Aspiring Docs Diaries

How We Are Structured and How We Function

Originally posted on UVM Medicine

Her features were flattened and deformed, showing she had been fixed. I thought of a Barbie doll whose limbs would stay in place as you lifted and moved her.

A line drawn down the back and three across, like a knife in pale dough, and as fast.

I felt very warm. A bead of sweat trickled down from under my arm.

“Is it just me, or is it really warm in here?” I asked my lab group.

Of course, it was just me. Lab is cold. Lab is always really cold.

Head swimming, I found Dr. Black at the front of the room. Confidently cool, with short blonde hair and long white coat, Dr. Black projected all business.

“Dr. Black?” I asked her, as she talked with another group.

“Yeah, what’s up?” she said, turning around.

“I don’t feel so good.”

Instantly, she dropped what she had been doing with the other group. “I’ll be back,” she told them. She gestured for me to follow her into the hallway.

Dr. Black got two sitting chairs from her office and sat down with me, elbows on her knees, chin in her palms, looking up into my face.

“What’s the matter?” she asked gently.

“The way they’re cutting her…It’s too fast,” I said.

She nodded. “When I had anatomy in grad school, it went even faster. You walked through the door on the first day, and people all around the room were already dissecting their cadavers…” She took a deep breath. “It’s really, really hard. You don’t have to stay here today. Get some fresh air, take a walk. You can go home.”

She said I could go, so I left, in a daze. I went outside, lay on the grassy hill outside the building, and bawled.

~~~

It was the fastness that was the problem. With the speed of the dissection, I felt like we were stripping our donor of her personhood too rapidly. If it had been me doing the cutting, I probably would have gone a centimeter a minute, silently asking my donor if it was okay all the way along. Although our donors had given their consent before dying, it still felt like desecration to me. Perhaps this dissection would not be as they had thought it would be when they volunteered to be donors. They were not around to change their minds if they decided they did not want their bodies cut into anymore. And even if they would not know, I would know. I would know that I was doing a very serious thing to a body that maybe had not wanted this. That mattered to me.

Before I left lab that day, Dr. Black had agreed to meet with me later in the evening to go over the day’s dissection after everyone had gone home. When I got to the laboratory that evening, the amber autumn sunlight was streaming in through the high windows, little dust particles dancing in the sunbeams. Twenty-one cadavers were zipped up in their white body bags, and it was quiet. From the fourth-floor anatomy laboratory at the University of Vermont, you can see the old ochre brick buildings at the front of the school with their green copper spires piercing the sky, reaching up toward the heavens.

First, Dr. Black and I went over to a table on which lay an isolated vertebral column. As Dr. Black animatedly explained the anatomical features of each vertebra, I felt two feelings collide inside of me. There was the part of me that felt like this was a spine that had been inside a real human body, and what right did I have to be holding it in my hands, preventing it from being in the ground or in ashes with the rest of the person’s body? The other part of me, the part that flowed in slowly, then saw the beauty of the fact that this had been someone’s spine, someone’s strong, curved spine, and they had given themselves that I may see it. It is not every day and it is not everyone that gets to see a spine, and it is a crime, because everyone deserves to know what is inside their body. I believe there to be no substitute for it for the learning of human anatomy.

As we continued with dissection in subsequent days and weeks, I learned to intertwine the reverence of the donor with the act of dissection. Before I would do a harsh cut, I would lay my hand on the donor’s arm or leg, and wait a moment, as though to comfort her, or to apologize, or to seek permission. Then, I would go forward and try to focus on the science and learn from what we were doing. I learned that trying to cut well, and learning as much as I could from the dissection, was an act of reverence in itself.

The other day, we had our second-to-last dissection, where we had to cut the body in half down the middle. While my tablemates used the saw, I held our donor’s leg and torso firmly in place, and I said goodbye to her. She’s far gone now. I am glad I was able to be there to say goodbye.

Meet the author:

Gilana Finogenov

Med Student

Gilana Finogenov studies medicine at the University of Vermont College of Medicine. She grew up in sunny El Dorado Hills, California. At the University of California, Irvine, she majored in Neurobiology, wishing to explore the biological bases of the inner workings of the human mind. She enjoys reading, writing, dancing, and sharing and listening.

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