Stanford University, California, United States (Winter 2014)
The Anatomy Lesson of Dr. Nicolaes Tulp, 1632
Death came out of the blue. I spent my last night with a glass of Jameson, grading biology tests and half watching a Matlock Marathon with my wife. We were happy: our daughter was pursuing a law career, our mortgage was paid off, and we had reached a level of comfort only possible after three decades of marriage. I must have died in my sleep: the last thing I remember is dreaming of running kites with my daughter in the park. Although I am grateful for my painless death, I had always imagined that I would spend my last moments surrounded by family and friends. I was relatively young, and according to my family doctor a month earlier, as “healthy as a horse.” I never really had the chance to confront or accept my mortality. I guess that stuff only happens in books and movies.
I entered a new world awash in colorful static and sound. I only have two fragments I can piece together from this time: the sensation of a cold metal table against my back and the light fragrance of lilies. My first concrete memory is the feeling of weightlessness. Remarkable calm enveloped my body, like floating through a dark ether. I could barely make out the gentle swishing of liquid. I wondered if I was drowning; I have read that people feel a deep sense of euphoria during the process.
Sensation slowly returned, first to my fingertips, which felt swollen and stiff by my side. A thought popped into my head: proprioception, the unconscious perception of movement and spatial orientation arising from within the body itself. Thirty years as a biology teacher had filled my mind with textbooks’ worth of definitions. I cycled through my favorite words as a memory exercise: mitochondria, phylum, splicesome, epitope, vacuole, ventricle. Ventricle. At that moment, I became aware that the rhythmic lub-dub that had served as the base line to my entire life was conspicuously absent. I reasoned that I must be dreaming, so I explored my new environment. I located my arms and legs, my stomach, and the hairs on my head. I felt the weight of my eyelids, the fuzziness of my tongue, and the discomfort of my unclipped toenails. I explored for hours, locating every wrinkle on my body, but I never “woke up.”
For weeks, I slipped in and out of consciousness. I had days filled with frozen panic, where I felt helpless and weak, and periods of supreme tranquility, where I just melted into the ether that surrounded me. I have been weightless, floating in this liquid for months. At first, the reality was difficult to grasp and easy to ignore. But the sickly, sweet smell in my nostrils was all too familiar. I am dead. And not only am I dead, I am floating in a vat of formaldehyde.
I was angry at first. For days, my lungs burned and pulsed from an oppressed scream, but I could not even whimper. This was followed by weeks where my unbeating heart was weighed down with unbearable dread. I could not overcome a gnawing sense of waste; my lifelong practice of delayed gratification was just beginning to bear fruit that I would never taste. As I came to accept my situation, I was a little disappointed. Is this really it? No Grim Reaper or River Styx? I do not even know where I am.
I think about my daughter a lot. And about my wife. And the yellow two storied stucco home we once lived in together. I think about the happiness of my childhood, the awkwardness of my adolescence, the excitement of college, and the tedium of graduate school. I think about the phone call I made to donate my body to science. I think of my students: the troublemakers and the high achievers. In my time in the vat, I have played through the brief, wondrous history of my life hundreds of times. Sometimes the memories are so vivid that they become too strong to bear, and I slip out of consciousness. At least in this life, I can escape from my troubles.
I return to find myself lying on a cold surface. My limbs feel heavy and my skin cold; I long for the enveloping comfort of the formaldehyde. I am wrapped in something, a thin layer that feels like plastic. There is something soft against my face; I can barely make out the sensation of small cloth loops, which elicits a cascade of memories of soft carpets and thick towels. All around me is the jostling of paper and muffled conversation. The sounds take me back to afternoons with my trusty overhead projector. I chuckle to myself as I realize that I must be in a classroom. The plastic wrapped around me rustles and I can hear and feel the gentle vibration of a zipper opening. Light floods my vision, and despite the cloth over my face, I can make out four young adults in green scrubs standing around me. They are older than the students I used to teach, and from the dark bags under their eyes, I assume medical school. The expression on their faces is a mixture of wonder and apprehension.
As my eyes adjust to the light, I get a glimpse of my body. The wrinkles and the wispy gray hairs on my chest and arms are familiar, but time in the vat has exaggerated my features and stained my skin pale yellow. My wrinkles are deeper and my hairs have been bleached of their gray hue. Worst of all are my fingers, which have grotesquely swelled with fluid. The tan line on my ring finger stands out as a painful reminder of my past life. Although I have been in an anatomy lab before, this caricature of my body is shocking. Is this really what has become of me? I notice that the students breathe through their mouths and I become aware of the stench. My stench.
The instructor passes by, and declares, “Male, fifty-six, stroke.”
Male, fifty-six, stroke. As I struggle to process these three words, the students begin running their fingers across my chest. At each point of contact, I feel, for the first time in months, warmth; a soothing warmth that permeates my chest and echoes the life I once had. Before the stroke. The word carries a heaviness that lingers in my mind.
A student raises a scalpel to my chest, and I catch my reflection in the blade. In the mirror of the blade, my body seems so frail and helpless. The white cloth covering my face robs me of my identity. Are the students afraid to look into my eyes and accept that I was once like them? I try to wince as the blade slices into my yellowed skin, but the layers of fat and fascia painlessly part to reveal the gray muscle of my chest beneath. The coloration is a dull grayish-brown, a far cry from the vivid reds diagrammed in my biology textbook. Yet, the structure is beautiful. I am transfixed as skin and fat is pushed aside to reveal the intricacy and organization within. Layers of compartments run and weave together inside me, perfectly packaged together. I look up to see the other students with their mouths slightly agape and my heart swells with pride. I am reminded of a John Wooden quote, “The best teachers never retire, they only find new students.”
Each day, I watch the students trace along their own bodies what that they will cut into mine. With their fingers, they palpate the muscles and bones beneath their skin, following on me in parallel, our bodies linked. The lesson plans pour forth from my body, revealing facets of my life: my liver showcases my penchant for Jameson, the thick muscles in my leg pay homage to my younger days as a college sprinter, the pink tissue of my lungs reveals the outdoor lifestyle I so dearly loved. The scalpel cleanly follows the path set by the grooves in my muscle fibers and the channels of my blood vessels. I want to whisper to my dissector, to guide his hand to unveil the knowledge and the secrets within me.
My yellowed skin has mostly been stripped away. It reveals the gray network below. Today, the cloth covering my face is removed. Through the lens of the scalpel blade, I appear tranquil; the wrinkles that reflect the memories of my life abound: each crow’s foot a happy memory. The students take pause, glancing at the face of their instructor for the first time. As the scalpel slices away at the roadmap of my life, the muscles that once made me laugh, smile, and grimace are revealed.
Several students visit me after class today. They retrace the cuts they made during the day, gingerly feeling the soft grooves of my face. As they finish their review, they carefully close up the patchwork of my skin and zip my bag closed, leaving me ready for the next day.
The weeks pass, and as my cavities are examined and my internal organs removed, I can no longer recognize what has become of my body; all that remains is an outline. The neat patchwork that once held me together has been trimmed and thrown into plastic lined buckets for disposal. Flaps of skin and fat hang off my muscles, and my internal organs lie on tables around the room. The cautious, wary touch the students once exhibited is gone. As I watch them examine pieces of me, I no longer see the wonder and awe in their faces. The movements of the scalpel blade along my body have become more forceful as the student cut across the striations and compartments, ignoring the routes I spent fifty-six years building. They no longer trace concurrent paths along their bodies and mine. Where I was once a mentor, I now feel like a lump of flesh, a mere tool.
Only one student visited me tonight. He smelled of cigarettes and stale coffee and his hands shook as he palpated my forearm. He spread my skin apart and dug through the grey muscle below. He located a white chord and tugged on it, animating my hand.
“Would you look at that? I made Strokey wave,” he smirked.
He finished examining my arm and as he stood up to leave, he grabbed a scalpel from the table and placed it to my scalp. In a sawing motion, he removed a tuft of my hair.
“Fabulous,” he declared as he shut off the lights.
Sometimes, they forget to zip my bag closed, leaving my darkest secrets open to the cold classroom air the whole night. I shiver and the desperation of thirst permeates my body cavities as they dry out. A black, putrid blemish has begun to grow and spread inside me, leaving me with a persistent dull ache. The stench stings my eyes. The incisions are beginning to burn, and they often throb through the night. I have started slipping out of consciousness to stop the pain.
Some days, I regret donating my body to science.
On the last day of class, the students held a memorial service for me. They read aloud poems of their experience, and the first time in weeks, I saw a glimmer of the awe they had on the first day.
Alex rolls down the window in his car and lights up a cigarette. A gentle drizzle beads on his left arm. As he takes a slow drag, the tremors in his hands subside. Another car pulls up alongside him.
Alex gets out of his car and exclaims, “We’re free at last, Eric. Free at last!”
Eric chuckles and the two of them walk towards the bar. They take their usual seats at the counter and two whiskeys materialize before them. Alex grabs his glass and thrusts it into the air.
“A toast! To the end of Gross Anatomy!” He declares.
“Here! Here!” Eric replies.
“And of course, to Strokey!” Alex continues.
“I always thought of him as Charles,” Eric adds.
Alex smiles and raises the glass to his lips. He closes his eyes to savor the familiar comfort of oak and caramel, but he catches a faint whiff of something strange: a sickly sweet smell. He pauses, his brow furrowed
He inhales again, but the smell is gone.
JAMES NIE is a junior at Stanford University and originally hails from Augusta, Georgia. He is pursuing a biology major with specialized study in neurobiology, and minors in chemistry and creative writing. He owes this story to his professor, Dr. Larry Zaroff, who inspired him to explore the human condition through medical humanities and creative writing. His experience in Dr. Zaroff’s class has encouraged him to pursue a career in medicine.