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Gross Anatomy at Harvard Medical School:

Their Bodies, Ourselves

There is never a surplus of bodies, according to Clerke and Goodenough. In fact, says Clerke, "we just made it in under the wire this year. People aren't dying as quickly as they used to."

About 200 people sign up for the program every year, yet the average age at the time of death for most donors is now above 80 years, he says. Donors who are in their late 50s or 60s "are still around. They're still out there," says Clerke.

The "Harvard" label, which can add prestige to the most ordinary sweatshirts and coffee mugs, may be an advantage even for the Anatomical Gifts Program. "I think that the name gets us more registrants than at other schools," says Clerke, "but we need everybody we can get."

The period of time between death and final disposition of the body is usually one or two years, says Clerke. After death, the bodies are embalmed and stored in "a rather extensive system of freezers and refrigerators," he says. The main freezers has a capacity of 160-"so we have room," says Clerke.

At the beginning of the course, bodies are moved from the basement-level morgue up to the fourth floor lab of the Medical Education Center. The transportation takes place early in the morning, says Clerke, since "it's a better time to work. Especially in public areas."

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On the first day of gross anatomy lab, students don white jackets. They "double-glove" to protect their hands from formaldehyde and the coldness of the body's insides. Some students choose to "triple-glove."

Some students may have decided to keep a special "gross anatomy" outfit in their locker outside the lab, feeling that clothes are unfit to be worn after eight weeks of formaldehyde saturation.

When the students enter the lab, they see the cadavers set up on metal tables. The bodies are covered first with layers of plastic and material to keep them moist, and then with a blue denim-like cloth. A metal bucket at the end of the table collects the excess formaldehyde that drains from the body. "Sometimes [the bucket] seems like it's getting a little full," says Elbert Huang.

Another plastic bucket under the table is for the removed organs. All parts are kept and eventually buried with the body at the Medical School's burial ground in Tewksbury, or else returned to the donor's family.

Four students are assigned to a cadaver. Their tools include forceps and scalpels, but also grislier instruments which might look more appropriate at a hardware store: hacksaws, wooden mallets, and pliers for cutting ribs.

"There's electric saws, too," says Elbert Huang. "The smell of bone is pretty incredible." He pauses. "Yeah, it's pretty gruesome," he says. "It's pretty gruesome."

A dissection group spends the next eight weeks not only getting to know the cadaver's insides, but also developing a sense of what the person might have been like when alive. They find clues to personality and reminders of the body's humanity that are sometimes amusing, sometimes disturbing but always thought-provoking.

Tattoos, pacemakers, and even staples have all been located in or on cadavers, says Elbert Huang, and often prompt students to hypothesize about the person's life. "We made up this story about him," says Sherleen Huang. Her cadaver's tattoo, large size and physical fitness made her think he may have been in the military.

Elbert Huang says that the cadaver's smooth hands indicate that the man may have spent much of his life sitting behind a desk: "I had visions of him being an executive," he says.

Other features of the cadaver are more upsetting. "The worst day" for one student isn't necessarily as bad for another. But students agree that the process doesn't get easier as the course progresses, since different parts of the body are worked on at different times.

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