The Anatomist - Bill Hayes [75]
Truth be told, Dana is not a big fan of prosections either. “Most of them are awful. They’re old, they’re dried out, and they’ve been handled by so many people.” Worse, prosections present in pieces what should be taught as a whole. “You simply can’t learn that way.”
Dana does not mince words, even between bites of a vegetarian Subway sandwich. She and I were sitting outside the Health Sciences building, between classes, on a gorgeous September afternoon. We had gotten together to catch up belatedly on our respective summer adventures—she in the Galapagos Islands with her twin sister; me, in the PT course—but talk had quickly turned to the anatomy program. Dana explained that the course I am attending is actually quite different from the one taught just a few years ago. Up until the year 2000, first-year med students at UCSF took six full months of anatomy, which was pretty much the standard for medical schools across the country. “Only four students per cadaver, and they dissected literally everything, from eyeballs to brains, genitals, toes. Everything.”
This “old curriculum,” as Dana called it, was indeed old, harking back to the 1830s, when legal cadavers started becoming widely available due to a change in law, first in England and, soon after, the United States. As a result, dissections by students themselves (not just by instructors and demonstrators) were feasible. The half-year-long anatomy courses that Gray and Carter took as students and taught as teachers became the norm, and, in fact, those classes were not substantially different from the ones offered 150 years later. Every other class in a modern med student’s curriculum had changed, however. For instance, Gray and Carter never had to study radiology, oncology, and immunology, nor genetics and molecular biology, the fields that have revolutionized medicine in the past fifty years. By the late twentieth century, the typical four-year med school curriculum had become so jam-packed that, short of adding another year, some courses had to be scaled back. To many administrators, the traditional six months of anatomy was starting to look like a luxury, particularly given the huge costs involved not only in acquiring and maintaining cadavers but also in staffing. As I had come to appreciate firsthand, having up to eight instructors supervising fledgling dissectors several times a week certainly must not be cost-effective.
In 2001, UCSF became one of the first medical schools in the nation to make a major move, implementing a change so radical as to cause an uproar from the students. The school eliminated the traditional anatomy course; integrated into other courses a fraction of what had formerly been taught (the anatomy of the heart and lungs, for instance, was taught in a class on the organs); and dispensed entirely with cadavers and dissecting by students. The small amount of anatomy still in the curriculum was taught with prosections. As UCSF is one of the top-ranked schools in the country, other med schools soon followed its example and started slashing their anatomy programs.
While it was an academic year Dana would rather forget, she also takes pleasure in recounting how a great many students successfully lobbied for the reinstatement of the course (albeit reduced from six months to the current six weeks, supplemented by some anatomy classes spread throughout the year) and the reenlistment of cadavers. Even so, repercussions of that failed experiment remain, as I would soon witness.
Following lunch, I accompany Dana to an appointment in the dissection lab. She is meeting with two fourth-year students, a young man and woman who had been part of the test class of 2001. We find them at the back of the empty lab peering into a nightmare cookie jar, a human head with the skullcap removed. They had contacted Dana because they were about to start their ophthalmology rotation and were worried about gaps in their knowledge.
The pair bump heads over the head