I scanned over the email’s contents—75 year old female using she/her pronouns, prefers visits in the early afternoon, small dog residing in the home—and jotted down the contact information listed for her daughter and the members of her care team. As a hospice volunteer, I was tasked with providing companionship as I visited this patient and, over time, wrote her memoir. I imagined what she would be like—perhaps she would greet me at the door, wearing fuzzy slippers and holding a wriggling chihuahua in the crook of her arm. Or, maybe her well-dressed, strawberry-blonde daughter would let me in and offer a beverage while directing me to her mother’s worn beige sofa.
As our first meeting drew nearer, I played out various scenarios in my head. But, none of them came to fruition after I received a message from the hospice coordinator. “Hi. I wanted to let you know that it is likely your assigned patient will pass away this week. I will keep you in the loop as it is confirmed.” For the rest of the afternoon, I wrestled to find the proper response to an abrupt notification indicating someone’s life was in the balance. An exclamation point felt too cheery, a “sincerely” sign-off too corporate. After being told shortly thereafter that she had indeed passed, it felt strange to continue going about my day as usual. Volunteering for hospice throughout college had somewhat acclimated me to the complex sentiments surrounding death… The emotional whiplash would almost immediately set in when, after starting a shift, I went to greet a patient whom I had become close with only to find their room empty and the sheets changed. However, the training never covered how to mourn someone I had never met.
Not a month later, I found myself repeating this pattern with my anatomy cadaver. Stepping beyond the little to no information shared about the owner of this body, I reluctantly assumed their pronouns. While snapping on latex gloves and flipping through my dissection manual, I unsuccessfully tried to shake the uneasy feeling that the 82 year old man in front of me, who died on December 26th, would suddenly bolt upright as if he had overslept. Was it better to give him a name, a story, as I sliced through and memorized the layers of his skin? Or would I sleep more soundly keeping him cloaked in anonymity, covered beneath his fixative-drenched sheet? It felt strange, tracing the twists and turns his innermost blood vessels took, while wondering about his cause of death, or whether he’d grown up in the area.
Over the duration of the course, I instinctively continued trying to piece together the clues of his existence. As I studied the orientation of his heart’s chambers, I considered who might have made it flutter and skip a beat in his chest. I examined the presumably malignant lumps in his esophagus, and imagined him feeling similar lumps in his throat while dropping his son off at college for the first time, or maybe before giving a big presentation at work. Later, I parsed out the nerves surrounding his eyes and thought about if they harbored a twinkle when he talked about his dreams of owning a cherry-red convertible. And, as I gazed upon his brain resting in my cupped hands, an instructor mistook my awe for confusion and asked if I needed help locating the cisternae. Rather, I was engrossed by the boundless possible memories this now-shriveled chunk of tissue once held.
The first time I clicked a disposable scalpel blade into place, my nameless cadaver had been a blank canvas for me to project my imagination and stories onto. But after many lab periods, I’d come to learn he wasn’t blank at all, bearing surgical scars on his abdomen, wrinkles under his eyes, and freckles dotting his shoulders. In the midst of one of our final dissections, I stepped back from my group and looked around the room. I noticed small aspects of other cadavers I hadn’t before, from upper arm tattoos to fingernails painted pink, and appreciated how these humanistic details make us who we are. We spend so much time hating folds and rolls where they aren’t supposed to be, removing unruly hair, and concealing the dark spots that differentiate us from one another. As I held my cadaver’s hand so I could better cut and isolate his palm muscles, I realized that these imperfections unite us. We have so much more to learn from one another than just surface anatomy — if only we could offer the same purposeful attention to these details and stories while still alive.
This is at least partially why I signed up to write memoirs for hospice patients. I now recognize what a gift it is to watch someone’s eyes light up and hear their words firsthand as they tell me about a fond memory. It’s partially why I signed up to be a doctor, too. I hope to establish my future examination rooms as sacred spaces for shared storytelling. Though it may be difficult to keep this at the forefront of my mind while I rush through the day’s backlog of appointments, or miss my lunch breaks to make sure every patient gets seen, both anatomy lab and my hospice assignment will continually serve as powerful reminders of the luxury of having a reciprocal conversation; a fulfilled, rather than severed, connection.
Natalie Brown is an MS1 at the Perelman School of Medicine.
Art by Andrew Lin, an MS4 at the Perelman School of Medicine.
