Of all the harrowing experiences that are a part of medical training, perhaps the most affecting is that of gross anatomy. No surprise, then, that the dissection of the human body attracts so many attempts at explication. Irresistible storytelling opportunities abound: The opening of the cranium is a metaphor for the opening of the medical student's mind to new ways of understanding the body; the dismemberment of a cadaver is an ironic comment on the disassociation students experience in becoming healers; and the cadaver itself is the ultimate paradox, at once the sacred vessel of our humanness and a lifeless object wrapped in plastic trash bags to keep it moist.
Many a traumatized medical student has written a heartfelt poem or a dispassionate historical survey or a distressed letter to a parent or friend that addresses such themes. In her well-wrought first book, "Body of Work," Christine Montross -- a psychiatry resident at Brown University -- has produced an unusual synthesis of these types of narrative. Part memoir, part love letter, part medical history, part rationalization and part poetry, "Body of Work" resists the silences of the medical profession to explore the author's relationship to the cadaver she dissected, one to whom she gives the loaded name of Eve.
"Body of Work" is at its best when Montross, who is also a poet, allows us to observe the astonishing beauty her dissection reveals, and to relish the language she uses to describe it. "The language of these bones slides along their edges," she writes. "Os coxae, the hip bones. Their three parts, with names like flowers: ilium, ischium, pubis.... The pelvic brim, as if water spills over it.... Brim, arch, spine. The ligament names like a call to prayer: sacrospinous, sacrotuberous. Sacrosanct."
EQUALLY gripping are the stories she shares of loved ones who fall ill, and later, of some of her first patients, whose living-and-breathing bodies insistently remind her of Eve's -- and her own -- humanity. Here, language, arising from the body, becomes healing, accommodating both knowledge and wonder, abetting not only the joy of discovery but also the empathic connection between teacher and student that underlies learning anatomy, and learning to heal more generally. Montross surely recognizes the humane healing power in language properly employed; she reads the work of fellow poets Mary Oliver and Mark Doty alongside her anatomy texts, and she consoles one of her lab partners, a sensitive former dancer, as she struggles through the dissection of the head, by listening to her story of a friend's death after a severe brain injury.
The narrative act is therapeutic for both Montross and her stressed-out classmates -- the decision to name Eve, and at the same time to imbue her with a kind of universal motherliness, both enables and forgives what they must do. Similarly, the elaborate Latinate naming of specific anatomic structures provides a kind of comfort in monumentalization and, as the complex terms are memorized, in mastery as well. Yet if such necessary acts of language help allay our anxieties, words can also become soulless, means to an end, no more than vehicles for exerting control over the previously unknown.
Montross seems at times to be aware of this challenge. Clearly, she wants her book to be a tribute to Eve, but often her newfound sense of mastery and privilege proves too intoxicating to allow a thorough critique of the dehumanizing first year of medical training. She treats the gallows humor that develops among her classmates rather breezily, pardoning herself for disrespecting people who gave their bodies for the sake of her professional advancement, and sparing no gruesome detail in describing the acts of dissection themselves.
It is one thing to represent honestly what goes on under the stark lights in the cold anatomy theater, and even moving to see our imperfect human responses uncritically laid bare; it is another to comment glibly on the more deliberate distancing that occurs. Midway through the book, Montross endorses the problematic notion of "detached concern," an oxymoron used to describe the stance many physicians are taught to adopt in the doctor-patient relationship.