“Inventive naming,” the study authors wrote, “allows students to acknowledge the cadaver’s personhood, while psychologically shielding themselves enough to be comfortable with the dissection.”
But Vannatta stressed that this “inventive naming,” like other unchecked coping mechanisms, can have implications for clinical practice later on. “Instead of referring to Mr. Jones in room 306,” Vannatta said, a physician might say, “‘Let’s go see the terminal in 306. Let’s go see the lung,’ referring to the patient as their sick organ. ‘The liver.’ ‘The yellow man.’” Before they’ve ever walked into an exam room, young physicians have already learned from the dissection that a little bit of comfort can be gained by putting space between the body and the human identity.
The Donor Luncheon, he said, provided a chance to close that gap, “to make it crystal-clear in [students’] minds that this was a person who lived a life—was a father, was an uncle, was an aunt, was a grandmother, was an engineer, an architect.” He added, “It’s changed the whole atmosphere of the Gross Anatomy experience in our medical school.”
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Cadaver dissections usually begin with three simple cuts: a horizontal cut from shoulder to shoulder, a vertical cut following the spine, and another horizontal cut above the tailbone. The skin of the back should peel away relatively easily, exposing a gelatinous layer of fat. If the skin doesn't lift, another smaller incision can create a sort of buttonhole, allowing a finger to hook and tug. When a student finishes removing (or "picking") the fat and cutting through the thin layers of fascia, the muscles of the human back are revealed.
Technically, these first cuts are among the simplest a student will make. Emotionally, they're often the most grueling.
Thurman, now in his third year of surgery residency at a hospital in North Carolina, remembers the first time his Gross Anatomy group opened the doors of the stainless-steel tank, roughly the size of a casket, that held their cadaver. The tank doors hinged open from both sides to reveal the body wrapped in formaldehyde-soaked sheets; they had to turn a crank to raise her to a workable height, and then peel back the layers.
Seven years later, he can still recall the discomfort of the moment: “She’s just this frail little woman,” he said, “and we’re about to take her skin off.”
Her face, after preservation, only vaguely resembled the family photos he’d seen at the luncheon, and the students immediately covered it back up. They also covered her hands, which were wrinkled with bright-pink fingernail polish—the most human thing about her, Thurman recalled. (It's not uncommon in labs for a cadaver to lay splayed open at the chest while the face and hands are kept conservatively wrapped.)
The woman was laying supine, face upward, and to begin cutting her back, they needed her in a prone position. But dead bodies are heavy and awkward, and most of the students had never touched one before. They discussed the most efficient way to flip her. “You’re trying to be as delicate as you would be with your own grandmother,” Thurman said. “But there’s really nothing graceful about it.” Finally, the students moved to her hips and shoulders, one at her head, one at her feet. They counted to three and lifted.