As a young medical student in the 1950s, my father was filled with gratitude for his “first patient” — the man who donated his body to the medical school for use in the gross anatomy class.
A rite of passage for generations, this course requires aspiring doctors to work in small groups to learn the mysterious architecture of the human body through meticulous dissection. For many students, the class is a series of firsts: first encounter with a dead body, first time cutting into human flesh. Technology has brought a huge number of advances to the field of medicine, but the awe and the power of working with that “first patient” remain. There is no virtual experience that can replicate the kind of learning that comes from examining a real human body.
My father went on to practice neurology and teach several different courses in medical schools, but he never forgot his “first patient.” He decided that this was a gift he wanted to pay forward, and made arrangements to donate his own body to Oregon Health and Science University, where he spent years teaching medical students.
When he was 80 years old, my father died of a stroke. He was not in his hometown when the stroke occurred, leaving us, his surviving family, with an unusual dilemma — how would we get his body to the medical school? It felt critically important to honour his final wish, like one last confirmation of our love.
After some phone calls, some finagling, some cost, and more talk about embalming than I’d ever heard before, we found a way to have his body properly prepared and delivered to the place he’d imagined it would go. He became the “first patient” of a group of medical students who he’d never met, but who would come to know him intimately. The cycle was complete.
I didn’t particularly want to imagine my father’s body opened up on a metal examination table, but the idea that he was fulfilling a promise he’d made to his younger self, and continuing to teach after he was gone, brought me comfort. His final act was one of service to others — the young students, the physicians they would become and all of the patients they would care for throughout their careers. His body itself was his legacy.
Unlike my father’s educationally minded, ethical body donation, the history of procuring human bodies for medical students is filled with financial motives and racism. Up into the 1800s, when the first laws governing the practice were put into place, medical students routinely worked with the bodies of people who’d been executed, and with bodies stolen from cemeteries by grave robbers, who often targeted graveyards where poor Black people were buried.
Today, medical schools have safeguards in place to ensure that donors’ bodies are treated with great care and respect, and that no money ever changes hands. But there are still stories of non-academic body donation gone awry. One widow who donated her husband’s body to a private company for medical research was shocked to learn that he was dissected before a paying audience.
An estimated 20,000 people donate their bodies to science every year — and often, it’s still not enough to meet demand. Tamara Ostervoss, director of the body donation program at OHSU, told HuffPost, “Oregon’s health education programs have long needed far more donors than our state typically has.” She said in recent years the program has received about 100 to 125 donations annually.
As is typical for medical school donations, OHSU arranges for local pickup of the body, and after studies are complete — up to three years later — the body is cremated and returned to the donor’s family at no cost to them. (It may also be possible to have the remains transferred to a funeral home if the family does not want them cremated.)
There are some limitations on who can become a body donor, though these differ by program. If the person died with a communicable disease, for example, this generally makes them ineligible. Some programs also have limits regarding weight or body mass index. The OHSU program changed its policy in 2020 so whole-body donors could also donate their brains to the OHSU brain bank to be used in research studies. But in most cases, it is only possible to be one kind of donor. For example, an organ donor could not also be a whole-body donor.
A gift inspired by family
Jim Mayo’s mother, Zella Vee Randall, donated her body to the OHSU program after hearing her granddaughter, a medical student there, talk about the importance of the donors and how there were often not enough of them to meet students’ needs.
“My daughter Jennifer was in medical school, and she was taking the gross anatomy class,” Mayo told HuffPost. “And my mother decided, ‘If it’s hard to get them, I’m going to donate mine.’”
Family members wondered if the medical school would accept a donor of Randall’s age, but there is no age limit for the program. OHSU says the average donor is around 72 years old.
Randall, who raised three children and put herself through college to become a teacher after being widowed, died at the age of 90. The body donation program, Mayo said, “took care of everything.”
“She was in a memory care facility,” he said. “And they came right there. They took the body. They did everything. They did all the paperwork. It was really easy on the family.”
OHSU holds an annual ceremony for the families of donors. “Students show their gratitude through song, dance, and spoken word,” Ostervoss said. “We present a slideshow of submitted donor pictures and offer family members the opportunity to speak directly to the students about how they have been impacted by their loved one’s death and whole-body donation.”
Because the families may have to wait years for the return of their loved ones’ cremains, and may not have held a separate funeral, “attending the service with others who have experienced a similar grief journey can be comforting for families,” Ostervoss said.
Mayo attended the gratitude ceremony to honor his mother, and was moved by hearing the students talk about what the donors had meant to them. “It was a deeply emotional connection between those students and the donors that they had worked on,” he said.
“It really hit home,” he went on. “It wasn’t just that class. It was shaping who they were going to be as a doctor.”
Jamie Henry’s mother, Gretta Gunckel, donated her body to the Ohio State College of Medicine when she died at age 86 following a stroke. Henry said the family was grateful for the opportunity to donate her body.
“My mother did not want any funeral service or memorial service,” Henry told HuffPost. “[She had] talked to us about how she could serve the medical field in some capacity.”
At the memorial service, students told Henry that having the opportunity to look inside the body of a donor cemented their desire to become a surgeon. One student felt there “was no turning back” on their chosen career path after seeing inside the donor’s body, and another used the word “awe” when describing the experience of viewing a real person’s organs.
“There was total respect by each medical student for the bodies they were able to learn from,” Henry said.
“Hearing directly from the students about how much their assigned donor — an absolute stranger — meant to them, and how students appreciate the sacrifice of each donor’s family, often provides families a sense of comfort,” Ostervoss said.
It often makes family members feel proud to know their loved one provided a final act of service after their life ended, Ostervoss said. In their grief, family members may be searching for a way to make meaning of their loss, and whole-body donation offers them an opportunity to do so.
“I feel my mother gave the greatest gift of all,” said Henry, who now plans to become a donor herself, as does her husband.
“Each time I drive by Orthopedic One or an Alzheimer’s care facility, I am hopeful some part of my mother’s body is helping find a cure for something,” she said. “My mother is at peace and so am I.”
A lasting legacy
Deciding to become a donor can give people a sense of agency over the shape of their life and the legacy they will leave as they face the reality of their death.
Bonnie Boyle, a woman who lives near Atlanta, has a diagnosis of stage 4 cervical cancer.
Boyle, 70, told HuffPost that she has long been registered as a organ donor. But given her age and diagnosis, she said, “I’m afraid that few, if any, of my organs would be useful to anyone after my death. My body might be useful, though.”
Boyle is grateful to the staff of Emory Saint Joseph’s Hospital, where she has received cancer treatment.
“While I am not in a position to make a large monetary donation, donating my body to Emory’s medical school is a way I can say thank you for my care,” she said.
Because the paperwork to become a donor required signatures from family members, the process also provided Boyle and her loved ones an opportunity to discuss her end-of-life wishes. (The consent forms vary from program to program, but they generally require more than one signature from a person’s next of kin, other family members and/or witnesses.)
“My husband of 40 years and our two adult sons support my decision and signed the paperwork, as did both of my sisters,” she said.
Boyle’s husband has begun the paperwork to become a whole-body donor himself.
Donors and their families may be able to find solace in the idea that there is no real endpoint to the effects of a body donation.
My father has been gone for over a decade, and the ache I feel, that he is not here to see his grandchildren grow up, can expand or contract, depending on the day. The students he taught, both in person and with the gift of his body, are out in the world practicing medicine. One of them may now be gently palpating a patient’s abdomen, imagining the shape of my father’s organs.
“Whole-body donation far surpasses the initial gift,” Ostervoss said. “Learners take this knowledge gained and apply it to all patients that they treat for the rest of their career. Anyone who has sought health care has benefited from this gift, whether they know it or not.”