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Internist and nephrologist Dalia Frumkin recalls an early mentor, who taught her a lot about being a doctor.
It was 1992, the second week of anatomy. I had named my first teacher Floyd because it was easier to say I’m on a date with Floyd than I’m off to the lab to dissect my cadaver.
I was two weeks into the thorax when the reality hit me that I was sawing open and pulling organs out of a human being. This deceased, elderly man was someone’s father, son, husband or life partner, brother, friend, and coworker. I was exposing and exploring individual bits of what used to be a complete human life. I was holding his huge heart in my hand. This big heart, emerging from a shrunken and shriveled shell, no longer symbolized generosity. It was no longer a symbol of love; it was a blood pump ravaged by disease. It was the remnants of a lost battle.
Just as I began to contemplate all this, my body began to shake. The smell of formaldehyde traveled through my head and I started feeling nauseous and dizzy. I walked out of the lab as casually as I could as the swaying darkness shrank my vision.
This was certainly “too much, too soon.” The reality of life and death and the thin line that stands between them was overcoming me. More than that, I thought, how do I overcome my own visceral reaction to the smell and the feeling of greasy residue on my gloved hands? How do I continue my studies and confront my fear and discomfort with death? What do I do when my own body betrays me and I feel nauseated and faint?
Outside the lab, I brought my thoughts back to Floyd. What can his lifeless form teach me? If he is my first teacher, what lesson is he offering me?
Individuals who donate their bodies to medical schools literally open themselves up and expose medical students to the beauty and art of their anatomy, and to the reality of death and disease. We never know anything about their lives but we become intimate with them, and that is a valuable starting point. Their generosity and bravery allow us to experience the human body and test our own bodies and minds in the process. Floyd made the choice to overcome his own physical limitations and rise above, offer more. He was able to think ahead and turn a dreaded outcome into hope for a future physician.
Medical training involves more than mere facts. There is an emotional component to every new experience. Through the deconstruction of the body, I learned that the flesh and bone that carry us are frail, but the human mind and spirit can be more. Floyd taught me that my own body can betray me as well; I almost fainted. Floyd taught me firsthand what the human body is capable of overcoming - and what it cannot. With his donation, I could confront my limitations and continue. I proved to myself that I was able to go on.
We are art: we make such serendipitous connections and involutions as embryos and are able to achieve so much in life and even through death. I understand that the electrical and chemical messages we send ourselves and each other make us who we really are, fragile yet powerful entities capable of wonderful things when put to the test.
Physicians are called upon to take others through and beyond illness; we do this despite the limitations of culture and language and even our own physiology and psychology. I was able to experience my physical limits, accept them, and move forward. I could listen to my inner voice, understand my physical and mental responses, take a deep breath, and go back into the room.
That lesson continues to help me throughout my career as an internist and nephrologist, business manager, wife, sister, daughter, aunt, student, teacher, and person. Acknowledging the complexity and feelings of being overwhelmed - whether it is caused by physiology, disease, or bureaucracy - I can step back for long enough to continue moving forward.
Floyd helped me answer important questions: Do I have the guts to dissect guts? Can I rise to the occasion? Can I draw blood, sew up skin, see the peritoneum and remember how beautiful it can all be? Am I weak if I feel overwhelmed by dissecting a cadaver or will I be able to use that feeling to become stronger? If I do persevere, can I use that newfound strength to challenge myself further? Feelings pass. Frustrations, thoughts, and fears are transient. Perceived limitations are just that.
Dalia Frumkin, MD, an internist and nephrologist, works in New York City with her sister, also a nephrologist.
This article originally appeared in the February 2009 issue of Physicians Practice.