The karakia from Māori kaumātua (elders) carries through a room filled with human specimens at the University of Auckland as a long line of students file towards the Human Anatomy Lab for the start of another year.
The specimens – brains, lungs, eyeballs – are a precursor to what awaits the second year medical students in the next room. They’re about to meet 35 cadavers, the donated human bodies that will play a crucial role in the students’ journey into the medical profession.
The cadavers are often referred to as a doctor’s “first patient”, a single body that a group of 10 students will dissect and investigate over the year.
As students walk through the swinging double doors into the lab, they’re greeted by cadavers laid out on stainless steel surgical tables. Although each one is in a blue or white body bag, the curvatures of human bodies are unmistakable. The lighting is harsh. The smell is sterile. The air is cold.
The second year students – 344 split into two ceremonies – fill every space in the lab, encircling each cadaver. They’re here for the Māori-led whakanoa ceremony. The primary purpose of the whakanoa is to lift the tapu – spiritual restriction – associated with death for Māori and Pasifika students.
The ceremony has also become a way to honour those who donate their body and a gentle introduction for all students to their cadavers. For some, it is their first exposure to death or a reminder of lost loved ones. Occasionally students feel queasy or faint, something academic staff say has dropped off since all students began joining the whakanoa.
During the ceremony in the lab, Toi Katipa, a kaumātua with the university’s medical faculty, lifts the tapu through karakia. Christian chaplain Rev Petra Zaleski’s prayer alludes to Psalm 139, that all human bodies were woven by God in the depths of the earth. Muslim Chaplain Shahela Qureshi reads a passage from the Qur’an that focuses on human dignity.
The ceremony ends with students encouraged to dip their hands in water, then it’s time for afternoon tea. Karakia, wai (water) and kai are the three parts of a whakanoa.
In a lecture before the ceremony, Dr Papaarangi Reid, a professor of Māori health, outlined the transition the students were about to embark on from layperson to member of the medical profession.
“Yesterday it was illegal to dissect a human body but from today you are expected to participate.”
In previous decades – and perhaps still at other universities – medical students were expected to “harden up and get on with it” when it came to working with cadavers, Reid told the full lecture hall. This trickled into how they treated their future patients.
She tells students while they must remain professional, “we can have our own personal feelings and emotions as we work in health and work in life and death”.
The cadavers are welcomed to and farewelled from the university with ceremony. Permission is received from the donor and their families before death. For legal purposes, the New Zealand Police monitor the university’s human cadaver programme.
It’s a change in narrative from the early days of medicine in the 18th century where grave robbing at Harvard Medical School was the norm.
“In the end, we need to talk to families who have donated the body of a loved one and be able to assure them that their loved one will be looked after… because learning off a human body is an incredible opportunity,” said Professor Maurice Curtis, a Professor of Neuroscience and Director of Human Anatomy, responsible for the human anatomy lab.
Dr Suzanne Stevens, a university psychologist, talked students through the potentially confronting feelings they might experience during the whakanoa or in the coming days when they begin dissecting the cadavers.
“Some of you might be feeling quite excited about this opportunity to learn about the human body in a more tangible way, whereas some of us might be feeling a bit more anxious or overwhelmed.”
In a near-eerie moment during a lecture following the whakanoa, Anna Laurenson, the coordinator of the Human Body Bequest Program, reads a letter that came with a donor. He congratulates students on their acceptance into medical school.
“I wish to present my body to you for your learning and wish you all the very best in your findings…” he wrote, according to Laurenson. She notes the commitment many donors have to ensure their bodies are donated and accepted into the programme.
Laurenson also brings up the matter of New Zealand being a small place and for students to inform the university if they know anyone who has donated to the programme recently to prevent encountering a cadaver they recognise (it has happened at least once before).
Arabella Urwin, 21, a second year medical student, describes the whakanoa as a shared spiritual experience for students that was similar to a tangihanga.
“I think being Māori, it feels normal but for others it is unique.”
“I was just thinking how brave it was to donate their body and the vulnerability of the family.”
Emalee Doake, 21, says she was shocked by the sheer number of cadavers laid out in the lab for the whakanoa. Yet, the ceremony felt like a manageable stepping stone to Friday’s first lab class, she says.
“I couldn’t imagine waltzing in for the first day of lab with the body just there.”
Sergio Alves, 28, had worked on cadavers before at a chiropractic school overseas. There was no whakanoa equivalent ahead of his first lab and students were “thrown into it,” he says.
“I was curious about what [the whakanoa] was going to be like. Once it was done, I felt protected and taken care of.”
There was no whakanoa when Jade Askin’s mother went through medical school. Now, Askin, 19, is on her own journey into medicine and the two were recently discussing how a student’s initial encounter with her “first patient” has changed. The whakanoa didn’t alleviate all of Askin’s concerns about her first lab class, but it did lessen them.
“I have no experience [with death] and I don’t know how I will react.”
A constant theme throughout the whakanoa and the lectures either side was the humanity of donor bodies. The cadavers are more than flesh and blood, says professor Sir Richard Faull, director of the Centre for Brain Research.
“The human body is incredible. it’s marvellous… but most importantly there is a spiritual and cultural side.”
By Serena Solomon for rnz.co.nz
