Our First Patient

Cold, freezing hands and naked, bare blue veins. Skin so light and pale like Snow White. Eyes are closed so peacefully, sleeping. Freckles smattered here and there and ah, some wrinkles too. Limbs stiff and unmoving.

As training doctors, we all go through the same things; it is almost a rite of passage into being a doctor. We all walk through the lab doors and we all know the smell of formaldehyde. What am I talking about? I’m talking about the dissection of the cadaver. They tell us that the cadaver is our first patient. I agree and I disagree.

I think most med students have done some sort of dissection before. Whether it’s been a cat or a dog or a rat or a pig or a cow’s eye or even an owl pellet (yes, I’ve done that before), we have all done some sort of cutting into a once living thing. But the dissection of the human body is a very interesting process. We are humans and while surgery is a common practice in our world nowadays, surgery is operating on a living human being and expecting them to wake up from the anesthesia. Surgical methods are also different in some ways from dissection methods.

So cutting open a human body is a very interesting process. I did not know what to think before I went into the lab, and I did not know how to feel except a weird mix of excitement and nervousness. Would I faint? Would I vomit? How will the person look like?

I got my answer quickly on day one when the body rose quickly out of the tank. With bated breath, I, with the help of my tankmates, threw the sheet off the cadaver and there he was. Lying so still. He seemed asleep. I have to say that I did not think much of it since our first dissection was the back so we quickly flipped over our body and suddenly the face was hidden from me.

I realized over the next couple dissections that I began to dissociate myself from the fact that he used to be a living person. I knew he was a person and a body, but I forgot that he was a human. It was so easy when you dissect on just one area of the body and that is all you focus on – the muscles, nerves, arteries, and veins. I became so busy memorizing everything that I just forgot who exactly I was cutting into.

I forgot until one day I was dissecting near the forehead while he was face down. Getting close to the forehead, I focused out of my area of dissection and realized that I was bent over staring right into his face. It was one of the first times I really focused on his features. I faltered for a brief bit and I knew my scalpel slipped out of my fingers but the slip was not enough for anyone else to notice. I just righted myself up quickly and went back to the dissection.

But afterwards I contemplated about what had happened in lab, and I began to realize something. We cut and we cut and we make cuts that we would never make on a living being. Many students forget that that their cadavers were actually human beings. The process is extremely dehumanizing. Why are we seeing this as our first patient? This is how we should never treat our patients. We should never forget that our patients are humans and we should never see our patients as just a disease or a mystery to be solved or a chronic problem to control. And in this way, I disagree with viewing the cadaver as our first patient.

But I also agree. I also agree that in many other ways, the cadaver is our first patient. Firstly, physicians do teach their patients a many number of things, but one of the special parts of medicine is how much our patients can teach the physicians. And thus just like our patients, the cadaver teaches us. The cadaver is the source of knowledge for all medical students. It is how we learn the human body and it also how we come to appreciate the human body. Although many times I forget that I am dissecting a person, I am reminded again and again when I encounter something in the dissection that is so fascinating and beautiful.

One of my favorite moments in lab was during the back dissection when one of our anatomy professors pointed at the arachnoid mater (a very spider web-like layer) overlying the spinal cord and told us, “This is probably one of the only times you will ever get to see something like this intact! Look how beautiful is it!” The human body is a very beautifully designed thing. I could not help but be so very appreciative of all those who choose to donate their bodies to science.

These cadavers became our friends oddly. We spent hours with them. In the afternoon and at night. Although we cut through them, we do our best to also be gentle with them. We learn from them, and sometimes we even take comfort from them. I have to say one of my favorite moments of hilarity so far has been during our pimping session. The stress was high in the air as our professor grilled us with questions. We passed with flying colors, but at the end, one of my tank mates looked at us with an amused grin and stated how he didn’t realize how he had been holding our cadaver’s hand the entire time for comfort. Laughter ensued between the four of us. It is one of the many times I am so thankful for our cadaver and for my amazing tank mates.

I still have many more dissections to go, but to all current MS1’s and future med students, remember to appreciate your cadavers and be thankful about their willingness and bravery to donate their bodies to science.

Looking forward to the next dissection,
-M