Thursday, June 28, 2007

Composition and Decomposition

I remember being afraid as I stood in line waiting to enter the anatomy lab for the first time in medical school. What I can't remember is why. Dead bodies can't hurt us. Practically speaking, we can't really hurt them any more either. But I was scared. I was nervous about entering a room and seeing dead human beings everywhere.

But I needn't have been. The most beloved professor of anatomy at my school, Matthew Pravetz, made sure to teach us from the start that we could not approach our cadaver, our "first patient," as he reminded us, without deep reverence in our attitude, demeanor, behavior, and indeed in our hearts. Dr. Pravetz, also a Franciscan priest, brought the gifts of his spirituality into his work, and ours, without imposing any kind of religiosity on us. Every time he gave a lecture or demonstration, you could see his sense of wonder at the way every sinew and vessel in the body had developed; his love of the human body and faith in its sacredness permeated the course and set us off on the right foot toward becoming true physicians. That's a good teacher for you.

The following year, when it was our turn to help the new first-year students take that first step into the anatomy lab, I was stunned to find myself breaking out of my usual timidity and lack of self-confidence, carried away by my own excitement about anatomy and growing love of medicine. I remember trying to pass on some of what I'd learned, touching a cadaver's thorax and explaining what its "barrel chest" might have signified about lung disease in life, laying their hands on the chest so they could feel for themselves and no longer be afraid, as I had been. The medical school chaplain was there, standing by just to support us all, and later he took me aside and said, "Good teaching in there."

I can still see my cadaver clearly in my mind, down to the graceful loop made by her recurrent laryngeal nerve after we dissected it free from the other tissues in her neck. Some of my other fond memories of the anatomy lab are spottier, though I remember my three wonderful lab partners vividly. I remember a guy once had an itch on his nose but his gloved hands had just been handling the cadaver, so in desperation (and apologetically) he rubbed the tip of his nose on the shoulder of my scrub shirt as I walked by. I remember being alone late at night with my cadaver studying for an anatomy exam and being startled when a light turned on at the opposite end of the lab, followed to my great relief by a friendly classmate's voice saying, "It's just me!" I remember having no child care for one of my anatomy oral exams and handing of my then-one-year-old daughter to the group ahead of us as they came out of their oral so I could go in with my lab partners and take mine.

It was so great to come out of that exam and find my little girl waiting in the lobby with my kind-hearted classmates. A new, fresh little life, bright and sunny, just beginning her journey.


I started thinking about the ubiquity of decay today because of mushrooms. We spent the afternoon at the Adirondacks' natural history museum, The Wild Center, a small but beautiful museum in Tupper Lake, NY. Despite the fact that I have almost completely shed the "doctor" part of my identity during this vacation, I was happy to see this defibrillator situated halfway through one of their nature trails:

You'd think the highlight for me would have been the adorable river otters, or the natural history hands-on cabinet, or the live kestrel presentation, but no, the highlight for me was...the mushroom exhibit. I didn't know there were 1.5 million species of fungus in the world (compared to 4,630 mammals). I had no idea that oyster mushrooms are predatory. But I did know that morels are DELICIOUS as well as mysterious.


Speaking of morels, I have to give vent to the foodie in me and rave about the dinner we had last night at our amazing hotel. My husband and I have been trying for weeks to celebrate our anniversary with a nice dinner, and last night we had our chance: the Narnia movie was showing in the hotel's small movie theater, and our kids were more than happy to be dropped off while we had our romantic dinner for two. We were done with it in time to see the last battle scene with them - perfect!

I had some delectable morel risotto with a perfectly prepared halibut garnished with a frizzled wild leek and some small carrots, paired with a delicious Sheldrake sauvignon blanc. My husband had lamb. For dessert I had a strawberry "shortcake" assembled from candied ginger scones, whipped cream, and strawberries with sorbet and a dark-and-white chocolate stick on the side. YUM.

Yesterday the New York Times featured a story about a chef , Rebecca Charles, who was fighting for her recipes and restaurant design to be recognized as her intellectual property. I don't know much about the case, but I do think it's time for creativity with food to have its due. Creativity and composition balance out ever-present decomposition and the relentless law of entropy, and the necessity for all life to fall into the cycle of decay and renewal.

In a couple of billion years our sun will explode and take all of our achievements with it - human language, writing, architectural treasures like Chartres cathedral and the great bridges of the world, chemical engineering, great musical works, art, painting, inventions, medical technology, spiritual insights, movies and shows, all lessons and artifacts, not to mention relationships and unique individuals...unless we find a way not to lose these by then. For now, our creativity is what we have as evidence of our vitality and witness to our preciousness. Creativity in the kitchen included!


This recipe for Morel Risotto is courtesy of Phillip J. Speciale and quoted from

1 cup of small dried morel mushrooms, reconstituted and cut in quarters
1 medium sized yellow onion, chopped
2 cloves of garlic, chopped
4 Tbls of butter
6 cups of chicken stock
1/2 cup of Marsala wine
2 and 1/2 cups of arborio rice
1/2 cups of freshly grated parmesan cheese
1/4 tsp salt
1/4 tsp of freshly ground black pepper

Pour broth in a medium size saucepan and heat to a simmer. In a slightly larger saucepan add the butter and sauté the garlic and onions for about 1 minute. Add rice and mix well coating the rice with the butter. Stir in the wine until it has evaporated. Stir in mushrooms. Add broth 2 cup at a time and stir until broth has been absorbed. Repeat until all the broth is used. When rice is tender mix in parmesan cheese.


Patty said...

I've thought about donating my body for this sort of thing. (After my dad died this January and I saw how much funeral homes take and what a bunch of junk that all is I thought, "There must be something better ...?") Anyway, I'm not concerned about what they do with me after I'm outa here. (I do believe in a resurrection of the body, but I think God can do miracles of recreating bodies since he can do anything.) Anyway, I've also thought I'd just want to have a little toe tag that says a little bit about who I was. Did you ever wonder about the people who inhabited those bodies? I wonder.

T. said...

Yes, I did wonder, and I gave her a name in my mind, just so she wouldn't be simply "our cadaver." If I can ever find the poem I wrote about the whole anatomy class experience, I'll post it. In it I basically have a conversation with my cadaver, and she tells me a little about herself - that her arms held tightly the people she loved, that she laughed and sang, that her eyes wept real tears, etc.

At the end of every academic year Fr. Pravetz organizes a memorial service for those who donated their bodies to our school and invites family members to come and hear tributes from the med school class that took anatomy that year. Strict anonymity of the donors is maintained. The students write letters, do readings, play music, or offer whatever else that expresses their gratitude and respect. I choreographed a dance piece entitled "Psaume" to one of Bruckner's choral motets, the one that starts with "Os justi meditabitur..." and recruited a few classmates to rehearse and video tape it to be shown at the service.

Sometimes I think people think med students and doctors don't actually care, but we did.

As for whatever becomes of us later - your thoughts remind me of Ezekiel 37:

1 The hand of the LORD was upon me, and he brought me out by the Spirit of the LORD and set me in the middle of a valley; it was full of bones. 2 He led me back and forth among them, and I saw a great many bones on the floor of the valley, bones that were very dry. 3 He asked me, "Son of man, can these bones live?"
I said, "O Sovereign LORD, you alone know."
...5 This is what the Sovereign LORD says to these bones: I will make breath enter you, and you will come to life. 6 I will attach tendons to you and make flesh come upon you and cover you with skin; I will put breath in you, and you will come to life...
"...14 I will put my Spirit in you and you will live... "

Lee said...

In this and an earlier post I was particularly struck by what you said about teachers. They can give so much; yet also destroy so much. My younger daughter is debating between psychiatry and teaching (though she's still got plenty of time) but is worried that teaching is not challenging enough! I think I'll show her what you've written.

T. said...

The good thing is, there are a lot of connections between the two, teaching and psychiatry/medicine, and she'll probably be able to blend elements of both, whichever she chooses. Thank you for reading!