Journey of Hearts 

The article that follows is one that I wrote as a medical student. It was published in the Southern Medical Journal in 1991. The article describes the rigors of human anaomy and some of the stragegies used for coping. This story was included in the Anatomy Syllabus for several years to follow as a way of helping medical students cope with many of the emotions and feelings associated with working on human cadavers.
Since the site is being accessed by medical schools as a resource for students, I obtained permission from the Southern Medical Journal to reprint the article for the website.

Evaginations - It's O.K.
This article originally appeared in the Southern Medical Journal in January 1991 and is used with permission.

There is an old expression, "Those who live in the hearts of others never die." The mastery of human anatomy is a traditional requirement of first-year medical curricula. The recollections of structures, the complexity of systems, and the intricate detail of organs comprise part of the knowledge gained from anatomic study. This information remains with physicians throughout their careers, to be used every day, perpetuating the lives of those who donate their bodies for medical education.

Gross Anatomy. The words elicit a cascade of thoughts, emotions, and sensory recall. Remember the smells of embalming fluid, burning bone, and preserved fecal material, the taste of formaldehyde in the back of the throat, the skin cold and stiff to the touch, the first look at the ashen face with its blank stare of death, the sound of ribs cracking, the constant feeling of nausea in the depths of your stomach, the dread of losing lunch, and the apprehension at making the first incision? All of these sensations are permanently etched in my mind.

Gross Anatomy is the most grueling and challenging experience encountered during the first year of medical school. Cadaver dissection is both physically and emotionally demanding. Not only is the medical student faced with the stresses of his [her] first hear, but he [she] is also forced to confront his [her] feelings about death, his[her] own mortality and whether or not there is an afterlife.

There are varied means of coping with gross anatomy. Denial, joking, wisecracking or assorted mind-numbing methods work for some. Others deal with the stress by distancing themselves, becoming clinical, scientific, and matter-of-fact. Some avoid confronting the cadaver altogether. They learn primarily form Grant's Atlas, rarely picking up a dissecting tool. The following story is mine:

As I pushed open the door, I was greeted by the now all too familiar smell of formaldehyde. At least this time my stomach turned only a bit. I had arrived before my lab mates to get things prepared for the afternoon's lab. I decided to start with "Joseph." Methodically, I went about my tasks, first pulling back the plastic cover, then unwrapping the cheeseclosth, carefully exposing the area we would dissect, spraying him once over lightly, and taking time for a quick review.
We had dissected the heart the previous afternoon. "Blood flows from the superior and inferior vena cavae to the right atrium, then the right ventricle, out the pulmonary artery to the lungs, back via the pulmonary veins into the left atrium, then the left bentricle, and finally out through the aorta."
I proceeded to turn my attention to the instruments and began sorting our dissection tools. We would need at least one probe and a scalpel.
My mind began planning the dissection when, suddenly, he sat up.

"Wait a minute, you're not supposed to do that!" I gasped.
OK, just calm down and try to think. It's just one of those postmortem reflexes. Right? He isn't really alive. Push him back down on the table and everything will be find. OK, he's back down now. Calm yourself and go back to work.
Wait, not again! Now what? Think.
What did they tell us during the morgue tour? The told us "our" bodies would be preserved. The embalming solution was supposed to fix him. He's had to lie in the morgue for at least 6 months, right? No one could live through that!
God, where is everyone? Why aren't my lab mates here? I can't even remember now if they said they were coming.
Help! I need some help! Someone Call 9-!-!. No breath, no pulse, begin CPR. but we've already dissected his heart, I can't start anything.
Why can't anyone hear me? I can't deal with this. I can't wait. I've got to get out of here!

Oh, no! He's following me!
Quick, down the hall. wrong way, it's a dead end. I've got to get away. Other direction. Out the door. Outside. Now run. Keep going!
Come on legs--Go. More epinephrine. Think fight or flight.
Flexors, then extensors. Quadriceps, then hamstrings. Maybe it's the other way around.
I don't know, but I have to remember to keep going.
If only I could recall the pathways, the innervation, the muscles.
Legs, I know you're getting tired. but can't yo tell he''s gaining? You have got to keep moving or he'll catch up. I can't keep moving, Why can't I run any more?
Oh no! Lactic acid overload. My legs just won't move.
I am going to have to stop...

Wait a minute.
Who is this? This isn't "Joseph"; he's much too young. Our Joseph is over 80 and this "person" is in his 20's.
You only want to talk? That's all, nothing else? I think I can handle that.
You just wanted to tell me not to be afraid, that you understand what we're doing and it's OK.....
 

Knowing that each of us, my lab mates and I, will keep a part of him with us, stored away in  our memories, perpetuates his life. I cannot think about anatomy now without thinking of "joe." I know that it may not be entirely logical, but the subconscious is a realm that is still unexplained and relatively unknown. Besides, if it made me and my lab mates feel more at ease thinking we had been given permission--literally or figurativley--who it to say?