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• Would there be benefit in mandating writing tributes?
  Laith Evans
  Published on: 12 May 2021

• Published on: 12 May 2021

  Would there be benefit in mandating writing tributes?

  • Laith Evans, Medical Student Norwich Medical School (UEA)

  Thank you to the authors for writing such an insightful article.

  In addition to the comfort offered to friends and family of donors’, the act of writing tributes enables reflection from students about their experiences and relationship with their cadaver, which is alluded to by the authors.

  I imagine for first year students this process is both cathartic and valuable in acquiring closure after forming such an intense and unparalleled relationship with their donor. At Norwich Medical School, where I am currently studying, anatomy dissections occur regularly throughout all five years of the course but with particularly focussed study occurring in the first and second years. I remember vividly the confusing emotions I would have after saying goodbye to each year’s donated body. A strange sense of sadness and loss, very similar to those of the Cambridge students but also gratitude towards the donor, I was proud of their decision to donate their body and pleased that one of their last wishes (to donate their body to medical education) had been fulfilled.

  The anatomy department at Norwich Medical School, similarly to Cambridge’s, encourages each of their dissection groups to write tributes to be read at a memorial service held each year, to which family and friends of the donors are invited, as well as a selection of students. Other members of my dissection group always took this mantle but I wonder if in hindsight group reflection and write-up would have...

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  Thank you to the authors for writing such an insightful article.

  In addition to the comfort offered to friends and family of donors’, the act of writing tributes enables reflection from students about their experiences and relationship with their cadaver, which is alluded to by the authors.

  I imagine for first year students this process is both cathartic and valuable in acquiring closure after forming such an intense and unparalleled relationship with their donor. At Norwich Medical School, where I am currently studying, anatomy dissections occur regularly throughout all five years of the course but with particularly focussed study occurring in the first and second years. I remember vividly the confusing emotions I would have after saying goodbye to each year’s donated body. A strange sense of sadness and loss, very similar to those of the Cambridge students but also gratitude towards the donor, I was proud of their decision to donate their body and pleased that one of their last wishes (to donate their body to medical education) had been fulfilled.

  The anatomy department at Norwich Medical School, similarly to Cambridge’s, encourages each of their dissection groups to write tributes to be read at a memorial service held each year, to which family and friends of the donors are invited, as well as a selection of students. Other members of my dissection group always took this mantle but I wonder if in hindsight group reflection and write-up would have been a valuable and therapeutic exercise for all students. This year I am intercalating but upon returning to medicine I will be sure to seize the opportunity to express my thanks to both the donor and their loved ones either on my own or in a session with my peers.

  For students in their first year, dissection is a world away from anything most students (most of whom are not even in their 20s yet) have ever encountered. By incorporating this reflective writeup into a compulsory final seminar the gravity of the donation and the relationship students have formed with their cadaver, even if they’re not consciously aware of it, to be highlighted to all students. Opposed to the current system where some students can ignore the difficult concept or are blind to it entirely. With the discourse around the value and appropriateness of cadaveric dissection growing, it could also form the foundations for an ethical debate around the practice. Admittedly, a reflective writing workshop would not be the appropriate time nor place for a potentially contentious and emotive discussion. Such a discussion would however help incorporate dissection into other areas of the curriculum and not just in anatomy teaching. Helping to build an interconnected and transdisciplinary curriculum.

  I am sure I am not the only student who, despite the vast amounts of knowledge gained from dissection, found the experience shocking and at times traumatic. I vividly remember seeing the undissected hand of my first year cadaver upsetting as prior to that I had been able to dehumanise the dissection material: the majority of it was covered by sheets and the sections we were working on had had the skin removed by technicians. I was able to view the sections as removed from the human identity and as flesh and tissue rather than an individual’s body. Upon seeing the hand, for the first time in my dissection teaching I acknowledged that the cadaver was a person, with details of their life etched onto their hands as shown by small scars, “liver spots” and with the way they kept their nails. From then on, I would hold the hand when it was exposed and I wasn’t actively dissecting elsewhere. In my head I was comforting the donor; I could have so easily have been holding the hands of my grandfather. In reality, I was comforting myself more than anything. I had been forced to confront the reality that on the table before me was a person who had lived a rich and full life, the details of which I could only imagine.

  Discussing and sharing this experience with my peers may have helped myself in processing the humanity of the cadaver and may have also encouraged others to speak about any of their own anxieties and upsets related to dissection. Whilst a mandatory session may feel intrusive to some students and superfluous to others, contribution could be optional, allowing those who prefer silent introspective reflection to do so whilst offering a safe space for sharing amongst other students.

  I think for students on courses where cadaveric dissection is taught, creating and writing tributes is an excellent tool for medical students, in their journey from layperson to clinician. Due to the intense emotions and connections formed with cadavers, as well as in respect to the immense gift donating ones body is, writing tributes and active reflection should be a compulsory part of anatomical teaching for all students. Without it medical schools risk allowing students to fail to grasp the gravity of their role as dissector or, as with me, allowing students to deal with complex and difficult emotions on their own before they are old enough and emotionally mature enough to process them alone.

  Note to the editor - my apologies if this isn't a suitable or standard response to an article. I am looking to develop my ability to correspond with journals and in research in general, so fully anticipate a steep learning curve ahead of me. Thank you for taking the time to read my response if nothing more.

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  Conflict of Interest:
  None declared.

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