Learning From the Man Known Only as 'Him'

First-year medical students still rely on cadavers to learn anatomy.

  • The students aren’t given any information about their cadaver, so, for now, they invent their own.
    Photo by Getty Images/kali9
  • As technology advances, so do educational tools, with ever more realistic and advanced representations of the human body. But cadaver dissection remains an essential part of medical school education in the United States.
    Photo by Getty Images/fotostorm

For some, even those who have lost a loved one, it’s the closest they’ve ever been to a corpse. But soon enough, these students will spend their days inches away from this man’s body, cutting through his skin, peeling back the fat, and trimming away the fascia—those bits of densely woven tissue that encase the body’s innards—to see his stomach and liver and bones. Soon enough they’ll pull on his tendons and watch as his toes wiggle in turn. They’ll cut his digestive system from esophagus to rectum, making much ado about the smell. They’ll hold his heart in their hands, and they’ll saw open his skull to remove his brains.

These are the Johns Hopkins School of Medicine students of Table 4D: Sina Famenini, Sara Jones, Ravi Medikonda, Jeremy Applebaum, Nathan Yueh, and Jennifer Qin. One week into med school, they are handed their first patient. He’ll teach them more about gross anatomy than they ever thought they could absorb in seven weeks. But he’ll also teach them how to care. How to detach. How to work as a team. A sense of curiosity and discovery. How to navigate the emotions they’ll face when they become fond of a patient but have to put him through the most painful experience of his life in order to make him well again.

They unzip the body bag and slowly peel back layers of plastic tarp and cloth to reveal his pallid, almost gray face. They decide to call him simply “him.” For privacy reasons, they aren’t told his name, and a nickname seems disrespectful, as if to minimize who he was when he was living. They thank him aloud for the gift he made to their medical education. Famenini grasps a scalpel, holds his breath, and makes the first cut.

As they work, the students move from Grant’s Dissector, the book that guides them through the day’s to-do list, to the cadaver, to a computer screen, back to the cadaver, trying to identify body parts and figure out what, and what not, to cut. Table 4D is tucked away in the last of four bays, each of which holds six dissection tables. Twenty-four bodies in total. Most of the 140 students in the lab are first-year med students, but there are a handful studying biomedical engineering and a few aspiring medical illustrators. A steady hum of conversation is occasionally interrupted by a brief commotion of discovery as the teams work just a few feet from one another.

Some cadavers have pillows of exposed fat while others, like 4D’s, look emaciated.

Some are tall, some short, some black, some white. Some have lungs that show years of breathing in harsh chemicals. One, near the entrance, still has a bright pink manicure that looks as though it could have been done hours before death. Another is missing his left leg, with a bullet wedged into his skull. The bodies have all been embalmed, and the smell of formaldehyde lingers in the air despite the state-of-the-art ventilation system installed in the lab. Above each table hangs a light, much like the one a dentist uses to get a better view of your molars. Below is a pan that catches drippings from the body, such as preservatives or fat that has melted under the lamp; students will often reuse this “juice,” as they call it, to keep the body moist.

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