The Gift

Yesterday we were introduced to the anatomy lab, and with it, our cadaver that will be probed and explored in the next 11 weeks. It wasn’t as traumatic as I had anticipated. As I entered the lab, I looked around to the 30 work stations: large stainless steel tables, containing drawers with all of our dissecting supplies; polished clean white floors; red bagged hazardous containers all around the room; 30 cadavers wrapped in white cloth and covered with plastic sheets; and two white coated physicians who are responsible for taking care of our cadavers. I’d like to think of them as the undertakers of our gifts.

Last week, we had an introduction to the Oregon Body Donor Program, to answer our questions about where these cadavers have come from. For our program, all of the cadavers were individuals from Oregon, or Vancouver WA, who specified prior to their death they wanted to donate their whole bodies. The average age is somewhere in the 70’s, as younger bodies are usually harvested for healthy organs and tissues. There is a 50-50 mix of women and men, in order for us to learn and understand the anatomy of both sexes. Unfortunately for us, the donors at this time are primarily caucasian, although I’m happy to discover that the lab table next to mine has been gifted an African American male.

What do we know about our cadavers? Not much. We are only told the age, sex, (pretty obvious), and cause of death. Our cadaver died of respiratory failure. Although the aim of our first class is to learn the normal anatomy of the systems and tissues of the body, it is inevitable that we will also start to learn about pathology as we open up our cadavers and see evidence of disease.

So after we entered the lab, as I’m waiting for the shock to hit me, my 3 lab mates and I surround our body, looking around wondering what to do next. We don’t actually start dissecting until Thursday so it’s with trepidation that we stand there, until my wonderful enthusiastic lab mate grabs a pair of gloves and asks, shall we take a look? All the bodies are covered first in a white cloth, with a separate shroud for the head. The bodies are also face up, ready to receive all that we are soon to deliver. As Markus lifts off the sheet near the shoulders, I am surprised by two things. First, how life like the cadaver looks, and second, how non-life like he looks. The skin looks like skin, but is gray. The body looks soft, but is actually firm to the touch (according to my lab mate – I haven’t yet touched him – one step at a time….). We confirm that our body is male (no breasts), and cover him reverently back up. I say outloud “Thank you Mr. Man”, as we have yet to come up with a name for him, a ritual I understand many students adopt as the weeks move forward.

As I’m ready to turn and leave the lab, my lab mate, still gloved, states “Shall we look at his face?” I look around to the other students, and numbly nod OK. I understand from reading Body of Work by Christine Montross, that the faces are covered so that students can initially be as comfortable as possible during dissection (same reason why we dissect the head and neck last). I am expecting yet again to be somewhat disturbed and shocked. We remove the shroud, and staring up at us is an old man, sleeping his eternal sleep, and again looking both alive and not alive at the same time. The only other time I have seen a dead person is when my grandpa died when I was six or seven. I barely remember seeing his face in the coffin, and as five seasons of “Six Feet Under” taught me, my grandpa was made up to look very much alive, like he was soon to wake up from a nap.
No comparisons here. Mr. Man is definately not alive, will definately not wake up, and yet, I am not shocked, not disturbed, but instead deeply moved that he has gifted his whole body to me so that I can learn to become a physician. I’m sure that the following weeks will push and pull me in many directions, but for now, I am left with a great sense of awe and gratitude to him and his family, and for all the others individuals in the world that give this gift to medical students.I leave you today with a quote from a previous donor:
The Gift
I am lying here in front of you now because of those doctors that saved me the first two times. They gave me 15 years I would never have had. Fifteen years to make things right with Elsie. To care for her after her stroke as she cared for me and the children those years when I was running around. Fifteen years to witness the births of my grandchildren. Fifteen years to spend time with my kids as I never did while they were growing up. Some might call me lucky, but I call that a gift. A gift from God, sure. But also a gift from those doctors. My body is my gift back to them.
As you examine me here in Gross Anatomy, I would like you to do a few things. When you look at the scars on my hands, remember I was a butcher for 45 years. When you examine my liver, remember I was a drinker. When you hold my heart in your hands, remember how I ate and my quadruple bypass. But most of all, when you are with me, learn, so that you too may be able to keep giving the gift that I was given.

Micheal A Grassi, Chicago, Ill
from “The Gift”, JAMA 276:854, 1996

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