The Anatomist: A True Story of Gray's Anatomy (26 page)

Epilogue

TWO YEARS PASSED BEFORE I RETURNED. I WAS NERVOUS BEFORE-HAND
, nervous in a way that brought to mind the very first time I had made the trip. I could easily remember stepping off the elevator, rounding the corner, and heading down that dim, narrow hall, looking for room 1320. The hallway had seemed to get dimmer and narrower the farther I got, if only because there was a bottleneck of students at the door—pharmacy students—the half of the class who’d accepted Sexton’s invitation to visit the anatomy lab a day early. It wasn’t that the door was locked. The problem was, no one wanted to go first, the unspoken fear being that an initiation was about to begin. Inside that lab over the next ten weeks, you would be forced to confront your innermost anxieties about death and dying while taking apart a dead body—an emotional vivisection, of sorts. How would you handle it? I wasn’t sure how I’d do myself.

I remembered hearing a young guy behind me ask another, “Have you ever
seen
a dead body?”

“Um, yeah, but I’ve never
touched
one,” guy two answered, sounding none too thrilled at the prospect.

Henry Gray and H. V. Carter would have gotten a kick out of that. As young men, those two certainly did not enter the Kinnerton Street lab expecting to learn life-changing lessons about mortality. They did not need them. Gray and Carter had each seen and touched plenty of dead bodies before they began dissecting them. And when they did dissect, many of the cadavers were likely close to their own ages. In the early nineteenth century, in England as in the United States, the life expectancy at birth for a male was half as long as today—just thirty-eight years. For a female, it was only two years longer.

Not only did people die at a younger age a century and a half ago, but death was dealt with more openly and with a greater attention to ceremony. This was particularly so in Victorian England, where the queen herself, widowed at age forty-two, set the example for mourning. People generally did not die in hospitals or nursing homes at the time, but instead where they had lived their lives, in their own homes, with loved ones at their bedsides. I will never forget a line in H. V. Carter’s diary. After receiving news of his mother’s death, Carter asks himself, “What did I feel?

“Regret, mainly,” he answers—regret that he hadn’t been there.

THIS TIME, I
had come to the anatomy lab by myself. There was no line of students waiting outside, and, in fact, the lab itself was almost empty when I arrived just before 8:00
A.M.
The class I’d come to observe was called Epilogue. It was part of an intensive “refresher” course for second-year med students before they took their board exams. Frankly, I thought it might be refreshing for me, too, a chance to reconnect with some of my anatomy teachers and to get reinspired, a coda to my experiences at UCSF.

Though the class was set in the lab, the students would not be doing any dissecting that day. Prosections would suffice. To make room for the whole class, the dissection tables had been pushed off to one end of the lab and all the cadavers lay on top. Piled two to three to a table, they appeared to be huddled together for warmth, waiting, quietly waiting. Waiting to be of use. Waiting, it seemed at that moment, for me.

Remember how scary they’d seemed at first?
I said to myself. The
thought
of what was inside those bags had been so much worse than the reality. I could still picture myself filing into the lab with the pharmacy students. No one spoke. It was as if there were forty pink elephants in the room—except that all forty were encased in bright white vinyl and bore the unmistakable profile of a human being: rounded skull, nose, mound at the stomach, jutting toes. I headed to the back counter, I recalled, and put down my things. As I eyed a body on a nearby table, I suddenly noticed its small feet poking out. I crept forward. Both feet were wrapped in gauze, which elicited in me feelings of sympathy and tenderness rather than fear or revulsion.
Oh, it’s wounded,
I thought instinctively, illogically. With a closer look, I saw patches of mottled, brownish flesh on the shins, which didn’t bother me at all. I unzipped the body bag all the way; I was ready to see more.

Later that same day, I started a diary. I had not kept one in well over twenty years and, unlike the diaries of my youth, this was meant to be just-the-facts. I simply wanted to get details of dissections and snatches of dialogue down on paper each night while they were fresh in my mind—an aide-mémoire for the writing of this book. It was not long, though, before I began including personal reflections. On October 10, 2004, for instance, I confided to myself:

I have to be honest. It’s not just the body I’m fascinated by but also death. The snuffed-out, no-second-chances finality of it. The randomness of it. The nearness of it.

Death has always seemed near to me. Even as a little kid, dying didn’t seem eighty or a hundred years away—impossible to conceive. But instead, as if it could be close. Not that it would be, but could be.

I still think about death all the time. I keep expecting it. Not my own, necessarily, but someone’s…. I can feel it getting nearer and nearer, now and then even brushing up against me. Lying awake in bed, sometimes I feel it pressing against my body.

Two years later to the day, at eight in the morning on October 10, 2006, Steve died in bed beside me. Though he was extremely fit and in excellent health overall, apparently a freak episode of cardiac arrhythmia led to respiratory arrest and, ultimately, cardiac arrest. I woke to the terrible sound and sight of Steve struggling desperately to breathe. Even more terrifying was the complete silence that soon followed, his body motionless. I started CPR, paramedics came, and we got him to the ER, but they were never able to get a heartbeat. Steve was forty-three years old.

WE HAD BEEN
together for sixteen years. Steve was my partner not only in life but in writing, especially on this book—the Carter to my Gray, as I would affectionately say. (“No, make that the Gray to your Carter,” he would tease in return.) After his death, going back and completing the final draft of the book seemed daunting. I wasn’t sure if I could do it without him.

Though Steve never set foot in the anatomy lab, I even sensed his absence at Epilogue that morning. He used to drop me off before every class and pick me up after every lab and listen to my daily debriefings on the ride home. After the Epilogue class, I would have told him how I’d seen Dana and Kim and Dhillon and Charlie; how Sexton had retired, Anne had been promoted, and Andy had taken a new job; how all the med students were unfamiliar to me (Meri and Kolja and the others I’d studied with were already in their third year); and how, just as in the past, I was repeatedly mistaken by the students for a TA. When I told them I was writing a book about
Gray’s Anatomy,
most students assumed I was talking about the TV show. “Yep, that’s right,” I’d say teasingly, “I’m telling the true story of Meredith Grey and Dr. McDreamy.”

Finally, I would have told Steve that I’d been nervous to see the bodies, afraid that they might stir up upsetting memories of his death. By the way, I think that is one of the strangest things about losing a longtime partner: the very person you
most
want to talk to about your loss is the person who is gone. Well, it doesn’t always stop me; sometimes I talk to Steve anyway.

“Honey-pie, you would’ve been proud of me,” I told him as I drove myself home from UCSF. “Before class got started, I just took a deep breath and marched over to one of the tables and unzipped a body bag.” The cadaver looked like a
cadaver,
I told him, and nothing at all like you. I laughed aloud, unsure how that had come out. “Well, you know what I mean,” I said, and I was sure he did.

“It was like when I brought your ashes home,” I continued. “To me, it was so clear that it wasn’t
you
in that nice cedar box; it was just…your remains.” He had long since left his body, I believed. I had seen it happen with my own eyes—life leaving him with his last breath.

You are dust, and to dust you shall return.

Officially, Steve was declared dead at the hospital.
Declared dead
—what a strange phrase. That makes it sound like an announcement was made over a loudspeaker. In fact, it was more like an unspoken exchange between the attending physician and myself. He left his position at the head of the gurney and approached me at the other end, where I was cradling Steve’s feet. The doctor’s pained expression told me everything I needed to know. I nodded, and practically in a whisper, he gave directions to his team. The medic, by now drenched in sweat, stopped CPR. A nurse shut off the respirator. And with that, everyone in the room quietly filed out and left me alone with Steve. Less than an hour after I’d awakened, I found myself performing a last rite, sacred in its intimacy: shutting Steve’s eyes entirely closed with my fingers. I removed his rings, put them on, and said what he had not been able to say to me: Goodbye.

Nothing I’d learned in anatomy class prepared me for that moment. Nothing. Even being able to understand precisely what had happened to Steve anatomically and physiologically—I was easily able to read and interpret his autopsy report, for example—did not make it any easier to bear or grasp the fact that he was so suddenly gone. Which I see now as the painful final lesson of my education in anatomy. True, in a literal sense, I had never been nearer to death than in the lab itself. Over the course of a year, the result of a journey that began with Henry Gray and H. V. Carter and their book, I touched and felt and dissected dead bodies with my own hands and was constantly surrounded by dozens of them, to the point that I became inured to the sight. I gained a keen understanding of the
fabric
of the body—the raw, organic nature of flesh and bone and blood. But you don’t learn about death from dead bodies. Just as you learn about the body by dissecting one, you learn about death by experiencing a death, by losing someone you love.

Conversely, what you learn about in Gross Anatomy is life, human life, clichéd as that may sound. In one of the last dissections I performed, I remember, I anatomized the knee, shoulder, and elbow joints, in effect dissecting the mechanics of human movement. And what is life—or, a defining sign of life—but movement? Whether the blinking of an eye or the wiggling of fingers or, with arms and legs pumping and lungs heaving, the running toward something in a great burst of speed—toward a goal, toward a finish line, flat out to the very end.

THE END.

Appendix

H
ENRY
G
RAY
1827–61

Gray’s final resting place is London’s High-gate Cemetery, where he shares the same grave as his mother, Ann, who died five years after him.
Gray’s Anatomy,
now in its thirty-ninth edition in England and thirty-seventh in the United States, has never gone out of print and has sold an estimated five million copies to date. The year 2008 marks the 150th anniversary of
Gray’s Anatomy.

H
ENRY
B
ARLOW
C
ARTER

1803–68

The patriarch of the Carter family, artist Henry Barlow Carter, died of bronchitis on October 4, 1868, at age sixty-five. As described in his obituary, Henry Sr. sounds very much like his eldest son: “There was a natural reserve about him that rather prevented an extensive friendship, but those admitted into that circle were often charmed with the geniality of his spirit and the originality of his ideas.”

J
OSEPH
N
EWINGTON
C
ARTER

1835–71

In 1859, H.V.’s free-spirited younger brother began teaching art and, along with sister Lily, converted to Christianity. “She and Joe walk as fellow Christians,” a happy H.V. wrote at the time. In May 1871, Joe, a working artist, married longtime love Elisabeth Smith Newham, who was widowed three months later. Joe died of double pneumonia at their Scarborough home on August 16, 1871.

E
LIZA
H
ARRIET
C
ARTER DI
V
ILLALTA

1860–91

Henry and Harriet Carter’s daughter, Eliza, married an Italian soldier, Federico di Villalta, in 1881. At the time of her death in Florence at age thirty-one (cause unknown), her only child, Ignazio Federico, was five years old. In his will, Carter established a sizable trust for his grandson.

H
ENRY
V
ANDYKE
C
ARTER

1831–97

Carter’s official cause of death was “phthisis pulmonalis” (pulmonary tuberculosis), and he is buried in a family plot at Scarborough Cemetery. Funds are currently being raised by the London County Council to commemorate his life with one of the city’s famous blue plaques.

E
LIZA
S
OPHIA
“L
ILY
” C
ARTER
M
OON

1832–98

Lily outlived her husband (William James Moon) and both brothers and died at her home in Scarborough on December 14, 1898, of “acute pneumonia.” She was sixty-five years old. Lily was survived by three of her four children.