Those who watch a spectacle share in the guilt of those who create it

I stood right beside them as they slowly slid your head into a plastic bag, looped the coarse twine about your neck and tied it tightly. Like the amateurs they were, they double-knotted it to make sure nothing came loose or dripped out. Then they casually walked away, chatting about what would come next.

Within minutes the bag fogged up, and a clear red liquid pooled at the bottom.

That was just the beginning of the ritual.

I’m sure that under other circumstances you would have put up a fight, Joseph, but today you were no match for them. No matter that they were six slender twenty-somethings, and you at least six feet and 250 pounds; you were on their turf and utterly at their mercy.

Your expression held fear, sadness and regret. Face flushed, mouth agape, eyes closed as if to shut out evil, you seemed to be begging for life. And although you were already dead, over the next few months I came to feel that you died many times over.

The rite took place in a basement-level room that recalled the Nazi gas chambers. The steel table on which you lay looked at least a half-century old. There was nothing soft about the room — every corner was sharp, every surface rough. The windows were sealed to prevent unfiltered fumes from escaping. The locked door bore the words “Authorized Personnel Only.”

I still remember the first cut — the way my classmate’s knife slid into the flesh at the base of your skull and traveled down to your buttocks. Then she took a gleaming new metal probe and pulled back the skin, revealing the “meat” underneath. The thin layer that had cradled your humanity was destroyed.

Almost instantly the comments began:

“Oh my god, he is just so fat!”

“Does he have any muscles in here at all?”

“This reminds me of steak.”

“I’m hungry.”

The milder examples.

The ritual continued.

After cutting through your back, Joseph, we slowly worked our way to the front of your body, turning you over as we went. Conversation focused on what were euphemistically called your “family jewels.”

Three women investigated your scrotum and penis in great detail.

“Is he circumcised?” one asked. The answer was no. (Your penis would later be cut out, circumcised and used as a tool on which to practice stitching.)

In the long, dreary winter days and months that followed, I tried to find ways to preserve your dignity. When I covered up the parts of you that we weren’t dissecting, our instructor intervened.

“Prudishness is out of place here,” she told me.

“I’d like to know more about our cadaver,” I said. “Do we know anything about his life?”

“That’s simply not possible,” she responded. “The cadavers are anonymous.”

In the lab, students and professors alike had decided that, in life, you had been a “workingman” — a catchall term for someone of your appearance. Calloused hands, thick neck and rugged facial features … clearly a workingman. I thought it ironic that, having gone to such lengths to protect your real identity, they would find this dismissive label an adequate substitute.

No matter how hard I tried, Joseph, I couldn’t discover more than your name, your age and whatever clues your body revealed. You had become, and would remain, “Joseph. Table B. Age 75. Caucasian male.”

I so wished that you could be my first real patient, and that I could be your doctor. I wanted to know about your childhood, your parents, your schooling. I pictured our imaginary office visits — you’d walk through my office door, which I would gently click shut behind you … I’d ask you the questions that would help build our relationship: Do you have kids? How are your loved ones? What do you do these days to keep busy? What makes you smile, cry, feel scared? I longed to know whatever you would want to share in the sacred privacy of my office. We might even develop the special bond that I have heard exists between a patient and his physician. We would care for and learn from each other in so many ways …

Meanwhile, in the lab, I kept proposing that we not use you as a resting place for dissection instruments, or as a makeshift drum set when boredom kicked in, as it inevitably did after a few hours of dissection.

Mostly the response was an eye roll; then someone would remove the instruments, only to replace them shortly thereafter.

More than once, I tried to direct attention away from your scrotum — the object of frequent derision — and to keep our conversations about you respectful and on topic. Every now and then the talk grew serious, but only until the next gobs of fat appeared, provoking more obesity gibes that inevitably circled back to your “jewels.”

There were times when glimmers of humanity crept in, when we would step back from the table and acknowledge the surreal nature of this medical ritual — you lying dead, helpless and cut into an infinity of pieces; we wielding the power saws, blades and other tools prescribed by our Gross Anatomy Dissection Guide.

Often, these moments of clarity followed some especially grotesque violation.

One such moment took place on a particularly cold winter day. We’d separated your head from the back of your neck as a prelude to exploring your cranium.

One of our group tilted your mostly severed head upward with a metal probe and started to animate your head and face by waggling them from side to side, while the rest of us stood silently by.

In a triumphal finale to this horrific puppet show, he thrust the filthy probe through your nose and out the base of your skull.

With this coup de grace, a sense of reality slithered back in through the sealed windows. For the rest of that period, silence reigned at our table. If only it could have brought absolution.

Writing you this letter at an ungodly hour on a cold winter’s night, I find myself reaching for my phone to answer a call. It is yours. Yet my phone has made not a sound; there’s just silence around me.

Please forgive me, dear Joseph. Every time I think of you, it is with self-reproach. I tried to protect you from the insults wreaked on your body, yet I did not do enough. I so wish I could have done more.

We’ve been taught that repentance begins with honest confession, and that, once we repent of our deeds, absolution may follow. Yet even repentance and forgiveness cannot undo every type of damage.

What has happened will always be part of my history. I must never forget my complicity: Those who watch a spectacle share in the guilt of those who create it.

Your death, I was told, provided a gift to others. Yet I hope your death will do even more. I hope it will awaken others to the need to cherish the dead. The dead are more than objects, cadavers or patients. You, my dear Joseph, are not Joseph of Table B; you are my neighbor, my friend, my brother.

Although ours was not the classic mentor-student relationship, you taught me something far deeper than anatomy. From you I’ve learned just how fragile, how precious, is our humanity — and how great the need for compassion in medicine.

These are priceless gifts that I may never be able to repay.

Although I’ll never have the chance to know the spirit that animated your body, I’m eternally grateful to have spent time with the vessel that bore your soul.

The author is an anonymous medical student. This piece was originally published in Pulse — voices from the heart of medicine, and is reprinted with permission.

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  • JR

    I think your professor should be fired.

    Yet – I understand this is pretty much standard across the board. This is how our doctors are taught. This is what they learn.

    • guest

      No, this is not at all standard, and it is not the way doctors are taught, as numerous comments from other doctors here are reflecting.

      • Med Student

        The putting a probe through the skull is definitely very unlikely to happen at other medical schools. Everything else though? Definitely seen it at my med school

        • DoubtfulGuest

          Thank you for being honest about this.

      • JR

        Medicine has some serious problems.

        Obvious ones include things like patients waking up with a catheter in place that no one told them they would be receiving, or worse, having it removed and never knowing it was there. Women getting abdominal surgery have been (and still are in some places) routinely given pelvic exams without being told about it in advance when having surgery. (See these two issues and more here: http://patientprivacyreview.blogspot.com/)

        I’ve read from a Professor teaching med students TODAY that he routinely takes med students in to observe surgeries. He has no idea what kind of consent his hospital gets from patients, but at a minimum they’ve never met him or his students. At most teaching hospitals it is just a statement hidden in the midst of a bunch of forms that say “students may be involved in your care” with no option to opt out.

        I’ve read the attitudes of students toward patients on the student doctor network.

        That doesn’t even get us to doctors who think asking patients for permission to examine them or touch them is “over the top”. I’ve seen doctors on Kevinmd state a patient is there to be examined, no one needs to explain to them what will happen or ask their permission. Showing up for an appointment, that’s all the consent that is needed.

        Add in my own experiences, and I’m very wary of any member of the medical profession.

  • guest

    Wow. We were instructed in medical school to have the utmost respect for our cadavers who gave us their bodies so that we could learn. This never would have been allowed at my school.

  • ninguem

    Is gross anatomy still at the very beginning of training?

    My school we would have been too scared to act like that so early in training. We all felt like…..”everyone else was highly qualified to be there, but I’m unqualified and got in by dumb luck”..

    Conversation could be light, it wasn’t Gregorian chants, but not like described here.

    Nothing looked like a steak to me, if any food comparison, I’d say a turkey that had been picked over after Thanksgiving dinner.The muscle of a preserved cadaver is not red.

    No particular fascination with genitalia that I remember.

    There was one little old lady faculty anatomist, that had been teaching anatomy probably since the 1930′s. She used to talk about stripping flesh off bones for anatomic skeletal demonstrations. She was a little grandma with white hair in a bun and tennis shoes, and somehow I could picture her with a cauldron while talking sweetly. Of interest, she described trying early plastination experiments with the cadavers. The idea had been around for years. Eventually a German perfected the technique in the late 1970′s and we see the “Bodies” exhibits today.

    Funny, the cadaver wasn’t “human” to us until we needed to dissect the head. All through the course, the head was covered. When all else was dissected, it was time to work on the head. Seeing the face made things sink in.

    I don’t know, I think that little old grandma would have thrown us into that cauldron she described if we behaved as described in this post.

  • guest

    The behavior described above would have been completely unacceptable at my medical school.

    • T H

      I agree. We had people tossed out of the day’s class for being disrespectful.

      The only part of the cadaver that was uncovered was the part we were studying for the day.

      • guest

        The concern I have is that, based on this piece, the public will assume that the behavior is considered acceptable by the medical profession.

        • T H

          Perhaps, but the control over others’ perceptions is a tricky thing. There is a public perception that sailors swear constantly. There’s even idiom to support it: ‘He swears like a sailor.’

          Obviously, they’ve never actually been around most sailors: the 2-3% of bad apples get the whole lot tossed into the stereotype.

        • T H

          Public perception rarely has little to do with reality. Assuming has its own pitfalls and its own (snerk) rewards.

  • Ed

    This is just so wrong on so many levels I don’t even know where to begin. I don’t have a clue how medical schools get their cadavers but I’d like to think this gentleman requested his body be donated for this specific purpose. I’m relatively confident that if he knew his gift would be repeatedly disrespected so profoundly, he would have changed his mind. And you folks wonder why we don’t trust you.

    • Lisa

      You brought up something I thought when I read this article. I’ve always hated going to the doctors. One reason is that I wonder what they would say about me behind my back. Would they make fun of my body? Say unkind things? I can imagine doctors during surgery, making jokes at the patients expense….

      • DoubtfulGuest

        I had a previous doctor make fun of my colonoscopy photos to my face. So, yeah, how bad does it get behind my back?

        “Ooh, LOOK! We have PICTURES of…YOU! Lots and lots of PICTURES!”

        I didn’t mean for them to send her the photos. I didn’t even know they were going to take images. She was just supposed to get a copy of the results.

        Hey, she presumably has one, too. And it probably looks about the same.

        • ninguem

          That’s fairly routine in colonoscopy reports.

          Sending pictures I mean……….

          • DoubtfulGuest

            I know that now, thanks. This was early on before I had much experience with tests. It makes sense, in case there are findings that need seein’. That’s not the problem here.

            Thanks for the clarification. I mention that I didn’t know that photos would be taken, because I had the report sent to each of my docs at the time. Trying to coordinate my own care, in case it turned out to be a multi-system disease (it is). But after that incident I wondered if the other docs, who chose specialties other than gastroenterology, were also making fun of that addition to my charts. I didn’t mean to send them icky photos.

          • Lisa

            When I had a colonscopy, I was handed a copy of the report with photos. The photos weren’t icky – they were sort of nice looking – pinkish and moist colon.

          • DoubtfulGuest

            I wouldn’t have thought to be offended. It’s just biology. But this doctor (my primary care at the time), a lot of it was in her tone. She didn’t think I needed the test or really any more tests at all, and she seemed disgusted by it. The way some of those other docs treated me later, I wondered if they felt the same way. It was probably a bit TMI for them, but I didn’t know they were going to get anything beyond a brief written report.

          • guest

            I would be extremely surprised if someone who had been to medical school was in any way offended or disgusted by images from a colonoscopy. I think it’s likely that you misinterpreted her reaction which was probably her being playful about receiving numerous images from what she considered to be an unnecessary test. Had you requested the colonoscopy for yourself? And did it turn out to reveal your multi-system disease? I would be interested to know what you were ultimately diagnosed with…

          • DoubtfulGuest

            Sigh…patient misinterprets again? ;) That sure seems to be a popular explanation.

            1) “Playful”, I guess. Not hateful, but mocking, I’m sure of it. She terminated me a few months later.

            2) Requested the test myself? Nope. I was recommended to have one at a youngish age due to concerning family history. The same day, I had an endoscopy for possible celiac disease (“Don’t worry — we’ll use a different scope!” said the gastroenterologist. I had the antibodies, which is why this direction looked promising). There may have been some CYA medicine involved, but I was not the primary driver in these tests being ordered. Both were essentially normal, but then GI symptoms were not major complaints on my end.

            3) Mitochondrial myopathy, not one of the better known syndromes with acronyms, but they know which biochemical defects. ATP synthase (Complex V), mainly. Under that umbrella, I have hypothyroidism, adrenal insufficiency, and I had endometriosis, also, but that is no longer a problem. These were each diagnosed in pieces over many years.

          • ninguem

            If you’re going to make a joke about a colonoscopy at a patient’s expense, I’d say, perhaps, getting a picture of the patient’s face and Photoshop it on the picture of the inside of same patient’s colon.

            Then…….perhaps…….same patient might……say……take the calendar hung up in waiting room, that patients use to check day for future follow-up appointments. Maybe same patient might take a day several months into the future and write “Dr. Ninguem will graduate medical school”.

            And receptionist wonders why patients give her a strange look when planning next month’s follow-up appointment on the calendar.

            I mean I’m just sayin’………..

            You better know your audience for that kind of joke.

          • DoubtfulGuest

            Heh heh…yes, it’s all about the relationship and the audience.

            Long ago, one year at the health fair, a hospital burn unit “partnership for safety” or something like that gave out “meat doneness” charts, complete with color changes. Whadya think…someone with a sick sense of humor or did they just have a breeze over their head? :/

          • ninguem

            Speaking of meat done-ness.

            http://www.bmj.com/highwire/filestream/431933/field_highwire_fragment_image_l/0.jpg

            It’s called the Bristol stool form scale. It’s used to help evaluate and monitor irritable bowel disease and similar conditions.

            It takes an Englishman to go into such detail over turds.

            Perhaps appropriate if same colonoscopy Photoshop patient is from England.

            He gives as good as he gets.

          • DoubtfulGuest

            I was reading down before I clicked on the jump, going “Huh…what on earth is…oh.”

            Like a sausage OR a snake. Priceless.

          • DoubtfulGuest

            Also, is playful-ness an appropriate response to an unnecessary test? Most people I know find a colonoscopy to be at least mildly embarrassing. What would a doctor hope to get out of reacting like that? Is that the way to make a lightbulb go on in the patient’s head and think “Wow, I totally didn’t need that test! It’s judicious use of health care resources for me from now on.”?

        • EmilyAnon

          “Docs Sued for Insulting Unconscious Patient during colonoscopy. The patient had been recording post-op care instructions on his phone and accidentally left the phone in record mode during the procedure.”

          (story here)
          http://www.outpatientsurgery.net/surgical-facility administration/legal-and-regulatory/patient-says-he was-defamed-during-colonoscopy–04-25-14

          http://tinyurl.com/l6tebop

          It’s interesting to read that respect was demanded during medical training. So where along the way is that principle forgotten?

          • DoubtfulGuest

            I don’t even know…what can you even say to that? These “very few bad apples” sure seem to get around a lot. (Disclaimer: IF this is all really true and accurate reporting blah blah…)

            I woke up with a big scratch near my lip (I had an upper scope the same day), and didn’t feel like I had a secure enough relationship with the doc to ask about it. The nurses were really nice to me when I was awake…they didn’t come off as sadistic at all…but I always wondered what went down. The report said “The patient tolerated the procedure well…”.

            I’ll skip the sedation next time.

            Unfortunately, this is far down on my list of worries. I’m busy trying to deal with all the accusations of faking that happened while I was fully conscious.

    • goonerdoc

      So because of one bad apple, you cast a broad generalization about the entire profession? You really think we all act like that?

      • DoubtfulGuest

        I’m sorry to join the cynics today, goonerdoc. I woke up on the wrong side of the bed. The problem is, many of us see parallels between how this gentleman’s remains were treated, with how we’ve been treated as living patients.
        I agree generalizations are not helpful, but are we supposed to stay quiet about it? We hear the “bad apples” thing for patients all the time on this blog. Might there be a double standard? What would be a better approach for this kind of conversation, do you think?
        I will say when I read this post, I felt a sense of dread over what I might find in the comments, and was mostly pleasantly surprised. That probably says more about me than it does any of you, but there you go.

    • JR

      I read elsewhere that now a days, most bodies are donated, though in the past it was mainly bodies that went unclaimed. I had two grandparents who both donated their bodies – it was their choice to do so.

      I know many people say “it you’re dead, what do you care…” but I can’t help but care. I hope I won’t be given an autopsy and can cremated in one piece.

  • Jennifer Jonsson

    I’m reconsidering donating my body to science. Maybe a quick cremation would be more dignified.

    • guest

      What was described in this piece is not the norm at all. In my anatomy lab we were told the first name of our cadaver and told to treat our cadaver with respect. They had given us a precious gift so that we could learn.

      • DoubtfulGuest

        I’ve always been treated with dignity and respect by medical students. Years ago one of them even stuck his neck out a bit for me with an attending who was giving me a hard time. Wish I recalled his last name so I could look him up and send him a thank you note.
        I can’t imagine any of these young folks behaving like this post describes.

        • EmilyAnon

          I agree, Doubtful, my 3 hospital stays have only good memories of my dealings with medical students, more so than with the harried residents. One time after rounds, one of the students stayed behind a few minutes to talk. She was so respectful and sweet, confiding that she was homesick for her family. I hoped she might come back, but never saw her again. I wish I made note of her name. It was many years ago, she’s probably a doctor by now. And I’m sure she would be surprised that I never forgot that brief encounter.

  • EmilyAnon

    There have been articles defending “humor” in medicine, as a release valve for all the pressure they’re under. And if at the patient’s expense, just make sure the patient isn’t aware.

    Also, Isn’t there a movement to allow students into medical school right out of high school like in Europe? Can you imagine the maturity level of teenagers in a cadaver lab?

    • Med Student

      I took dissectional anatomy my first semester of college (so basically the same level of maturity as a high school senior) and the respect given to cadavers was far, far higher than my anatomy course in medical school (where the median age was 7 years older than that of my undergrad class). Maturity has little to do with it, institutional cultures will dictate how students treat the cadavers.

    • ninguem

      There have been medical schools accepting students straight out of high school since at least the 1960′s.

      Here’s a list of schools currently offering such a program.

      https://www.aamc.org/students/aspiring/347100/bsmdprogamlists.html

      A quick glance, I see about three dozen schools offering medical school entrance from high school, in a combined bachelor-and-MD degree.

      Nothing new about it.

      When it comes to educational systems between countries. Picture a group of untrained people on the left. Picture a “black box” in the middle. Picture a bunch of trained people on the right.

      People go through the “black box” and come out the other end as…….accountants, physicians, lawyers, welders, plumbers, etc.

      There’s lots of different black boxes. Lots of different ways to train the type of professionals or tradesmen that you need. They can be radically different, and still product the same “product” in the end.

      The accelerated (six-year, seven-year) bachelor-and-MD programs haven’t taken over, so they have their problems. They didn’t disappear after decades, even grown some, so they’re not necessarily bad.

      Just a different “black box”.

      Not having been in such a program, I do not know if the high school students go straight from high school to gross anatomy. I suspect not, but I don’t know. Anyone here been in such a program?

  • goonerdoc

    In response to those shaking their heads at doctors because of this piece and saying essentially “no wonder we don’t trust you,” let me say that (as many others have already done) THIS IS NOT THE NORM. This is very, very far from it, and a gross breach of acceptable medical behavior. We were taught right off the bat to treat our cadavers with the respect they deserved. Please cease the broad generalization of my profession because of one bad, if not horrible, apple.

  • ninguem

    And for what it’s worth, although I saw no such disrespectful behavior in my medical school class, I will also say that RUMORS of such disrespectful behavior circulated in the town all the time.

    A cadaver dragged out in public. Cadaveric penis cut off and displayed for shock event in some crowded men’s room. Same old story. Urban legend. Person knows someone who knows someone who swears his cousin saw it.

    Those very stories did make the trash talk radio shows, and another anatomy instructor at my school had to make appearances at the trash talk radio shows and in the newspapers, to disabuse the listeners and the readers of such rumors. No such thing had ever happened, nowhere that I’d seen or even heard about, as it was affecting body donation.

  • ninguem

    This is the only story that I know of, and it did not involve students.

    http://articles.philly.com/1986-08-18/news/26063806_1_body-parts-police-hope-medical-school

    It involved anatomy lab and morgue technicians, and a medical school faculty member at the University of Pennsylvania.

    Thing is, the place the cadavers were being shipped to, in Colorado, was engaged in legitimate medical teaching. Private courses for surgeons if I remember correctly.

    It was fair enough for the academic center to ship cadavers to this institute if, say, the school had more cadavers than they needed. It is legitimate to pay the parties involved for their trouble.

    There are certain rules for shipping human remains. Rule one, you might think, is to label the parcel as such.

    So that when the container leaks, the UPS guy that opens the mislabeled box doesn’t get surprised by cadaver heads staring up at him.

    The med school faculty, and the techs, were, shall we say, free-lancing.

    There was the problem if figuring out exactly what law was violated. There was a public health law prohibiting the shipment of a Pennsylvanian out of state for anatomical research.

    Thing is, if the cadaver had come from Jersey, than maybe it was OK…..

    I lived near Philly at the time. I always though that town was a little bent.

    • EmilyAnon

      UCLA had a body donor scandal some years back. It was unravelling on the local news for weeks.

      “The scheme was a clandestine collaboration between the willed-body program’s director and a private tissue broker, who told The Times he retrieved the corpses from UCLA’s cold storage room, cut them into pieces with power tools and hauled them off, packaged in coolers. He made more than $1 million providing the cadavers and body parts to pharmaceutical and medical firms. The scheme had been going on for years before coming to light.”

      “Both men were sent to prison, and the university’s body donor program temporarily shut down. News coverage and legal proceedings had exposed embarrassing problems in macabre detail: Unsanitary conditions, overcrowded cadaver rooms, a tracking process so disorganized that UCLA couldn’t account for hundreds of missing bodies.”

      Lots of people with dirty hands.

      http://articles.latimes.com/2011/mar/19/local/la-me-banks-20110319

      • ninguem

        And notice that none of these were medical students.

        • EmilyAnon

          Yes, of course. I meant no comparison between these crimes and inappropriate campus hijinks.

          Anyway, to add to the UCLA story, one of the people jailed wrote a script about his dealings and it was being considered for a TV movie. ( Well, this is L.A.) Don’t know if it was ever made, but think he became a medical consultant on some doctor show for awhile. It’s easy to make a silk purse out of a sow’s ear in Hollywood.

          • ninguem

            And with respect to Philadelphia.

            If you’ve ever had scrapple, you might suspect there are ongoing misdeeds with cadavers in The City of Brotherly Love.

          • EmilyAnon

            ha! Had to look up scrapple. If I’m in doubt, I go vegetarian.

          • DoubtfulGuest
  • PrimaryCareDoc

    My anatomy instructors would have killed us if we behaved like that. Seriously. We would have been on the table next to the cadaver. Our first lesson was in respect for the gift of our donor. We held a memorial service at the end of anatomy where we all thanked our donors (and their families, who were invited).

    Your professors should be ashamed.

  • ninguem

    Where’s DeceasedMD?

    We need his expertise on this one.

  • DoubtfulGuest

    Thank you for your kind words, goonerdoc. It means a lot because I’m really struggling to stay positive. I always enjoy reading your comments as well. Sometimes I should follow your lead and be of fewer words. I hope your patients appreciate you, as they should. I don’t have a problem with a single thing you say here. I don’t like the doctor-hate going around either, the recent NYT stuff for example is reprehensible I think. On both sides, it seems like the nicer ethical folks are paying for the sins of a few. You’re right to question that. I wish I knew how to fix this mess.

  • DoubtfulGuest

    Very well said. This distinction between the professions and the impact on us, gets glossed over way too much, IMO.

    • DoubtfulGuest

      Why does chaplaindl’s comment appear to be undergoing moderation again? She’s (?) not targeting anyone in particular and she’s right.

  • ninguem

    I’ve been to a few medical courses where certain medical procedures were being taught, where you really needed cadaveric material (read…..bodies) to practice the technique.

    I mean continuing medical education courses, not in the medical school.

    These courses were being held in your nice fancy downtown hotels that host conventions all the time.

    Those ballroom meeting spaces, they would wheel cadavers in, and you would do whatever it was you were there to learn.

    Needless to say, there’s significant security, they check your badges carefully when you enter the ballroom. Last thing they want is someone from the lawyer convention down the hall to wander in the wrong ballroom. There’s usually screens erected on the other side of the door, so passers-by don’t catch a glimpse.

    I know I’ve done that, twice, at continuing education meetings, and I’m not a surgically oriented physician. Probably those docs have done even more.

    Not cheap to do it, for all the logistics necessary.

    Conversation may well be light, nothing funereal. Bodies donated legitimately, usually obtained from the medical schools. Scandals from the 1980′s tightened up oversight…….or at least I hope so………they SAY it’s tightened up.

    Remembering we’re practicing physicians now, and have paid money……usually a LOT of money…….to learn a specific thing.

    So, I dunno. For decades I’ve heard RUMORS and STORIES of such disrespectful behavior towards the cadavers in medical school, but I sure as heck haven’t seen it.

    Medical school gross anatomy days, we were overwhelmed with things to learn, we were too scared to behave the way it was described here. Later on…..it’s business, I’m paying lots of money to learn something specific.

  • DoubtfulGuest

    Sometimes I wonder about medical necessity in these cases…like when is it appropriate to place a catheter, and when might a patient need to be less covered for quick emergency access? All reasonable questions, though, instead of carte blanche for the medical folks…

    I’ve had modesty (okay, really it seemed like liability concerns) go too far, like weakness/alignment problems in my legs and hips but no one actually looked at the affected body parts. There can be important visible changes in the muscles, like decreased bulk and kind of a spongy appearance. But you can’t see those very well through long pants…or the baggy shorts they give you in PT. I’d have preferred to wear a flimsy gown for exams with no female chaperone, and get the right diagnosis faster. Keeping me covered didn’t mean my dignity was protected. It’s complicated…

  • Doug Capra

    What’s most disturbing about this piece is the writer didn’t stand up and advocate for respectful behavior. The fact that the writer has to remain anonymous is also disturbing, suggesting that whistle-blowing in a serious case like this would have serious impact on the student’s career.
    At some point, medical students need to realize that they need to behave as a medical professional even before they officially become one. Developing the habit early is essential. Being afraid that some one above them in the hierarchy will react negatively to them stopping behavior like this is no excuse. Even as doctors, there will always be someone above you in the hierarchy. Medical school is the place to begin standing up for humane, ethical behavior and being a patient advocate. Standing by and watching this kind of behavior and saying nothing is an ethical sin of omission.

  • JR

    That’s really sad.

    Patients who are kept warm during surgery have better outcomes (which is why bair huggers were invented). Also, people with serious chronic illness may have undiagnosed cryoglobulinemia – look that one up if you aren’t familiar with it.

    And it’s just disrespectful in general too. It shouldn’t be exposed if it doesn’t need to be.

  • JR

    I don’t want to put words in Ed’s mouth, but I’ve seen him around.

    He certainly isn’t looking at what only ONE medical student did when he makes that statement.

    A lot of us patients who hang around here are trying to learn how to navigate the system successfully in the future, because we’ve treated badly by the system in the past.

  • http://joannevalentinesimson.wordpress.com/ ValPas

    This was an excruciating reminder of experiences I had both as an anatomy graduate student and as an anatomy faculty member in medical schools. Many years ago, cadavers were often disrespected, but more recently, especially as donated bodies have replaced unclaimed bodies from mental institutions and prisons, respect for the cadaver as teacher has improved considerably. There have always been a few medical students who disguise their discomfort by frivolity or disrespect: future patients beware.
    I sometimes used this theme in fiction written partly as therapy during this period and afterwards. One such story has been posted in a blog site: http://vpascoefiction.blogspot.com/2012_01_01_archive.html

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