IN SHORT
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In the old days, death was shrouded in taboo and mysticism, but now it’s simply a final destination. And why not do something useful with the body afterwards?
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If you want to have good surgeons, you have to give them sufficient opportunity to practice on real material.
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After a dissection, one minute of silence is observed, out of respect for the dead and gratitude they enabled us to get better at our profession.
In the new podcast Stoffelijk (Mortal Remains) by Flemish daily newspaper De Standaard, Veerle Duflou tells the story of her deceased partner who donated his body to science. She wonders what happens to bodies like his and when a person turns into “mortal remains”. Luc Van Nassauw, anatomy teacher and boss of the dissection room, is perfectly placed to answer these questions. “No bones, no body” is the slogan that he had tattooed on his body and that can be read in the anatomy room at Drie Eiken. ‘We are very grateful people want to donate their bodies to science, because this results in better doctors with more accurate 3D knowledge of the body.’
Insiders only
Professor Luc Van Nassauw plays a prominent role in the new podcast Stoffelijk by De Standaard. Luc is a scientist, heavy metal fan, anatomy teacher and manager of the dissection rooms at Campus Drie Eiken. Every year, he supervises hundreds of students in their first dissections of the human body. Earlier this year, Veerle Duflou paid a visit to see with her own eyes what had happened to her deceased partner’s body after he had passed away. ‘That podcast really goes down to the bone, both literally and metaphorically,’ says Luc Van Nassauw. ‘Normally, only insiders find out what happens in such a dissection room, but this podcast suddenly turns this into public knowledge. In the old days, death was much more shrouded in taboo and mysticism, but that’s pretty much a thing of the past. For people nowadays, death is simply a final destination. And why not do something useful with the body afterwards?’
In Belgium, you do still need to register if you want to donate your body to science. This isn’t done automatically. ‘You actually have to write a will by hand, in which you state that the University of Antwerp may use your body for scientific and educational purposes,’ Van Nassauw says. ‘The body is normally sent to us as soon as possible after death, but sometimes a farewell moment or service for the family takes place first. We honour the wishes of the relatives in this respect as best we can.’
Better 3D knowledge
Instead of dissecting a real body, can’t you just acquire the same knowledge through guidebooks or 3D programs? ‘That’s not the same,’ Luc feels. ‘First of all, those guidebooks are generally geared towards the “ideal body”, whereas our students are confronted with real bodies that are quite different from the pictures in the guidebooks. We’ve noticed that the practicals give the students a better command of anatomy, as well as better 3D knowledge of the body. If you want to have good surgeons, you have to give them sufficient opportunity to practice on real material. I often compare the anatomical knowledge of doctors to car mechanics. When you take your car to a repair shop, you want the mechanic to open the bonnet and tell you what’s wrong. You don’t want him to get out a guidebook to check how the engine works.’
'I often compare the anatomical knowledge of doctors to car mechanics. When you take your car to a repair shop, you want the mechanic to open the bonnet and tell you what’s wrong. You don’t want him to get out a guidebook to check how the engine works.’
It turns out not all bodies are eligible for dissection: ‘We have a list of contagious diseases, such as Creutzfeldt-Jakob (a rare brain disease, editor’s note) and AIDS, which we won’t accept. We also reject bodies with a BMI that’s too high. They aren’t easy to store, they’re too heavy to lift, and it’s not pleasant working with them because they have too much body fat.’
Black humour
In the second year of their medicine studies, the students have to perform dissections for two weeks under the supervision of Luc and his team, and many of them get quite nervous about this prospect: ‘It’s often the very first time they cut into a human body,’ says Luc. ‘Typically, they have most trouble with the head. The face of the deceased sometimes reminds them of elderly people that are close to them. Once the skin and eyes have been removed, it often gets easier.’
Luc has to balance two extremes in the dissection room: on the one hand, he and his students have to switch off their emotions to work with the bodies, on the other hand, some empathy is expected of him to provide proper guidance to students who are working with a corpse for the first time: ‘It may seem inappropriate, but I do often try to keep things light with humour and to distract the students a little bit. At the same time, I keep my eyes on them and make sure the experience doesn’t traumatise them. They really have to learn to flip that switch and to forget that the body they are dissecting was full of life until very recently.’
1 minute of silence
What also doesn’t always help is the “smell” that’s unmistakably present in the dissection room, which causes the air circulation system to work overtime. ‘Unfortunately, that smell lingers in your nose for a long time,’ says Luc. ‘In pathology it often stinks even more because the bodies are often already in a state of decomposition. Ours are immediately stored in a cool room, but as the week goes on, the smell gets heavier.’ One of the final steps in the dissection is to sever the limbs and part of the head from the torso. Putting everything back together would be impossible, so the corpse is put in the body bag in pieces after the assignment. It is then put into a coffin and “released” as quickly as possible. The undertakers are contacted and most bodies go straight from the dissection room to the crematorium or cemetery.
And that’s it? ‘No,’ says Luc. ‘Afterwards, we observe one minute of silence together, out of respect for the dead and gratitude they enabled us to acquire knowledge and get better at our profession. In the Netherlands, medical faculties often have memorials with the names of the people who donated their bodies to science. I would like to have something like that too. In the meantime, we have the minute of silence and a loud applause afterwards. That’s the least we can do.’
Meandering
Can dissecting bodies your entire life really be a calling? ‘Believe me, that’s not what I had in mind originally,’ Luc says with a laugh. ‘I also took a seven-year break, but then they tracked me down to teach those dissection practicals. I actually trained as a biologist-zoologist and concerned myself with the anatomy of animals at first. I even got a master degree in Environmental Management in Leuven. But then I ended up in Antwerp, at the laboratory of pet animal anatomy and embryology. Not even a year later, I heard of an assistant position opening up at the Laboratory of Human Anatomy. I was given a few manuals and a box of bones and they told me where to find the guidebooks. The prosector taught me how to prep bodies, and pretty soon I started dissecting them myself. I learned a lot from that. And look, here I am, still doing it and trying to do the best job I can, so students really benefit from it.’
No bones, no body
It’s hard to look at Luc and not notice his tattoo of a winking skull and the slogan “No bones, no body”. The exact same drawing is hanging in the dissection room. ‘My tattoo was first!’ Luc says proudly. ‘It actually serves to reflect on the importance of the skeleton and, more generally, the importance of anatomy in the medical, biomedical and rehabilitation sciences programmes. The tattoo is based on a comment by a student, who felt bones weren’t clinically relevant. My response was: “Break a bone and we’ll talk again.” Bones are the foundation of our body shape and our movement possibilities. The skeleton protects organs and is important for the production of blood and stem cells. Take away the skeleton and you’re left with a pile of goo.’
Wishes for the future
Does Luc have any wishes or dreams for the future of the anatomy practicals? ‘Yes, one important one: that we get the infrastructure we need to keep doing our job well. The growing student numbers are creating challenges when it comes to space. Surgeons at the University Hospital also ask us if they can come practice certain techniques on our bodies. Spacious practical rooms with the right infrastructure and gender-neutral dressing rooms, that’s what I wish for the colleagues that come after me.’
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