Visit ) at 7/22/2014 2:33 AM


It provides all variety of clothing for both men and women. The clothes are always available to the prospective clients in different varieties which they can pick on the ones which please and satisfy them most.
Posted by: hyderali.urgetech@gmail.com ( Email | Visit ) at 7/22/2014 2:33 AM


If you love pets and do not have time to physically go to the pet shop and select what you are looking for, online pet shop plays vital role to provide you convenience shop for the pets.
Posted by: hyderali.urgetech@gmail.com ( Email | Visit ) at 7/22/2014 2:33 AM