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Spring 2014
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Anatomy Lesson
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Comfort Zones
“One of the main reasons that I came back to Brown is because there are good resources for the medical students. The medical students are really motivated, they’re really smart. They’re into it,” Ritter says.

Even so, the anatomy course can be grueling for some students. At the same time, it’s a seminal, sometimes even lifechanging, experience. Many students remark that it’s when they begin to feel they are truly on their way to becoming a doctor.

And though several classes have now passed through the basement of the Biomed Center under his direction, Ritter does not downplay the impact on his students’ lives.

“They spend a lot of time together in a very stressful situation, and they are depending on one another. It’s a less drastic version of going to war,” he says. “In working down there it sort of forces them early on to deal with issues that they are going to have to deal with for their whole careers.”

For instance, he says, “How do you honor and respect this person who made this great gift but at the same time you are doing these things that feel like you are mutilating the body? In some ways it’s similar to what they are going to have to do when they’re practicing. They need to empathize with their patients and they need to communicate with them but they can’t get drawn into their lives and their problems, because they’ll give themselves away. They’ll be burnt out in a year.”

And then there’s touching a dead body, and cutting into it. Even though every student who accepts admission to medical school knows he or she will have to do this, it can still be difficult.

“I always tell them that there’s no way to know how you’re going to react to this experience, so the best thing to do is just be open to it and go in and see how it’s going to go,” Ritter says. “We just talk about it and acknowledge the fact that we know that they are nervous.”

As much as he wants to make students feel comfortable, Ritter sees anatomy lab as one way medical students learn to work through the many things that may make them uncomfortable as physicians. Doctors do and see things that most people never will.

“Some elements of the physical exam are very tough and personal,” Ritter says. Gaining comfort touching another person’s body through the cadaver is an important step in the transition to becoming a doctor.

“It’s interesting because one of the toughest parts of the dissection is the hand,” Ritter says. “Hands are really intimate structures. Students start at the thorax and work across, dissecting into the upper arm—and then they take off the covering [over the hand] and it surprises them.” Christine Montross MD’06 RES’10, author of the memoir about her anatomy experience, wrote, “The most alarming moments of anatomy are not the bizarre, the unknown. They are the familiar.”

While most students work through their discomfort, every year there are a couple who cannot get past it. Because four students work together dissecting one cadaver, they are expected to work cooperatively. When one hits an emotional roadblock, it can be construed as not carrying one’s weight.

“Ultimately they have to let their partner and their tablemates know what’s going on with them. It’s just like life, right? They have to communicate,” Ritter says. “Health care is about working with all kinds of people, so it’s a good lesson for life. You’ve got to talk to people.”
Teamwork is critical, Ritter says, in the anatomy lab, in healthcare, and in life in general.
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