Donating your body to science: Shocking or inspiring?

As a psychiatrist, I don't often deal directly with death. For the past five years, though, I have been treating men and women returning from deployments in Afghanistan and Iraq. Listening to them talk about their war experiences, I've spent some time thinking about death and dying.

Yet I was shocked recently when my wife, 74, announced that she was planning to donate her body to science - specifically, to Georgetown University Medical Center in Washington, where I work and teach, and its anatomical donor program.

My first thought was that she obviously had never been a first-year medical student in a Gross Anatomy lab. My next impulse was to warn her of her mistake, though I restrained myself.

My wife had been heavily influenced by the example of a friend. George had gone back to school in his 80s, after his wife died, enrolling in Georgetown's School of Foreign Service. The school treated him well; he found the programs very stimulating and had a great time. So he decided to return the courtesy by "gifting" himself to the anatomical donor program. He spoke about it frequently and enthusiastically - especially to my wife - and when he died at age 86, his wishes were fulfilled.

I knew the financial benefits of this arrangement. When you die, Georgetown arranges to pick up the body, preserve it appropriately for the anatomy lab, cremate the remains when the medical students are finished and return the ashes, all expenses paid. That is a potential savings of several thousand dollars, money that could be used instead for, say, a grandchild's college tuition.

Still, I remember how bodies were treated when I was a medical student 48 years ago. My worst recollection involves a group of young men removing a cadaver's sexual organ and using it to harass one of our few female classmates. I wanted no part of such treatment for myself or my wife. I decided that I would tell her my concerns, but not discourage or interfere with her plans.

When I raised the subject, she responded, "I'm going to attend the School of Medicine's annual liturgy and Catholic Mass for families of donors." An annual event organized by the medical students and their Jesuit advisers, the Mass is celebrated each May, after the Gross Anatomy class has finished. I decided to tag along.

When the day arrived, we drove to the School of Medicine and were escorted by a medical student to a large classroom.

A bit apprehensive at first because I had no idea what to expect, I was surprised and delighted to see many of the first-year students whom I had taught the previous fall.

The room filled up with people like us who were interested in the donor program but mostly with family members of those who had already donated and who had come to collect the ashes of their loved ones. Soon, nearly 200 students filed into the classroom; they each carried a lighted candle in honor of their donor body and placed the candles on a stage. There were Jews, Muslims, Protestants, atheists and outright anti-religious students in the procession, I later learned.

A student choir, formed especially for this Mass, sang many lovely hymns, accompanied on guitar by a Protestant minister, one of several clergy members of various faiths.

In the center of the choir I spotted a young woman who had fainted during the Introduction to the Patient class I'd taught last fall. (She'd been overcome by the stress of conducting interviews in the overheated examining rooms. Fortunately, we'd caught her as she was falling to the floor and had sent her to the ER; a full recovery followed.) Now she waved to me as I walked down the aisle to take Communion.

The minister offering me Communion was another former student. A Jesuit delivered the homily; then others stepped forward to offer their own prayers. It was tremendously moving, all of it underscoring a heartfelt gratitude to the donors and their families. This was not the Gross Anatomy I remembered.

At a lunch afterward, I was struck by the students' thoughtful descriptions of working with their donated bodies.

"Whenever I think of the heart, I always picture my cadaver's heart," one student said. "The blue veins, green lymphatics and red capillaries that you see in the anatomy textbook don't look that way in real life. Even modern three-dimensional technology is no substitute for hands-on learning."

Another student remarked that although she would never try to persuade her parents to donate their bodies, there was no doubt in her mind that she would donate hers.

And another commented that throughout the entire class, the cadavers' faces had remained covered, out of respect, until the time came to study the face. She spoke almost reverently of how moved she felt the day she and her classmates removed the covering over the face of their cadaver and looked for the first time into the donor's eyes.

Their experience of dealing with donated bodies was clearly different from what I'd had as a student. This was definitely not the Gross Anatomy that I remembered.

Attending the ceremony and talking to those students altered my view of my wife's decision to give her body to science. No longer a mistake, it seemed rather a thoughtful, sensible choice, an option everyone should consider.

So, too, has twice-a-week work with wounded soldiers altered my view of death. Their altruism is infectious. Many of them have given their bodies in service, suffering serious, life-altering injury even if they did not die. They knew death was a possibility.

Giving one's body to science after death is consistent with that altruism. The idea of continuing to be a teacher even after my death is quite compelling. I haven't entirely shaken the memory of my own cadaver class, but I'm almost there. I guess I owe George and my wife a thank-you note.

• Beal, a distinguished fellow of the American Psychiatric Association, is a clinical professor of psychiatry at the Georgetown University School of Medicine.