Abra-cadavers!
The anatomy of incompetence Ever since just after the Middle Ages, when cutting open the human body after death was forbidden (even if being hacked open had been the CAUSE of death), the standard method of educating doctors — and what passed for them in the old days — in basic anatomy has been the dissection of cadavers. But nowadays, the cadaver and all the anatomical education it represents is slowly disappearing from Medical School curricula. Hmmm. Doctors without first-hand knowledge of the human body. Now there's a good idea! Yet according to a recent New York Times article, even the President of the American Association of Clinical Anatomists is today uncertain as to whether or not every medical student needs intensive lessons in gross anatomy. There are even medical schools out there (in California, of course) that teach anatomy without ANY hands-on contact with a body, living or otherwise. Proponents of the new corpse-less curriculum point out that much of traditional anatomy training — the litany of Latin names for every pathway of every nerve and blood vessel, and things like that — is irrelevant to current medical practice, which increasingly focuses on treatment at the cellular and genetic level (read: drug-based). Plus, they claim that new, high-tech computer models and virtual reality software do a better job of teaching the body's structures than actually touching them… But beyond the simple identification of bodily parts, where they are, and what they look like in their normal states, hands-on education teaches doctors the fundamental skill of their trade: What it FEELS like to heal. How can a video screen teach what it feels like to set a broken bone back into place? How can a software program truly impart the art of finding an artery to test a pulse or a vein to draw blood from? How can a thing without a face or flesh teach the reverence for life all doctors must have to be anything more than merely technicians? Did you know that in many Latin American countries students go from high school directly into medical school, which means they have no basic training in the sciences except the pitifully little they learn in high school? If they follow our lead — and they always do — they will be even less qualified than they are now. Of all the old maxims, the cardinal one is this: The best way to learn is by doing. That goes for doctors, more than anyone. Would you want to be treated for a femoral fracture by an M.D. who'd never seen one up close, or felt the way it was put together as original equipment? Yes, doctors using real human bodies for practice may be going the way of the dinosaur. What will they be replaced with (besides video screens)? Dummies… Almost as absurd as med school students not practicing on cadavers is the idea that they won't need to hone their skills on the living, either. Yet that's exactly what the future holds, if the latest
in virtual reality educational technology is any indication. According to CBS News.com, many new doctors these days are making their first diagnoses not on live patients while a seasoned M.D. looks over their shoulder, but on life-sized electronic replicas complete with hair, skin, moving eyes, and inject-able veins! The dummies can be programmed to breathe, react to stimuli — even simulate every imaginable medical crisis to challenge new doctors' diagnosis and treatment skills. It's like the kid's game (Operation!), but on a bigger scale. Barely 10 years old, this kind of technology has already been adopted by over 120 medical schools nationwide, and has been aggressively implemented by the U.S. military (where I cut my teeth in medicine). Apparently, these "smart" dummies are the future of medical training. Some seemingly credible sources cited in the story claim that these "mannequins" are far BETTER for
medical training than real live patients… But I have trouble believing it. Maybe I'm old fashioned, but I think the skills a doctor learns from the living are some of the most important ones — and they aren't found in textbooks or in the eyes of souped-up CPR dummies. Things like bedside manner, intuition, and listening skills come to mind. These plastic patients are no doubt good for one thing, though: Rendering harmless the potentially lethal mistakes-in-training made by surgeons who don't know their anatomy.
Always hands-on, but never a dummy,
William Campbell Douglass II, MD | 
