REQUIRED READINGS FOR THE MEDICAL HUMANITIES ELECTIVE:
“CUTTING COLD FLESH: PERSPECTIVES FROM THE HUMANITIES”
Fall 2014
Welcome to the Cutting Cold Flesh elective! During the course, students are encouraged
to prepare and submit to Dr. Soricelli no later than November 25 a “reflection” on their
experience in Anatomy or in this course – a poem, brief essay, journal entry, or art work.
On the Anatomy web page are many wonderful examples of the work submitted by
students during the past few years. Do check them out as they provide a helpful guide and
much encouragement for your own creative work. Written work is to be submitted by
email in a Word document to RLSoricelli@comcast.net. Art should be submitted in a
jpeg file.
Students are also encouraged to bring their reflection to discuss in one of the sessions
entitled “Creative & Affective Responses to Dissection” led by Dr. Ted Fallon. Please
note that these sessions will be held on November 7 and 11 in SAC-A.
Students who submit a creative reflection receive one unit towards the eight
required for course completion.
The following readings, excerpts from a physician’s memoir and four poems, are also
rich reflections intended to give you a further sense of how other medical students have
responded to the experience of dissection. Their responses include awe, irony, emotions
that ebb and flow and constantly evolve, and the creation of an imagined life for their
cadaver. Enjoy the readings, and good luck with your own creative work.
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Excerpts from Body of Work: Meditations on Mortality from the Human Anatomy
Lab by Christine Montross. New York: Penguin Press, 2007, 295 pages.
Christine Montross and her table-mates called their cadaver Eve. Montross was so
affected by her experience with Eve that she set out to learn more about the history of
cadavers and the study of anatomy. She traveled to the old anatomical theaters in Britain
and Europe, sought out holy relics, and kept a journal not only during her anatomy
course but throughout her four years of medical school. In this wonderful book, Montross
vividly describes her learning of gross anatomy. More importantly, she explores how her
experience in the dissection lab and her relationship with her cadaver influenced her
response to patients each step along the way. The excerpts below were selected to show
Montross’s varied emotions and responses in the early months of anatomy lab.
Body of Work, which shows how the keeping of a journal can help one process the many
demands of medical education, is highly recommended for students to read before their
completion of medical school. Christine Montross is now Assistant Professor of
Psychiatry and Human Behavior, and Co-Director of the Medical Humanities and
Bioethics Concentration at the Warren Alpert Medical School of Brown University.
The table behind ours, with the large male cadaver and his large heart, is getting
angry. One of my classmates, Roxanne, is a spitfire of a twenty-two-year-old who has
lived her whole life in Rhode Island. She does her dark brown hair in big curls and wears
blush and eyeliner to lab every day. She lives with her college boyfriend, who teaches
gym to special-ed kids in a small town nearby and earns extra money plowing snow.
Roxanne speaks her mind; I like her instantly.
When she sees us turn our cadaver back over to begin the arm dissection, she lets
out an exasperated groan, pushes her hair away from her eyes with her wrist, her gloved
hands holding forceps and slick with fat, and says in frustration, “Why does our guy have
to be such a flippin’ horse?” The comment flies in the face of the hushed reverence we
have felt the lab required. It is perfect. After a quick moment of silence from both our
tables, all eight of us break into giggles and wisecracks. We wait for lightning to strike in
response to Roxanne’s transgression, and when it doesn’t, we all sigh happily into this
new place where laughter is both acceptable and sometimes necessary.
We return to our respective tasks with a recalibration of balance. In college a
treasured instructor pulled me aside after I had submitted a particularly dark series of
poems in a creative-writing seminar. “You know,” she said, “Shakespeare was great
because he wrote tragedy and comedy with equal vigor.” Whether this was advice on
writing or a well-meaning attempt to pull a nineteen-year-old back from the edge of
writerly angst, the comment resonated then and has continued to resonate for me. Even
the most comic moment contains an element of melancholy; even the deepest tragedy
harbors a trace of the ironic.
Roxanne’s comment then (and the many equally prescient ones that followed)
also granted our work in the lab a kind of honesty and perspective. Dissection is work.
The hours are long; the toll on our own bodies is felt in both emotional and physical
ways. And what each of us knows is that work becomes mundane and demands a sort of
levity, whether the profession is that of store clerk or surgeon, counselor or coroner. “I
think we can feel free to break for coffee,” Roxanne says one afternoon, when frustrated
with the lab’s slow progress. “It’s not like our guy’s going anywhere.”
Even with the new freedom of humor in class, aspects of dissection remain deeply
disconcerting. (pages 68 – 69)
~
Most nights, in the dream space between wakefulness and sleep, I am skinning
people.
Not that I can see myself standing at the table in lab. It is just my hands, and the
left pulls back skin from some unidentified part while the right fingers sweep away the
fascia beneath.
It does not feel depraved. It is the slight annoyance I felt as a breakfast waitress
when, in the same near-sleep moments, I would think, Syrup to table twelve. Extra butter
to twenty-six. As then, I wake myself with logic―there is nothing to do now but sleep.
Nothing to do here but rest. Then eyes closed, deep breaths, and the returning pull of the
left, sweep of the right.
Wake, logic, breathe, left pull, right sweep, wake.
In the deeper moments of sleep, the body is in bed with me. I roll up against her.
Feel her weight on the mattress. In night paralysis I cannot lift the body away. I beg her
to get up, knowing she can neither leave nor hear my request to do so.
I wish her gone.
By the end of the first month of medical school, my classmates and I become
further immersed in our dissection, and we begin to compartmentalize our responses to
our cadavers. We are more and more comfortable in lab. The quiet of our initial forays
has given way to a loud buzz . . . (pages 137 – 138)
~
Another dream: The body I am to dissect is underwater. Her shape is not constant;
the edges are rippled and quivering from the creek flow’s dappled light. The water gives
her motion that does not belong in a body that is dead. The creek is shallow, her body
lying beneath the surface on water-polished stones.
With my scalpel and forceps, I kneel beside her, the water rushing around my
waist, the current tugging me off balance. I make tentative cuts, yet each opening I create
becomes a new outlet into which the creek can flow. Water courses through her femoral
artery. Water eddies in her abdomen.
And just when I begin to think maybe this is beautiful, the current begins to carry
parts of her away, splashing them over hidden rocks and pulling them along tree-lined
turns. I am stricken with guilt. I futilely reach and reach in an attempt to contain the loss,
but the water is strong and wide, and even what I manage to touch slips quickly through
my fingers.
As her body empties, I feel more and more hollow. I think I must offer her some
explanation, but when I look to her face, there is clear and perfect water swirling from her
mouth, a question in a language I cannot comprehend. (pages 163 – 164)
~
One gets accustomed to one’s job, and the normal range of human emotions
needles its way into any working space. For my classmates and me, we have begun to
realize that this desensitization is a vital part of our rite of passage. We must learn not to
be frozen in place by the sight of death, by the sight of nakedness, by disease and the
body cut open. We will be called upon to act calmly and ably when we are confronted
with the body in crisis. We must begin to individually shape how we will cope with the
impact of these extraordinary moments of urgency and whether these coping mechanisms
take a healthy or unhealthy form. (pages 193 – 194)
~
For me, thoughts about life’s boundaries emerge at both expected and unexpected
times . . . Some of the most concentrated contemplation comes for me during the pelvic
dissection in the seventh week of anatomy. I love the shape of the pelvis, as I have since
the first day when I carried home my bone box and held the single pelvic bone in my
hand. When we are learning the pelvic geography, Dr. Goslow brings a massive model of
the bones to lecture, the size that an elephant might have. The model seemed to me like a
beautiful sculpture, with perfect, proportional, continuous lines and series of holes whose
dimensions shift as the structure rotates: from one angle, mirror images of near circles
separated by bone; from another, asymmetrical ovals; from another, creases of light,
overlapping and oblong. The language of these bones slides along their edges. Os coxae,
the hip bones. Their three parts, with names like flowers: ilium, ischium, pubis. The place
where all three parts fuse: acetabulum. Coccyx: ancestral vertebrae―a tail?―now fused.
The pelvic brim, as if water spills over it. The obturator foramen, the ischial tuberosity,
the pubic arch, the ischial spine, the sciatic foramina. The names are so geographic it is
impossible not to lose oneself in the massive model. Brim, arch, spine. The ligament
names like a call to prayer: sacrospinus, sacrotuberous. Sacrosanct. (pages 212 – 213)
~
There are spaces in the body that lack the kind of emotional weight that the
genitals possess but that share the idea of bodily entrance. At the mild end of the
spectrum, we feel this when hooking a probe through the nostrils or deep into the back of
the mouth. At the more extreme end, it is unnatural to push a probe through the
eustachian tube of the ear, and it is an awful feeling to poke metal into the orifice of the
eye. These are deeply held, practically innate lessons that even my toddler niece and
nephew know―you don’t put anything into these spaces in your body, and certainly not
in anyone else’s. You do not probe the ear, the socket of the eye, lest you cause damage.
And we cannot help but feel we are. (page 216)
~
Picture This
picture this:
Two A.M., Thursday night, I’m trying to find myself
amidst a brachial plexus of fibers; my nerves
shredded from picking at a torn-up stylopharyngeus, muscles
aching from overarching my secondary curvature, back
stiff as the epiglottis pierced with my blunt scalpel.
Yet I keep standing, searching, for that one structure
that will make this body complete, that will make my self
feel found in this body that I now feel is my own
as complex and torn up.
―Katherine Freeman
Katherine Freeman was a student at Northeastern Ohio Universities College of Medicine
when she wrote this poem. In Body Language: Poems of the Medical Training
Experience, ed. by Neeta Jain, Dagan Coppock & Stephanie Brown Clark. BOA Editions,
Rochester, NY, 2006: 23.
Apparition
I thought I saw him in the mall yesterday,
sitting on a bench wearing
thick glasses and a blue knit
hat from underneath which
peeked unkempt gray hair that
fell over his ears and framed his
vacant gaze. As I was walking
quickly by, I thought I saw my cadaver
sitting in the mall yesterday,
even though at that point his legs
were spread so far apart that the
one leg had decided to
sever its longstanding relationship
with the other, and even though I
had installed a skylight for each
of his eyes directly through the
frontal bone, and even though his
removable breastplate uncovered
a bereft thoracic vault,
and even though I knew the
shape of the rugae in his
stomach better than I knew the
shape of the nose on his face, and
even though it was not him,
it could have been.
―Gregg Chesney
Gregg Chesney was a medical student at the University of Rochester when he wrote this
poem. In Body Language: Poems of the Medical Training Experience, ed. by Neeta Jain,
Dagan Coppock & Stephanie Brown Clark. BOA Editions, Rochester, NY, 2006: 27.
On Studying Anatomy
What is before me in these rags of skin, human
fragments guttered on a metal table . . . should be as
much the subject of poetry as the pooling of shadow
in a brook or the subtle changes in a woman’s face.
―Charles LeBaron, Gentle Vengeance
She knew down to her bones
that everything that lives
wants to go the limit.
She lived to bellow naked on a dry dirt road
split fast by black skid messages
that she rode out each hot noon.
The messages always read the same,
scarred in every crevice of her body’s day:
leather, fancy feathers, strong perfume
strutted all night, then at high sun, stripped away.
She was a mama, wild mama.
Gave birth to a night-black motorcycle bird,
sucked and licked it clean until it angled like a hawk.
Mounted it, and rode fast.
One day she rode so fast she split the sun,
that faithful high noon blood,
and with a joyful bellow,
soared naked, jubilant, to a gleaming
ninety-mile-an-hour tomb.
Now, student,
to anatomy:
cleave and mark this slab of
thirty-one-year-old caucasian female flesh,
limbs, throax, cranium, muscle by rigid muscle
dissemble this motorcycle victim’s
every part (as if
so gray a matter
never wore a flashing ruby dress).
―Diane Rostin
In Literature and Medicine, Vol. 3, 1985:109 – 110.
Diane Rostin was a student at the University of Wisconsin School of Medicine when she wrote
this award-winning poem for the William Carlos Williams Poetry Competition. Sponsored by the
Human Values in Medicine Program of the Northeastern Ohio Universities Colleges of Medicine
and Pharmacy, the competition is open to medical students attending schools of medicine or
osteopathy in the United States and Canada. For more information, go to
http://www.neoucom.edu/audience/about/departments/behsciences/poetry.
Fear of Gray’s Anatomy
I will not look in it again.
There the heart in section is a gas mask,
its windows gone, its hoses severed.
The spinal cord is a zipper
& the lower digestive tract
has been squeezed from a tube like toothpaste.
All my life I had hoped someday to own
at least myself, only to find I am
Flood’s ligaments, the areola of Mamma,
& the zonule of Zinn, Ruffini’s endings
end in me, & the band of Gennari lies near
the island of Reil. Though I am a geography
greater than even I surmised, containing as I do
spaces & systems, promontories & at least
one reservoir, pits, tunnels, crescents,
demilunes & a daughter star, how can I celebrate
my incomplete fissures, my hippocampus &
inferior mental processes, my depressions
& internal extremities? I encompass also
ploughshare & gladiolus, iris & wing,
& the bird’s nest of my cerebellum,
yet wherever I go I bear the crypts of Lieberkuhn,
& among the possible malfunctionaries,
floating ribs & wandering cells, Pott’s fracture,
mottles, abductors, lachrymal bones & aberrant ducts.
I will ask my wife to knit a jacket for this book,
& pretend it’s a brick doorstop.
I will not open Gray’s Anatomy again.
Brendan Galvin (1977)
In Sutured Words: Contemporary Poetry About Medicine. Ed. by Jon Mukand. Aviva
Press, Brookline, MA. 1987.