by Patricia McBroom
This is my body ...the shell of my being ...which is given to you ... final offering to the world.....
With these words from a poem written to medical students by an anatomical donor, Professor Hugh "Pat" Patterson began the final session of his gross anatomy class on Aug. 15, a memorial service for the cadavers the students had been dissecting for eight weeks.
The medical students who learned anatomy this summer responded with poetry, Bible readings, music and the offer of a weeping fig tree, all aimed at thanking the donors for the gift of their bodies which lay covered by brown canvas on two gurneys during the service.
The unusual service drew more than a dozen reporters and TV cameramen, who witnessed the ceremony, crowded in among students, flowers and candles in the anatomy laboratory of the Valley Life Sciences Building.
In spite of the media presence, it was a powerfully touching ceremony. Students had been struggling throughout the course with their own feelings of mortality. Anyone who had lost a relative recently was reminded of that death in this innovative course aimed at training physicians to be sensitive to the dying patient.
The students had touched the head and hands of the cadaver. They were given the option of knowing the names and occupations of the donorsto see them as real people, not as nameless dead bodies, cold and lifeless on the dissection table.
Berkeley's class was sponsored by the School of Public Health, representing an expansion of its Joint Medical Program into the arena of medical ethics and will be the first of many innovations to bring not only ethics, but the humanities and social sciences, to bear on medical education.
Berkeley's Joint Medical Program with UCSF offers a five-year program resulting in both a master's in public health and an MD degree.
While memorial services are increasingly held in anatomy classes throughout the country, Berkeley's course reached further in opening up the dreams and feelings of students as they dealt with the first-time trauma of exploring a dead body.
"Students are exposed to a view of the human body that is potentially dehumanizing," said Patterson, UCSF adjunct professor of anatomy. Yet there was a tradition in medical education never to talk about death in the anatomy course, he said. "It was horrendous. Here you were as a new medical student, taking apart the body bolt by bolt, with your emotions boiling under the surface and you could not talk about it. If anyone dared, the professor's attitude was, 'That's your problem,' or 'I don't want to hear about it.'"
Patterson said that because of this kind of training, doctors have often withdrawn emotionally from dying patients.
The abandonment causes pain and anger on the part of the patient and family, who may then sue the physician for malpractice.
"Many malpractice suits are about anger, and being abandoned can certainly generate anger," said Patterson.
It is hoped the kind of training offered by the class this summer will prepare students for the moment when they will be faced with the death of a patient, said Patterson.
"It's hard to lose a patient but it's also inevitable," he said.
"As physicians, we should be able to get through our guilt and grow to the point that we can accept the coming of death. That way, we can continue to serve the patient," he said.
"Sure, we should focus on saving the patient's life, but if that is all we do, the patient will be hurt when he or she has to face death alone."