If I’d already seen a dead body, how hard could cadaver lab be, really?

The dead bodies of the two people who’d conceived and birthed and raised me, no less. The nauseating sterility of formaldehyde and dissection instruments wouldn’t be dissimilar from hospice rooms six degrees too cold and miles of tubing and Neurology’s excruciatingly tactless commentary that yes, chemotherapy is a well-established stroke risk factor, and that “patient failed tPA” (my apologies for her shortcomings), and that no, it was so catastrophic that your mother will not hear any desperate goodbyes from her imminently-newly-orphaned children.

Family was counseled. Thank you for this interesting consult.

I knew anatomy lab could provoke quite visceral responses: I’d heard of chaplains on stand-by at Emory’s; and a dear friend confessed she’d stepped out and cried during hers, the cadaver a triggering likeness of her grandfather on his deathbed. To me, however, no stranger would it be to reconcile what once brimmed vitality with an environment seemingly void of humanity. I would don my lab coat and goggles, emphatically swear “oh yes, there’s the phrenic nerve,” and leave unbothered. But then our faculty shared with us that foremost in their memory of their anatomy coursework in medical school was the nail polish on their donor’s fingers. And a semi-suppressed memory of my own reemerged.

As much as I didn’t want an attending’s sugar-coated lie that my mom would somehow receive and comprehend the millions of things a daughter wants to say to her mother, I couldn’t bring myself to speak into the ether those millions of things. I couldn’t. Not if I wasn’t sure she was listening. And sometimes, more than two years later, I burn with half-rage, half-devastation that he didn’t feed me the lie I would need to say the goodbye I still need. But in that moment, between delivery of Last Rites and drop-ins from distant family delivering guilt-absolving condolences, all I could think to do was paint her nails.

I drove home from college all the time that first summer after my mom’s diagnosis, clinging to her through chemotherapy and looming mortality and our shared, cutting grief of losing my dad just months prior. Somewhere in there, she started asking me to paint her nails, something I hadn’t done since I was a little girl eager to practice “makeovers” on my amused victims. I was far from an expert. My unshakeable nail-biting habit meant I never got done nor did my own, let alone someone else’s, but she wasn’t deterred. She’d beam despite my shaky painting job, done with clammy hands, the peachy coral color our go-to because it was the only one in the medicine cabinet not yet a sticky, gloopy mess. I’d retrieve it from its place alongside the oxycodone and Creon, and I’d sit in front of her, crisscross, to the background noise of Law and Order reruns, on the same bed I’d climb into as a toddler on early weekend mornings, sandwiching myself between my parents’ arms.

I wish I could put those very conversations on playback. Vague details I can recall: planning day trips to Cape Canaveral and St. Simon’s Island; talking through choked throats and red, misty eyes about my dad; nervously anticipating applying to medical school and dreaming about the White Coat ceremony she’d never get to see. The exact words exchanged during those appointments have blurred with time, but what is indelibly etched into my mind’s eye is a photo of her, fingers splayed out proudly towards the camera and coated that peachy coral, hair that as long as I could remember had been long and brown, now strategically styled into a pixie cut, grinning even when it didn’t seem there was much to be happy about.

Nothing quite like a stage IV pancreatic cancer diagnosis forces all one’s ducks in a row, so estate attorneys had been consulted, funeral homes paid upfront, and urns selected, but even knowing her body would be cremated, even knowing this exercise would be pointless, some unspoken force compelled me forward. With boundless compassion and grace, hospice personnel enforce an “anything goes” anticipatory grief policy, so I got to work. Someone scrambling to be helpful had brought that same peachy coral bottle from home, and her hands got ever colder as I painted, using the sharp edges of my nails to wipe away mistakes. She wore her and my dad’s wedding bands on her right ring finger, now, not her left, because she wasn’t married anymore, she said. I always hated it when she said that. I didn’t stop even as the revolving door of visitors crossed the door’s threshold, into that mindfully-designed and lavender-scented hospice room, peering over my shoulder curiously. I felt defensive, as if they were intruding on something intimate and unexplainable – and, in a way, they were.

Towards the end, my dad had been so stoic about dying, but my mom had voiced her terror, and whenever she did, I was at a loss for the perfectly comforting, consoling words she deserved. The least I could do, once the moment arrived, was try to make it hurt a little less. To make her feel more beautiful and recreate something resembling the safe space of their bedroom at home: that became my goodbye, my disbelief and despair wrapped up in a perhaps-childish act of love. I guess the neurologist’s professional opinion was that our presence wasn’t felt and our farewells unheard, but visitors had been milling in and out for days on end, and it wasn’t until my brother, my sister, and I were alone in the room with her for the first time that she took her final breaths.

This all came rushing back that first day of anatomy lab.

As I’ve begun medical school, these and other unpleasant memories have of course resurfaced. When we learned about Virchow’s Triad and prophylactic anticoagulation for ICU patients in stasis, I thought of my dad, bed-bound for his last four months of life, made red and black and blue from blood thinners. It was wild that the years of havoc my dad’s IPF wrought on our family could be summed up by a lecturer in half a sentence as a “pretty bleak prognosis.” I’ve long wondered how I might wield that constructively, letting it shape me into a better physician. Can I wield that constructively? Trauma of a certain magnitude breeds cynicism some days. Sometimes I fear I’ve lost all capacity to empathize with tragedy not meeting my warped standard of significant loss. But other days, I remember how tears sprung to my eyes, out of something close to joy, at our first patient presentation of M1 year: a father of three young kids, leukemia in remission, who’d get to see his kids grow up. I saw my brother, my sister, and I in their story, raised by a once-young father of three once-young kids, multiple myeloma in remission, an extraordinary dad who only got to be an extraordinary dad because of medical miracles and the miracle workers who realize them.

It's so tempting to turn off the emotions that surge during lab and prevent those unpleasant memories from making themselves known. It’s so tempting to see only tissues and systems, to blunt dissect layers of adipose and compartmentalize that this was once a breathing, emoting person, whose absence must be felt so acutely. Sometimes, though, I think about seeing myself in their story. I think about wielding that pain, so that it meant something, so that I can build it into something greater rather than let it destroy me. I lean into the discomfort, just for a moment, and wonder about my donor: about trips planned and left unplanned; conversations had through choked throats and red, misty eyes; watching her daughter worry and dream about graduate school, perhaps. We do ourselves and someday-patients a service by getting good at restoring some humanity in people and situations stripped of it, even if it means tapping at the underlying hurt. In all the months and years of training ahead, we’ll have to juxtapose humanity, again and again, with medicalized mortality and prolonged suffering and circumstances utterly devoid of dignity. Anatomy lab is none of those things, but it’s something resembling a preview. So, even while on the hunt for the azygos vein or cricothyroid membrane, I think of painting my mom’s nails, or our faculty’s donor’s daughter painting hers, or my donor’s daughter painting hers, maybe with unclean lines and sweaty palms and acetone-soaked Q-tips to clean up the mess. It does tap at the hurt. But they feel a little ore human, and so do I.