First Cut; A Season in the Human Anatomy Lab

The author reflects on his year spent observing new medical students dissect human cadavers, concluding that besides learning the biological truths of human existence, the students also gained insight into the cycle of life and death

Dissection of the human cadaver is the first rite of initiation into the medical profession for virtually every medical student. Whatever its obvious practical educational value, human anatomy lab carries enormous symbolic value as a sort of hazing ritual. Touching and exploring a dead body violates deep taboos of our society, which shuns death. For this reason, the medical student's lay friends and relatives typically are intensely curious: What was it like? Did you faint? Were you squeamish? Most medical students have difficulty responding properly; the emotional impact of anatomy lab tends to get dissipated in the whirlwind of stress and excitement that is the first year of medical school. To capture fully the sublime quality of this experience requires the voice of a poet.

First Cut: A Season in the Human Anatomy Lab is a compilation of the observations and insights of Albert Howard Carter III, an eloquent professor of English who accompanied first-year medical students during their anatomy course. Carter had personal reasons for taking on this project. His father had donated his body to a medical school, and the author wanted to satisfy his curiosity about his father's fate, perhaps to reach a kind of closure that he felt he was denied because of the lack of a burial. Moreover, he wished to allay his concern about whether his father's remains had been treated with proper dignity. Carter also viewed this project as a chance to take a few steps on a road not taken. He had considered becoming a physician but instead became an English professor; although he was happy with his career, his love affair with things medical persisted. He sought out medical topics within literature and even completed an emergency-medical-technician training course simply out of his love for medical terminology and ways.

Carter, a superb writer, paints us a marvelous picture of the human anatomy lab. He captures the "many moods on this trip, from disgust and repugnance to elation and wonder, from jokes and high spirits to fatigue and depression." He focuses on the little things -- the sights, smells, and sounds -- that startle the students and compel them to remember the humanity of their subjects. He found that students passed through three stages in their relationship with their cadaver. First was "disgust and aversion." This was soon replaced by an effort to reduce it to a "biology exhibit." Finally, there emerged slowly a "rehumanization," as the cadaver asserted its individuality through its unique features. The philosophical challenge was to try to come to terms with death. Though a chaplain was present throughout the course, and a service of reflection and gratitude was planned and held, it fell to each student to create his own private understanding of mortality. "Our society's attitudes toward death are another kind of ice within the minds of the students, an ice that melts as the students learn."

The author has created an elegant record of the first milestone of a medical career. This book would be a very useful complement to the standard textbooks of anatomy; it might serve as an atlas for the emotional and spiritual aspects of dissection, standing alongside the classic dissecting atlases. It would also be ideal general reading for a recertification course; the senior physician is allowed to step back briefly to experience the energy and optimism of the first-year medical student. It is refreshing to peer into the medical world through the eyes of an outsider filled with admiration for what the physician is and can be.

Carter's visit to the anatomy lab enabled him to conquer his personal demons. He was satisfied that his father's donation of his body was worthwhile and that the cadavers were treated with respect; he did achieve a measure of the healing and closure for which he longed. The experience persuaded him to make a serious commitment: "When the time for my death comes, I can think of no higher purpose for my muscles and bones, blood vessels and nerves, skin and, yes, even fat, than to send them to a human anatomy lab."

Reviewed by Charles Gropper, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Musings and observations of a literature professor with a penchant for things medical as he follows a group of first-year med students taking human anatomy, a course that includes dissecting cadavers. Carter (Eckerd College), a bioethicist who volunteers in an emergency-room trauma unit, has a lively curiosity about the human body and how it works. To satisfy this, to learn more about the mysteries of life and death, and most important, to discover what happens to a body donated to science (his father had willed his body to medical research some years before), he spent 16 weeks with students in the human anatomy lab at Emory University in Atlanta. Two of the students gave him permission to follow them closely as they thoroughly explored an embalmed human body, and Carter at times became somewhat more than a mere observer, getting to poke his fingers into a heart and hold a lung in his hands. While no great insights about life's mysteries or the meaning of death are to be found here, the sights and smells of the lab, the sheer hard work of dissection, as well as the emotions of the student are all forcefully presented. What Carter notes about the respect with which cadavers are treated, and thus how his father's body was probably handled, is so comforting to him that he decides at the end to donate his own body to an anatomy lab. Interspersed throughout the text are 29 strangely beautiful anatomical illustrations from De humani corporis fabrica by Andreas Vesalius (1543), to which Carter has added his own explanatory captions. Although its author seems to have had a grander purpose in mind, the book's real value is in its clear depiction of what medical students must do to learn human anatomy. -- Copyright ©1997, Kirkus Associates, LP. All rights reserved.

Humanities professor Carter spent a semester as a Dana Foundation Fellow observing the human anatomy class for first-year medical students at Emory University, and this book is the result?a rare opportunity for outsiders. As a book, however, it's something of a missed opportunity. While readers are taken carefully through the series of cadaver dissections by which medical students begin to learn anatomy and integrate their own humanity with their chosen profession, this book is too much step by step, with too little integration. Seeming to be largely nonintrospective, the students rarely come alive themselves, because the focus of their struggle is narrowly confined to performing well on quizzes and exams. The author's search for familial identity and history (his father willed his own body to anatomical study) is human but not compellingly narrated. Note to general and K-12 collections: although maturely handled, parts of the narrative are almost gory, and the "jokes" are potentially upsetting. More suitable for academic collections.?Mark L. Shelton, Univ. of Massachusetts Medical Ctr., Worcester
Copyright 1997 Reed Business Information, Inc.