Memento mori: cadavers in the classroom


The LA Times recently reviewed Body of Work: Meditations on Mortality from the Human Anatomy Lab, a memoir by medical resident Christine Montross. I’ve been trying to decide if I want to read it, and I’m still uncertain. Although a relative novice when it comes to medicine (my degree is in molecular biology), I taught anatomy using human cadavers, and have dissected them. I never found cadavers the least bit disturbing. But I may be unusual in my detachment – my students reacted with disgust, distress, nervousness – and constant anxiety that their reactions weren’t normal.

But what is normal? How should we relate to a donated cadaver in the anatomy lab – as a person, or a thing? Some reactions seem to be universal – gallows humor, for example. Humans have been laughing at death since long before Shakespeare. (What other weapon do we have? Death always wins, and the cadaver’s the un-living proof of it.) We have some general rules of conduct – for example, treating the cadaver with respect, keeping the pieces of the various cadavers separate, covering face and genitals when they are not being examined. But such rules seem to be mostly for the students’ comfort, since it’s hard for a cadaver to retain modesty or dignity, at least in a traditional sense, when skin is missing and viscera are exposed.

Students respond to cadavers in personal ways, based on their own family histories, so one student’s experience of dissection is unlike any other’s. Everyone sees the cadaver differently: is this a person, or a patient, or a body, or a teaching specimen, or an illustration. . .? When students take limbs from a skeleton and hold them up to their own arms, turning them to determine the correct orientation, they enact a little unconscious ritual: memento mori. One student was fine with the cadavers until her grandmother passed away; after that, she found the cadaver so disturbing she couldn’t be in the same room with it. The boundaries of life and death, previously comfortably clear, had blurred intolerably. Before class began, students came to me, concerned that they might find the body of a deceased relative in the lab: when and were and who, they wanted to know. (Why came much later.)

Montross’ book takes on some of these issues. As reviewed by Harvard professor, poet and doctor Rafael Campo,

“Body of Work” is at its best when Montross, who is also a poet, allows us to observe the astonishing beauty her dissection reveals, and to relish the language she uses to describe it. “The language of these bones slides along their edges,” she writes. “Os coxae, the hip bones. Their three parts, with names like flowers: ilium, ischium, pubis…. The pelvic brim, as if water spills over it…. Brim, arch, spine. The ligament names like a call to prayer: sacrospinous, sacrotuberous. Sacrosanct.”

This wonder cabinet of anatomical language is familiar to any biologist. It is indeed beautiful. So is the body it describes. But Campo rebukes Montross for allowing such language to establish a clinical distance between herself and the life history of her assigned cadaver, “Eve:”

I believe it is the depersonalization first modeled for aspiring doctors in their encounters with cadavers that accounts for much of the lack of professionalism and career burnout in physicians, and the callous treatment patients too often receive nowadays.

Really: studying the body as beautiful, complex object is a precursor to treating living patients callously? I have never known anyone to leave an anatomy lab feeling less respect and wonder for human beings than before they began. Yet Campo wants the anatomical curriculum to explicitly address the spiritual, not just the physical:

In this age of frequently misapplied technology, here is a chance to make productive use of video cameras and monitors: Might not a video of Eve, telling of her life and created at the time she decided to donate her body, help mitigate some of the mistreatment Montross documents, as well as the subsequent distancing she (however uneasily) comes to approve?

A pleasant idea – and what I’d expect from the author of The Desire To Heal: A Doctor’s Education in Empathy, Identity, and Poetry. Empathy should be part of the training of doctors and nurses alike. But is anatomy lab the right venue in which to share the life history of a cadaver? Personal details would increase the discomfort of beginners – in my experience, overly powerful empathy for the deceased disrupts their ability to cut and handle the body (a point Campo seems to dismiss). Would cadavers without life stories receive less respect or care than those who had documented their lives?

Isn’t the point that regardless of our living identities, whether we are good or bad, our bodies are kin, after death and in life? When the cadaver was alive, it was home to a unique mind. Now that its cells are dead, is its role in the laboratory to elegize that mind – or to represent universal anatomical mechanisms? As a biologist, the answer seems fairly clear. Perhaps a doctor feels differently; I don’t know. But I was disappointed as Montross appears to conclude her book by backtracking from scientific objectivity to elegaic ritual (with Campo’s approval):

Great teacher,” she intones, “I give you flowers. I carry your body to the funeral pyre. When you burn, may every space in you that I have named flare and burst into light.” Thus she aligns herself with the humane tradition of honoring the dead, and the act of love inherent in tending to them. The detached concern she professes to want to emulate seems refreshingly absent here. Perhaps, in recognizing our universal and very human contradictions, there is hope for the beleaguered medical profession, after all.

Honestly, this leaves me cold. I can’t speak for anyone else, but if my body ever ends up in a cadaver lab, I don’t want people intoning poetry to it. I want them to dissect it. And yes, I said “it,” not “me.” I’ll be dead. My body is a wonderful clockwork, but it ain’t me.

The imagined ritual may be beautiful and humane, but it is a pleasant fiction, meant for the observer, not the observed. It has nothing to do with the cadaver’s living identity – we have no idea who “Eve” was, nor if she even desired commemoration. Most importantly, the manifest beauty of the human body doesn’t require validation by tradition or flowers (or words). We don’t have to turn a cadaver into a spiritual symbol to make it a wonder: it already is wonderful, even in death. And if someone fails to understand that, I doubt they should be practicing medicine at all.

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6 Responses to Memento mori: cadavers in the classroom

  1. Wunx~ says:

    I took human anatomy my junior year in college and can still remember the feeling when I looked at my first cadaver. It was an old man with long hair, finger and toe nails. Those little details made him just too unique and real to me. I felt disconnected and hollow with a strange buzzing tingle between my diaphragm and stomach.

    Touching the cadaver was what recentered me. The body had been preserved in formaldehyde and felt nothing like human any longer. It allowed me to move mentally from “him” to “it”. I don’t think I could have coped without the distance.

    The distance was not a lack of respect. My respect is great enough that I have specified on my driver’s licence that any and/or all parts of my body are to be donated when I no longer need them.

    I agree with you, Cicada, my body isn’t me. But it can still be useful.

  2. Vanessa says:

    I wish I could have known more about the cadaver I dissected in anatomy lab. Our table named her Tilly, and all we knew was that she was 101 and died from hardened arteries that made her heart twice as big as it should have been.

    Like Wunx said, as soon as you touch a cadaver it loses it’s human feel. To me, they looked like props in a Hollywood movie.

    But the first time I was bothered by death was during my first autopsy. She was a young beautiful woman around my age, who died of a drug overdose. Seeing a fresh body cut and flayed open, jiggling organs removed, blood spilling everywhere, made it all very real and disturbing. I don’t think many people could distance themselves from that.

  3. cicada says:

    Excellent points from both of you! There is a huge difference between a preserved cadaver, and one that has not been embalmed. Although the practicalities of the anatomy lab require preserved specimens that can be used over many lab sessions, I’ve been lucky enough to dissect fresh mammals and it’s a completely different experience. For one thing, the insides of an unpreserved animal are aesthetically beautiful on a completely different level – the colors and textures are amazing! The best I can describe it is like wet pearls. For another thing, the chemicals used to preserve cadavers are nasty, and the smell itself can make some students sick. But I imagine most students would have real problems handling themselves in the autopsy situation Vanessa describes, and would prefer a stinky, rubbery, but “less human” preserved specimen.

    Most of the students who did dissections agreed with me that the texture of a cadaver is much like carving a Thanksgiving turkey. And yes, despite your brain’s best efforts to remember the context of what you’re doing, it can make you reflexively hungry to cut up something that looks like turkey. (I had to reassure several students that my stomach was growling too, and it did not mean we were cannibals).

  4. Christine says:

    Hi Cicada–

    A friend forwarded me this site today because they suspected I’d like what you wrote in trying to decide whether to read my book. They were right. I think our collective response to cadaveric dissection is chock full of exactly the ambivalence you describe. A person, but clearly not a person any longer. Beautiful and also disturbing.

    I do hope you’ll read Body of Work, despite your reservations, and that you’ll let me know what you think.

  5. cicada says:


    Thanks for dropping by! I’m glad you aren’t offended that I said so much about your book, without having already read it.

    It is an extremely ambivalent and personal subject, and the fact that Vanessa and Wunx have weighed in already with their own personal experiences, speaks to the importance and wide range of perspectives on the topic! I’m eager to read your book directly without the filter of this reviewer – I may not have reservations about your book, so much as I do with his interpretation of it.

    Best wishes for the book’s success!

  6. Trevor says:

    A very interesting post. Thanks for sharing your thoughts on mortality and cadavers.

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