Thursday, 10 March 2011

A Prosection Memorial Service...

I’ve just got back from a memorial service. I’ve never been to a memorial service before and, come to think of it, have only ever been to one funeral. I’m well aware that that’s going to change dramatically over the next few years – my mum keeps reminding me that everyone we know is reaching that age. She’s not saying it to upset me, but to prepare me. I can see her point.
But today’s memorial service was different. It was for the bodies we use in the prosectorium.
When I found out they did prosection at Birmingham, as opposed to dissection, I was quite upset. It was part of my medicine dream. The one where I was at Cambridge, enjoying the course, top in the class, top in the year, wrote for the newspaper, directed plays, had a book published and was well on my way to becoming the next Dr. Shephard, or a nicer version of Dr. House. Someone cool. The kind of doctor they make TV programmes about.
I dreamt a lot as a child.
Anyway, in this dream we did dissection. I thought it was the only way to learn anatomy. The best way. But, I was at Birmingham, and anyway, prosection was better. Is better. I thoroughly believe that. When you’re a first year and you’re presented with a cadaver it would be easy to accidently slice through something important. At least this way someone else has already done the hard bit and all the important structures are there for you to try and identify. And anyway, it turns out that I hate prosection.
I remember my first session. I was excited. We had had the lectures on the Human Tissue Act and the appropriate decorum and dress for the prosectorium (no skin visible ie don’t wear dolly shoes that day!!). We had been threatened with jail sentences if we brought a mobile phone into the room. My class had been talking about it for ages. I imagine I was literally jumping for joy, as I do. We had gathered in the antechamber, hair tied back, labcoats and aprons on. I couldn’t wait.
Then we went in. I think I expected it to be wonderful. It wasn’t.
There were tables, and on each table was part of a body. It was yellow, and wet from where they had sprayed it to preserve it. The smell of formaldehyde that I had been warned about by cousins and English teachers was quite strong. The sections looked so small on the big tables, the way you see a baby on a king sized bed. They had the vulnerability of a baby on a king sized bed.
For me the worst bit was how it wasn’t a whole body. There would be an arm, or part of a pelvis. I’ve seen a whole person with their private bits exposed and organs taken out. A head, or a head in sections. I don’t like how it’s not a whole body. I feel like they’ve been violated in some way. I wonder if the donors were fully aware that this is what would happen to their bodies. I could tell you so many (horrible) sights but I won’t, in case I’m breaking confidentiality in some way and because I don’t want the bodies to be remembered in that way. I want them to be remembered for the people they were.
 I hate prosection. Thankfully today was my last session, apart from the test next term.
I could rant about how it isn’t useful either. It isn’t. There aren’t enough demonstrators and sometimes you have no idea what it is you’re looking at. Is that a nerve or an artery? Which muscle is that? Which part of the body is that?
But it isn’t all bad. You do get a greater understanding of how the body comes together; you understand the scale of it more. The brainstem isn’t as big as the diagrams in the book – it’s probably the size of a pebble. It’s fascinating to see how the body comes together in all it’s layers and systems. And when you get a demonstrator you leave that station with a much better understanding of that part of the body. I feel it helps when it comes to revision and exams to have seen textbook diagrams in the flesh, as it were.
I think today’s memorial service was exactly what I needed to come to terms with it all. I think it’s good to remember the human aspect of prosection, which I think gets glossed over sometimes. I’m sure most medical students are aware of it but I know it affects some more than others. But it was important that today we took time to remember the donors, and their family and next of kin who are deprived of a funeral or cremation. A list of names of those we have seen was read out. There was a bouquet of flowers at the front of the lecture theatre and tributes were read. We had two minutes silence. It was beautiful, and graceful, and appropriate.
I wish I had written a tribute. I didn’t. Instead I’m going to write one here. In a way this whole post is my tribute to those who donated their bodies to the medical school. I know that they, you, will never read it and I doubt that your families will ever see it but...anyway...

Thank you. Thank you for allowing your body to be used to teach the next generation of medical students. Thank you for allowing us to prod and poke and lift and inspect. It takes great courage, and is probably the greatest sacrifice, knowing that your body is being exposed in that way and your family aren’t having a funeral. But we are grateful. I am grateful. You are all individuals, you have all had your own lives. You loved, you fought, you got ill and cried. You maybe got married and had children of your own. You each had your own story. But your donation has meant that even in death your story continues. Your generosity means you influenced and helped, even in death. Especially in death. Thank you for allowing me to learn from you, in more ways than one. The knowledge that I have gathered from my time with you will help me to treat and save in the future, and hopefully to make a difference to people’s lives the way you made a difference to so many people both then and now. I hope that my conduct was appropriate; I hope I treated you with the respect you deserve. Thank you.

I want to end the way the memorial service ended, with a poem by Simon Armitage. It’s light hearted but also poignant and I think it sums up everything I have said, and everything that was said at the service. I hope Mr Armitage won’t mind me reproducing his poem here.

I've Made Out A Will; I’m leaving myself
I've made out a will; I'm leaving myself
to the National Health. I'm sure they can use
the jellies and tubes and syrups and glues,
the web of nerves and veins, the loaf of brains,
and assortment of fillings and stitches and wounds,
blood - a gallon exactly of bilberry soup -
the chassis or cage or cathedral of bone;
but not the heart, they can leave that alone.
They can have the lot, the whole stock:
the loops and coils and sprockets and springs and rods,
the twines and cords and strands,
the face, the case, the cogs and the hands,
but not the pendulum, the ticker;
leave that where it stops or hangs