A Death Knell for Cadavers

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If “video killed the radio star” and Zoom squelched the commute, it seems certain that virtual reality and 3D imaging will be the death knell for cadavers.

Recently, NBC Nightly News did a story featuring staff members from Case Western Reserve University’s School of Medicine using the metaverse and 3D imaging to map out the details of an upcoming complex brain surgery. No matter that the four participants were in different places (including a different continent) — they were all staring at the same oversized 3D image of the afflicted brain. Let the strategizing begin.

Later on in the piece, it was time for Case Western medical students to don the VR headsets and peer at a 3D, skinless human body. Walk around it, drink it in, admire it like one would a piece of unfathomable beauty and priceless art, which it is. Want to see just the cardiovascular system? No problem. Just the nervous system? Here you go.

As an internist entering his pre-geezer years, it seems certain that dissecting a cadaver will soon become just one more “I remember when” story that I can use to dazzle — or maybe bore — medical students and resident physicians.

Walking into the cadaver lab as a newbie first-year medical student was a very high honor, an induction ceremony that was arguably more solemn and weighty than any white coat ceremony. Some kind and generous soul had donated their body to you and your colleagues in the hope that it would make you a better doctor. Where so many had chosen to be either incinerated or cosmetically and chemically preserved and sealed away in a coffin, these people were allowing you to quite literally study them to pieces.

Predictably, the solemnity of the honor eventually wore off, as anatomy became just another line on a first-year medical student’s lengthy to-do list. There was work to be done — “today, dissect out the nerves of the forearm” — and there was no time to pause and consider who this elderly woman had been, the people she had loved or who had loved her, or the meaning of her life. After all, it was her body that had been preserved in formalin, not her soul.

That’s what I remember most about the cadaver lab: the smell. Even with gloves on, the caustic stench got into your skin and followed you home. It came to be the smell of death, a “can’t miss” kind of medical aroma, as strong as the fruity smell of ketones or the ominously dark and heavy smell of anaerobes on the prowl.

I’m not sure much will be lost when cadaver labs close. The dissection skills might have been useful to future surgeons, although my first impression on seeing the inner workings of a live human being during a third-year surgery rotation was that a living body doesn’t look anything like what I saw in the cadaver lab.

So out with the old, and in with the new. Out with the formalin and in with the virtual. Merge anatomy class with pathology class in a way that augments both. Tell the computer, “Show me a type-A aortic dissection.” “Show me a healthy rotator cuff on the left and a torn one on the right.” “L4-5 spondylolisthesis, please.”

Yes, the opportunity to dissect a cadaver was a humbling honor, but one that is logarithmically exceeded by the honor of caring for patients, of trying to figure out what ails them, and how to fix it. As the news piece details, Case Western faculty has found that 3D imaging helps students learn anatomy twice as fast and remember it longer. Why spend 3 hours tediously dissecting out the branches of the brachial plexus when there’s more to know than ever before?

It doesn’t seem that anyone understands exactly what “the metaverse” is or will be, but I’m not really interested in what Mark Zuckerberg describes as an “even more immersive” and “embodied” internet experience. I feel plenty immersed.

But if some functions of the metaverse can help us better understand and deal with the real world — in this case, the anatomical complexity of the human body — then bring it on.

Craig Bowron, MD, is an internal medicine physician.

This post appeared on KevinMD.

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