"Bringing Out the Dead" in One Way or Another

I would like to bring to the attention of my visitors a new publication. It is ATRIUM- The Report of the Northwestern Medical Humanities and Bioethics Program of Northwestern University Feinberg School of Medicine. The title of this first issue is “Bringing Out the Dead”. Amongst other considerations, the ethics of the use and display of the dead is discussed. There are articles presenting the two views of whether specimens of the dead fetuses representing developmental anomalies should be displayed in a museum-type setting. There is an article dealing with the “Body Worlds Exhibit” which is a public display of human corpses which have been preserved in plastic “appearing in naturalistic, non-clinical settings and pose with their skin removed, revealing the inner dimensions of the body to the museum goer.”

An article, to which I was most interested dealt with the medical school teaching of human anatomy either by the longstanding practice of student dissection of the dead body versus the relatively new teaching of anatomy only by prosections: students looking and studying anatomical specimen which had been previously professionally dissected out by their anatomy teacher. With prosections, the medical student will not be faced with a whole human corpse and will not spend hours cutting through fat and muscle to find or follow an anatomical structure. It will all be there clearly defined in the prosected specimen. The student will save time, save frustration and save much of the odor of formaldehyde permeating the nasal passages. But will the student miss something? Would there be some value for the students to actually be introduced to their “first patient” on the anatomy table? To recognize that their “patient” was once a live human being with all the capacity for feelings and anticipation of the future which the students themselves hold. And that the students, as humans, are no different than their subject except they are still alive. Would it provide them with a special experience to emphasize, from the beginning of their careers, that all human beings deserve respect including the deceased and the disabled?

Apparently, there are both advantages and disadvantages for medical schools to teach by prosection. It would be important to know what differences in knowledge or skills have been observed in students who learn anatomy by prosection alone as compared with personal dissection. Of interest would be studies to establish whether the absence of this “first patient” in year one anatomy makes any difference in the clinical relationships with the later live patients.

Have any of my visitors had their own human anatomy education in medical school solely by prosection? I would like to know what it was like and if the lack of dissection experience makes them feel now like they are not a “real doctor”. ..Maurice.