A Parting Gift to anatomy from my late wife Anne and other donors

I have just watched the second part of A Parting Gift, RTE’s documentary about people, including my late wife Anne Holliday, who donated their bodies to the anatomy school in Trinity College Dublin. I’ve already reviewed the first part here, which like this followed medical students through a year of learning from their silent teachers, as well as talking to staff and families of donors.

By coincidence the second part aired on our wedding anniversary, so it was an emotional day for me. We got married five years ago, shortly after Anne’s terminal cancer diagnosis, thinking that we would never have an anniversary together. Anne defied the odds and we did get one anniversary, but she died in 2011 after a quarter of century of us happily living together.

My father Michael died less than a year after Anne did. For a while I was visiting him in hospital during breaks in Anne’s chemotherapy, as well as visiting a neighbour who was dying, leading my brothers to label me the atheist chaplain. This video is my father welcoming Anne into our family at our wedding, and also remembering my late mother Mary. I loved all three, and I miss them.

Surgeons, students, staff and families

The second part of A Parting Gift began with more explicit images than the first, as consultant surgeon Patricia Eadie conducted an operation in St James Hospital. The patient had injured the back of his fingers with a bandsaw, and his tendons had to be repaired. Surgeons who routinely perform such operations first learned by cutting cadavers, as students can not cut living bodies.

Then we saw students in Trinity examining a donor’s hand that was stripped back to show nerves. Patrick Carr said this made anatomy come alive. Conor McCaughey noticed so many nerves in the hand, that would have been impossible to replicate by machine. Jessica maguire talked of new learning as they moved from the hand down the limb. Serafino Sauref said you can know what a bicep looks like, but you don’t understand it until you feel it. Courtney Murphy, Grace Rothwell Kelly and Jasmine Sadri noticed the differences in each body’s individual anatomy.

Outside of the teaching lab, Chief Technicians Siobhan Ward and Philomena McAteer pondered on the balance between being approachable to donors’ relatives and maintaining a professional distance. They now have more time with families, as their new building has a relatives’ room. after two Irish emigrants to Edinburgh, William Burke and William Hare, went beyond stealing bodies and instead killed people before selling their bodies to medical schools.

A Dublin Pledge to move away from grave robbing, and the 1832 Anatomy Act, resulted in more bodies being used of criminals and poor people in the care of the state. This in turn resulted in people insuring themselves to be able to pay for funeral, which was the ultimate sign of respectability. By now the Trinity anatomy school had been built, but hidden behind a wall at the end of the campus and with little interaction between medical students and other students.

We saw three graduates from the class of 1975. Consultant urologist Ronnie Grainger recalled the respectful church-like silence with anonymous bodies whose names were not even revealed. Emergency medicine consultant Linus Ofiah stressed the need for students to deal with cadavers without endangering human life. And consultant orthopaedic surgeon Kieran O’Rourke revealed that he comes back to learn about new procedures.

Then we were back with today’s class, practicing extension and flexion on their own hands while comparing it to the body before them. Sean Barrett talked of the intimacy of holding the hand of a donor. Ciara Broderick Farrell saw a mark from a wedding ring on one donor, and considered leaving before reminding herself that the donor wanted to do this, and to become a good doctor she had to do it. And Jiaying Lau contrasted Ireland to Malaysia, where a tradition of preserving bodies for next life means that Malaysia has one plasticised cadaver for six thousand students.

My reflections on life without Anne

I paused the television when the segment about Anne was shown, and took a break to think about our life together. As well as showing photographs of her contributions to family and community life, the programme showed me contemplating on what it meant to be without her from a philosophical perspective. I didn’t remember what I had said, so it was as if I was watching someone else say this:

Throughout her life she was concerned with helping others, and it was a natural extension when she knew she was going to die that the final thing she could do to help others was to donate her body.

If you are an atheist one of the things you have to think through is what happens when you die, and the natural conclusion if you understand science, if you understand that we are animals in the same way as other animals are animals, is that we don’t think something extraordinary or mystical happens when a beetle dies or a cat dies, and it is the same with us.

We just recognise that when we are dead, we are the same as we were before we were born, and it makes you appreciate the time that you have more, because it is not a rehearsal for some eternal afterlife. This is what it is.

And particularly so when after Anne was diagnosed and we were told she had six months, it end up she lasted for a year and a half, but when you have that specific amount of time, and you know that is it, then you really appreciate it and you live every day much more intensely and with much more appreciation of the fact that you are here.

I miss her every day. Even here on this couch, I miss her when I am watching television, because we spent so much time watching box sets of DVDs when she was ill. I miss her when I go to bed. I mean, we were together twenty five years, so it’s not something that I am ever going to stop missing her.

Other relatives remembering their donors

Of course, ours was not the only philosophical perspective expressed in the programme, as one would expect in a modern pluralist country, where most people still believe in a god.

Footage of young students walking hand in hand through Trinity was followed by a photo of donors Kay and Harry Hannegan, holding hands cutting their wedding cake. Their son-in-law, Ronnie Grainger from the class of 1975, said that their lives were defined by who they are not what they did, and by their identity in Christ. Daughter Joyce and granddaughter Ruth said there was a calmness about death as their souls had gone to be with Jesus, and they were proud of them for being prepared to do this.

Kathleen and Anna McAllister said that their wife and father Christopher was not religious, and had his own beliefs which were quite different. He had believed in reincarnation, and he wanted to be useful in an educational sense. That made Kathleen and Anna proud to think that he is wherever he is, looking down and saying yes, I am being of value.

Bobbie Bryan was shown bringing a bag of her husband Maurice’s X-rays to the anatomy department, so that they could follow the progress of his illness as part of their learning experience. Martin and John Coleman said of their late mother Margaret that losing someone close to you ,no matter what age, create a hole in your life that takes time to fill.

And Shiela Smyth’s son Darren and daughter-in-law Vera spoke movingly of the anatomy school’s annual Act of Remembrance and Thanksgiving. They felt that Shiela would have loved to be there, as a poem by a student about a donor taking her hand was read out. Chief Technician Siobhan Ward explained that the event acknowledged the family and donor, in a way that used not be prioritised in old medical books about great surgeons and physicians.

The academic year continues

After Christmas, student Robert Farrell explained that they had moved beyond studying limbs and were now examine the trunk. They were now looking at the heart, lungs, abdomen, thorax, gut, kidneys, liver – the viscera of the body – things that keep you alive. Ciara Broderick Farrell talked of how small one donor’s stomach was compared to otehrs. Jessica Maguire recalled finding pacemakers that had been left in for their learning experience. Haaris Shiwani was now finding anatomy more normal, apart from taking out a heart, and even that was not as bad as the start of the year. And Lili Patterson noted that what is happening inside the donors’ bodies is also happening inside each of us.

An International gynaecological conference was also featured, and Declan Keane of the National Maternity Hospital stressed that bodies were also used for postgraduate study. Doctors from around the world had come to this conference, and American medical educator Danny Schwartz said cadavers are the gold standard in terms of realistic tissue and anatomy. Martina Hennessy, director of undergraduate medicine at TCD, pointed to the reduction in complications in what we now consider safe practices, and concluded that donors definitely save lives.

The students finished their year with exams that included a practical fifteen minute question and answer session beside a donor’s body, with a certain part exposed to allow questioning about it. With the exams over, the students could walk through the campus differently. As Jasmine Sadri said, they were now 20% doctors! But they had formed a bond with their donor, and seeing them for the last time was strange. They expect to see them again, but will have to readjust to whichever donor they choose for them next year.

Meanwhile the donors’ bodies, having ended their time as a silent teacher, were returned to their families for burial or cremation. Some are buried in the Dublin Medical Schools collective plot in Glasnevin Cemetery. The programme ended with Bobbie Bryan at the grave of her husband Maurice. The memories come flooding back, she said, given the distance between the memorial and burial, but now she was saying goodbye, and she finally had somewhere to go that was special to her and Maurice.

Anne’s burial and the new secular memorial stone

As a postscript to this review, when Anne had finished her posthumous teaching, in a positive move towards an inclusive Ireland, the Dublin Medical Schools respected Anne’s wish for a secular burial. At my request, they replaced the decades-old religious memorial stone at their burial plot in Glasnevin Cemetery (which referred to praying for the souls of the donors so that they might rest in the peace of God) with a new, neutral inclusive one.

This means that, from now on, when anybody donates their body for medical education and research, their loved ones can now remember them at their grave in accordance with their own personal beliefs, whether those beliefs are religious or atheistic, and nobody need feel excluded or marginalised.

It also means that Anne is still helping others through the only afterlife that we know actually exists, not in a comforting but untestable imagined heaven, but in the reality of our memories of how she lived and loved, and our continuation of her life’s work for a peaceful, liberal and caring Ireland.

I would like to thank the Medical Schools for their compassion and empathy, and their recognition of the changing nature of Irish society where everybody deserves equal respect regardless of their beliefs. I would particularly like to thank Nick Mahony, Philomena McAteer and Siobhan Ward. I would also like to thank Patsy McGarry of the Irish Times for this nice record of the new memorial stone and Anne’s life.

Some final thoughts

I will end with some thoughts that I shared in my review of the first part.

This programme spanned all stages of adult life, from enthusiastic teenaged students starting out on the university education that would shape their careers, through the compassionate and committed staff in their fourth decade working at the Trinity Anatomical School, to ninety-year old bodies left behind after lives that were almost as old as the Irish Free State. And the common thread connecting all of those unique lives is a desire to help others.

Thank you for everything, Anne. Thank you to Trinity College for facilitating Anne’s final project. And thank you to RTE, and Kathriona and Gerry at Loosehorse Television, for an important and sensitively produced programme.