Students learn from the dead

Cadavers offer an unequaled look into human anatomy.

Kathryn Elliott

When Dave Lee responds to questions about the Anatomy Bequest Program, heâÄôs a little nervous and a little defensive âÄî with good reason. As director, Lee is “custodian of the trust” for those who donate their bodies or the body of a loved one to the University of Minnesota.

Lee is painfully aware that one indiscrete anatomy student could destroy the program he has carefully stewarded for decades.

At the orientation of each incoming anatomy class, Lee directs students to treat the donors with the same respect the students would accord a family member. Students are told never to discuss the details of the lab outside of class.

The lab itself is protected from the outside world on a number of levels. The name of the building where the cadavers are maintained isnâÄôt published. University tour guides may know, but Lee said you wonâÄôt find it in print.

Students are asked before an anatomy course whether they know anyone who has donated their body to the University in the last two years. Every year, Lee said, at least one person does, and that particular donor is taken from the course.

“We have a very elaborate system of checks and balances so nothing can go wrong,” said Tony Weinhaus, director of the Program in Human Anatomy Education.

The heavy doors that lead to the dissection labs are locked, and the entry codes are assigned only to faculty, medical students and the licensed funeral directors who work in the Anatomy Bequest Program. The codes are often changed.

Cell phones and cameras are prohibited inside the lab, lest photos end up on Facebook. Bequest staff members monitor the Internet, not wanting to leave an inroad for the kind of impropriety that would offend a potential donor.

“Nobody would donate if they had any question about the dignity with which the donor would be treated,” Weinhaus said.

Shifting Perception

All human anatomy courses take place in the same state-of-the-art labs, run by Lee and the Anatomy Bequest Program staff. The labs are equipped with high-quality lighting and good ventilation.

Although they use the same facility, undergraduate anatomy studentsâÄô course structure and attitude are markedly different from that of medical students.

Sooyung Kim, a chemistry major whoâÄôs considering applying to pharmacy school, just finished her second week in the Principles of Human Anatomy Lab.

Kim said she had never attended a funeral but felt ready to enter “Lab Four,” where the cadavers were, the first day it was offered. A teaching assistant was there to explain and answer questions.

“I was nervous but excited about learning,” she said.

Undergraduates like Kim learn the body “system by system,” with a unit on bones, for example.

Teaching assistants prepare the bodies, which have already been dissected by medical students, so the systems can be easily examined by undergraduates.

Full Circle

Gross anatomy, the course for first-year medical students, âÄî “gross” meaning macroscopic, or what is visible to the eye âÄî is more active.

First-year medical students learn “region by region.” They might study a unit on all the structures inside the abdomenâÄî from connective tissue to membranes to organs.

The first class of the 18-week course is limited to a physical exam of the cadaver. Students ease into the program by looking for scars from past surgeries or visible traces of the anonymous donorâÄôs provided medical history.

First-year medical student Kacia Lee is a teaching assistant for the undergraduate anatomy course and recently completed the gross anatomy lab. Lee said taking the undergraduate course convinced her to go into medicine.

“Learning about the cardiovascular system and digestive system was amazing to me,” Lee said.

Lee described learning anatomy in the labs as acquiring a language vital for accurate communication between medical professionals.

“YouâÄôd never hear a doctor say, âÄòItâÄôs kind of near the dangly part,âÄô ” she said. Rather, doctors must have an intimate knowledge of how everything in the body fits together and how to talk about it.

Lee started the class thinking, “I canâÄôt donate âÄî other people are going to have to.”

Now she is certain she wants to become a donor.

“What am I going to do with [my body] after IâÄôm dead?” Lee said. “I want to keep teaching.”

Critical Need

Weinhaus is grateful for the growing number of people who have decided to donate but is adamant that there is a constant need for more donors. The undergraduate course offered every spring semester has 480 registered students who need hands-on experience.

The UniversityâÄôs Medical School, Dental School, occupational therapy program and mortuary science program all use the anatomy labs at some point. A course in human anatomy is required before a student can apply to graduate school to be a pharmacist, physical therapist or physicianâÄôs assistant.

Weinhaus also firmly believes that working with human bodies is the best âÄî and only âÄî way for the medical and dental students to become proficient in their field.

“Which mechanic would you rather hire to work on your car: the one who saw a movie about changing your engine or the one who has actually taken it apart?” he asked.

Linda McLoon, a former gross anatomy professor who taught at the University for more than 10 years, agreed that developing a 3-D understanding of the human body is crucial.

Over the years, she noticed her first-year medical students were always surprised and a little frustrated that their cadavers did not look like the diagrams and pictures in the textbook.

“It is the huge variation in anatomy between individuals that makes dissection so critically important,” McLoon explained. “ItâÄôs very eye-opening.

“When a dentist or a nurse or a doctor is giving a local anesthetic injection, they have to know where the nerve they are targeting is âÄî how deep, what are the most common landmarks, how much variability is there in its location?

“The human body is really beautiful and amazing and complex,” McLoon said, her eyes tearing up. “I view [human body donation] as an incredible gift.”

Becoming a Donor

Creating a donor file with the Anatomy Bequest Program is fairly simple âÄî itâÄôs making the decision to bequeath oneâÄôs body thatâÄôs the hard part.

Interested individuals request information about becoming a donor, which the program then mails to them. Once theyâÄôre on file, they receive a donor card and Bequest suggests they notify their doctor and “next-of-kin” of their decision.

There is no further contact with Bequest after this, although Dave Lee said people on file to donate sometimes call with questions or even “just to chat.”

BequestâÄôs phone line may be called 24 hours a day, 365 days a year, Lee said, to notify the program of a donorâÄôs death.

After the anatomical study is complete, Bequest takes care of final disposition according to the donorsâÄô or familiesâÄô pre-arranged wishes.

Each year, a student-initiated memorial service is held in honor of the people who donated their bodies, helping the University train the next generation of health care providers.

Last yearâÄôs memorial service drew more than 2,000 family members, program supporters and potential donors. It was a chance for families to see the impact of their gift, Weinhaus said.

A reminder of a past memorial service hangs framed outside the anatomy lab. The certificate bears the gold seal of the International Star Registry, listing a star that students renamed “Doctor Silens,” Latin for “Silent Teachers.”