In rite of passage, students meet cadavers
Stanford's class of 93 first-year medical students meet their cadavers for the first time, a rite of passage on the journey to becoming physicians.
The first day in the anatomy lab begins with a moment of silence in honor of the donated bodies lying hidden inside plastic, blue bags on shiny, clean, metal tables.
Then the bags are unzipped.
It’s one of the essential firsts of becoming a doctor at Stanford’s School of Medicine: Cutting into your cadaver in Surgery 203-Clinical Anatomy surrounded by a team of fellow first-year medical students, sharing both excitement and trepidation as the journey to become a physician begins.
“Why learn anatomy?” said Sakti Srivastava, MD, associate professor of surgery and chief of clinical anatomy, during the lecture that preceded the visit to the lab. “It’s the quintessential medical school course. It’s an experience you will probably remember the rest of your life.”
On Aug. 30, this year’s class of 93 new medical students met the cadavers that they will be dissecting over the course of the next seven months. The experience followed a series of firsts for the students: dressing in clean blue scrubs in preparation for lab; meeting fellow classmates during a camping trip to Stanislaus National Forest the week before; being awardedwhite coats and stethoscopes during a ceremony the afternoon of Aug. 26 on Alumni Lawn.
“There’s no doubt you are brilliant and driven,” Lloyd Minor, MD, dean of the School of Medicine, told the class at the ceremony. “You were selected from a pool of 7,500 applicants, making this year’s 2.3 percent acceptance rate one of the most competitive we’ve ever had.” The new class is comprised of 47 women and 46 men. Four have doctorates and nine have master’s degrees; 25 were born outside of the United States; 44 have studied abroad; 13 played varsity sports in college; and about one-third play a musical instrument.
And most, it seemed had prepared in some way for the first day of anatomy lab.
Nerves and anticipation
“I have mixed feelings,” said Victor Contreras, a student from San Diego, the morning before the lab. “I’m obviously very excited. At the same time, I’m kind of nervous. This is a human person. This is someone’s loved one. I’ll basically be cutting them up.”
“I’m looking forward to it simulating a relationship with real patients,” said medical student Maria Interrante, who attended Stanford as an undergraduate. “We will be introduced to the cadaver as a person. I think it’s one of the most important parts of medical school.”
During the Aug. 30 anatomy lecture, students were prepped for the dissection of the chest. They learned the number of ribs — 12 — and the different type of ribs: floating, false and true ribs. They learned the names and locations of the bones in the chest, and much more. Then, they walked next door to the anatomy lab, found their lockers, pulled on their purple gloves and prepared themselves to peek inside a human chest.
“We’ll be looking inside somebody who gave their life and their body,” said Osama El-Gabalawy, anxiously awaiting the unveiling of his cadaver.
The students crowded around their assigned lab tables, rolled back the blue body bags and got to work. First they assembled their scalpels, then looked nervously at each other. In a corner of the room at table 3, where Contreras was assigned, teammate Ryan Brewster made the first incision into the team’s cadaver. With a firm hand, he sliced down from the jugular notch to the xiphoid process, the lowest part of the sternum. And then one by one, the four other teammates took their turns.
“How deep should we go?” Brewster asked, looking up at the team’s teaching assistant, Heather desJardins-Park, a second-year med student. Cut through the skin to the subcutaneous fat, then down through the deep fascia — the connective tissue — to the chest muscle, the pectoralis major, she told them. Then stop. Don’t cut too deep, she added.
As the students made the first slices into skin, their tense faces relaxed and the learning began. A faint odor of formaldehyde hung in the air. The team members at table 3 took a moment to discuss their feelings about cutting into a cadaver, how they thought they should feel, how they actually felt. Contreras wanted to see the cadaver’s face so that he could feel more like he was working with an actual person. The cadavers’ heads will remain covered with gauze throughout the first quarter. The students see only the outlines of the lips, the profile of a nose.
‘Respect and care’
“Every now and then it hits me this is a real person,” Contreras said. “But with the face not visible, it seems less sacred.”
“I feel like if I saw the face, my hands would be shaky,” said Tim Chai, an MD-PhD student and UCLA graduate, looking down at his gloved hands.
“This is, like, us,” Brewster said with amazement, glancing inside the chest of the cadaver, meaning this was a glimpse inside what their own bodies actually look like.
Team 3’s cadaver is a male. The five students will learn his age and cause of death in the coming days. In the second quarter, after the head is uncovered, they will dissect the head and neck. In March, after completion of the course, the class will hold a ceremony to honor their cadavers. They can write thank-you notes to the families of the donors if they choose, but they will not be told their cadavers’ names or the names of their family members.
“At the end of the day, medicine is all about the patient,” Srivastava said. “The patient should be the center of the universe. We keep the cadaver at the center of this course. It encourages students to think about bodies as human. It teaches empathy.
“We treat our cadavers as we would treat our patients: with respect and care.”
Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.