The Ultimate Gift

 

Introduction:

 

In November 1995, we were at the Center for Inquiry for the opening of the library.  We attended a Humanist workshop where one of the speakers discussed Memorial Societies and thoughtful planning about death.  My comments are intended to expand on such planning.

 

Scene I

 

The year is 1944.  The 59 first year medical students are apprehensively awaiting their first class in gross anatomy.  We are eager to begin our chosen career, but not at all sure about this first stage of our education.  The doors open, we go in groups of four to our assigned tables, where a cadaver waits, shrouded not only in a sheet but in tantalizing mystery:  will we really be able to learn all that the body can teach us?

 

Our first efforts at dissection are clumsy – we try to lay out the muscles with their arteries and nerves, but often lose them, and never can fool the instructors with the cleverly “synthesized” nerve made of a few tissue fibers.  However, as the weeks go by, we become more skilled and utterly fascinated at the wonders we discover:  the folded heart with its chambers and valves, the spongy lungs, pink in non-smoking country folks, but black in city-dwelling smokers or miners; the networks of blood vessels and nerves; and on and on.  Four months later, our old friend is unrecognizable but our minds are not only stuffed with facts of anatomy, but ready to move on, to study function in the framework of structure, and eventually to learn about dysfunction and disease.

 

Not only does our class become a close-knit group, each of our foursomes also develops a chummy relationship with “our” cadaver.  Medical students can’t resist their bent for humor, at times even a bit crude, but in the case of our body we felt respect and gratitude that we had learned together in a partnership.  We were reassured that the remains (everything had been saved) would be cremated and buried.

 

Learning anatomy by personal student dissection is not universal throughout the world, although the majority of US medical schools use this method.  Students who have been through the course are almost unanimous in their approval, whatever their apprehensions may have been initially.  And in medical practice, we use our anatomical knowledge daily, even if we never do surgery.  It is hard to believe that plastic models and computer simulations could ever give that intimate and three-dimensional awareness of what’s inside.

 

Scene II

 

It is the late 1970’s, and my parents are discussing with us their wish to donate their bodies after death to a medical school.  They and we are among the many thoughtful people who are dismayed at the inappropriateness of elaborate and expensive funeral practices, when really the goal is to honor the life and achievements of the departed.  At the time of bereavement, it is not easy to resist the pressures to spare no expense in the arrangements. There is a small but growing

 

movement to form Memorial Societies that help individuals and families to arrange and actually contract for modest services.  Making such arrangements in advance not only can save money and avoid painful decisions when a death occurs.  The very act of preplanning helps families to discuss their values and wishes, and accept the inevitability of death.

 

It seemed very natural to honor my parents’ wishes, and in fact, my husband and I have similarly registered as body donors at the Anatomy Department of the closest medical school.

 

To conclude with some practical comments, In making an advance donation of one’s body after death to a medical school, not only is there no unnecessary expense, but the body becomes a valuable educational instrument.  The details are easily arranged.  The Anatomy Departments of all Medical Schools have a standard form to be filled out, with copies for the donor and the person responsible for carrying out the donor’s wishes.  As with all end-of-life decisions, it is important that the family be fully aware of the individual’s wishes and agree to carry them out.  At the time of death, the Anatomy Department’s morticians will pick up the body at the hospital or nursing home (or funeral home if death occurs at home).  The ashes can be returned to the family if desired.  It is even possible to delay the pickup if it is desired to have the body present at the time of the funeral service.

 

Is there a need for such donations?  Dr. Ed Burso, of the UW Madison Anatomy Department, tells me that their school alone needs about 100 bodies a year for all their teaching programs, for future doctors, nurses, occupational and physical therapists, and for specialized studies.  Multiply this by the about 100 medical schools in the country and it will be clear that donations are always welcome.

 

Organ donation is a very attractive choice, but elderly kidneys or hearts cannot be used for transplants.  Corneas, on the other hand, are useful at any age if not damaged, and cornea donation does not preclude the gift of the entire body for educational use.

 

Donors should also know that the Anatomy Department may judge a body unusable because of recent trauma, far advanced cancer, or recent major surgery.  And if an autopsy is required for any reason, that precludes the anatomical gift.  This determination is made at the time of the notification of death, so donors and their families should give thought to their alternate choice, such as simple cremation of the unembalmed body.

 

 

Hate is like taking poison and wishing your enemy would die.

                                           Hasidic traditional wisdom