Medical Students Accept Profound Gifts With Reverence, Gratitude
Christine Gilbert of Brookfield, Vt. holds a portrait of her parents, Faye and W. Bruce Dudley, whose decision to donate their bodies to Dartmouth's Geisel School of Medicine was made well before their deaths in 2013 and stemmed from their experiences as patients at Mary Hitchcock Hospital in Hanover. Gilbert is her mother's first child, born after she received an experimental operation for polycystic ovaries at Mary Hitchcock Hospital. Friday, October 18, 2013.
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Kris Minsinger, a first-year medical student at Dartmouth and a Randolph, Vt., native, stands outside of the Gilman Life Sciences Laboratory on the Dartmouth campus in Hanover, N.H., on Oct. 15, 2013.
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Alix Perry, a first year medical student from Los Angeles, CA, stands outside of the Remsen Medical Sciences building at Dartmouth College in Hanover, N.H., on Oct. 16, 2013.
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Hanover — The pungent odor of formaldehyde filled the room, and as Alix Perry unzipped the bag to reveal a naked body, she paused a moment to gather herself.
“It’s shocking and overwhelming to think here’s this person who had a family, but I’m about to cut into them without ever knowing anything about them,” said Perry, 23, a first-year medical student at Dartmouth’s Geisel School of Medicine.
The experience of working with a cadaver for the first time is unlike anything Perry or her classmates will encounter in their medical education. Anatomy class is something that incoming students talk about long before beginning their coursework, and which is a formative experience in the education of young doctors. In working with actual human bodies, they will learn things that are never mentioned in a textbook and develop a deeper appreciation for the human body. They also come to appreciate the deceased people and their families who donated bodies to Dartmouth.
Dartmouth has been accepting and storing bodies through its Anatomical Gifts Program for at least 50 years, said Rand Swenson, an anatomy professor at Geisel. All of the donations come from Vermont or New Hampshire residents, many of them from the Upper Valley, creating one of the most intimate, yet little known, connections between the college and surrounding communities.
Students speak of donors with reverence and gratitude. Every year, they organize a memorial service for donors, and both students and instructors are sensitive to the donors’ dignity and work to protect it. Swenson would not allow a photographer or reporter in the anatomy lab while students were working with the cadavers.
Because studies can take up to two years to complete, the bodies must be embalmed and kept in cold storage at the medical school. The room can hold up to 35 bodies at a time, and because the number of donors has increased in recent years, there are some people who are turned away because of space constraints. (Donor programs exist at other regional medical schools, including the University of Vermont and the University of New England Osteopathic School.)
Dartmouth receives between 25 and 40 donations a year and cremated remains are returned to families within two years, Swenson said.
In studying actual cadavers, students gain tangible insights into how the human body works, and discover abnormalities that supplement the conventional wisdom in textbooks. But students learn to do more than trace veins and identify organs, Swenson said. They are asked to consider the experience, in writing, and to contemplate the humanity within the medical profession.
“Our students get to come to grips with dealing with death and dying. They come to grips with concepts of professionalism in their interactions with fellow students and patients,” Swenson said in an interview this summer before classes began. “It allows our students to reflect on some things many people don’t reflect on in life.”
Kris Minsinger had seen a dead body before he began medical school at Geisel more than a month ago. The Randolph native worked as a nursing assistant at Gifford Medical Center when he was in high school and as a college undergraduate. But he was still unsure of what to expect when he stepped toward the table on which his cadaver lay.
Minsinger had been told by his professor to set aside what he thought he knew about the human body. The textbook was wrong, the body was right, the professor said. As Minsinger traced a nerve in the cadaver, he found that it branched into two nerves and then came back together, which happens in some people but is still uncommon.
He also found that by actually seeing the layers of tissue and putting his hands on a real body, he began developing a “feel” for medicine.
“As physicians, we know we have to put our hands on patients,” Minsinger said.
“You have to have that actual touch or feel for what things should be or shouldn’t be.”
Similarly, Perry said, seeing certain anomalies, such as nerves branching out along unexpected paths, reinforced the lesson of individual variability. She also developed a more holistic understanding of the human body, she said.
“You know the body is tissues, but to see how they are arranged has been surprising,” she said.
There are also lessons to be learned in humanity, said Perry and Minsinger. Perry was struck by the idea that she was working with a person who made a conscious decision while he was alive to donate his body for her education. Dartmouth accepts only donations from individuals who have personally registered with the school before their death.
Two of those people were Christine Gilbert’s parents.
Gilbert’s mother, Faye Dudley, died in February and her father, Bruce Dudley died in July. The Woodstock residents were not Dartmouth alumni, but had received life-altering care at Dartmouth-Hitchcock and felt a deep sense of connection with the institution, Gilbert said.
A Dartmouth surgeon performed an operation on Faye Dudley that allowed her to have children. Bruce Dudley was treated for lung cancer at Dartmouth-Hitchcock and lived to be 90.
Both of Gilbert’s parents felt a debt of gratitude to Dartmouth-Hitchcock and hoped to repay it by donating their bodies to training the next generation of doctors, said Gilbert, a Brookfield, Vt., resident.
“They felt it was so important that doctors be able to learn from whatever experience possible because that’s how change happens,” she said.
Twenty years ago, after they learned of the Anatomical Gifts Program, Bruce and Faye Dudley sat down with Gilbert and her two siblings and made clear their desire that their bodies be donated to Dartmouth. The subject came up repeatedly in the years after that, and the family made sure their wishes were fulfilled.
Bruce Dudley died surrounded by his family at Woodstock Terrace. The first call the family made was to notify a nurse that he had died. The second call was to Knight Funeral Home to make arrangements for his body to go to Dartmouth, Gilbert said.
There was no certainty that he would be accepted. The program administrators have to consider available storage space and also the condition of the body before accepting it; certain infectious diseases, vascular diseases, open wounds or obesity would be reasons for declining, according to Dartmouth’s website.
Less than an hour later, the family learned that his body had been accepted. The cheer that erupted around Dudley’s deathbed may have sounded odd to anyone listening outside the room, but it seemed natural to Gilbert.
“We were cheering because we got to honor his wish,” she said.
Minsinger and Perry said they are thankful for people like the Dudleys.
“It’s a big step in medical school to apply what you’ve learned in a textbook and see what it looks like in a human body,” Perry said. “A lot of people were excited, but also thankful for the gift we’ve been given with these cadavers.”
“Obviously it’s a local program,” Minsinger said, “And we think it’s wonderful to have this experience.”
At the end of the school year, students organize a memorial service for the donors, inviting the families of the deceased to attend as well. The service, held in Dartmouth’s Rollins Chapel, typically includes music, reflections from students and families and the reading of the donor’s names. In the hallway outside Swenson’s office are framed programs from some of the services held in years past.
The second-year medical students found it to be such a profound experience that they visited the anatomy class this year and read a few reflections, Minsinger said, believing that the first-year students should not wait until the end of the year to appreciate what the donors had given them.
Gilbert said she and her family plan to attend the memorial service. And one day, she may even become a donor.
“I strongly think that is where I want to go when I meet my end,” she said.
Chris Fleisher can be reached at 603-727-3229 or firstname.lastname@example.org.