Real Anatomy

John Warner and James Edmonson recently published a collection of photographs from early twentieth century gross anatomy classes in American medical schools. The pictures date from a time right after Kodak introduced cameras to the masses, and when it was considered fashionable for medical students to pose with the remains of dissected cadavers. The publication of these pictures, however, arrives at a time amid much discussion as to whether this rite of passage the first year of medical school – dissecting a human corpse – should be phased out in favor of new technology which allows for the possibility of virtual dissection.

Virtual dissection? I simply cannot understand how a virtual process can come even remotely close to offering students an experience similar in kind to that of a real dissection. I am not a doctor, so I suspect I must be missing something here. After all, my only first-hand experience with dissections I acquired in high school biology. I did visit a gross anatomy class once though. But that was years ago, when I myself was in my first year at law school. I was a bit tipsy, and it was sometime around 2 or 3 a.m. And no, I wasn’t supposed to be there. I had been out that night with a couple of friends who were in their first year at medical school, and they decided it would be fun to show me the cadavers. Despite my alcohol influenced mental state, the experience left its impression. The cadavers were preserved in what I guess was formaldehyde, in shiny metal, coffin-like tanks. A lever was pulled, and the corpses popped out of the boxes in a ghoulish version of jack-in-the-box, with the preserving liquid streaming off their bodies back into the tank. I remember telling my friends that the scene didn’t disturb me in the slightest, and that I found a nearby skeleton on display far creepier.  That was a lie.

One of my friends took me aside and told me, with a deeply serious, grim look on his face, to never even consider donating my body to science after my death, or to allow anyone I love do so. He said I wouldn’t believe the level of disrespect shown the cadavers, a fate he could not wish or imagine for anyone he had known or had cared about. I think now that he must certainly have turned into a fine doctor. I suppose the disrespect he spoke of was a mark of detachment, the beginning of a defensive mechanism that doctors often use in order to cope with the kind of emotional turmoil faced when constantly reminded of one’s own mortality. The knowledge that the corpse they were dissecting was once a living, breathing, human being – for most of them, this was their first real confrontation with the emotions stirred up by that simple fact. I wonder, will a computer program similarly be able to force them into that stare-down with the grim reaper, that dark, robed figure lurking about the hospitals that these young doctors will really be fighting against for the rest of their careers?

Another thing I remember from that night was a discussion, or rather, portions of a discussion, my friends had about a specific body part that was the focus at that time in their anatomy class. Unfortunately, I can no longer remember what this body part was or even the general area in which it was located. All I remember was that it was apparently very, very tiny, and didn’t seem to be located in any of the cadavers where the textbooks said it should be. They were trading stories about the surprising locations they ended up finding the part, or the bizarre ways it had been bloated, shrunken, or otherwise distorted nearly beyond recognition. How can a computer program capture these infinite variations? Wouldn’t the installation of virtual dissection programs necessarily involve a degree of standardization to a far narrower range than is seen in real life?

Proponents of virtual dissection maintain that the programs represent a vast improvement over the smelly, messy inconveniences of flesh. But isn’t that precisely what we are supposed to be training doctors to cope with – the smelly, messy inconvenience of the human body? There is something else that strikes one as they look through the old pictures: no one is wearing gloves. The pictures were taken before latex was invented. So I wonder, am I playing the part of a nostalgic and a Luddite? Were people back then voicing similar concerns concerning the use of gloves? Were they worried that something essential would be lost when they no longer felt the raw sensation of touching entrails and secretions with their bare hands? At what point is it that a change spurred by technological development brings about a qualitative, essential difference in experience, and when does it matter? Or does it ever matter?


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