Letter to a Friend, #1

Author’s note: When I joined the UTMB blog, I wanted to be able to write candidly to you about medical school in the same way that I would to a friend from home. I worried that having an unknown audience would, consciously or unconsciously, change the way that I talk about medical school. To circumvent that, I’ve typed up copies of letters I wrote to a close friend during my MS1 year to serve as my blog posts. When I wrote them, I never thought I’d show these to anyone else, and I think that gave me the opportunity to talk about medical school with the kind of honesty and vulnerability that I’d like to be able to share with others.
Enjoy.
_____________________________________

10/17/15

 Hey [X]! 

You should know better than almost anyone by now that when I talk, I communicate almost exclusively via storytelling.

So it really shouldn’t surprise you that my writing is the exact same way.

 On the first day of medical school, I held a knife in my hands and made an incision straight down the center of a dead woman’s chest. Then I skinned her upper body and pulled back her pectoral muscles.

By the 3rd day of class I was holding her heart in my hands.

Anatomy lab is a lot of things all at once, and I don’t think I can exactly put into words any of them. It’s difficult emotionally. My cadaver died of widely metastatic pancreatic cancer. Sometimes I’ll be cutting, and then all of a sudden you can SEE it. I never thought about what cancer looked like before—it’s white splotches in the lungs with sinister creeping edges and a huge dense white mass on her spinal cord that must have hurt so much. It’s the fact that she had scars on her abdomen, and when I opened her up… It was like the surgeons had already done the dissection for me. Everything was gone. Her pancreas, her gallbladder, her uterus. Even her appendix. When I counted, she’d lost something like 7 or 8 organs. I can’t help but wonder who this woman was and what she was like. The kind of cancer she had is essentially unsurvivable. Less than 1% chance. Why did she choose to have a massive surgery anyway? 

She knew she was going to die and donate her body to an anatomy lab.

 Why did she paint her toenails before she died?

 I don’t know why the toenails hit me so hard. They shave all the cadavers’ heads and cover them all in the same white towels. In the whole room, there is one reminder that these were people who had families and lives outside of the cadaver lab. It’s a set a pink toenails.

 A few days ago I sawed off the top half of my cadaver’s skull and took out her brain. We had these little electric bone saws we were using. Kind of like a pizza cutter with a battery. When other people first started sawing into their cadavers I was like “oh god no this is gonna be bad” because it SOUNDED like the dentist’s office and smelled like burning hair and the room was filling with bone dust… I felt like a weenie, but I put a face mask on to diminish the smell and also bone flaking into my face. As soon as I wimped out everyone else in my group clambered to go grab a mask too. We usually make the 6’2″ guy in my group saw things because with a regular saw you really have to put your weight into it and he’s got the best leverage, but I think sawing someone’s head open was kind of wigging him out. Same with the other guy in my group—he started feeling faint and had to walk away. The girl in my group universally hates doing violent things and never uses the big knives or saws. Sometimes when you can hear the bones breaking in our cadaver like tree limbs, I see her tense up her shoulders and grimace like she’s in pain before she just turns around and walks away.

 And then there’s me.

 I loved it. I could saw skulls open all day. Once you get that pizza cutter in there it’s like opening a can. Plus, when I wasn’t the one sawing, I was looking at her face. We finally uncovered her face yesterday. She was beautiful. Her eyes were open and they were a beautiful light blue. And then we skinned her face. And then she wasn’t beautiful. Not in the same way. And when I looked at her I understood why people believe in souls, because how could it possibly make sense that I was about to hold in my hands everything that ever made her her when she wasn’t even here anymore. 

 I felt like one of those British archeologists who broke into old Egyptian tombs. The kind with a pith safari helmet like in the movies. Like, before the discovery of the Rosetta stone I can picture those guys illuminating the walls of a tomb with a torch and just KNOWING that the writing had to MEAN something, that there was a pattern to the symbols if they could just decode it. But without any kind of Rosetta stone, there was just no way.

That’s what holding her brain was like. I just KNOW that there’s so much going on inside. She probably died of pancreatic cancer because she was a smoker. Somewhere in that 5lb lump of Play Doh there is the memory of the first time she smoked a cigarette. The last time she told someone “I love you.” Making the decision to paint her toenails right before she died.

I know it’s all there. Or at least I think it is. But we have absolutely no way of getting to any of it. Her brain might as well literally have been made of Play Doh for all I could tell. 

 Whatever the answers are, next week is my last week of anatomy lab. After that I’ll do biochemistry. Somehow I don’t think it’ll inspire the same level of soul searching.

Love always,

[Anonymous]

 Author’s note: After I wrote this letter, I brought up our cadaver’s toenails to my anatomy lab partners, and we came to the conclusion that we thought it was an artefact of the preservative process rather than something she had purposely done in life. When we flipped her over, parts of the skin on her back also appeared to have been dyed pink. Somehow “artefact of preservative” is less poetic than “toenail polish,” but I’d be remiss if I didn’t point out the truth.

 -UTMB MS2

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