Wednesday, February 26th, 2014

Closing Time

Tehreem Rehman

Very recently, we had our last day of anatomy. Anatomy class quickly grew to become a defining milestone in our medical education journeys. I still recall the first day in which we were assigned to our four-person groups as well as designated to larger “societies” that were named after former Yale medical professors. As the names flashed on the projector screen in front of us, I felt that we were part of a Harry Potter movie scene, with our names being put through a sorting hat as we anxiously awaited our assignments. When my name finally flashed, I rushed to find my new team mates and we headed up together to meet our donor.

As we walked in, our donors were laying supine on the tables we would be working on for the next several months. The body was completely enclosed in drapes and to the side was a list of the age and cause of death of all the donors in our society. Our donor was 94 years old when she died of a stroke. I was initially brimming with excitement as our first anatomy class drew closer and closer. However, at this moment, suddenly confronted with the body in front of me, I fumbled with words as I muttered that we should probably have a moment of silence before commencing our first lab.

 Particularly during our first sessions, we strived to treat each body part with as much consideration as possible. We took care to cautiously displace any portion of the body when conducting our lab procedures. I noticed my partner whisper “sorry” if he felt that he had handled the body too harshly to perform a maneuver. I myself endeavored to keep all body segments not immediately being addressed by our lab protocols covered by the drapes. It felt wrong to unnecessarily expose her lower limbs, for instance, when we were only going to be focusing on the thorax region that day. What was unspoken, however, was that keeping the drape over her face also helped preserve a sense of anonymity and detachment that helped us cope with prodding our fingers into the most intimate spaces of our donor’s body in the coming weeks.

On the last day of lab, the procedure dictated that we saw the head in half. We had already been compelled to expose the face last lab when working on the eyes. However, performing such a drastic procedure on someone’s face, a conventional embodiment of personhood, seemed just cruel. Fortunately, due to a snow day, we were already behind and the procedure was thus rendered optional. As soon as this announcement was made, my team mates and I looked at each other with the implicit understanding that we would forego this final step in the lab. Instead, we focused our attention to navigating the cranial nerves in the intact head.

As the lab period drew to a close, students around me could no longer contain their enthusiasm over almost being done with this capstone of their medical education. They had already been calling out to their peers to check out successfully sawed head specimens. Groups were in the process of taking photos of themselves to preserve these final moments. In the midst of all this, my group slowly worked to gently place our donor inside the body bag while making sure to include all major extractions, such as kidneys.

One of the tables nearby had on music, which isn’t an uncommon occurrence in an anatomy lab. The music had made me feel uncomfortable for the past couple of weeks. The song sang, “Closing time. Open all the doors and let you out into the world Closing time. Time for you to go out to the places you will be from.” My partner across from me caught my glance and asked, “Is the music bothering you too?” And without any hesitation, I give a resounding “Yes.”  We solemnly resumed the rest of our clean up and then we exited the final moment of our anatomy experience.

 In some ways, one may assert that the events that transpired that last day reflected a culmination of a highly personal and transformative process for us as medical students. While my group’s relationship with our donor may have developed into a relatively formal and dignified dynamic, it did not necessarily mean that ours was the only acceptable dynamic for relationships with donors. For many others, our last day of anatomy lab was a celebration of life.

 “Every new beginning comes from some other beginning’s end”—the final words of the song.

On April 1st, my class will be holding a donors appreciation ceremony in which we will be commemorating the lives of these people who left us with an invaluable gift for which we will forever be indebted with gratitude. These people let us explore their corporeal presence left behind in this world to allow us to gain a deep understanding of the human body. We left with a sense of great appreciation of the multitude points of vulnerability in the human body while concurrently being left in awe of the overall majestic nature of this biological machine. For this indispensable contribution to our medical education, we hope to celebrate the less material and more ethereal facets of our donors’ lives as a true final ending to our anatomy experience.

About Tehreem Rehman

Tehreem Tehreem Rehman is a first year student at Yale School of Medicine.  She recently graduated from Columbia College as a John Jay Scholar with a B.A. in Women’s & Gender Studies. As a Co-Founder of Columbia’s Public Service Initiative, Tehreem was selected to be a People for the American Way Foundation’s Young People For (YP4) Fellow for the 2012-2013 academic year in order to expand the program. Tehreem has previously served as the National Chair of the American Medical Student Association’s Race, Ethnicity, and Culture in Health committee and as a National Editorial Advisor for the New Physician Magazine. She is currently a Humanity in Action Fellow through which she intends to create a multi-school platform to address institutionalized racism and sexism in the medical school admissions process. Tehreem is interested in clinical interventions for violence, addressing gender power dynamics in the clinical setting, and the impact that health inequities have on women of color and low-income backgrounds.

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