February 26, 2015

Dehumanizing the Human

Dehumanizing the Human

 

Death terrifies me.

So when our professors first herd- ed us to the human dissection lab, through the foul-smelling corridors of the Medical Education Building, I grew apprehensive that I would be the fool who fainted at the sight of

a cadaver. After a few introductory remarks from our professor, we opened our dissection tanks. As I drew the formaldehyde-soaked sheet from my cadaver, I stared down death for the first time in my life. Only a few seconds after the initial shock, a wholly unexpected feeling came over me—indifference.

Human dissection has evolved into a medical school rite of passage,
the first test to evaluate whether someone is fit to enter the fraternity of physicians. To painstakingly clean and identify the thousands of structures within the body forces its participants into surgical patience, an appreciation for the human body’s intricacy, and an unwavering commitment to education.

But an unintended, and maybe counterintuitive, consequence arises from spending hundreds of hours
in front of a dead body: desensitization. This numbness comes not only from the passing of hours in lab, but also from the utilization of a person as a scientific frontier. Each passing day in the cadaver facility brings a new anatomical discovery. Findings such as a massive aortic dissection, pervasive hematomas, extensive muscular atrophy within the limbs and face, and a complete hysterectomy contributed to the metamorphosis of my first patient from a rosy grandmother into a three-dimensional textbook figure. Even the most humanizing characteristics of my cadaver—her hot pink nail pol- ish and tattoos etched with a Biblical verse—faded into the background during our tedious scientific exam- inations. What remained was an educational tool, not a human.

Perhaps that’s a good thing. Physicians shouldn’t cringe at the sight of blood or an open wound. Early exposure to death and suffering is necessary in a profession where our entire lives will be spent dealing with it, in some form or another.

But it’s also an extraordinarily unhealthy thing to forget the humanness of our cadavers. Ancient physicians realized this. Although the fathers of Western medicine, Hippocrates and Galen, dissected and vivisected thousands of mammals to uncover the anatomical basis of disease, they steered clear of human dissection. In Homer’s Iliad, one of the only things that pauses the nonstop battle is the collection

of and prayer over fallen soldiers. And by sacred Greek laws, homes that contained a newly-dead corpse were considered so desecrated that other villagers were prohibited from entering the home. In sum, remarkably powerful legal, religious, and social taboos surrounded the scientific investigation of corpses for over two thousand years, stretching into the Renaissance. This attitude persisted despite society’s self-conscious realization that it hindered

medical breakthroughs for generations. Why were the ancients, even the most scientifically-minded ones, terrified of human dissection and dehumanizing their dead? And why has modernity since decided that it’s OK to interact with cadavers?

The tension between the usefulness of dissection and its dehumanizing nature is omnipresent.
As future physicians—bearers of the torch of humanism—we must come to terms with this tension in our own ways. This takes time, effort, and discomfort. But just as the Greek and Trojan soldiers in the Iliad once realized, sometimes we too must pause our battles, under- stand the gravity of our cadaver’s sacrifice, and offer a prayer over a fallen soldier.

Amol Sura is an MS3 at Louisiana State University School of Medicine, and a Duke undergraduate alumnus.