Alma is 105. We know how she died—hypovolemia, a decrease in blood volume associated with dehydration—but not much else about her, not about how she lived.
We don’t even know her real name. Alma was given to her by the students in Dr. Monika Baldridge’s class on the day they met her body, in Carroll’s cadaver lab.
Baldridge is an associate professor of physician assistant studies and chair of the department of health and medicine. This summer-long class is PHA500: Human Gross Anatomy. For this new cohort of students seeking a master’s degree in physician assistant studies, the class is their introduction to the program, to cadaver dissection and to Alma.
Alma’s is one of three bodies the students will dissect during the semester. There is Cooper, an 87-year-old man who died from colon cancer, and Beatrice, a 66-year-old woman who died from gastro-esophageal cancer. Like Alma, which means soul in Spanish, they have been named by the students at this first session in the lab.
This particular Friday morning lab is historic, the first in the new cadaver lab in the basement of the Michael and Mary Jaharis Science Laboratories. “We’re christening the room today,” Baldridge tells her students. Baldridge and Adjunct Lecturer Dr. Lori Brock have taught this class for years, but always at another university. Depending on another facility meant that Carroll’s class didn’t receive scheduling priority and that the cadavers weren’t available for Carroll students for out-of-class study.
At Carroll, the cadavers are kept in a separate locked storage area, and students in the class can gain access whenever the building is open.
Bodies in the cadaver lab have several lives. New bodies will arrive annually, ready for dissection by a new class of physician assistant grad students. Once a body has been thoroughly dissected, or prosected, it will remain in the lab as a specimen for other classes. The bodies eventually will be returned to the Medical College of Wisconsin (MCW) for cremation. Some cremains may be reunited with their families, others will be buried by the MCW.
“It’s truly a gift that these individuals have given us by donating their bodies,” Baldridge tells the class. The students appear to understand that—the typical first-class nervous energy here is weighted down by solemnity. When Baldridge tells the 17 women and three men that it is time to meet the bodies, there are more than a few deep exhalations.
Most of the students have dissected animals previously, and many have already seen prosected bodies, but for some, this is a first, and a major milestone on the journey to become a physician assistant.
Before the class, student Kasia Czajkowska-Baciak admitted to being nervous. “I was nervous because I wasn’t sure how I’d react. I was scared I may actually pass out,” she said. “I was raised in Poland where, after death, bodies are kept at home until the funeral. I saw many dead people throughout my childhood. All these memories were sad and it made me anxious.
I had learned to respect the dead and I was not sure if I would be able to do the dissections. When we actually unpacked the bodies and started it was better. I just had to look at this from a different perspective. These people decided to donate their bodies so that we can learn. They deserve our respect and I try to show it by learning as much as I can.”
In this way, the dead teach the living.
Alma, Beatrice and Cooper arrived at Carroll from the MCW, which operates an anatomical gift registry program and prepares bodies for use by schools such as Carroll. The bodies have undergone an extensive, special embalming process and been sealed in bags. Once properly embalmed, the bodies are completely free of any bacteria and may be stored for up to several years before use.
Baldridge notes the indicated cause of death, though she cautions that the students may happen upon evidence of other illnesses, injuries or even causes of death during their examinations. “You never know what to expect: pacemakers, knee or hip replacements…But you’ll need to make note of anything you find.”
And then it is time. Three tables, each carrying a large blue bag, are wheeled into the classroom. The students have broken into three teams, one to each body, and they carefully and gently begin the process of freeing the bodies from their bags and draining the bags of their embalming fluid.
“Gratitude,” answers Ann Weisman, when asked what she is feeling as she first meets Alma. “I think it will be a constant going back and forth between viewing this as a research specimen and realizing it was a human life.”
Over the next two months, the students will come to know intimately the body they are just now meeting. They will cut, lift and probe, seeing how the body is held together and how it functions. Experiencing this with a real body is a priceless benefit.
“I can actually see how the structures are interconnected, how the body is built, how different tissues look,” noted Czajkowska-Baciak. “It is so much different than the plastic models, where everything is perfectly shaped and formed. In the body, nothing looks that perfect. We can look at all the bodies and compare the build and structure of muscles, nerves and vessels. We can actually feel their texture in our hands and learn to differentiate. We opened the spine and skull and actually looked at the spinal cord, the vertebrae, brain, various ligaments. When you do it on your own it helps to learn and I hope to remember a lot of what we do now when I become a PA.”
The dissections follow a consistent progression: the skin, the outer layer is examined first; then the back and a look at its dense, criss-crossing musculature; next the upper chest; then arms and shoulders; then the various elements of the nervous system—the brain, spinal cord and face; then the abdomen, with its motherlode of critical organs; and finally, the reproductive system and legs.
The skin is pale, gray-hued, drained of blood, and appears almost translucent. Muscle and bone definition is lacking—the bodies have over time settled onto the flat table.
Alma’s group has slowly rotated her body—they’ll be performing a prone dissection. The first task is to locate her spine, but the flat, featureless surface defies easy identification. Then, a first, gloved hand reaches out and presses lightly on the back, feeling for the spinal column. Another student will gently probe as well, and together they will begin to locate landmarks. Today, they’ll be making a rectangular incision on the back, peeling the skin away to locate and identify the trapezius and latissimus dorsi, the large, triangular muscles that extend over the neck and shoulders.
They have studied for this moment, poring over anatomy textbooks and watching endless, looping videos. They have made color-coded illustrations and written countless notes. It has all led them here, to this room and to this sharp edge of a scalpel, to this profound and intimate moment.
There are more deep breaths. And then the scalpel sinks into skin, and Alma’s body prepares to reveal her secrets.