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Teaching and Learning Moments: Burial in Completion

Sukhera, Javeed MD

doi: 10.1097/ACM.0b013e31821d851b
Other Features: Teaching and Learning Moments

Dr. Sukhera is a post-graduate year five child and adolescent psychiatry fellow, University of Rochester Medical Center, Rochester, New York; e-mail:

The smell was an unforgettable mixture of preservation and decay that stung my nose as I walked into the laboratory. I felt a mix of insecurity and excitement as the rows of cadaver benches came into my view—dull gray metal with bodies wrapped in layers of fabric, plastic, and preservatives. I learned quickly that everything has a purpose and a flow. Each nerve has a function and each vessel a destination. Anatomy is a systematic science. Working layer-by-layer, the student comes to an understanding of the whole by learning the details of the parts.

While I sat at home one afternoon attempting to memorize innervation and blood supply, I heard a loud thud and walked onto my balcony, expecting to see construction in the area that could explain the sound. Finding no explanation, I returned inside only to hear another sound. This time, I could hear the vibration of air whooping up against the doors and windows of my apartment. I felt a tiny ball of sickness grow in my stomach. I heard the sirens next, one after another in a symphony of wails. I rushed to my bedroom window to see a nightmare unfolding across the street. At the main intersection of town stood two buses with gaping black holes in their centers and smoke shooting out. Before long, individuals wearing white vests were collecting the remains of the victims off the same street that I walked on my way to school each day.

When I learned about the details of Jewish burial practices in my anatomy course, I was surprised to hear how similar they were to the Muslim rituals I remembered from my childhood. Both traditions originated in the temperate climate of the Middle East. Both incorporate traditional burial clothing, both throw handfuls of earth on the dead body, and both sit for well-defined periods of mourning.

In the Jewish tradition, a strong emphasis is placed on burial in completion. Organ donors are difficult to recruit because of the common belief that the body should be buried in an undefiled state, as complete as it was at birth. The men and women in the white vests searched the site for any pieces that could be considered human remains. They meticulously covered the scene with no other job than to ensure that the greatest possible respect be paid to the victims.

Their bags reminded me of the containers that I had used in the anatomy lab the day before. As we were dissecting our cadavers, we were encouraged to place every piece of human waste in a special container to be returned to the body upon completion of the dissection for the eventual burial. Both their bags and our containers served the same purpose but in entirely different circumstances.

Each morning after the bombing, I walked the same street to class, pushing aside questions of faith, life, and death as I focused on my studies. My anatomy course continued as expected, despite the tragedy that I had witnessed, and we moved on to studying the anatomy of the chest. We worked our way through the mediastinum to reach the heart. Learning about the chambers and valves of the heart was nothing compared to the day when I reached into the thoracic cavity and held a human heart in my own two hands. The anatomy of the heart was a poignant reminder of the fragility of the human experience.

Javeed Sukhera, MD

Dr. Sukhera is a post-graduate year five child and adolescent psychiatry fellow, University of Rochester Medical Center, Rochester, New York; e-mail:

© 2011 Association of American Medical Colleges