Deeded bodies bring greater understanding of life
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Editor's note: This story originally ran in fyi on Aug. 17, 2011.
Mildred Elliott was a practical sort, a survivor of the Depression who was not wont to waste nor form sentimental attachments to physical things, a belief that extended to her own body.
“She was a practical person and the idea of giving her body for research struck her as a more sensible thing to do than just sticking it in the ground,” says Linda Sturdevant, Mildred’s daughter.
Mildred and William Elliott
And so after Mildred’s full and energetic life of 97 years ended in 2008, she deeded her body to the University of Iowa to be used by students and faculty in the health sciences to learn about how the human body is put together. Her father, William, donated his body, too, after his death in 1976, and while Sturdevant doesn’t know who learned from their bodies or what they learned, she’s comforted knowing their deaths helped give others a better understanding of the human body.
“I’m sentimental about my parents and my memories, but not about their grave,” says Sturdevant, who lives in Washington. “I don’t need a grave to remember them.”
The Elliotts are among the 250 bodies that are donated to the university each year, says Darrell Wilkins, director of the Deeded Body Program in the Department of Anatomy and Cell Biology. The university established its formal program in 1965, although it’s been accepting donated cadavers since the 19th century so that faculty can show students in the health sciences how the human body works.* Wilkins says more than 800 people use the cadavers each year, coming from medicine, dentistry, physical therapy, nursing, and other departments across the health sciences.
* There was a time when less savory means were used to secure cadavers for such purposes. In 1870, the university fired an anatomy professor who led a team of students that dug up a recently buried body in Oakland Cemetery for research.
“Cadavers are a vital teaching tool and an indispensable part of medical education and research,” Wilkins says. Every student in the health sciences learns anatomy from a cadaver, but it goes beyond that. Athletic trainers practice with cadavers, and orthopedists use them to develop new devices that help people walk and move. With cadavers, students learn how tough and resilient the human body is, what the heart and brain feel like, how the liver sits in relation to the kidney. They learn of the amazing amount of force that is needed to break a bone.
Bryan Brown used cadavers to learn how people talk to each other. A doctoral student, he dissected a cadaver for Speech and Hearing Anatomy, a class taught by Professor Jerald Moon of the Department of Communication Sciences & Disorders. Brown says that peeling back the skin and peering directly into the body is the only way to fully appreciate the intricate network of muscles, tendons, and bones that work together and allow us to talk.
“The only way to observe the organization is by dissecting,” he says. “When I was learning about the muscles of the head and neck as an undergraduate, I wondered why there appeared to be so much overlap. Now I see that there isn’t much overlap at all, but these muscles all contract at a different angle, to a different length, at a different strength.”
Without seeing that chain of events, that movement of one muscle that moves a tendon that moves a bone, he said we would be unable to fully understand how we meet our human need to communicate with others.
The deeded body office is in the basement of Med Labs building, blank and austere and not much different from most other scientific office spaces on campus. What sets it apart are the U.S. Marine Corps banner hanging on one wall* and a huge walk-in refrigerator holding dozens of cadavers mere feet from Wilkins’ desk. Their presence has never spooked him.
* Wilkins is a vet and has the crew cut to prove it.
A certified mortician, he has been working with cadavers for decades, including time spent at mass disaster sites helping to identify the victims and preparing their bodies for what comes next. He spent weeks at New York City’s Ground Zero after the September 11 terrorist attacks and in New Orleans after Hurricane Katrina. He was recently in Joplin, Mo., helping to identify the victims of the May 22 tornado.
The Department of Anatomy and Cell Biology at the University of Iowa Carver College of Medicine will hold its annual memorial service for the Deeded Body Program at Oakland Cemetery. Read more...
He has long since made his peace with working with the dead.
“Some of us are better at handling this kind of work than others,” he admits. “I don’t think too much about it. I go out the door and leave it behind me.”
Wilkins gets about 60 inquiries a month from people who are interested in donating their bodies. Not everyone who wants to donate can do so—bodies that died of excessive physical trauma or underwent autopsies are unusable. Bodies that had certain diseases or are too tall or too obese can’t be used. Donors must be adults. He said bodies that had organs donated can’t be used, because that would make it difficult to show students where the organs are, which is the point of the dissection.
But in the end, he said those limitations eliminate only about 2 percent of the bodies that are enrolled. Cadavers are usually used for research for one to two years and then cremated, after which the cremains are returned to the family or interred at Iowa City’s Oakland Cemetery following an annual memorial service (see sidebar).
The program does no marketing, relying only on word of mouth, and most of the donors are from Iowa or Illinois. Wilkins says local funeral homes transport the bodies to Iowa City when a donor dies, usually after the family has held a traditional visitation and funeral.
“The donors come from all walks of life,” Wilkins says. “I’ve got doctors, ministers, attorneys. I work closely with Catholic societies in Dubuque and Davenport. I’ve got entire families that donate their bodies.”
Sturdevant is one of those. She’s following her parents’ lead by donating her own body, and her daughter is donating hers. For Sturdevant, it wasn’t just the practical desire to make one’s physical remains useful to others. She, too, was the beneficiary of a cadaver in her own professional training, as a dental hygienist in 1965.
“It was one of the most powerful educational experiences I’ve ever had,” she says. “You can read about it in a book or see it in a picture, but you need to see it up close to understand the richness and variation of the human body.”
The university thanks her for her gift—and hopes it will be many years before she fulfills it.
After the funeral has ended and tears shed, the obituaries published and the last of Jell-O salad cleaned up in the church basement, a subtle change happens to donated bodies once they reach Iowa City. The bodies, one-time repositories of life, turn into cadavers, specimens for scientific research. All references to their past lives and identities are wiped clean. They become a number, identified only by sex, age, cause of death, and, if relevant, medical history. Towels and sheets cover body parts until the dissection begins. They are quite intentionally depersonalized, letting students and researchers create some emotional distance with who the person once was, so they do not see their cadaver as someone’s parent or child or golf buddy or bridge partner.*
* Wilkins said once a student was mistakenly assigned his grandmother’s cadaver. The error was caught in time to avoid emotional disaster.
But despite all those contingencies, it’s impossible to get past the fact that there is a dead body on the table and people are going to see what it looks like from the inside. Many have a hard time coming to grips with that. For the families of some donors, the thought of their loved one coming to this end is too much to take and they withdraw the donor’s permission. Wilkins is fine with that.
“There are no hard feelings,” he says. “We don’t want to generate ill will.”
For the students who actually stand at the table, learning with a cadaver for the first time can often lead to some degree of emotional trauma. To get past that psychological block, students can opt for an orientation, visiting the lab in advance to view a cadaver, or meeting with a hospital chaplain for spiritual preparation and help in overcoming their discomfort.
“We tell our students that these donors made a great act of self-sacrifice and because of their gift, the students are going to learn some amazing things about the human body and how it works,” says the Rev. Mary Kay Kusner, a chaplain in the hospital’s palliative care unit who specializes in end-of-life issues. The use of cadavers often inspires questions of meaning, she says—who was this person, why did she die, what was her life like. Kusner encourages them to think through those answers because it helps them learn to become better doctors.
“With medicine, it’s so much about our heads, but unless we connect our head to our hearts, we’ll never develop as medical practitioners,” she says. “These are opportunities to make those connections.”
But she cautioned they shouldn’t go too far. Some students make the mistake of dealing with their discomfort by getting to know their cadaver, which, of course, they can’t do, so they make it up. They imagine what the person was like in life, their families, their work. They personalize them, and it seems a sensible thing to do when you are about to become so intimate with someone, to get to know them, even if it’s only in your imagination.
But as Megan Dean has seen, that just makes it all the harder.
“The students who think about it that way are more weighed down during the dissection,” says Dean, a master’s student also taking Moon’s class. “Especially when they get to the brain, the people who make up stories about their cadavers have a really hard time with it because they’ve made up this personal attachment to them.”
Kusner says that in those cases, the students go too far to the heart.
“Sometimes, staying in the head is much safer,” she says. “Always lead with respect and the understanding that this is a body that housed a spirit once, that had a life and connections. But know also that there’s a line you can’t cross, and that you can’t get too attached.”
When they went into the lab, Dean and Brown took a strictly business, scientifically detached approach to their cadavers to avoid developing what is in the end a manufactured sense of intimacy.
“I tried to maintain, what was in my opinion, a professional distance,” Brown says, while acknowledging that he had butterflies his first time in a cadaver lab. “I wasn’t fearful, just nervously excited. Like the feeling you get as you reach the crest of an incredibly tall roller coaster.”
But there are always moments when holes are poked through even the most scientific sense of detachment. Dean was momentarily troubled when she dissected her cadaver’s eyes, the windows to the soul, “the most human thing on the body,” she says. And the stubble on his face brought back memories.
“It reminded me of my grandfather, when he got old and we had to shave him,” she says.
“Your mind can’t help but wander off thinking about the family that loved this person, what kind of job he had,” Brown says. “When these instances came I acknowledged that I was curious, but tried to put them out of my mind. For me, it wouldn’t have been beneficial to dwell on the curiosity. I’m here to learn about the body so that I’ll be able to teach people about the body. The cadavers’ back stories are unimportant.”
William Elliott designed gas stations for a living. After attending classes at the Art Institute of Chicago, he went to work for Standard Oil and became an engineer. Given charge of building the company’s service stations in Iowa, he moved to Des Moines with his wife, Mildred, a homemaker.
They stayed in Des Moines and raised their family there until William died of heart disease at age 65 in 1976. Mildred lived long after that, eventually moving to Washington to live with her daughter Linda, and she died of breast cancer in 2008 at age 97. Living a full and healthy life was important to her and so she exercised daily, but the cancer made life difficult near the end and she decided to quit when she moved into hospice.
“She said, ‘I think I’ll stop exercising so much if that’s why I’m still here,’” Sturdevant says.
She avoided telling her parents about her own learning experience with a cadaver in dental school, thinking that might cause some discomfort. But she was glad they offered their bodies for research because she knows how profoundly powerful the experience was.
That power is shared by most everyone who learns about being human and being alive from someone who has been both.
“You open yourself to amazing lessons that these people can give,” Kusner says.