Body of work: the silent teacher helping students learn anatomy

For over 450 years, students have been studying anatomy at Cambridge through whole body dissection. But students find that they learn far more than just the architecture of the human body during their classes.

“This isn’t a book you take from the library that hundreds of other people will read and you put back. Someone has died and has actually left you their body to look at.” — Lynn Haythorpe

“I feel like I’m in a bit of a daze at the moment as to what just happened,” says Giri Nandakumar. “I have never seen a dead body before. The complexion, the expression of the face, the position they’re in, this was all quite new to me.”

Nandakumar is a first year medical student at Cambridge. He has been at the University less than a week, and has barely had time to unpack his belongings and settle in before entering the dissection room and taking his first steps towards a career in medicine. While students in other disciplines are poring over textbooks or listening keenly to a lecture, he has come face-to-face with a tutor of a very different kind: a donated, dead body.

There are occasional fainters in the first sessions, but the students quickly become accustomed to their new way of studying.

“We encourage our students to see their donor as their first patient and their silent teacher,” says Dr Cecilia Brassett, Head of Human Anatomy Teaching at the University of Cambridge. “That’s why whole bodies are important. Although entry into the dissection room is emotionally challenging, it does develop their professionalism in a way that teaching using models and images does not.”

Throughout the course of their first year, the students will work in small groups, always with the same donor. They will be guided through the dissections by tutors who will point out key points of interest that will prove essential to their future studies and careers, comparing what they discover under the skin with what they can learn from examining a live patient. There are occasional fainters in the first sessions, says Brassett, but the students quickly become accustomed to their new way of studying.

Portrait of John Caius, 16th century (Wellcome Library, London)

Whole body dissection has been taught at Cambridge for over 450 years now — possibly even longer, though earlier records are not clear. It was introduced to the University by John Caius in 1565. Caius had been a student of divinity at Gonville Hall, at the time spelling his name as it sounds, ‘Keys’.

Upon graduation, he spent time in Padua in northern Italy, where he studied under — and shared lodgings with — Andreas Vesalius, author of one of the most influential books on human anatomy, De humani corporis fabrica (On the Fabric of the Human Body), a copy of which is now in Cambridge’s University Library. This time clearly influenced Keys, who returned to England, Latinised the spelling of his name, and became a physician and member of the College of Physicians. There, he introduced annual anatomical demonstrations at the Barber Surgeons Hall in London.

His medical practice brought Caius into contact with the great and the good in London, including royalty. It proved lucrative, too, and he used some of the money to re-found his old Cambridge college, which had come into some disarray. The college now carries his name — Gonville & Caius College — and has a rich history of medicine; William Harvey, who first described the circulatory system of the human body, studied at the college in 1593, as did Harold Gillies, the ‘father of plastic surgery’ in the early 20th century.

Gonville and Caius College, Cambridge c.1690 ( Wellcome Library, London)

“Caius was always keen on medicine, and in particular the study of anatomy,” explains Professor David Riches from Gonville & Caius College. “So when Queen Elizabeth I visited Cambridge in 1565, he obtained from her a decree to obtain two cadavers each year for dissection purposes.”

It isn’t clear where the bodies came from, according to Riches, but they were almost certainly convicted criminals or unclaimed bodies. However, Caius made sure that the bodies were treated with dignity. In the new statutes, Caius ensured a provision of £1 6s 8d for anatomical dissections and stipulated that the bodies should be treated with the utmost respect and subsequently buried in St Michael’s graveyard opposite the College, with the whole College attending.

Dissection was most likely practised at other colleges in later years, but it wasn’t until 300 years ago this year — in 1716 — that the university set up its first Anatomy School, close to Queens’ College.

The Anatomical Theatre at Cambridge (Wellcome Library, London)

Nowadays, Anatomy sits within the Department of Physiology, Development and Neuroscience on the Downing Site. Cambridge is one of only a few medical schools still teaching using cadaveric dissection — dissection of whole bodies — and just under 300 students a year study this at the university as part of their medical education. Some of these students will go on to become doctors and surgeons, others medical researchers, for example. But their education would not be possible without the generous gift from donors of their bodies after death.

“The bodies that come to us will be teachers. They’ll teach first year medical students human anatomy through dissection.” — Lynn Haythorpe

Lynn Haythorpe is the Bequeathal Secretary at the University of Cambridge, and it is her role to speak to potential donors and explain to them how the process of donation works. She receives around over 1,000 expressions of interest each year and the University usually receives up to 50 bodies.

Like Brassett, Haythorpe talks of the donors as active participants. “The bodies that come to us will be teachers,” she says. “They’ll teach first year medical students human anatomy through dissection.”

Learning by working on a human being is a huge responsibility for the students, she adds. “This isn’t a book you take from the library that hundreds of other people will read and you put back. Someone has died and has actually left you their body to look at.”

Throughout their first year, the students become very attached to their donors — even protective of them, explains Haythorpe. As they come to learn all the intricacies of the body, they will discover how unique each individual is, how much variation there is between individuals. The whole experience tends to fill the students with awe.

Demonstrator and student during anatomy class

Yet despite working on the same individual for several months, other than the information they can glean about their donor from his or her body — age, weight, scars, tattoos, for example — they know nothing about who their donor was. But all this changes at the end of the academic year.

In May, the University holds a committal service where the students and tutors can pay their respects to their donors and express their gratitude. It is a closed event, but family and friends are invited to a memorial service held later in the year at the University Church, where they are able to say their own farewells.

The committal service itself is held in the dissection room, which is transformed from its usual austere, clinical room, to one decked with flowers and curtains, with requiems playing in the background. As the students enter the room, they find the coffin that contains their donor and will finally learn who their donor was. On top of the coffins are biographic details — name, age, photographs even. In some cases, families have provided much more information, helping paint a picture of the life of their loved ones.

“At the service, the students are saying goodbye: they will not see their donors again,” says Haythorpe. “It’s a very emotional time for the students. They’ve learnt a great deal, they’ve been given a great deal by this person. Students do get upset, and I think that’s a natural expression of how they’re feeling, and that’s a good thing.”

Each group of students writes a tribute to their own donor, but two students are chosen to write general tributes to read. Rachel Fox and Barney Fogg, this year’s representatives, say the service was profoundly moving and both are extremely grateful to their donors.

“If I could send my donor a message, the biggest thing I’d have to say is ‘Thank you’” — Rachel Fox

“If I could send my donor a message, the biggest thing I’d have to say is ‘Thank you’,” says Fox. “‘We’re so, so grateful for the gift that you decided to give. Its impact on our lives and on the lives of the patients we’ll go on to treat has been immense.’”

Fogg agrees. “What they’ve given us is difficult to sum up. It’s not just the donation of their bodies; it’s the connection we’ve built with them. I’m sure I’ll be a better doctor because of the experience.”

Written by Craig Brierley. Film by Nick Saffell.

If you are interested in donating your body for anatomical education, training and research after death, please email leh42@cam.ac.uk with your name and full postal address or see here for further information.