Saturday, July 28, 2007

Mystery Revealed



Body of Work: Meditations On Mortality From The Human Anatomy Lab
By Christine Montross
The Penguin Press, $24.95 cloth
ISBN 978-1-59420-125-7

It begins with an image.

She is floating out on the Michigan lake of her childhood. She describes the way her body suspends itself over the watery abyss, inhale, exhale, rise, sink, “as if gravity were a law you could choose to disobey.”

So begins Christine Montross’ superb poetic meditation on her first year in medical school and her experiences in anatomy class dissecting a human cadaver.

“The dead body harbors the great mysteries of creation and humanity,” she writes, “the hidden beauty and intricacy of function, the insistence of individuality, the inevitability of decline, the incontrovertibility of death set up against the ill-defined boundaries of life.” Montross knows what the cadaver dissection will reveal, yet she is unprepared for the connection and depth of feeling she develops for the corpse she will come to know as Eve.

The book is laid out like a syllabus, specifically, the anatomy syllabus. It begins with the issuing of the bone box, “a wooden, handled box a little larger than a briefcase,” that contains two thirds of the skeleton of a human body. Montross also meets her fellow classmates and they make small talk. Once home, she marvels at the intricacies of the bones—“twenty-eight bones in the skull alone,” she writes.

The next morning, after some trepidation, she meets her cadaver Eve and her lab partners: “Tripler, a bright and wonderfully quirky ex-ballerina; Tamara, a shy and often-absent twenty-one-year-old…and Raj, a recent biology major who cannot wait to begin dissecting.” Eve is introduced in almost mummy form, her arms, legs, face, and body parts wrapped in “translucent, cheeseclothlike material.” As Montross and her fellow students begin to uncover and dissect the body, they come to learn many things about how Eve lived and died. There will not be one square centimeter of the body that is not used in the course of the class. The use of cadavers in anatomy class is all consuming, and the bits remaining at the end are gathered together and cremated.

As a guide during the weeks of class, the students follow the Essential Anatomy Dissector, a manual they must consult during the dissection procedures. Montross quotes often from this book. Eve’s body, indeed all bodies, differ slightly from the manual, leading to some confusion and missteps along the way. But the students manage to fumble through each dissection, growing in confidence and skill. It is Eve’s donation of her body that allows this to happen, and Montross expresses her reverence and gratitude throughout the book.

She also gives the history of human cadaver dissection in the anatomy lab, from the days of grave robbery and the use of criminal remains to the present day donations to science that allow people to elect to give their dead bodies to medical schools. It is a fascinating history full of taboos, and I have rarely heard them discussed with such candor.

Later in the book, Montross compares her dissection of Eve with procedures she witnesses performed on live bodies during her assignments as an intern in a hospital. One is left with the idea that medicine often involves traumatic procedures and operations to cure the human body of its ills. Montross details some of the more traumatic, such as cutting open a chest and sawing through the rib cage, and cauterizing a bleeding uterus with an electrically charged device that leaves the flesh grey and charred. She also probes the moment of death. What separates the living from the dead? she wonders. She uses anecdotes and powerful imagery of real cases to light up this issue.

The most difficult parts to dissect for Montross are the genitals and the face. In the genital region, she feels as if she is violating Eve’s person, cutting and examining areas so personal as to be seen in life by only a lover or intimate, possibly, or personal physician. “It is this moment that makes me wish to speak to Eve,” she writes. “I do not know which weight the balance favors. I do not know whether the new acquisition of knowledge, this vision of her depths is worth what I have done to her. I do not know if it is worth it to me. I wonder if her bodily womanhood was centered here or someplace else, more subtle…” Montross is humbled by Eve’s gift, and when she uncovers the uterus, the seat of womanhood, the student yearns to offer it a blessing.

The neck, face and head dissection take a tremendous toll on the students as they near the end of the course. They are cutting into, and pulling apart, the region of the body that gives Eve an identity. Strangely, the brain is also in area where the exact function of each part remains somewhat of a mystery, even though it dictates personality and intelligence. The graphic descriptions, both here and elsewhere, are often difficult to read, but the sheer honesty and power of the simplicity in which Montross describes the procedures make for clear and enlightening reading. If one yearns to know what it is like to become a doctor, this is the book to read.

In the end, Montross comes to two conclusions: in the lives of her grandparents and the examination of Eve’s body, she comes to understand “that the dearest and most enduring moments of our lives are sometimes the quietest ones,” and that “No harm can come to one after death.” The first is wholly spiritual and intellectual. The second is mostly practical, because after reading the book, some might be discouraged from following Eve’s example and donating their cadavers, or those they once loved, to medical schools. Montross realizes that the body is only a vessel for this life. Once we are finished using it, what once held ourselves is now empty, a husk of our former species, an empty chrysalis that once contained us, but now rests in decaying fragments. We have flown away.

Christine Montross does a superb job of using the experience of her dissection of Eve to illuminate what it means to be alive. Along the way, she crosses the frontiers of taboos and mysteries of the human body, but she is never exploitive, and always insightful. Her writing is poetry, her science is art, and we are left with a deeper understanding of human existence and its often untimely end.