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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