Monday, August 19, 2013

A Special Gift - First Day of Medical School

credit: Instagram @skiddiejoan
What are your plans for tomorrow? The next year? Decades from now?

How about plans for after your death? No, I'm not talking about what you will leave your family, or even your legacy. But your physical plans. What will you be doing? Where will you be? It's not something most people think about. In fact, it's probably one of the things we choose to think about least. Place me in a box and in a special place with some sentimental value (under the tree where we got married, for example) and be done with it--let's not talk about it anymore.

Today was my first official day of medical school. And as I end it quite appropriately--sitting in the library with eBooks on my iPad, notes on my laptop, and anatomy flashcards spread about--I can't help but think back on what our professors call our 'first patient': my group's anatomy lab cadaver. He was an old man in his 80s who died of complications stemming from the West Nile Virus. I have no clue what he did for a living, or even the most basic of identifiers, like his name or where he lived. I have not even seen his face; we met him facedown, a black bag covering his head. From the color of his skin I would think he's Caucasian, but that's quite an assumption, isn't it? I can also assume that he was an academic, hence his reason for having an inclination to donate his body in the first place. Again, an assumption. If I do some research on West Nile, I can probably come up with a narrative about how he contracted the disease, and what his final days might have been like. And just after one day...such begins a string of tales I can't help but weave together about this man...a man who will never know a thing about me. And I'll never know much about him, but at the same time I will know more about him than anyone else has. 

And that's the fascinating part about it--for me, at least. This man gave his body to become a part of something he ultimately has no control over, no say in, and no representation of himself except for the body he has left. I wonder how much he understood what he was doing. Whether he knew that we'd peel back the layers of his being slowly and methodologically, marveling at parts of him that no one has ever seen before. When his family remembers him, he will be a father, or a husband, or an asshole uncle who no one went to visit in the hospital (because, let's face it, it would be unrealistic for every obituary to be filled with praise). When we remember him, it will be for the almost perfect way the striations of his muscles were revealed. Or the difficulty we had with getting through such a deep layer of fat. We will remember the shape of his vocal cords, though we will never hear his voice. The curve of his hip bone, though we'll never know the specificity of his gait. The grooves of his brain without gleaning a single thought, memory, or emotion.

It's scary. It's impersonal. It's intimate. It's confusing.

It's funny...because going in to anatomy, you dread getting the overweight cadavers. You hear they are hard to work with, take longer to dissect, and sometimes the structures can't be cleaned fully. Once in the lab, we comment about his girth and the difficulty that comes with it. We look at other cadavers for a moment more than a cursory glance and silently exhibit a bit of jealousy. Then we realize that this 'curse' is a blessing in disguise: our cadaver's muscles are big and well-defined. We quickly have one of the best cadavers in the room. Teaching assistants marvel over the detail. Very quickly, excitement replaces what had looked to be a particularly hard semester.

It's unsettling, when I think about it. When this man decided to donate his body to science, was he imagining that people would sing him praise or express frustration based on how easy or difficult it would be to dissect him? Would he have been as willing if he knew the criteria that we would evaluate him on?

Then again, maybe he had the right expectations. Maybe he didn't care at all about his body after his spirit/mind/consciousness had left it. Maybe he realized both the gift he was giving and also that it wouldn't always be considered a perfect gift. Maybe he realized that the students his body would be donated to would be uncomfortable, and that the only way to cope with three hours cutting through a being that was once capable of writing poetry, raising children, murdering, flying airplanes, or what have you...would be to focus on some physical characteristic that detaches the body from its resemblance to us.

It's hard to imagine my body lying in a room, under a sheet, all the lights off with my back torn open. Then again, it's hard to imagine lying in a coffin six feet underground (talk about scary....who started that tradition, anyway???). Maybe it's just hard to imagine being dead. And maybe going six feet under is more for the living than the dead, so that we can protect ourselves from the constant reminder that one day that will be us. In this way, cadavers remind us mortality. That something happens to us after, whether we're aware of it or not. If we're not on a lab table, we're somewhere else, most likely a lot less useful. And a little less remembered. And that's uncomfortable. 

This is borderline procrastination. I should be working on my novel, or studying (or trying to find some revolutionary way to do both at one time), and this somehow feels more legit than browsing Facebook. I guess it's important to get my thoughts down, because who knows how much of me will change. Maybe a little, maybe a lot, and I can't say yet which would be bad or good. I only hope that I retain my reflection, my humanity, and at least a memory of the mindset I once had. And keep writing. Otherwise, how will I be able to speak up for myself when it's my turn to be a gift?

Sidenote: I haven't updated this blog in quite a while but I'm still writing and chugging along. There have also been big changes in my life (med school, marriage, alien abductions). I'm not sure yet in which direction this blog will go, but let's hope it stays live. I don't think my well-being depends on it, persay, but it can't hurt!