In the first two years of medical school, students drive the quality of the experience. Classes outside of anatomy, pharmacology and our core physician courses are structured similar to college courses, with a slightly more accelerated time frame. The onus is on you to explore specific fields in medicine. Case-in-point, this past week I was offered the opportunity to participate in human brain dissections with the department of pathology in collaboration with our school’s neurosurgery group.
I eagerly volunteered, knowing nothing of neuroanatomy. My expectation of the session is best depicted by Rembrandt’s “The Anatomy Lesson of Dr. Joan Deyman.” This painting was completed in 1656, and is the second painting commissioned to Rembrandt by the Surgeon’s Guild of Amsterdam. The instructor is Dr. Deyman, Dr. Tulip’s successor. The same rules apply to this painting as the last: surgeons paid to be in the scene.
Immediately apparent about this image is the damage to the top border, caused by a fire. The remains of the painting are only a fragment of the original, which is known to us by Rembrandt’s preliminary sketches. In the painting, Rembrandt shows the scalp uncovered with an assistant holding the calvaria (skull cap) to the right of the instructor, who is probing the brain. Note Rembrandt’s positioning of the cadaver in the scene has been likened to Andrea Mantegna’s “Christo in scurto” (1480).
The damage to this painting may strike most viewers as a disappointment, but I think the damage transforms this group portrait into a powerful work of art, exposing the relationship between student and surgeon. Notice how the surgeon’s head is missing, and the gaze of the student is on the cadaver. In medicine, students sit at the bottom of a caste system which idolizes those at the top. In this paining, the student, and the viewer, appear unworthy to look upon the face of the surgeon, adding to an already (presumably) God-like ego. In my view, the painting almost has two creators: Rembrandt and the invisible force controlling the fire which burned the canvas. Perhaps the fire also wanted viewers to focus on the corpse, another criminal donated to the guild for dissection, illuminating the disregard for human life based on status.
Getting back to my brain dissection of last week, needless to mention it was nothing like this painting. The brains had already been dissected. Our responsibility was to point out anatomical landmarks, make coronal slices, extract specific areas, and send those samples for lab analysis. As previously mentioned, I have no background in neuroanatomy: we cover that in two months.
Throughout the session, I looked upon the brain with amazement. My other classmates seemed to look as if it were some foreign object, which it is based on our current education. During the session, I picked up the brain, and it seemed heavier than one would presume. I looked over to my fellow student and said, “Look! I have an entire lifetime of memories and experience in my hands.” The student smiled, but I continued to marvel the moment.
I held the brain in my hands, and imagined its possibility. The brain could have belonged to a pilot who flew countless times around the world, an artist who painted masterpieces or another physician who stored the same information I will hold in my brain someday. Endless possibilities. Some established physicians argue that there is a disproportional relationship between work and reward in the medical field, attempting to veer away aspiring doctors, but they certainly overlook the remarkable opportunity bestowed upon us to serve our patients.
Tarlow, Sarah. Ritual, Belief, and the Dead Body in Early Modern Britain and Ireland.
Cambridge: Cambridge UP, 2010. Print.
P.S. I promise not to mention a Rembrandt painting in my next post 😉