In a Medical Sanctuary

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Jean Gaumy/Magnum Photos
Doctors and interns in a pediatrics ward, Le Havre, France, 1975

A doctor’s education classically begins with an introduction not to the living but to the dead. And so it was for me some forty years ago. After the opening lecture on human anatomy in a large amphitheater, our class moved to a cold subterranean room. There, scores of cadavers covered by plastic sheets lay on stainless steel tables. The pungent smell of formaldehyde filled the cavernous space.

We were divided into groups of four, each group assigned a body. As a fellow student lifted the plastic sheet, I saw a female of indeterminate age with bronze-colored skin, a taut belly, and puckered breasts. Age was hard to ascertain because the bodily features we focus on to recognize individuals—face and hands—were covered in tightly wrapped gauze. The instructor directed our attention to the arm, and I made a tentative first cut with a scalpel to open the skin and expose the biceps muscle. Over the ensuing weeks, we marched across the limbs, meticulously dissecting muscle and nerve and tendon, tying fine strings around each isolated part with a small tag to identify the structure. Ultimately, we reached the boundaries of the exposed skin, and were told to remove the gauze coverings. My cadaver’s head was crowned by matted gray hair and her hands were fine and boney, the knuckles distorted by arthritis. We made precise incisions and exposed the muscular splay of the palm.

It was a late autumn afternoon when we completed the dissection, and as I walked along Fort Washington Avenue to the dormitory, I glanced down and saw something on the toe of my shoe. At first I didn’t know what it was, and then realized that a thick clump of flesh had fallen from my cadaver. I stood motionless for a long while. I felt as if I had committed a sacrilege, violated a boundary, by removing the dead from a proper hidden place.

I thought how the cadaver was intentionally masked so as not to be a person. And how the dead were distant to me. No one I knew had died, and I had never been to a funeral. My mind in the dissecting room had been fully occupied with recognizing the shapes and locations of anatomatical parts. Now, I was gripped by the sense that I must be much more than simply these parts, that I had a dimension distinct and above the physical. But might the reductionists be right? Was I in the end merely a mass of interacting molecules, and my sense of self, the conscious perception of an existence beyond the material, an illusion?

The anatomy laboratory was locked after each dissection, so I slowly retraced my steps, careful not to dislodge the piece of flesh, back from Fort Washington Avenue to a small garden behind the medical school. There, I took a leaf and detached the fragment and then covered …

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