Learning the body form

Heart Beat: "Good memory wherewith Nature has endowed us causes everything long past to seem present

Heart Beat: "Good memory wherewith Nature has endowed us causes everything long past to seem present." These words are taken from the notebooks of Leonardo da Vinci. Sure enough, my recollections of medical student days are vivid.

Whether they are accurate is another matter, and it strikes me as I think back that I should have the material for several books. However, the libel laws sadly may preclude their ever seeing the light of day.

Trying to tie the threads of the past to the complexities of the medical situation as it exists in Ireland today is a very difficult task. I also have to ask myself if it is relevant. I think beyond question that it is.

While this is not the place to give a history of Irish medicine, it must be pointed out that it is a very honourable one. Many of the foundation figures of modern medicine, surgery and obstetrics were Irish and the Dublin School of Medicine was famed worldwide.

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A tortuous path and a rambling journey connects the eminence of yesterday to the problems of today.

This little traveller, having cleared the hurdle of the pre-medical year, was about to become a real medical student. From this moment forward, everything I studied would have real relevance to my future career. So I rather naively thought.

It goes without saying of course this was nonsense; partly because of the explosion of medical knowledge at the time which rendered some of what we were taught obsolete even as the lectures were being delivered. Lesson Number 1 again: no doctor knows everything, all he or she can do is their best to keep up with such a vast and changing discipline. God knows it was hard enough to retain the little bits necessary to pass the exams.

For the next two years we still would not see a patient but would engage with the foundation subjects of anatomy, physiology and biochemistry. We would learn the basic structure of the human body and its workings. In that era we dealt only with the normal - the abnormal and the effects of disease would come later.

We were now located in Earlsfort Terrace, home to much of UCD at that time. That time was a different time in a different city. I don't think that we pondered too much at the time what the future would bring. Our philosophy, if we had one, was basically Carpe Diem and don't forget the bloody exams. There is always a serpent somewhere.

I remember that for myself, and indeed for most of my class, a truly awesome moment came with our introduction to the dissecting room where, for the next two years, we followed generations of our predecessors in examining the human body in detail.

It goes without saying that those responsible for teaching us made absolutely clear the dead were to be treated with dignity and respect. Those who donated their bodies to medical science made available to generations of doctors the basic understanding of the human frame.

This privilege has not always been easy to obtain. We do know that B.C. and in the Hippocratic school of medicine, dissection was practised. It was forbidden in the Roman Empire and this prescription, although not total, remained until the Middle Ages. Indeed, a Papal Bull "De Sepultris" of Pope Boniface VIIIth in 1300 was held by some to forbid dissection. That being said, we're still here.

Along came the Renaissance; Leonardo, Michelangelo, Albrecht, Durer and others changed things forever. Doctors and artists began to understand the mechanics of the human body. The problem was that access to bodies for dissection was very limited. The activities of Burke and Hare in Edinburgh; the sack 'em up men; and the acquisition of the bodies of those hanged gave a slightly sinister and ghoulish cast to the whole procedure.

The knowledge gained by such study, initially the normal and later the diseased, laid the foundations of modern pathology and surgery was a necessary part of human progress. It presents another irony. On the one hand, those who donate their bodies for dissection and their organs for transplantation; on the other, those who want organs back after surgery or death.

Perhaps the failure here lies with the profession as we did not clearly explain the connection between organ retention and detailed study and the understanding and treatment of disease. Certainly, cardiac surgery could not have progressed as rapidly as it did.

Every medical college and most large hospitals possess such material from the best motive, the betterment of mankind. I feel tribunals and litigation are not the way forward here. Perhaps the past could be commemorated in the development of facilities for the present with acknowledgement of how this came about. I am a hopeless author partly owing to an incurable penchant for lateral thinking.

• Maurice Neligan recently retired as a leading cardiac surgeon