Rough Cut

A film-in-progress dissects the relationship between med students and their cadavers

Jason Morrow's cadaver was a woman, around 80 years old, who died of lung cancer. Jason was surprised that the dissection began with her anterior chest wall. It seemed like a big place to start. It seemed… personal. He'd expected the anatomy class to go more slowly, to start somewhere less significant. With a toe, maybe.

Like all bodies, this cadaver told a story. Bedsores: a slow death. But also fingernail polish and lipstick: vanity that seems almost heroic. For Jason and his lab partners, thinking of her as a human being was eerie. They kept her face covered.

But still, over eight weeks, they came to know her in an oddly intimate way. Seeing her naked was only the beginning. They put their hands inside her body. They took her apart. Sometimes -- when the team sawed through her vertebrae, or cut the flesh between her vagina and anus -- sometimes Jason wondered about the woman: Had she known this would happen to her body? He felt guilty. He wanted to apologize.

Tom Cole: Humanizing the medical profession from the very first slice.
Tom Cole: Humanizing the medical profession from the very first slice.

Nobody told the students how to handle their emotions. Jason's team gave each other jokey nicknames: Chainsaw, Hacksaw, Jigsaw and Seesaw. One student e-mailed the class a poem she'd written about her cadaver. Others dreamed that the bodies lurched back to life, angry and bent on revenge.

Jason dreamed, too, but his dreams replayed the sensory details of dissection: the greasiness of the cadaver's fat, the toughness of her muscle. Similar details stick in his waking memory. Long after he's forgotten the Latinate names and locations of minor muscles, he'll remember the smell of the formalin from the tanks, the wetness and weight of the woman's body, the colors of her organs. Medical students never forget their cadavers.

"Necessary brutality," Tom Cole calls it: the clinical detachment that medical students learn in anatomy class. Surgeons must be able to cut human flesh. Clinicians must make cool, rational decisions. The trick, Cole says, is to balance that rigor with humanity, to remember that the patient is more than a problem to be addressed. And the way he sees it, a doctor's future relationship with his patients first takes shape in medical school, in anatomy lab. The cadaver is the first patient.

Cole teaches at the University of Texas Medical Branch in Galveston, but he's a historian, not a medical doctor. For almost 20 years, as a professor at UTMB's Institute for Medical Humanities, he's watched students like Jason harden into doctors. Cole's job, in a way, is to prevent them from becoming too hard. In conversation, he uses unscientific phrases like "the human spirit" and "spiritual growth." This year, as a visiting professor at the University of Houston, he's teaching religious studies, not history or premed.

The humanities, he tells his students, offer useful perspectives; a historian or poet can see things that a doctor might miss. Sometimes Cole uses an example from his own life. In 1984, in a class that introduced medical students to major psychiatric illness, Cole met Eldrewey Stearns, who exhibited a textbook case of manic depression. Police had found Stearns in a boozy stupor; a psychiatric resident in the class recalled seeing Stearns before, in the hospital's emergency clinic, after Stearns had tried to circumcise himself with a razor.

When Stearns claimed that he'd launched Texas's integration movement, the students detected a symptom: delusions of grandeur, an earmark of manic depression. But Cole, the historian, wondered whether there might be some truth to Stearns's claims. Cole discovered that many of them were true: Stearns had led the sit-ins at Houston's lunch counters. The book Cole eventually wrote -- No Color Is My Kind: The Life of Eldrewey Stearns and the Integration of Houston -- was fashioned into an hour-long, much-praised documentary, The Strange Demise of Jim Crow.

Cole had hoped the book project would somehow cure Eldrewey Stearns. It didn't; the man remained manic-depressive, grandiose and cranky. But in a way, the book and documentary helped Stearns reclaim his life. They documented his personal history, his very real achievements, his life. They showed that he was more than a collection of symptoms.

Cole, pleased, began looking for a new project.

Someday, when Bob Harvey is a cadaver, his body will tell its own story. "Various and sundry physical faults and failures," he says of his inventory: skin that bears the scars of barroom knife fights; lungs that once withstood three cartons of Pall Malls a week; a liver that endured years of boozing.

Bob no longer wrecks his body in such interesting ways. At 67, he looks fit and limits his vices to coffee and black humor. "I don't smoke anymore," he says. "Don't drink. Don't chase women. If I caught one, it'd only disappoint her and embarrass me."

A few years ago, Cole began offering a workshop called "Share Your Life" through UTMB's Office for Senior Services. Bob had recently retired and was separated from his second wife; he was, in short, at loose ends and mostly alone in the world. He signed up for Cole's workshop, and for the first time, he tried to tell the truth about himself.

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