Last year, as a first-year medical student, I resected a tumor the size of a roasted chicken from a 76 year-old man who had died of metastatic lung cancer. The tumor arose from the body of a man whose name I did not know, a man who had graciously donated his body for the advancement of my medical education. As I pieced through the large mass that had enveloped his aorta, I noticed smaller satellite tumors hugging corners of his pelvic muscles. They had infiltrated his intestinal mesentery, and inflamed his axillary lymph nodes. There were even small tumors that cradled his kidneys – they oddly looked like gray suckling babes on either side of his aorta. I removed most of the tumor including the smaller satellite tumors that dotted the landscape of his open body, and I thought that this was the least I could do – the one truly respectful deed. I did what he must have hoped a surgeon could do: Remove his collection of inoperable tumors.
My group mates must have thought I was a bit crazy. We had finished the dissection two hours prior to the session’s end, but there I remained, standing in veneration of our cadaver as I cut and chipped away the aggressing tumors that had clawed their way through his insides. I was half-filled curiosity to investigate the boundaries of his tumor – to determine the physical demarcations between his self and the rogue cells that had turned cancerous. Mostly, I was driven by an unexplainable need to relieve him of his tumors – to heal his physical body in whatever way I could. I preserved his thin vena cava, which had been compressed by a large bloated tumor. I salvaged what I could of his inferior mesentery artery, scraped the fat from his adrenals and irrigated the dry maroon-colored blood from his common iliacs.
I was humbled by the intimate presence of his splayed body. He was the quintessence of physical vulnerability – his insides as visible to the world as the skin on his face. This experience took an almost ritualistic feel; I was possessed by the hypnotic intensity of a painter pouring paints to achieve just the exact hue for the canvas. At that moment, I was driven, ambitious, fueled by a fire that was fanned by a deep need to “heal” this man. This completely immersive experience is perhaps best described by psychologist Mihaly Csikszentmihalyi: “The ego falls away. Time flies. Every action, movement, and thought follows inevitably from the previous one, like playing jazz. Your whole being is involved, and you’re using your skills to the utmost.” This is flow, or the psychological and mental experience of being completely mindful of the task at hand. It was an empowering moment in my medical education. It reminded me of the humanity that had inspired me to choose medicine.
At the end of the arduous resection, I peeled the gloves from my aching hands (I had been grasping the scalpel too tightly and was now paying the price). My neck ached, too. I gazed at the pile of individual masses – some small and some very large – that had lived in this man. As a first-year medical student, I’ve learned that even in death, people can be your teachers. Our cadavers are our teachers: Their bodies are both our atlases into a novel corporeal terrain, and our guides into the somewhat uncomfortable and confusing landscape of life, dying, and death. Now, as a second-year medical student, I welcome the lessons I continue to learn from patients about not only the process of dying and death, but of healing as well.
