Anatomy Now

October 7, 2020

Personal Grief in the Anatomy Lab

The anatomy lab is my ‘happy place.’ I love dissection, exploration, and discovery of the amazing patterns, structures, and variations of the human body. I strive to complete dissections that will look like the pictures in an anatomical atlas… not usually possible! Teaching and helping students become self-sufficient in the lab is a familiar joy. I love to assist them in identifying and defining structures that they have only seen in books. I love those ‘aha’ moments when I can see in their eyes that they understand. I love to encourage them to use this new knowledge and understanding to study more effectively and to make connections that lead to deeper comprehension.

That being said, I don’t tell many people about my happy place because, even though it is a place of learning, exploration, and discovery, it is also a place of death. The other teachers in the laboratory are cadavers – dead bodies. They chose to use their death to teach others about life. I have always had great appreciation for the donors in lab; they were once someone’s loved one. Yet, for the majority of the general population, my job of working with cadavers is perceived as ‘creepy.’

In 2019, the donors in the anatomy lab became reminders of my husband, who passed away quite suddenly. I found myself asking many questions, including: how do I return to what I love after losing a loved one? I felt emotionally surrounded by death at every moment; how could I go to a physical place and be surrounded by death? I’m supposed to model professional behavior for my students; what happens if I fall apart? How am I going to do this?

It was a wintry day when my husband, aged 59, died from a sudden cardiac event. It was shocking. Losing him turned my world upside down. I took time off, but it was January, right in the middle of the school year. My colleagues were wonderful, understanding, and supportive; they gave me as much time as I needed. However, I knew that I would have to return, and as anyone who has experienced grief will tell you, you are never fully prepared to do so.

After some time, I honestly felt ready to return. Returning to work was one thing – returning to the anatomy lab was quite another. I took small steps, and I was slowly able to return to the lab, to the donors, and to what I love to do.

I have no training in counseling or psychiatry, but I do have this deep, personal experience. Here are a few coping mechanisms that helped me and may help other anatomy faculty in the unfortunate loss of a loved one.

  1. Be kind to yourself and take your time. Some days are just for crying. It is strange what can trigger an emotional response. Accept those moments, those automatic responses, and allow yourself to grieve.
  2. Have a healthy outlet for your emotions. Use exercise, meditation, journaling, prayer, or something to help process the emotional and physical reactions that can seem overwhelming. It is very tempting to use an unhealthy method to drown your sorrows, to numb your feelings, or to escape, but that is not sustainable or helpful. Go slow; take time to sit with and process all the emotions. Let it out; don’t bury it or hold it in.
  3. If it’s too hard, step back. At first, I was able to return to lab for sessions that did not remind me of my husband’s death. Some days I would walk in, turn around, and walk right back out. It took a long time to return for the cardiac dissection, but eventually I did so.
  4. Have someone to talk to. It is extremely helpful to have a counselor, a doctor, a good friend, a support group, or family members to talk with, to let your emotions out – the good, the bad, and the ugly. Someone from outside your personal life can often add perspective you may not be able to see.
  5. Develop ready answers to questions and concerns. My students and colleagues knew that I took a leave and why, so upon my return, many wanted to offer condolences. It was very kind, but the conversations often turned awkward. Someone recommended to prepare responses for such moments: “Maybe that is something I will share at another time.” “I appreciate your thoughts and concern. It means a lot.” “I don’t feel like talking right now.” Don’t be afraid to excuse yourself if that’s what you need in the moment.
  6. Everyone’s grief is different. I read several books on grief – some were very helpful; some were less so (Didion, 2005; Groeschel, 2018; Sundberg, 1998; Westberg, 2011). What I learned is that each person has a different experience and a different journey. Listen to yourself to reflect on what helps and what doesn’t. Take small steps toward a ‘new normal.’ Allow it to change you and make you better.
  7. “You don’t move on… you move forward.” I first learned this on a TED talk, (McInerny, 2018) and it was very helpful. As life moves quickly into the future, you do not have to leave your loved one in the past. I carry all the memories of my husband forward into the future because our life together formed and shaped me into the person I am today. Nothing can change that or take that away. I think this is especially important for anatomists. The donors who chose to look to the future to assist in the teaching of health professional students are treated with respect.

Being an anatomist is amazing, but it comes with many challenges. The anatomy laboratory is life and death. Teaching health professional students about the human body is a marvelous experience. Teaching with a human cadaver is a unique privilege. The cadaver, the ultimate teacher, is someone who is grieved over, someone who is missed by their loved ones.

Every day that we walk into an anatomy laboratory, we have an opportunity to remember and honor someone else’s loved one. As part of that experience, students are asked to reflect on their emotions associated with their ‘first patient’ (the cadaver). As faculty, do we reflect on our own feelings? Often, we do not, until we are compelled by life events, as I was the day I lost my husband.

There are many studies and surveys investigating students’ emotional response to the cadaver lab. I identified eight articles from the last 20 years about students and their anatomy laboratory experience (Dinsmore et al, 2001; Dosani and Neuberger, 2016; Hopkins, 2012; Houwink et al, 2004; Lamdin et al, 2012; Prayson and Dannefer, 2014; Romo-Barrientos et al, 2020; Sergentanis et al, 2010). Yet I was unable to find a single source addressing anatomy faculty and their emotional response to the anatomy laboratory experience. This apparent gap in the literature inspired me to share my own experience of personal loss and my subsequent return to the anatomy lab.

As anatomists, we cannot set aside our personal emotions every time we enter the classroom or the laboratory. We must learn to process our feelings and experiences in order to continue teaching with a true appreciation for our colleagues, the donors, and our students. I hope others can benefit from the things that helped me, made it possible for me to move forward while also carrying my loved one with me, and allowed me to return to the anatomy lab – my happy place – as a teacher and role model.

Literature Cited

Didion, J. 2005. The Year of Magical Thinking. 1st ed. New York, NY: Vintage Books. 227p.

Dinsmore, C.E., Daugherty, S. and Zeitz, H.J. 2001. Student responses to the gross anatomy laboratory in a medical curriculum. Clin Anat 14: 231-236. (in press; doi:10.1002/ca.1038)

Dosani, F. and Neuberger, L. 2016. Anatomy and humanity: Examining the effects of a short documentary film and first anatomy laboratory experience on medical students. Anat Sci Educ 9: 28-39. (in press; doi:10.1002/ase.1532)

Groeschel, C. 2018. Hope in the Dark. 1st ed. Grand Rapids, MI: Zondervan. 173 p.

Hopkins, R. 2012. Teaching and Learning Moments; A Negotiation between Death and Learning, Academic Medicine 87 (3): 331. (in press; doi: 10.1097/ACM.0b013e31824485ac)

Houwink AP, Kurup AN, Kollars JP, Kral Kollars CA, Carmichael SW, Pawlina W. 2004. Help of third-year medical students decreases first-year medical students' negative psychological reactions on the first day of gross anatomy dissection. Clin Anat 17(4):328-333. (in press; doi:10.1002/ca.10218)

Lamdin, R., Weller, J. and Kerse, N. 2012. Orientation to dissection: Assisting students through the transition. Clin Anat 25: 235-240. (in press; doi:10.1002/ca.21244)

McInerny, N. 2018. We don’t “move on” from grief. We move forward with it. TED Conferences LLC, New York, NY. URL: https://www.ted.com/talks/nora_mcinerny_we_don_t_move_on_from_grief_we_move_forward_with_it?utm_source=tedcomshare&utm_medium=email&utm_campaign=tedspread. [accessed 17 August 2020].

Prayson, R.A. and Dannefer, E.F. 2014. Fostering self‐reflection on the anatomy laboratory: Dealing with death and the taboo. Anat Sci Educ 7: 417-418. (in press; doi:10.1002/ase.1437)

Romo-Barrientos C, Criado-Álvarez JJ, González-González J, Ubeda-Banon I, Flores-Cuadrado A, Saiz-Sanchez D, VinuelaA, Martin-Conty JL, Simon T, Martinez-Marcos A, Mohedano-Moriano A. 2020. Anxiety levels among health sciences students during their first visit to the dissection room. BMC Med Educ 20(1):109. (in press; doi:10.1186/s12909-020-02027-2)

Sergentanis, T.N., Papadodima, S.A., Evaggelakos, C.I., Mytilinaios, D.G., Goutas, N.D. and Spiliopoulou, C.A. 2010. Students' physical and psychological reactions to forensic dissection: Are there risk factors?. Anat Sci Ed 3: 287-294. (in press; doi:10.1002/ase.182)

Sundberg, J. 1998. Hope in Times of Grief. 1st ed. New York, NY: Harold Shaw Publishers. 95 p.

Westberg, G. 2011. Good Grief. 3rd ed. Minneapolis, MN: Fortress Press. 63 p.

About the Author

Jennette J. Ball, DC, MS, is an assistant professor of anatomy in the Department of Cell and Developmental Biology, Upstate Medical University, Syracuse, New York. She teaches gross anatomy and neuroanatomy to first year medical students and gross anatomy to first year doctor of physical therapy students. Her interests are in anatomy education, specifically innovative teaching practices.

Acknowledgements

Dr. Ball wishes to thank her family; Dana Mihaila, MD, PhD; Gary Johnson, MD; and Sherry Downie, PhD for their editing, feedback, and support, as well as those who donated their bodies for anatomical study and education.