After 64 years with his wife, Dorothy, James Purcell has a lifetime of memories to share with five young medical students he has invited to the home where the couple raised their 11 children.
But he is also eager to learn more about her—or, at least, how she died—from them.
These students, one-fifth of the second-year class at the tiny medical school at Indiana University Northwest, dissected Mrs. Purcell’s body last year in their first-year anatomy class. This year they are continuing to study the rare medical conditions she suffered from at the end of her life and hoping that information might help others.
The unusual anatomy program that brought 90-year-old Mr. Purcell, his 46-year-old son Michael, and the students together offers a unique twist on the first-year lab—a rite of passage for all medical students—by breaking down the wall of anonymity that traditionally separates medical students from the families of cadaver donors.
Last year all six donor families opted to join the program. So far this year, three families have agreed.
The approach reinforces the idea that the donors are the Indiana students’ first patients. “Keeping in touch with the students and hearing about their progress has helped soften the blow” of his mother’s death, Michael Purcell says from the family home in Munster, Ind., a 20-minute drive from the medical-school campus.
Talking with the family has also enhanced the students’ research. In the anatomy lab, they learned that Mrs. Purcell—"Dot,” as she was known—suffered from a rare and aggressive form of melanoma. But they didn’t know that she had always worn a wide-brimmed hat and avoided the afternoon sun.
They had analyzed the deformity that bent her right foot at a painful angle, which was determined to be Charcot foot, but they learned from Michael Purcell how his mother, an elegant and vivacious blonde, “dressed to the nines, but always wore tennis shoes” to ease the pain.
In discussions and reminiscences punctuated by laughter, the students and the Purcells seem comfortable, even when the conversation veers into the nitty-gritty of Mrs. Purcell’s medical conditions. The students are wearing their crisp white lab coats when Mr. Purcell, who walks with a cane, greets them warmly at the door and ushers them into his living room.
Lucas T. Buchler, now a second-year student who e-mails and visits the Purcells regularly, says they treat him like family. But he initially felt uneasy. “Here we were, all excited about starting medical school, and we were meeting with someone who had just lost the love of his life,” he says.
Family Meeting
The program’s founder, Ernest F. Talarico, understands why the whole thing can seem awkward at first.
When he studied anatomy, in 1985, the cadavers were assigned numbers, but students often gave them nicknames. His group came up with “Salty” for its subject, a man with a naked woman tattooed on his chest. That always bothered Mr. Talarico, who directs the medical school’s course on human gross anatomy and embryology. “When you give a donor a name that’s not their own,” he says, “it’s not only disrespectful, but unprofessional.”
Patrick W. Bankston, assistant dean and director of the medical school, says that when Mr. Talarico suggested the idea of introducing the students and the families, he had mixed feelings. “This was a change in paradigm from thinking of a cadaver donor as a tool to learn about gross anatomy to thinking about the donor as a human being with unique personal attributes,” says Mr. Bankston, who is also a professor of anatomy.
That shift is evident in the anatomy lab, a sunny, surprisingly cheerful room whose walls are decorated with photographs and biographies of the donors. Six jewel-toned laptops, each labeled with the first name of a donor, contain MRI’s, X-rays, and three-dimensional CT scans.
Mr. Purcell had cringed at the thought that his wife’s body would end up in such a lab. But her father had been a doctor, and she was adamant about donating her body to science. Her husband teased her that her body would be too old to be of much use. A devout Roman Catholic, she had hoped to end up at a Catholic institution, like her husband’s alma mater, the University of Notre Dame. But she didn’t complete the paperwork to designate where her body would go after she donated it to the state’s anatomical-gift association, her son says.
Still, both father and son were shocked by the invitation from Indiana University Northwest, a public institution just 10 miles from their home, to meet the students assigned to her body. “When I got Dr. Talarico’s letter, I wasn’t too sold on this whole concept,” Mr. Purcell says. “I called Mike and said, ‘Come on over and read this. You’re not going to believe where your mother ended up.’”
Looking for Answers
Michael Purcell was open to the idea, and his father had to admit that the letter was persuasive. In it, Mr. Talarico explained the program and included a paragraph from each student about what he or she hoped to learn from the experience.
“It looked like it might be an opportunity to find out what she died from, but at the same time, I was reticent, because it resurrected all the pain of her death,” her husband says. The fact that her doctor had told him she’d died of leukemia but her death certificate said melanoma was only one of the mysteries that was eating away at him. She also suffered from an unusual calcification condition that caused a bony formation to grow under the skin of her legs.
Father and son drove to the medical school to meet with Mr. Talarico. With some trepidation, they agreed to meet the student team. “They were just as scared of me as I was of them,” the elder Mr. Purcell says. The no-nonsense former public-relations executive set to work quizzing each of them on why they went into medicine and what area they planned to specialize in.
Lyndsay A. Langbehn, who lives in Munster, the same town as the Purcells, surprised him by asking what kind of music Mrs. Purcell enjoyed. Dot had been devoted to classical music, her widower said. Ms. Langbehn made a mental note to play classical music—her own favorite as well—during their lab sessions.
Students learned much more about their donor last month during an hourlong chat in the Purcells’ living room, which was decorated with dozens of family photographs.
One student commented on Mrs. Purcell’s radiant smile, and her husband nodded. “She was movie-star beautiful,” he says.
His determination to understand what caused her death is partly for his children’s sake. His daughters are worried they might have inherited their mother’s bone-calcification problem, he says.
“No one could figure that out. I want to know what you come up with,” he tells the students.
Michael, meanwhile, suspects that he inherited his mother’s painful foot condition.
Some of the conditions she suffered from are common among diabetics, but she was never diagnosed as such. “She was an enigma to her physicians, and she’s an enigma to us,” Ms. Langbehn says. “She taught us that it’s OK to be frustrated and not to know all of the answers.”
Mr. Buchler and his lab-mate, Paul Connors, spent much of last summer analyzing tissue samples of Mrs. Purcell’s enlarged liver, using the skills they had learned in their first-year histology course. They concluded that it was infected with the same rare melanoma found elsewhere in her body. Students from the anatomy lab have continued their research and stayed in touch with the Purcells this year, using tissue samples, organs, and computer images that were preserved after Mrs. Purcell’s body was cremated.
The elder Mr. Purcell has been doing his own melanoma research, which he discussed with the students during a dinner he invited them to at his country club. He says he plans to be at their graduation, two and a half years from now.
In January, at the end of their anatomy course, the students gathered with relatives of their donors in the lab for a “service of thanksgiving.”
“I was uncomfortable at first, thinking what goes on in there,” Michael Purcell says.
Cloths were draped over the cold metal examination tables, and flowers and candles softened the room. Students read poems and essays about their donors, and some played music.
Asked what his mother would have thought about the whole experience, Michael Purcell laughs. “She would have been thrilled.” And to those who doubted that her fragile body had anything useful to share, “she would have said, ‘I told you so.”
