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Anatomy Lab
By Jeanne Bereiter, M.D.
Genre: Fiction Level: Adult
Year: 2000 Category: UAA/ADN Creative Writing Contest

We lived on rumors our first year of medical school, especially in anatomy lab. Rumors supplied what our instructors did not: instruction about what it meant to be in medical school. Rumors taught us who would pass, who would fail and why. The most persistent rumor in anatomy lab concerned four male students back in the "old days." They were clowning around. One dared another to eat a piece of his cadaver. It was late in the afternoon, they'd been studying too hard and were at that silly, unthinking point of exhaustion where all one can do is laugh. We understood. We were in that condition half the time ourselves. As the rumor went, the young man accepted the dare. He was a wild young man, well liked. He tasted the formaldehyde-preserved flesh. Somehow the head of anatomy heard of this. The young man was expelled. Not only that -- and here came the real punishment -- the head of anatomy made sure he was barred from all medical schools in the United States, forever.

This was a difficult story to forget. What the young man did was gruesome, and probably unpardonable. We did not condone it. Yet we were all afraid of doing something so awful that we would fail or be expelled. We feared we would do this thing without realizing it, in a moment when our guard was temporarily down. The rumor spoke to this anxiety. For this was the breath that blew through medical school. This was what we could not speak about directly: The fear of banishment from medical school. The anatomy-lab rumor had another, important message. It taught us that our personal judgment was unreliable. Our judgment had led us this far, to one of the finest medical schools in Canada but could lead us no further. We could mess up, irretrievably and not even realize it. If we could not trust ourselves, then whom could we trust to teach us right from wrong? Our professors. The head of anatomy.

We were silent the day we began the dissections. Eighty medical students in a room the size of a hockey rink, we stood without speaking in alphabetically arranged groups of four. Each group surrounded a gurney, two students to each side. I was at Table 5. My lab partners were three men: Omar, Dave, and Steve. I peeked sideways at the object lying beside me. It was covered with an opaque plastic sheet. I could see the outline of a shoulder, a knee. I was tremendously excited.

The laboratory demonstrator bustled about at the front of the room, checking dissection kits for completeness. We waited. I wasn't sure for what. Then the head of anatomy entered the room. A gaunt man in his 60s, with pale skin and an unimpeachable seriousness, he terrified us. He was so like a caricature of an anatomy professor that his existence lent credence to the cannibalism rumor. He spoke about the class schedule and the plan for the next nine months. The dissection would begin with the chest cavity, then move to the abdomen, then the arms and legs. We were to respect the people the cadavers had been. We were to treat them with dignity. At this, nervous laughter trickled faintly through the room and stopped. We had all heard the rumor. We were scared of being expelled even for laughing. We were that nervous. Then he said something about the privilege we had of training as doctors and how people had donated their bodies to science in order to help us. Many were called, few chosen. I looked at my lab partners. We smiled nervously at each other. The head of anatomy left the room. At once, the demonstrator gave us instructions. Remove the plastic sheets, carefully. Put them in the garbage. Messiness is not tolerated in the lab. Begin the dissection with a vertical incision from the sternum to the navel. Cutting into human flesh is a taboo. Breaking a taboo was what made the first cut so difficult. Our hesitation was not due to squeamishness. I knew after the first few moments of breathing the sweet thickness of formaldehyde while looking at my cadaver that I wouldn't faint or throw up. But my hand guiding the scalpel through the skin was heavy. Was this really OK to do? That was the question that stayed with me from the first. Was this really OK? Not able to trust our own instincts, which told us it was wrong to cut open dead bodies, we listened to an authority, who told us it was a privilege to dissect cadavers. Gradually, the feeling it was wrong went away. Don't people say the second murder is easier than the first?

To protect the dignity of the people our cadavers had been, we were given no information about them. We did not know their names, their ages or why they died. We knew nothing. We wanted to know everything, so we told each other stories under our breath. We assumed it was wrong to speculate, but we could not stop. My anatomy-lab partners and I named our cadaver Ben. Ben was 73 when he died. He died of cancer: we found that out when we dissected his abdomen. Tumors were everywhere. That explained his thinness. We could not conceive of Ben having a grieving wife, so we made him a widower. He lived alone in a little apartment. His children had moved to California years before. They seldom visited.

Naming Ben made cutting him open easier, as if now we had his permission. From remarks we overheard at other tables, my lab partners and I were not the only ones to personalize our cadaver. Table 4, next to us, had a woman. Judy. Judy had let herself get overweight, and Table 4 didn't like it. Fat stuck to their scalpels and obscured the landmarks. Initially angry at Judy, and wishing they had been given an easier cadaver, after a few weeks Table 4 stopped complaining. The stories, to compensate, became elaborate. Judy had gone to a fat farm, Judy had tried the grapefruit diet. Although proud of Ben, at first, for having remained thin, we became envious of Table 4. Judy had lived a more interesting life. Every time I thought this, I apologized silently to Ben. He was mine. My loyalty to him was profound.

By the end of the first month, anatomy lab had become routine. We complained, proudly, to our friends who were not in medical school, about how difficult it was to get the smell of formaldehyde out of our clothes. We traded stories of using vinegar, or lemon juice, on our hands. Competitive with each other, we compared how quickly we were completing our dissection, how accurately, and we promulgated rumors. Thomas had memorized every vessel in the upper extremity. We no longer said "arm." Table 9 was coming to the lab on Saturdays, and had completed its dissection of the legs. They were going to ask for an extra assignment. Someone at Table 12 had begun crying last week and had to leave the room.

We dissected the cadavers, and our uncomfortable feelings went away. Dissection became schoolwork, like everything else. We were deep inside the body now, in the abdomen. The viscera didn't look like anything living. They didn't have the shock of humanness I'd felt when we were cutting through skin. I had seen livers and intestines before, from animals, on TV and in the grocery store. My mind normalized what I was doing. Human liver, cow liver, a liver is a liver.

The first set of exams approached. I began to memorize: veins, arteries, nerves. What were their names? Where did they lie in relation to everything else? I studied absurdly long hours, pushing myself beyond all my previous study limits, taking breaks only to eat and sleep. It was like running a marathon for someone whose previous longest run was five miles. Rumors stuck in my head and kept me studying. "Last year," the second year class said, meaning the class before theirs, "12 people failed the fall midterm in anatomy, and they really knew their stuff. One guy was in the library every night until closing, writing things down on note cards. The exam came and he froze. His mind was a blank for the first hour. Then he recovered and began to write. But he couldn't catch up. It was hopeless."

The midterm came, and I passed it. Most of us did. We began to relax. Anatomy was the neophyte medical student's test. If you got through anatomy, you were in. As the months went by, the rumors tapered off then stopped altogether. It seemed that we knew what first year medical school was all about, and there were to be no more surprises. In early spring, however, a new rumor began. We would cut our cadavers in half, through the waist. Then we would cut the lower body in half again, through the genitals, separating it into a right leg and a left leg half. "We had to do it," the second year class told us. "The department does it to save money." Apparently the caskets bought to contain the cadavers after we had finished with them were half-size. The demonstrator couldn't cut up all those cadavers by himself, so they got us to do it to help him out.

I first heard this rumor on a Friday, during histology lab. Anatomy lab was on Monday. I looked into my microscope at a slide of connective tissue and began to draw the cells. This would help me to recognize them later, during our final exam. I kept seeing the anatomy lab and a row of half-size wooden caskets. The demonstrator was stuffing the cadavers into them, head one way, and feet the other, so that the toes ended up beside the ears. Then he nailed shut the coffin, to keep the family from seeing inside. I dismissed the rumor. Nothing that disgusting could be true.

On Monday, when we walked into anatomy lab, the demonstrator was at the front of the room, beside a table on which he had assembled a collection of hand saws. They were two-handled, like the ones used to cut down trees before there were chain saws. We assembled in our usual groups beside our cadavers. The demonstrator explained the procedure. We would saw the cadavers in half, then in half again. He would help us. Did anyone have any questions? Yes. Why were we doing this? It's the best way to learn the anatomy of the pelvis.

I looked at my lab partners. "I can't believe we really have to do this," I whispered. "Can you guys believe this?" They couldn't believe it. Around the room, there was a pause, then a quiet flurry of conversation, as we struggled to assimilate what we had been asked to do. But there was no revolt, no organized dissent. It was too late to complain. Class was in session, saws were being distributed. And, in a more general sense, it was much too late to complain. We were already in it too deeply to get out. If you accept the first senseless command, how can you say no to the second? I thought of walking out. I thought of the hours I had spent studying, while outside it was summer, then fall, then winter and now early spring. Soon I would be done with my first year of medical school. The trees were in bud. I could not quit now.

The demonstrator walked by, a saw in his hand. I flagged him over. "Do you need some help getting started?" he asked.

"No," I said, though it was true that we hadn't yet decided which two of us were going to hold the handles of our saw. "I have a question." He paused, and while he lingered at our table, David and Omar picked up the saw. "Couldn't we just use prosections?" I asked. "To learn the anatomy of the pelvis?" Prosections were pieces of cadaver that had already been dissected. We were going to use them after the spring midterms, to learn the anatomy of the head and neck. The dental students would do the original dissections, taking over our cadavers for the purpose.

"No," said the demonstrator. "You need to dissect your cadavers." He motioned Omar out of the way, leaned into the saw and cut, David holding on to the other side. The body began to separate, and with a crunch of bone they were through.

"That's how you do it," the demonstrator said. I looked up. The students at the tables surrounding us were all watching. None of them had yet begun. We were the first to saw our cadaver in half.

My lab partners and I stared at our cadaver for a few moments. The room was loud with the sound of sawing. Ben lay naked on the gurney, his top half separated from his bottom half at the waist. He seemed surprised. I wondered whether he had known this might happen when he donated his body to science.

"Well?" David asked.

"You mean who's going to cut the next part?" Steve replied. Omar was silent.

"What?" I said. They were all looking at me.

"It makes sense," said David. "You're a girl. It won't be so hard for you."

I looked at Ben and at his genitals. Was is technically possible to dissect them evenly? An aberrant thought came to me. I was not going to learn the anatomy of the pelvis by sawing a penis in half. They were lying to us. I would learn more about anatomy by looking at pictures in a book. I banished the thought. It was irrelevant. We needed to get our cadaver cut up or we would all four flunk out of medical school. My partners continued to look at me, pleadingly. I had never seen them vulnerable before.

"OK," I said. "I'll do it." I took my scalpel, and before I could think some more and stop myself - it was done. Laying the scalpel down, I noticed that my hand was trembling. My breath was heavy in my throat.

Omar and Steve took the saw and finished the dissection, cutting through the pelvis and bone. Ben lay in four pieces. We had all participated. We looked at each other in relief. We were done.

"Class," the demonstrator called from the front of the room. He had a leg slung over his shoulder. "I want to show you how to wash out the specimens." He walked over to the sink in the far comer, stuck the leg in it, turned on the water, and began to scrub at it with his gloved hand. "You need to be careful not to cut yourself on any bone fragments," he warned. After a couple of minutes he held up the dripping leg. Placing it back on his shoulder, he took it to table 11 and lay it down. "Come on," he said. "We're nearly out of time."

"I absolutely cannot believe this," I muttered. "It's like something out of 'Night of the Living Dead.'" Silently, white-coated medical students were carrying legs to one of the two round, foot-operated sinks in the room. A line began to form, as the sinks weren't large enough to accommodate everyone. Angrily, I hoisted a leg onto my shoulder, not looking back to see who, among my partners, was taking the other one. The leg was surprisingly heavy. My shoulder began to ache.

We washed out the legs of our cadavers, avoiding bone fragments, trying to do a good job. We concentrated on cleaning, not meeting each other's eyes. I was furious. The medical students around me were so matter of fact it seemed as if this didn't bother them. Was I the only one with a conscience? I cleaned Ben's leg through eyes filmy with tears. I was ashamed of having violated him in this way, and confused as to whether or not I had actually done something wrong. Medical students were expelled for misbehavior. Although I felt like a criminal, I was actually being a good medical student. I felt vertiginous. Right and wrong swirled together so thoroughly I was off balance. "That's just because you're hyperventilating," my medical student voice informed me. It was a new part of me, but it spoke with conviction. I felt my doubts lessen. Nonetheless, I wanted to flee.

When finally allowed to leave the lab, we washed our hands quietly, hung our lab coats up in our lockers and returned our dissection kits to the shelf. No one mentioned what we had just done. I held my hands under the water until my fingertips wrinkled. The formaldehyde smell seemed stronger than usual, and more persistent. It mixed with the odor of the surgical gloves, and, for the first time, nauseated me. I thought of Lady Macbeth with new sympathy. Like her, I had just killed a part of myself.

Outside it was still spring. Someone pulled a Frisbee out of his pack and threw it into the air. I sat on the lawn and watched the Frisbee game for a few minutes before heading home to study. We looked so normal, medical students relaxing after class. Yet we had been indoctrinated that day. We were people who would obey orders, violate human bodies and work harder than made any human sense. A feeling of separateness, and privilege, slowly settled upon me. There was no turning back. Like a cow branded with its owner's symbol, I had the imprint of medicine upon me. I was going to become a doctor.

About the Author: Jeanne Bereiter, M.D., is a child psychiatrist who lives in Anchorage. "Anatomy Lab" won first place in the Open to the Public division of the UAA/ADN Creative Writing Contest; it also won the Grand Prize.

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