In medical terminology, the words history and physical almost always appear together in that order. As a physician, you do not engage a patient in the neurological examination until you’ve gathered the de-tails of his or her debilitating headaches.
But at one time in our medical careers, we are instructed to perform the most thorough physical examination possible without learning so much as the patient’s name. All we are given is an anatomy table number, an age, and a cause of death. We work our way through the anatomy lab—inspecting, searching, and feeling every muscle, bone, and organ—and we write our patients’ histories ourselves.
To better understand the life of the woman who had donated her body for my education, I created the Obituary (讣告) Writing Program at Georgetown University during my first year of medical school. I worked with an obituary writer, Emily Langer, to develop a workshop to help interested medical students reflect on the lives that their corpses may have lived. She instructed us on the art of weaving disconnected memories into a single story. A series of creative writing prompts resulted in one student’s story of a dramatic foot-ball injury occurring in the middle of a competitive match. This moment in his corpse’s life was imagined from a pink prosthetic (假体的) hip beneath massive layers of muscle.
The first conversation with my donor’s son lasted over an hour despite my initial fear that I would ask the wrong questions or offer the wrong words of sympathy. His mother was a small-town farm girl from Wisconsin, Dr. Carol Kennedy, Georgetown University School of Medicine, Class of 1972. She was a devout Catholic who considered being a physician a privilege and an opportunity to serve others. She wanted to continue to serve even after her death by donating her body to Georgetown University in order to educate future medical students like me.
We have finally put the history in its rightful place before the physical—students now interview the families of their donors before making the first cut in the anatomy lab. Our corpses are our first counterparts in the privileged patient-physician relationship, and now we are able to begin that partnership just as we hope to do throughout the rest of our medical careers.
What is the teaching approach in the anatomy lab described in Paragraph 2?
Identifying the real cause of the patient’s death.
Learning anatomy by taking patients’ histories into account.
Training students how to do physical examination clinically.
Writing patients’ histories based on the physical examination.
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