Students in the gross anatomy lab stand with trepidation before their human cadavers, uneasy about making that first cut, writes T. Kenny Fountain in his new book, Rhetoric in the Flesh: Trained Vision, Technical Expertise, and the Gross Anatomy Lab (Routledge, 2014).
The associate professor of English at Case Western Reserve University explains in his ethnographic study of education in the anatomy lab how the experience is part of the transformation of students into medical professionals.
To overcome the students’ unease, the professor and a bequest staff member, who works with the donors who gave their bodies, explain the donation process and stress the unique opportunity to explore the physical bodies in front of them.
Early on, students hear two messages: the cadaver is a gift to their medical training, and the act of dissection is a unique way to learn human anatomy.
Students are encouraged to accept the cadavers as both anatomical objects and former human beings, Fountain said.
And with the anatomical gift comes a social and cultural obligation to reciprocate. In this case, students are encouraged to respect the cadavers and take advantage of the dissection opportunity to learn as much as possible. Students will eventually return the gift as health care professionals who use that knowledge to understand and treat the bodies of their patients.
This vital lesson heard and learned by students contributes to transforming medical students into physicians and dentists.
Fountain began his research by studying gross anatomy courses for medical and dental students and undergraduates. He observed; took field notes of how students, teaching assistants and faculty interacted with the bodies, images and objects of the lab; and interviewed participants about their experience.
He studied the language and activities used to make sense of these objects, and he found, along with anatomical terms and concepts, a special rhetorical language of the discipline of anatomy.
Fountain said medical and dental students’ professional training is shaped by the analogies, metaphors, verbal illustrations and statements of value used to describe both the cadavers and the process of dissection.
Most students find it impossible to completely forget that these cadavers were once living humans, Fountain said, and their instructors do not want them to completely forget it.
The rhetorical formations of the lab—the analogy of the gift and the praise of dissection—encourage students to keep both of these elements in play, he said.
“The type of clinical detachment that many anatomy students develop is best described as a re-sensitization to bodies rather than a de-sensitization,” Fountain said. The situation fosters a simultaneous connection with—and distance from—the human body, which students need in order to respectfully perform these very invasive dissections on the dead, he said.
Yet, he explains that many of the same practices of the anatomy lab play out across campus in other professional schools. Students in engineering, law, nursing and social work, for example, all become full-fledged members of their profession by learning how to engage appropriately with the images and objects of their profession.
At the center of this shaping process is the special rhetoric of each discipline, which structures how participants view the objects, practices, outcomes and values of their profession, Fountain explained.