Sunday, November 14, 2010

The Fifth Member

In this post, I am not going to be a hypocrite.  We have not called our "donor" "our donor" in a very long time.  In fact, I don't think we ever did.  He is "our body" and "our guy."  It doesn't feel right in writing.  It is jarring, but it is honest.  So I will call him that now.

One night, alone in the anatomy lab, I was reviewing our body's abdominal and pelvic organs.  I knew that the next time I saw him, I would be dissecting his face and neck.  There would be little time for reflection.  I lifted the sheet that had covered his face for the last month.

Our guy was entirely dissected, in some places far less than perfectly.  During lab, I no longer mused about the now bloated, skinless hand while I was wrist-deep in intestines and embalming fluid.  I no longer thought about "the person" or "the patient" while I cursed the smell--an unfamiliar and unpleasant mixture of embalming fluid and bodily contents--that strongly emanated from our body, particularly when we dissected near the rectum.  (I had long given up trying to breathe through my nose.)  I often wished that our guy weren't so darn moist, and yellow, and fatty--that, like our classmates, we could easily distinguish among arteries, veins, nerves, and ducts.

It is amazing what a difference a face makes.  I looked at his face, completely intact, feeling a combination of awe and shame.  His eyes weren't completely closed.  His nostrils flared a bit.  He had strong, gray stubble.  Who was this person?  What would he think if he knew what we were doing to him?  How much worse was it than what he'd imagined?

I thought about this man with the metal knee replacements, the hardened coronary and femoral arteries, the strong tan arms, the large amounts of visceral fat.  Sometimes during lab, we would hazard guesses about who our guy used to be: a fisherman?  A construction worker?  A park ranger?  We were probably horribly, offensively wrong.  My three labmates and I knew him in ways that no one else, including he, ever would.  Yet at the same time, we knew nothing about him at all.

If this were a movie, we would probably we treated to flashbacks about this man's life while we puzzled over his innards.  Maybe he would be shown at the dinner table, eating a hearty meat-and-potatoes meal while his arteries slowly calcified.  Maybe we could see how he developed such strong muscles, surprisingly well-formed even years after death.  Perhaps we would see him contemplating what he wanted to do with his body after death, having deep discussions with his wife and children.  Was he ever in a hospice, on a "death bed"--or did he die suddenly, perhaps of a heart attack?

Who was this man?  Would he have laughed along with us as we surreptitiously tried to get our instructor's attention with some well-placed coughs?  Would he too have flinched at the smell?  Been frustrated by the layers and layers of fat?  Felt disappointment when we accidentally cut a major nerve instead of preserving it?  Felt that same awe when we held his heart and lungs in our hands?  When he donated his body to science, how much did he know what the aftermath would look like?  That he would be groped deeply in cavities he probably never knew he had.  That he would get a circumcision.  That he would be seen every day by at least forty students--but not really seen so much as "looked past," as though he were part of the decor. This sounds more like a horror story than a gift.

The moment I stared into his face was oddly sad.  In some way, I felt as though he were witness to our work all along, a fifth member of our group.  I wished I could have a conversation with him.  I wished I could tell him what he looked like inside.  I wished I could tell him that we are just kids, to ignore our pouts and moans when we can't find what we're looking for and when we're tired of digging.  I wished I could tell him that holding his heart was the most humbling experience of my life.  Throughout lab, I sometimes imagined I could find a clue as to who he was by searching through his body, that physical signs could somehow magically impart answers.  Of course, this was fruitless.

If this were a movie, perhaps we would be rewarded with a final scene, a culmination of our efforts and his.  A meeting, of sorts.  A brief but meaningful conversation that would change how we viewed each other.  A videotape delivered by his family.  A hand-written letter.  A spiritual epiphany.  But there are no such endings here.  Our reward is learning anatomy.  This is the psoas muscle.  Sometimes I wish it were all bit more Hollywood.


  1. Thanks Shara. ;)
    You articulate beautifully what I feel.


  2. Beautiful! This was really thoughtful and moving.

  3. Coming late to this blog, but this is a beautiful piece. Please try to keep this perspective in your practice. Too many practicing physicians give their living patients no more regard than your classmates gave your donor.

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