Teaching and Learning Moments

As anatomists, we live with the constant concern for the public trust that makes our willed body programs possible. With this in mind, it was with considerable consternation that we received a grievous concern from a patient. Following the first day of our gross anatomy course, this patient (we will refer to her as Ms. X) was in the local post office when she and other postal clients could not help but overhear one of our first-year medical students talking on his cell phone. He enthusiastically and loudly described his recent experience of dissecting a cadaver, detailing the skin, fat, and other structures that he had just encountered. Ms. X's mother had recently died and had donated her body to our program and Ms. X felt like the student could have been discussing her own mother's body in a public place. Ms. X was horrified and reported this to her doctor, who forwarded her concerns along to us. Our constant concern had become a reality. A detailed description of our student from Ms. X enabled us to identify the student, but after thoughtful discussion we decided that a direct disciplinary action would not be the most productive option. Instead, we presented this incident in general terms to the entire class during our next session in an attempt to convert this negative situation into a positive experience for the entire class. In a short presentation, we talked about what it means to be professional in medicine. We pointed out, as stated in our course policies, that as medical students, they are provided many specific rights not available to the public. One of them is a right and privilege to dissect the human body in the gross anatomy laboratory. In return, each medical student has specific responsibilities and duties not generally expected of the public, and among them are confidentiality, responsibility, and accountability to patients, teachers, and society. Next we presented the scene from the post office based on Ms. X's perspective. It was so quiet in the classroom that you could hear them breathing. This was their first lesson in professionalism in medical school, a lesson based on a real situation with which they could all identify. At the end we asked students to reflect on this situation and put themselves into this scenario and then write a letter of apology to Ms. X. In the week that followed, we received letters from every student in the class expressing deep and heartfelt apologies to Ms. X. After discussing this with Ms. X, we sent anonymous copies of these to her. We were later able to play a recording of Ms. X's emotional acceptance of these apologies to the class. Everyone was deeply moved. It was a profoundly moving experience that made this teaching and learning moment one that we hope our students will never forget. We trust that our students will retain this lesson in professionalism for the rest of their careers. We gratefully acknowledge the review of this submission by Ms. X, her physician, and the student involved. Stephen W. Carmichael PhD, DSc Wojciech Pawlina MD