First Cut: A Season in the Human Anatomy Lab (review)

Gross anatomy serves multiple roles in medical training. In addition to its obvious and comprehensive instruction in the technical names, locations, and structural relations of body parts and perhaps equally obvious practice in wielding a scalpel, gross anatomy teaches medical students to respond as physicians to vivid exposures to death and graphic details of body processes. It is an early and crucial initiation into the medical profession and an important point in the development of students’ medical perspectives. Gross anatomy has also been described as troubling by sociologist Frederic Hafferty (Into the Valley: Death and the Socialization of Medical Students, 1991), in part because students must learn to cope with their cadavers’ dual identity—part biological specimen and part formerly living human—or, in Hafferty’s terms, ambiguous man.

First Cut is a gentle and sympathetic personal memoir of sixteen weeks of observation in the gross anatomy lab at Emory University. The author, Albert Howard Carter III, is a literature professor from Eckerd College in Florida who has an interest in medical humanities, works as a pastoral care volunteer in an emergency room, and teaches bioethics and literature and medicine. In his introduction, he mentions his motivations for undertaking this work as wanting to explore in middle age his unrealized childhood dream of becoming a physician; wanting to explore an unusual or extreme world through examining the stories, images, and language of its participants; and, as he ultimately realized, attempting to fathom the fate of the remains of his father, who died at fifty-six of a brain tumor and whose body then vanished to a medical school because he had willed it for dissection.

The text mainly follows the time line of the dissection and depicts students’ conversations and interactions in the anatomy lab as they make their first cuts, then go sequentially through the back, chest, abdomen, pelvis, extremities, and head. It is interspersed with wonderful woodcut illustrations from Andreas Vesalius, De humani corporis fabrica (1543), and thoughtful captions that elaborate the historical context of these illustrations and gross anatomy in general. Among the strengths of the text are its frequent exploration of the etymology of common words associated with gross anatomy. This is a natural exercise because so much of the scientific vocabulary for body parts stems from Greek or Latin roots, whose understanding it is the students’ task to develop. The word anatomy, for example, comes from the Greek ana, meaning up, and tomy, from temnein, to cut (p. 102). The author elaborates on the connection to tome, or a book that has been cut, as from a roll of papyrus; atom as in a, not, and tom, cuttable; and the broader metaphoric significance of cutting in Western culture (pp. 102–3). My favorite among the dozens of etymologies the author includes is that of hypochondria, which stems from hypo, or under, and chondros, or rib cartilage. Taken together these root words refer to the spleen, which in the Middle Ages was associated with black bile or melancholy (p. 86).

Carter depicts the process of dissection in generally glowing terms and the students’ reactions as mostly favorable, beginning with a mild degree of disgust and aversion, progressing through comfort achieved by viewing the cadavers as biological specimens, and culminating in a rehumanization of the cadavers (p. 105). In describing the students’ initial incisions, he poetically likens the dissection manual to a “piece of music ready to be played” and the scalpel to a “cello bow” (p. 25). The students struggle emotionally with certain body parts—notably the pelvis and head—but manage not to lose sight of the forest for the trees. At one point, two students who are demonstrating their understanding of thigh and knee anatomy dress the cadaver in “a pair of Reeboks and sweatbands at the wrist” (p. 179). Carter interprets this gesture, along with a joke about resting another student’s eyeglasses on his cadaver’s face, as “symbolic attempts to ‘reanimate...