When I returned home from a dizzying day of orientation to medical school, its shiny black corpse was waiting at my doorstep. It lay glistening in the heavy August sun, like something wet and brand new, in place of the welcome mat I had meant to roll out. I took it as a bad omen—a dead black bird at my door, at the end of the first day of my career in medicine, could not be considered good, or even neutral. To have to begin this endeavor towards becoming a healer with such a confrontation seemed unfair and unbefitting. I almost blamed that stone-still creature for choosing that particular spot to die.
My mother, who was helping me move-in, put on gloves to bury the bird in the backyard. We had had some experience with this careful ritual. Over the course of my childhood, we had buried three pet parakeets. I helped dig a small hole in a clear patch of dirt, while my mother wrapped the round black body in a cloth. She laid it down, and I settled the dirt back over it, patted it down until it was nearly flat. As I patted, I could feel its hard, sloping belly beneath the tips of my fingers. It was a strangely intimate process, this burying business. We burned some incense and planted the sticks into the earth when we were done. For a while, the twigs that remained from the incense marked the spot. They stood tall and straight, like soldiers keeping vigil.
As the school year trudged along, a few stray weeds slowly invaded the formerly bare patch of dirt. Squirrels, and sparrows, and at least once, a stray cat, scampered across the dead bird’s territory. I sometimes worried that one of these small visitors would disturb the dead bird. Uproot him. The incense soldiers, after all, were no longer there to protect him. Somehow, this bird, whose lifeless body I had once resented, seemed to need protection now that it lay helplessly in the ground. Burying the bird had not at all buried my consciousness of him. On the contrary, it had heightened it.
It was not until the end of a six-month long foray into human anatomy and dissection that I finally realized a corpse is not a bad omen; a corpse is a gift. Initially, there were days when I resented my cadaver the way I had resented that black bird. I resented him for, in some way, contributing to the responsibilities and hardships of medical student life. And, more than that, for imploring me to consider mortality, that of others and my own, on a nearly daily basis—a mentally and emotionally taxing task.
A corpse is a gift
On the day we met for the first time, I resented him most for exposing my lack of manual dexterity. I watched as one of my tablemates made the first, rather unceremonious incision. He began to peel away a flap of skin on the cadaver’s back, exposing an underlying layer of fat. He started at a corner, and made swift, controlled swipes, separating skin from the dimpled, yellow tissue beneath. Soon, my other tablemates set to work. So, with a dainty pair of tweezers and a blunt blade as my only weapons, and a thin layer of latex as my only shield, I, too, began to peel.
Instead of a tidy square flap, I ended up with multiple, unsightly strips of skin. Sometimes my slicing was too deep, sometimes too shallow, and it wasn’t until the next session that I would understand how little it actually mattered. The whole layer of fat was going to come out one way or the other, and there was no need for grace or elegance in that. It was the muscles underneath that mattered most.
On another occasion, I held my cadaver somewhat responsible for earning me the reprimands of a lab professor who circled around the room like a vulture surveying the scene. “Haven’t I warned you about how to hold the tools?” he sighed. Visibly irritated, he proceeded to lecture my tablemates and me (but mostly me) about the ills of poor scissoring technique and the barbarism of “palming” one’s forceps, which refers to burying the end of the forceps inside your palm, instead of letting the end stick out between your thumb and index finger, like the end of a pencil.
He said it was not “civil” to hold the instruments in any other way. The very foundation of the task at hand seemed to me wholly uncivil. But, in truth, I understood and appreciated his point. It was not a piece of cardboard I was cutting through or colonies on a petri dish that I was picking at. It was a fellow human, dead or alive, aware of what I was doing, or not. And though I wanted to blame my cadaver for putting me in the line of fire, I was mostly disappointed in myself for not having the sensitivity to understand that without being told. For defiantly holding my tools in whichever way felt the least awkward, forgetting that professionalism is often defined by the details.
Little by little, cut by cut, I slowly began to accept the presence of this body in my life. I learned to respect my cadaver, to allow him to make me feel uncomfortable, and, eventually, to consider him my accomplice rather than my adversary. When I gave up on trying to master anatomy outright, and gave in to confusion and uncertainty, I found that every time I touched my cadaver he presented me with a new challenge. Every peeling back of skin, every shifting of organs, every delicate scissoring, revealed something both beautiful and fascinating.
The intricacy of the nerves that clung to the hand, or to the bones of the cheeks, left me in awe, while some of my tablemates were more enamored by the larger structures—the enormity of a soft clean lung or the contents of an infected kidney. The sophistication of the sympathetic trunk, the simplicity of the intestines, and the eerie resemblance of the brachial plexus to the organization of a tree never failed to captivate us. Every inch hid a secret to be uncovered. Our cadaver told a relentless story, and as long as we learned from him, we seemed to be keeping him animated. Each fresh incision rendered him not more definitively dead but rather, more assertively alive.
An unpleasant yet trivial inconvenience
We had begun the year almost afraid to actually put our hands on our cadavers. We strove for precision, following lab manuals and instructive video clips with an exactitude rivaling that of architects or engineers. But the more we probed, the less certain we were. We discovered the only thing we could really be confident about was the impossibility of perfectly mapping the human body. All the digitally enhanced images, the cleverly angled illustrations, the pinpoint labels, were not as sure of themselves as they wanted us to believe. In fact, these resources provided, at best, a series of landmarks. A trail of hints but not answers. Because, in truth, nothing looked the same in any two cadavers, and there were innumerable anomalies and variants and surprises.
Nor was anything as clean and tidy as we had initially anticipated. There is, in fact, nothing sterile about the human body. We could wear two sets of gloves with a layer of soap in between, and we could don our goofy-looking aprons over our scrubs, and we could wrap our cadavers in as many wasteful layers of gauze as we wanted to. But things were bound to get messy. Someone was bound to get a piece of fat in her hair, and someone was bound to breathe in a cloud of bone dust, and someone was bound to get splashed with a strange mix of preservatives and body fluid while flipping the cadaver over. At some point, we were so intimately connected with these cadavers that such unpleasantness became only that—an unpleasant yet trivial inconvenience.
But just as we had taught ourselves to form an attachment to our cadavers, to trust them, and to let them teach us, the day also came when we had to learn to let them go. The day we assembled long cardboard boxes for our cadavers, the lab rooms were a flurry of simultaneous elation and confusion. Elation from the feeling of accomplishment that comes with having conquered, at least theoretically, human anatomy. And confusion from the uncertainty of whether or not we were doing this the right way—this ritual packaging of cadavers. Which half of this cardboard is the lid, and which is the base? Is that tie knotted tightly enough or does that wall of the box look like it might collapse when we try to put our cadaver in? What’s the best way to lift the cadaver into it? Where’s the marker to label the box? It had to be done right.
Memories of my black bird
I was reminded then of my little black bird, over which a vibrant crop of mint had sprung up. I was reminded of how burying him hadn’t helped me forget him but had, instead, forced me to remember him. By putting my cadaver in that cardboard box, I haven’t removed him from my mind. Instead, with my cadaver stowed away, I know not where he has begun to grow within me. As the mint continues to spill over that formerly bare patch, and as new experiences pile on over the memory of anatomy lab, that bird and my cadaver will always be there, forming the foundation for new life and new knowledge.
TDWI Writer’s Group member, Margaret Cary, developed and teaches the Narrative Medicine/Personal Essay course at Georgetown University School of Medicine. Her students’ essays reflect their thoughts on being in medical school and becoming physicians.
This essay was first posted on 07/08/13. It was reviewed and republished on 9/18/2017.