‘I remember thinking that his eyes should be closed so I closed them’– Students on dissections and their corpses.
There are only a handful of medical schools in the UK where students are assigned a body they dissect throughout the year, Cambridge being one of them.
Painting of ‘The Anatomy Lesson of Dr.Nicolaes Tulp’(1632), currently at the Mauritshuis in the The Hague.
‘So at any one time there are two of you dissecting a body, you have a partner. But I think it’s sixteen people per body.’
The history of dissecting bodies is one fraught with violence. Rembrandt’s 1632 painting, The Anatomy Lesson of Dr. Nicolaes Tulp, shows the dissection of Aris Kindt shortly after he was executed for theft. The author W.G. Sebald saw the work as a society which viewed itself as entering ‘out of the dark and into the light’ perpetuating the “archaic ritual of dismembering a corpse, of harrowing the flesh of the delinquent even beyond death”. He, among others, view the erroneous rendering of Kindt’s left arm (it shows the anatomy of the right arm) as a critique of the doctors’ inability to see Kindt as a human: they are too concerned with the anatomical atlas, the images of which they superimpose over the real body. As the demand for cadavers grew, thieves began to supply bodies, with groups known as ‘resurrectionists’ practising body snatching. The Anatomy Act 1832 attempted to put an end to this illegal trading, but only by allowing anatomists access to the bodies of those who died in workhouses, other societal ‘“delinquents”.
“But formaldehyde, famously, makes you crave meat”
Today, cadavers are supplied through body donations. Those who chose to donate their bodies often come from medical backgrounds. At Cambridge, students work in pairs and are assigned a particular body which they work with over the duration of their first year. A medical student in her 4th year told me about her experience.
‘We had a “Meet the Donor” session. It’s the first session. It’s quite intense being told “you’re going to have a body and you’re going to dissect it”. Nobody has ever cut into a living person, no one has ever seen a dead person – or at least it’s not common. So even being in the same room is crazy. It’s like in TV shows when you see a body on a metal bed covered by a white blanket, it’s just like that. They’re lined up, two or four rows. And you just exist in the room with them, you don’t have to uncover them. You can touch them if you want to. It’s good to just get used to it psychologically, touching the body. I did nothing for most of the session, I just lifted his arm up and put it back down at the end.’
How do they preserve the bodies?
‘Formaldehyde. They replace all their blood with formaldehyde. It has a really strong smell, and the worst bit is that when you get deeper into the body, the smell gets more intense. But formaldehyde, famously, makes you crave meat.’
Oh. Is that an uncomfortable experience?
‘Yeah, especially because you’re standing up for so long. A normal session is about two hours.’
And you do that for all of the first year?
‘For the first year. The second year is just head and neck. It’s the difference between dissection and prosection.
Dissection is you doing the cuts yourself and you have a whole body. It’s not very common for universities to do it anymore, Cambridge is one of the only ones that still does. But prosection is just a part of a body, and it’s been dissected for you so you can see all the anatomical features. But you don’t cut, you can move things around yourself and feel it, but you don’t cut.’
Did you ever get a name at the “Meet the Donor” session? To what extent do you feel you met them?
‘You get an age, a name. You don’t get a cause of death, as you go through the year, you’re meant to find it out.’
How did your donor die?
He had lung cancer. The first term we were doing the arms, and it was weird – everyone was saying “Oh you guys are so lucky, your patient has no fat on him”. You’re learning, and it’s hard to balance that with keeping their dignity, being respectful. It’s easy to forget that, but then you get pulled back when someone says something like that, “you’re so lucky, we’ve spent all the session trying to get the fat off”. And he’s so skinny because he has a massive cancer.
“It is a strange tension to have, something so otherworldly for some being so routine for others.”
The patient – I don’t know, the “patient”, or the “donor”? – he was 65, which is young. And we got to the chest and saw a huge tumour pushing into the heart. You could see, like you know polystyrene balls? Like that, all over the inside of the ribs, on the organs. You could see how much it spread. You have it in your hands and say, “this is what cancer feels like”.
But right from the start, they tell you to never forget that this is a real person. When you die, you can do anything with your body, and they decided that this was the most important thing to do, and you need to treat them with respect – use it for as much of a learning opportunity as you can, because that’s what they’ve given themselves for.
We all thought we would meet the family of the patients. This turned out not to be the case, but we thought at the time we would have to present all of our findings to the patient’s family.
There is a ceremony at the end of the year for medics, but the relatives aren’t present. It’s called a “Committal Service”, and each group writes a “Donor Tribute” addressed to the relatives of their donor. Some of them are read aloud at the ceremony, all of them are sent to the families of the deceased donor. The department says, “your tributes are important, as they mean a great deal to the next of kin, therefore this is your opportunity to convey to the donor’s family, your appreciation and understanding of the sacrifice made by both the donor and their family members”. I saw some past tributes, some striking phrases included, “we saw him as both our first patient and our best teacher”, and “although we can never hope to know him, we are familiar with him as the most important member of our team”.
“They say ‘have at it’…”
‘Up until the day that when we went in, I thought that the families were going to be there’.
In the past, relatives were invited to these ceremonies. Now, it feels less confrontational, but it is still a personal event and marks the end of what is for some medics a very personal relationship with their first patients.
‘I remember closing the eyes. I remember thinking that his eyes should be closed so I closed them. They were a bluey grey, but I was thinking that they would have been bluer when he was alive. I don’t know if that’s a thing with eyes, but I was just imagining him alive.
‘I went into my first surgery in a hospital a month ago. And I never thought about it before, but the patient is completely covered, only the area for surgery is exposed. You forget that there’s a person underneath.’
It’s like walking into the “Meet the Donor” session?
Yeah. And in dissection, my partner and I always uncovered the face but loads of people wouldn’t – if they were dissecting the legs, they would stick to the legs. For me, you don’t want to forget that it’s a person. Especially because some people weren’t respectful. You get told, “don’t cut what you don’t need to cut”, “don’t cut anything off”.
Here, I am assailed by some vivid medical imagery which I will spare the reader. I spoke to a veterinary medical student at Cambridge, also in her 4th year, wondering if they form a relationship with their “patients”, or are similarly urged to err on the side of caution with their cadavers lest dissection spills over into mutilation.
‘It was the second to last dissection, and in their words, they were like “have at it”.’
I suppose not.
“You loved these dogs more dead than were ever loved in life”
‘You’re given a dog for the whole year, and there’s a tradition where you name it in your first session. Because it didn’t have a name before. They were all euthanized from the pound. Our dog was two years old, and had no obvious health problems.
‘You do all the normal muscles in first year, and then in second year you do head and neck anatomy. So, at the end of the first year, they decapitate your dog, and you switch dissection tables, so someone else has your dog’s head. And then they’re without a name again.
‘They say “have at it”, because the rest of the body will be discarded. My partner wanted to keep a memento – he was sad to leave the dog after a year together – so he cut out a tooth. He gave one to me, and I put it in my lab coat and lost it. He’s upset about it. But someone asked to keep the skin of the head of a horse. It was a fresh frozen dissection. The dogs are dried, having been soaked in formaldehyde, whereas the horse heads were frozen, so were bloody and fresh. So, she asked to keep the skin. It creeped everyone out a bit.’
Where do they get the cadavers from?
‘It depends. The chickens came from a poultry farm, and I know this because we asked since they were so dirty, they were mites crawling all over them. It was gross. The sheep were from a farm, same with the post-mortems.’
What’s that?
‘It’s like a real patient. You cut them up to see the cause of death. So, the ones I did two weeks ago, they were real peoples’ pets, two dogs. We were given case information – their name, their owner’s name, how old they were. Kind of depressing.
‘With our dog, we were studying the reproductive system, and we cut open her uterus and there was an early set of puppies inside her. And our supervisor said, they’re from the pound, they’re not neutered, they were strays. And then we were saying how horrible it was, and she, knowing how attached the students get, giving them names and all, said “You loved these dogs more dead than were ever loved in life”.
‘The way we treated the animals, I kept on thinking about how glad I was that I wasn’t a medic, that this wasn’t someone’s family member. Especially with the post-mortems, it’s invasive, you saw off skulls, I struggled with that. The first one we did, we had a final year student with us, and that was really helpful. I think the first cuts are the hardest. By the end, as bad as it sounds, it doesn’t really look like an animal anymore. But the first cuts are terrible. And she covered its eyes for me because I was freaking out.
‘When it’s just a head, you don’t get attached to that. It feels more like a specimen than an animal. But I think with the dogs, it’s good that we have the dissections. It’s nice that they had some sort of value, they got to feed into the lives of others, not that they would ever know it.’
Like the two I spoke to, I’m also in my fourth year of studying at Cambridge. I have friends who study medicine and veterinary medicine, but it has taken me four years to truly consider the fact that some students have regular, daily interactions with the dead. The recurring faces they see throughout their studies, who guide their progress and learning, are dead, deceased. These, as they seem to me, otherworldly interactions take place everyday alongside all the other modes of study in Cambridge, and are for the most part confined to the dissection halls.
“And she covered its eyes for me because I was freaking out”
It is a strange tension to have, something so otherworldly for some being so routine for others. The history of dissection is one of invasive violence, and that’s how it has appeared in my head; I wanted to speak to those who dissect, learn about what it actually entails, and hear about the relationships they form with their “patients”. The responses are of course, personal and individualised, but point to the extent to which one might feel perpetuators of this violent tradition, and how one navigates having control over a lifeless being whose dignity is at their “mercy”.