Thursday, September 29, 2016

Reducing the (Virtual) death count

            The medical community has had a long and (mostly) noble history of human dissections. The works pioneered by Renaissance surgeon Andreas Vesalius shed a new light on the inner workings of the gross human anatomy. Like a fine watch, the human body is comprised of intricate parts, all clicking away harmoniously to keep us breathing. The process of training on a medical cadaver has allowed for the next generations physicians, surgeons, and practitioners to fundamentally understand the organism they are treating, in a piece by piece breakdown.


(An Andreas Vesalius Illustration, ca. 1543)
            Despite centuries of tradition, there is a faction within the medical community that wants to do away with this physical dissection lab for medical students – what is commonly called “Gross Anatomy”. In 2011, Stanford University, one of the premiere American medicalschools supplanted their gross anatomy curriculum with a hundred thousanddollar digital table. Instead of students preparing their own cadavers, they spectate as a professor leads them through a perfectly curated digital specimen projected onto the lavish digital table in front of them. The cross sections are clean, precise and otherwise perfect. Like a lecture for a chemistry course, the students simply observe and take notes.

            And the wave of digital cadavers isspreading, in 2012 St. Mary’s hospital in London became the first majorEuropean hospital to integrate a “digital cadaver table” into their program, again supplanting the traditional viscera of the classical dissection. Similarly in the United States, major universities are altering their policies, and the virtual-reality-doctor fever is beginning to spread. And there’s certainly a case to be made about the ever-expanding role of digital media in our lives and the difficulty and cost of sourcing bodies. But the substance beneath the argument falls flat. It’s nothing more than a trend and cost cutting. And why should we be cutting corners on the very individuals responsible for keeping us healthy?

            This is a terrible disservice to the public health at large. If you were asked on the street, “would you want a robot to replace your family physician? it can predict illness just as well, with an equal error rate.” The unequivocal answer would be a firm, “NO.” Yet that is exactly what we are doing. By training our medical students on digital patients, we have prepared them to observe the human body as a robot. They’ve never held a scalpel to skin, only a finger to a touch screen. Wouldn’t it be a frightening prospect to go into brain surgery with a surgeon who’s never touched a brain? I’m speaking of course in hyperbole, brain surgeons go through extensive training on cadaver heads, but if the trend continues the way it has, this could easily become a reality.

            In a documentary short I directed, I sat down with three second year medical students to discuss the process of working on a real human cadaver. Though very different in their career outlooks, they all agreed on the importance of the gross anatomy course. Perhaps this process is best summed up by one student, “I think they were really our first true patient. They trusted us with all of the nuances of their bodies for us to study.” This tradition of dissection isn’t a ritual born out of nothing, but a monumental stepping stone in the career of our doctors. Why should be so eager to take away the very class that forges our next generation of physicians? 

1 comment:

  1. I couldn't agree more. It's difficult to fathom a generation of doctors operating and caring for patients, when they're training has not included physical practice on the human body. It may be attributed to the PC movement, wanting to be modernized, or moving away from a more "antiquated" teaching. But I want to say that it's going to be rather difficult separating practicing on an actual human body from a profession that is meant to heal human bodies.

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