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Breathing New Life Into 'Body Donors'

— To the most sincere gift I have ever received, I thank you

MedpageToday
 A photo of the corpse of a body donor in a plastic bag in a morgue.
Nidhi Bhaskar is a second-year medical student.

The main emotion I recall from my first day in the cadaver lab was the overwhelming relief that my body donor had lived well into old age. Though I did not know his name, we were told that he had owned a local business, had been married, and had passed away after a short battle with lung cancer. I remember thinking that these few characteristics provided only a mere glimpse of our donor's individuality. After all, how could these facts do justice to the rich tapestry of experiences, stories, emotions, and relationships that undoubtedly comprised the 86 years of life preceding our donor's gift? But then again, in the words of a classmate, "Maybe it was better not to know who we would be dissecting."

Over broken bodies and careful incisions, my medical school class embarked on a journey to navigate the human body. During the initial labs, most of us struggled to discern between nerves, veins, or arteries, let alone differentiate the many muscle fibers that seemed to merge into one another. But amidst the challenges, we found community. The cohort of body donors much like our cohort of future physicians, had unique features and intricacies that collectively illustrated the complexities of the human form far more authentically than illustrated atlases or computer simulations. While our donors had been depersonalized at the start of our program, the dissection process breathed new life into their identities. Table B6 was "the body with the pacemaker," while C8 had "exemplary cerebral vasculature." As we flocked around each station to study the resident body donor's anatomy, our donors' distinct features parlayed into the bedrock of our medical education.

During the winter months, I joked that my body donor probably saw me much more than my own family. I found myself in the lab for hours after class, poring over the origins and insertions of tendons, labeling the foramen of the skull, and detangling the brachial plexus. As my donor's bodily remains grew increasingly fragmented, my knowledge of the human body developed until I simultaneously anticipated and dreaded our final lab.

Should I mourn or celebrate? Was this whole experience a prolonged substitute for a funeral? Or did this year-long process represent a closing chapter of our donor's life well lived?

While the final week of anatomy-lab passed amidst a haze of emotions, I finally found the answers to these questions at our medical school's Ceremony of Gratitude. As members of the planning committee, my team and I organized a program to invite families of body donors and express our gratitude for the gift that their loved ones had bestowed upon us. We chose student and faculty speakers, scheduled musical performances, and organized a letter-writing event and flower ceremony that aimed to express our class' appreciation for our donors. However, this experience was more than just a symbol of gratitude for the families of body donors. It provided me and my classmates an even greater gift: that of resolution.

The quintessential "anatomy lab" experience of medical school is one laden with emotions -- both for students and families. Body donors occupy a liminal state in which, through death, they impart knowledge and wisdom into the lives of the next generation of physicians. But in this process, their families often sacrifice. Donor bodies are separated from their families for almost a year after their deaths, leaving families without the ability to say a final goodbye or lay the physical form of their loved ones to rest soon after their passing. A ceremony of gratitude recognizes the interstitial space that body donors and their families occupy, providing much-needed closure in the chapters of their loved ones' lives.

Furthermore, this Ceremony of Gratitude provided the much-needed space to re-humanize our body donors and learn more about the sentiments behind their donations. The anatomy lab is undoubtedly taxing, and the long hours spent memorizing the names and relationships of body parts to one another can reduce the human body to a set of working parts, occluding the humanity of our profession that drew many of us to the physician's path. Over the course of the night, we heard the stories and legacies of our donors told through the voices of their partners, children, and friends.

We shed tears as a grieving husband described his wife's decision to donate her body to our program after a lifelong career as a critical care nurse. "She spent her whole life caring for other people, and now she's carrying that legacy on even in death," he recounted at the podium, holding up a large framed picture of his wife.

We laughed alongside the son of another of our donors who described his mother as a "tough old bird" who never settled for anything less than perfection from her kids or her husband.

Each narrative shed greater light on the people behind the tremendous gifts that we had received and reaffirmed and attuned humanity behind each of our subjects.

Marcel Mauss's suggests that the true meaning of a gift extends far beyond the physical object being exchanged. Mauss believed that the exchange of gifts facilitates a culture of reciprocity, uniting the giver's sacrifice and imparting a sense of gratitude and obligation upon the recipient. Through his sacrifice, my body donor gave me the incomparable gift of knowledge of the human body in its authentic form, and also imparted a novel perspective of what it means to be human. Our ceremony was neither a celebration nor an exploration of loss but encapsulated both to recognize and honor the final gifts that each of our donors left us. While this ceremony was a small step towards expressing my appreciation, I will carry my donor's legacy forward by embracing the humanity of every future patient I treat.

To my body donor -- my teacher, my first patient, and the most sincere gift I have received -- I thank you.

Nidhi Bhaskar is a second-year medical student at the Warren Alpert School of Medicine of Brown University in Providence, Rhode Island. An alumnus of Brown University and the University of Oxford, she hopes to bridge her background in medical anthropology with the practice of medicine to shape global health interventions and public policy.