The Last Gift - an article on body donation

[bubbachuck]

http://jama.ama-assn.org/cgi/content/full/298/18/2116

humbles me everytime i read it

More than anything, what my mother wanted from physicians was commitment and wonder. She would have celebrated with the students when they held that small pump—her heart—in their hands. She would have laughed as they noted the elaborate pathways of her veins and plucked the tendons lifting her fingers. And she would have nodded when they noted the vast distances her disease had spread—from the right lobe of her lung to her pancreas and then up and down her spine.

She would have whispered, "Study me hard, and come back to me again and again. You learn everything there is to learn from my body—so that someday you can do something about these dreadful diseases." And then she'd have looked at them straight on with those unflinching blue eyes.

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[45408]

So I didn't protest, and eventually, a gentle man who must have been in his 20s from the willed-body program came to my mother's room, zipped her into a gray bag, and thanked us. We walked with him out into the hallway and then rode down the elevator with him. "I know how hard it is," he said quietly as the elevator hummed downward. "My wife died last year and she donated her body too. It's a cool thing to do, man." His mouth twisted a little as he spoke, and he looked up and then away from us. When the doors opened he nodded at us respectfully, looking at each of us in turn. Then he carefully pushed my mother's gurney down the hallway and away from us.

If my wife died in her twenties, I would have a very hard time with her donating her body....


good article though

 

[Drogba]

Has anyone had a 20 year old as their cadaver in lab? I've seen someone get a thoracotomy and subsequently die that young (18) but I think it would be completely different to actually dissect a young women like that for 8+ weeks. I know life is life but viscerally having a pretty young woman as my cadaver would probably be pretty trying.

 

[45408]

Has anyone had a 20 year old as their cadaver in lab? I've seen someone get a thoracotomy and subsequently die that young (18) but I think it would be completely different to actually dissect a young women like that for 8+ weeks. I know life is life but viscerally having a pretty young woman as my cadaver would probably be pretty trying.

I sure wouldn't want to. It's nice to have a bit of a disconnect with the cadaver. I think the youngest donor when I was an M1 was about 60. My group had a 90-year old, but he still had a pretty fair amount of muscle mass for that age.

Furthermore, I think they'd rather that you donated your organs at that age (as did a 16-year old girl who died a few days after a major interstate accident recently). Our body donor had metastasized cancer, so he was not an organ donor candidate.

 

[bubbachuck]

i heard that in miami there are a lot of young cadavers due to the gang violence there. something along the lines of "if the body isn't claimed, it's donated to the medical school."

 

[SugPlum]

An optometrist told that the bodies for anatomy at his school in the '60s or '70s came from mental hospitals. The bodies of some patients were unclaimed so they were sent to medical schools.

 

[alphaholic06]

i heard that in miami there are a lot of young cadavers due to the gang violence there. something along the lines of "if the body isn't claimed, it's donated to the medical school."

This is no longer the case for body donation in the US.

 

[pseudoknot]

This is no longer the case for body donation in the US.

Are you sure? Our anatomy faculty told us otherwise. The following article in JAMA says that 20% of US med schools used unclaimed bodies as of 2004:
http://jama.ama-assn.org/cgi/content/full/291/1/122

 

[alphaholic06]

Are you sure? Our anatomy faculty told us otherwise. The following article in JAMA says that 20% of US med schools used unclaimed bodies as of 2004:
http://jama.ama-assn.org/cgi/content/full/291/1/122

Good article. I stand corrected. I thought our Gross course director said that all bodies had to willed by the donor before death. Therefore families couldn't donate bodies of love ones, and unclaimed bodies are also not accepted. But I maybe he was saying that those are the standards for our school.

 

[nlax30]

i heard that in miami there are a lot of young cadavers due to the gang violence there. something along the lines of "if the body isn't claimed, it's donated to the medical school."

Looks like in Florida unclaimed bodies can be used.

Some exceptions though (applies not only to unclaimed bodies):
Bodies cannot be accepted for donation if:
1. an autopsy has been performed
2. death was caused by a crushing injury
3. the individual had sepsis, extreme obesity, or a highly contagious disease (such as hepatitis, AIDS)

Looks like any unclaimed bodies must be turned over to the anatomical board (except in the above circumstances), and only after the county/gov't official that's in possession of the body may a reasonable attempt to locate any relatives to determine their wishes.

Here the Florida statutes concerning the disposition of human bodies/remains for completeness:
http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=Ch0406/SEC50.HTM&Title=-%3E2007-%3ECh0406-%3ESection%2050#0406.50

 

[alphaholic06]

Looks like in Florida unclaimed bodies can be used.

Some exceptions though (applies not only to unclaimed bodies):
Bodies cannot be accepted for donation if:
1. an autopsy has been performed
2. death was caused by a crushing injury
3. the individual had sepsis, extreme obesity, or a highly contagious disease (such as hepatitis, AIDS)

Looks like any unclaimed bodies must be turned over to the anatomical board (except in the above circumstances), and only after the county/gov't official that's in possession of the body may a reasonable attempt to locate any relatives to determine their wishes.

Here the Florida statutes concerning the disposition of human bodies/remains for completeness:
http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=Ch0406/SEC50.HTM&Title=-%3E2007-%3ECh0406-%3ESection%2050#0406.50

Damn, I wish my school had this provision.

 

[pseudoknot]

Damn, I wish my school had this provision.

I was thinking the exact same thing when I read this!

 

[45408]

Damn, I wish my school had this provision.

you guys had 400+ pounders? I think we had a BMI threshold, because nobody had more than 3" of fat.

 

[alphaholic06]

you guys had 400+ pounders? I think we had a BMI threshold, because nobody had more than 3" of fat.

Not quite that high, but pretty close to 300. I know my cadaver had more than 3" of fat.

 

[USCguy]

Our first cadaver was ~300 lbs. She had an unknown dissected AAA. She didn't embalm from the diaphragm down (as far as we know. once we realized she had the AAA, no one was going anywhere near her. Her abdominal cavity was full of fluid. They wheeled her to the crematorium REAL quick).

The second cadaver wasn't as bad, more of a normal person size. However, I still burned with envy for the groups with the cancer patient cadavers that didn't have a lick of fat on them. I know everyone says drying out is a problem, but you can prevent that; if you have to pick fat for 8 hours straight, you just have to pick fat.👎

 

[45408]

if you have to pick fat for 8 hours straight, you just have to pick fat.👎

You can usually just cut it off as well, or if it's intra-abdominal, peel the capsule off the organ and then chuck that, rather than scraping fat off the capsule. If you're talking about regions like the ischioanal fossa, well, then, you're screwed.

 

[USCguy]

You can usually just cut it off as well, or if it's intra-abdominal, peel the capsule off the organ and then chuck that, rather than scraping fat off the capsule. If you're talking about regions like the ischioanal fossa, well, then, you're screwed.

yeah, I was mostly referring to our leg dissection. We had to go from the iliac crest down to the toes. I didn't expect there to be that much fat on the leg. It is amazing the way fat is ingrained in the muscle.

 

[Drogba]

On a related note, I saw my first pannus the other day. Man was this patient hung! It went down to like mid thigh at least. It was a battle of an abdominoplasty. She definitely needed breast reduction too, but that was a surgery for another day. Its crazy the way some people are built/let themselves get. I saw a 25 yo girl a few days ago who had apretty decent figure except for the enormous double d's that hung down to her belly as if she were 60+.

 

[sprinkibrio]

We had a 25 year old man in our lab... he didn't seem very different as the solution does strange things to bodies.

 

[FutureBodyDonor]

[quote=USCguy;5932236]yeah, I was mostly referring to our leg dissection. We had to go from the iliac crest down to the toes. I didn't expect there to be that much fat on the leg. It is amazing the way fat is ingrained in the muscle.[/quote]

NASTY. Personally, I once worked in tissue banking, assisting in removing bones and tissue from recently dead donors, which is pretty graphic.

As for my final disposition, I am an alumni of USC, who registered as a donor to the USC School of Medicine 20 years ago. At 5-11, and 190 pounds, I would hope that my cadaver would present a better specimen for dissection than what you are describing, should it end up in the gross lab.

Recently, I've registered with the USC-SOM polymer preservation program, for "plastination", hopefully becoming a permanent specimen at the school. The medical specimens processed with polymer preservation techniques, and the international touring "Body Worlds" exhibit of plastinated cadavers, are captivating. While traditional body donation still provokes mixed responses, medical professionals and anatomists that I know endorse plastination, and seem willing to be plastinated in death.

What's your take on plastinated specimens in anatomy education? Is it useful for med students, and is plastination the future of anatomy, as some experts say? Your feedback would be appreciated.