by Christine Montross (Penguin 2007)
This book has been on my to-read list for years, possibly since it was published, but I could never find it. Finally, I bought a used copy. It was worth the wait. Christine Montross was a resident in psychiatry when the book came out; she based it on the journal that she kept during her first semester in medical school, when medical students study human anatomy by dissecting a human cadaver which has been donated for the purpose.
Montross describes the dissection and the feelings engendered by it; she adds a dose of history when she travels to Padua to visit the theater when the father of modern anatomy, Andreas Vesalius, essentially began the practice of cadaver dissection for medical students; she explains that without donated cadavers, doctors and students used the bodies of executed criminals or bought cadavers which had been dug up at night, in secret–and sometimes actually did the grave-robbing themselves. But she remains convinced that no other method can replace actual dissection, saying that the woman whose body she essentially destroyed during that semester in anatomy lab gave her a precious gift: “. . . She neither knew me nor knew anything about me, and yet she bequeathed to me this offering, unthinkable for centuries, that has formed the foundations of my ability to heal. My hours with her neither cured her nor eased her suffering. Bit by bit, I cut apart and dismantled her, a beautiful old woman who came to me whole. The lessons her body taught me are of critical importance to my knowledge of medicine, but her selfless gesture of donation will be my lasting example of how much it is possible to give to a total stranger in the hopes of healing.”
The last part of the cadaver to be dissected is the head and brain. Despite their progress in with the emotional component of cutting up the body of a stranger, Montross and her classmates find it extraordinarily difficult to dissect their cadavers’ faces and heads. Montross writes, “The brain is the true embodiment of my own conflicted response to anatomy. Somewhere deep within its crenellations, here lies wonder, and here lies the question of whether we have a right to pursue wonder in seemingly inhuman ways. Here is the knowledge gained by dissection, which drives our actions forward, and here lies the toll the process takes on each of us, in stress or dreams or dissonance. Here in the brain is the newly transformed identity of the doctor-to-be, with a beginner’s knowledge of disease and healing, with a stomach more steeled to trauma and to death. But somewhere, too, there must be the echo of the person who existed before cutting a human body, before feeling the cool stiffness of a pulseless heart.” Montross’ prose is exquisite; I was not surprised to learn that she is a published poet as well as a doctor.
I don’t know why it was so hard to find this book, because I think every doctor in training should read it (probably before they take anatomy lab).