July 31, 2011

Day 5 – Intro to ICM, Honor Council (and Orientation Day 3), and “meeting your cadaver”

Apologizes for the lateness of this post – the weekend was spent either out doing stuff or catching up.  So to re-orient ourselves, this is the post that was supposed to be on Friday.  The first couple paragraphs are just a brief summary of the day, the rest is on  our intro to anatomy.

Friday was a lot of stuff.  First, we had our Intro to ICM, which is basically a course on introducing us to clinical medicine and a chance for us to see patients, even in our first year of medical school.  Not much to say about that at the moment, except that apparently classes like this are more necessary than ever nowadays because people stay in hospitals for a shorter duration, so we will need to learn things at a faster pace in the clinic, with less time for our preceptor (aka clinical mentor) to teach us things.  Also, I liked this quote: “To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all” – Sir William Oslen

Next was our 3rd day of orientation, where we had a financial aid talk (where I found out I would have had to pay ~$50,000 in school tuition/fees as an out-of-state student @___@… thankfully, as an MSTP, I don’t have to worry about that).  Next, we had representatives from different med school organizations talk to us, such as AOA (the med school honor society of which only the top quartile is eligible for in our 3rd-4th years), the Honor Council, and the Student Senate.  Apparently, skit night is also a huge thing here (and in other medical schools) – might be interested in joining that.

A quick word here about the Honor Council. The concept of it is pretty interesting.  Basically, the students run it and hold each other accountable to try to provide a fair academic environment.  In other words, the Council tries to make sure there is no cheating or any sketchy stuff going on in the med school.  It brings to mind the “conflict managers” we had in my elementary school, except instead of solving conflicts between people, they solve issues of morality and ethics.  There seems to be a pretty elaborate system in place, with an investigation, jury, and hearing for people who have allegedly broken the code.

Apparently the honor code says for us not only not to engage in academic misconduct, but not to tolerate it either (willfully ignoring said conduct).  And it makes sense – as they put it, in med school, cheating has a whole different implication than it did in undergrad or below.  People who cheat in med school will eventually become doctors who don’t know their material, and that could potentially cause serious consequences for their patients down the road.  There is a reason we’re learning what we’re learning, and there are no shortcuts.

As someone who’s always been interested in law, I think I might just apply for it.

The last academic thing of the day before the welcome-back party was Intro to Anatomy.  One of the first things the professor asked was “Does anyone know anyone who was donated?”  Apparently, that happened last year, and that student had to be switched out.  That’s definitely one (effective) way of jumping right into the potential issues and questions of working with cadavers…

The first slide had the following: “Dissection of the human body often raises questions about the source of cadavers, invasion of privacy, and human mortality.”  That was certainly on my mind when thinking about this course.  So for anyone interested, here’s how we do it at our school:

  • Donors have to pre-register themselves while alive, and their family carries out their wishes after they are gone.
  • Donors are kept for only ~1 year, even though the embalming process will technically keep them preserved for 10-15 years.  This is so we can return them to their families as soon as possible, which I think is really thoughtful of them.
  • We apparently get a lot of donors (~150/year) compared to a lot of other schools, some of which are having an increasing shortage over the last few years.  Not all of them are accepted of course – exclusion criteria include trauma, autopsied people, those with infectious diseases, or the morbidly obese (because they are hard to work with).
  • It is surprisingly not free to donate – it costs $750, which covers transportation, the embalming process (see next point), cremation, and return/burial of ashes).  Despite this cost, it is apparently the cheapest way someone can be cremated around here, so some people might opt to do it just for that.  Some people even give them a $5 check/month just to pay for this.  Man, I hope most people don’t donate for that reason – I would find that very sad.
  • The embalming process uses traditional embalming methods, but the chemicals used are 7x stronger, and they flush the blood out and replace it with phenol and a bit of formaldehyde
  • Most donors are in their 60-80’s
There you have it – all you need to know about how to donate and what it entails in a nutshell.  Apparently we will be sharing a cadaver with the 2nd years (not exactly sure how that works since we will need to be dissecting the back and neck first, while they are probably going to be needing organs or the other side of the body…)  As an aside, we apparently have the largest class in a while (apparently ~11 “recycles” (great name, huh?) – people from last year who either had medical issues so couldn’t finish classes, or people who failed.  Mostly in the former category)
A great quote on why we need to take Anatomy was by Ernest Juvara (1870-1933), who said “One must start on a cadaver and end up operating on a patient, unless one wishes to start with a patient and end up with a cadaver!”  Very true, unfortunately.  Another great quote was from the professor herself, after describing what we should do to take care of the cadaver (make sure it is always wet, covered, and bagged before you leave, and make sure to put any organs you take out into the bin for that particular donor, so when they cremate them, they can cremate ALL of them).  She said “These are your first patients, and you should treat them as such.”  Very insightful.
After the class, we moved down to the lab to “meet our cadavers”.  Quite a poor choice of words I thought, considering a “meeting” usually implies that both parties are present.  It was at about this time that I started feeling a little jittery in the stomach as I went upstairs to store my backpack in my locker and back down to the basement, where the labs were located.  I have never seen a dead body before, and the idea of cutting into someone that was once a living, breathing, being twists me the wrong way.  The two things I was least looking forward to in medical school were anatomy and sticking needles into each other (I hate needles).  And apparently with our current curriculum, we will have to have anatomy all throughout our first two years.  Joy.  T__T  Anyways.
My first impression of the lab was of course, the smell.  Thankfully, it was a LOT more muted than I expect, which was encouraging, though I hear it won’t be nearly so nice when we actually cut into the bodies.  We were told to wait until all our group members were there before opening the body bag, so that we could make sure everyone was ready.  Most groups had 5 to a cadaver, some had 6.  In our group of 5, one of the other girls and I were both admittedly jittery about seeing a dead body for the first time, though I think I was in better shape than she was.  The other two girls opened the bag and helped lift the towels off.
My first impression was that our donor was very well preserved.  I’m not sure what I was expecting – rotting appendages perhaps? – but she looked remarkably well, except for the incisions on her chest (she had passed from lung cancer).  All the cadavers had their heads shaved, and with her tattoo and earring, she looked pretty tough.  I may have to give her a name at some point this year to make it easier to refer to her, but my housemate’s group named their cadaver “Marty” and when he told me that so casually, it made me feel really weird inside, so I might hold off on that for a while.
We were only in the room perhaps a total of 5-10 minutes, but I felt sick in the stomach for a good hour or two afterwards.  And as we were leaving, the smell/remembrance of the smell made me gag a couple times.  A bit reminiscent of my reaction after we had to dissect a rat in bio lab in undergrad – it doesn’t hit until later.  And I don’t know that I was feeling queasy because of anything in particular really… it just felt like my stomach did not want to settle. Bleh.  But yeah.  Man.  It was easier than I thought it would be on some levels, but harder in others.  I can’t imagine actually having to cut into someone.  The rat was hard enough.
I leave you now with the last slide the professor had before we moved down to the lab, which was certainly the case for me upon leaving the lab on Friday. “It is commonly known that medical students dissect the bodies of the dead; it is less commonly realized that these same dead do a great deal of cutting, probing, and pulling at the minds of their youthful dissectors.” –Alan Greg, MD, 1957

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