One Breath Apart

What started in the mid-seventies as brown-bag lunchtime optional seminars for students, faculty, and staff of the (then) University of Massachusetts Medical Center evolved into a magnificent project. The medical students' courageous willingness to acknowledge their feelings about death and dissection has made this book possible. It is our hope that this slim volume - this collection of words and images created by the medical students at University of Massachusetts during the last thirty years (and augmented by Meryl Levin's documentary photographs of students from Weill Medical College of Cornell University and their journal entries written in 1998 and published in Anatomy of Anatomy) - will provide you with what good doctors provide for their patients: catharsis, personal insights, and support. From the Foreword: 'One of the enduring images of my first year in medical school is the narrow, unshaven face of Ernest, the cadaver I shared with three classmates whose names I can't remember. We named him 'Ernest', so we could impress our parents by telling them how we were working in dead earnest. In reality, like most cadavers in those days, he was an anonymous indigent man who died in the county home and whose remains were used for our education without his consent. My group was considered lucky because cancer had burned away every bit of Ernest's fat, thus making him an excellent 'specimen' for dissection. Even then I knew that Ernest was more than a specimen, but it took a long time to understand that he was actually my first mentor in the joys and sorrows and successes and failures of medicine. Surprisingly, it was Ernest rather than my basic science professors - the living ones, that is - who provoked the most important questions about what it means to be a doctor and forced me to confront them. As I recall, though, this was a solitary process because my classmates and I never discussed, or perhaps even admitted to ourselves, our feelings of ambivalence, fear, pain, gratitude, and exultation, or the changes in us as persons during the first year of medical school. We tried to hide all this because at the time that's what doctors were supposed to do. Today things are different. As students at UMass, you are especially privileged to have a module like One Breath Apart integrated into your anatomy experience. This module provides you the opportunity to explore and share your personal responses to dissection, and with this publication it gives you access to an additional resource: a splendid introduction to the written and visual tradition established by UMass students over the last two decades, along with evocative photographs and journal entries from the medical students at Cornell, documented by Meryl Levin in Anatomy of Anatomy. As I read through this book, I was struck by the Nancy Long's title poem. She writes, 'I pretended you were here/To teach me the details'. How reminiscent of my own experience those words are! 'Then I saw your face/And I knew...' That's the turning point. As physicians we can either embark on the journey of learning to see others' faces and to hold their hands, or we can attempt to distance ourselves and focus only on 'details'. This is a decision that every medical student must make, and our cadavers present the first difficult challenge. In a 2006 class poem, UMass students wrote, 'We felt the brain/And imagined its power to create. We held the heart/And imagined its ability to embrace'. These words represent an affirmation of empathy and compassion over detachment. One of the most compelling images of One Breath Apart shows the anatomy cadaver as a bridge spanning the chasm that lies between ignorance, darkness, and death on one side and knowledge, health, and life on the other. Dozens of tiny figures march across the span. Like me, they won't forget the backbone of that bridge. As another UMass student writes, 'I know that I will be irrevocably altered - Jack Coulehan, M.D., Professor of Medicine, Stoney Brook University, NY.