Bethanne Frazer, MS, LPC, NCC, ATR-P
Philadelphia, PA, USA

Bethanne Frazer works as a Licensed Professional Counselor and Art Therapist in private practice within the state of Pennsylvania. Bethanne earned a master's in science degree from Thomas Jefferson University in their Community & Trauma Counseling program, with a specialization in Art Therapy. She has clinical experience in various treatment settings, including residential treatment, outpatient community mental health care, and college counseling centers. As an art therapist and teaching artist, Bethanne believes in creative expression as a means of self-discovery and a therapeutic healing process. She is a visual artist who works in mixed media, painting, drawing, and capturing analog or digital photos as well as digital audio and video. Bethanne is a native New Yorker from Brooklyn residing in Philadelphia, PA since 2015. 

On Wednesday evenings in academic year 2017-18, I would draw cadavers in the Hahnemann Gross Anatomy Lab. I recall feeling my nerves crackle with anticipatory anxiety the first night the instructor brought us to the lab. Out of the elevator, you could immediately smell the vinegary smell of embalming fluid. He opened the door and turned on the lights, where each metal table had a figure at rest beneath a white sheet. They seemed huge from the doorway but smaller as we entered their space. The instructor put a pair of disposable gloves on and beckoned us around. A mound of stained white linens vaguely resembled a human form. The room seemed to grow quieter once he pulled the sheet down. At some earlier point, the skull cap and brain were removed. The skull was then bisected revealing a cross section of teeth and tongue. I had never seen anything like this before.

I attended the weekly cadaver drawing sessions with determination to set up quickly and make the most of my time. I would don an apron and put on a respirator mask in the elevator.

With similar dutifulness to the surgeons before me, I would be equipped with pastels and charcoal in a cigar box, a drawing board and assorted large paper when entering the lab. The flow state I entered in the space felt reverent. I was a part of the life and history of these human remains. Each unique and decipherable as a person that existed in the world before this place, yet the similarities amongst them indicated their new experience in death. Their noses all seemed a bit mashed in from having been, at some point, lying on their face. Their heads had been shaved. There was a lot of yellow ochre in the colors of their flesh. They all had wrinkles in their fingertips as if they had washed a sink full of dishes.

We respectfully re-draped the sheets and towels over the bodies once we were done for the session. I appreciated the quiet of this space. I found it to be meditative, relaxing, and non-threatening. Everyone here had a goal, and everyone here was receptive to the gravity of what we were doing but it all felt very normal. It was like any open studio figure drawing class, but the model did not require breaks to rest. I rarely ever felt time pass. I would stand for the duration of the 90-minute session, despite my experience of chronic pain. If I did sit, the stool was positioned between the metal tables. If they could, one of the bodies would have easily been able to lift a hand and place it on my shoulder as I sat drawing. Sometimes, I felt like I was close enough to hold their hand.

Whenever my partner would text me to ask what I would like for dinner those evenings, I found it comical that I would always refrain from suggesting meat, as it seemed especially repulsive. I accepted this as one of the innumerable ways that the cadaver drawing experience had carved its way into me. There are many ways in which this was not a typical experience, but it really ought to be something less taboo and exclusive. I feel fortunate to have had the opportunity to draw and make art in the Hahnemann Gross Anatomy Lab. Based on what I have found in the literature, engaging in the experience of cadaver drawing by healthcare providers is an opportunity for personal, professional, and clinical self-reflection.

The cross-disciplinary history of cadaver or anatomical drawing amongst fine artists and medical professionals continues. There are ongoing Art & Anatomy courses being offered to medical students such as the one at the New York University School of Medicine led by Laura Ferguson. Both Laura Ferguson and Katie Grogan compiled images and narratives from students and healthcare professionals that have participated in this course, in the book, Art & Anatomy: Drawings (Ferguson et al., 2017). Several recurrent themes in artwork and narratives support the importance of arts-based pedagogy in the space, such themes as: developing the ability to perceive and accept variations in bodies; appreciating the beauty and complexity of the human body; safely encountering, and reflecting on death and mortality; and experiencing catharsis and emotional wellness through artmaking (Grogan & Ferguson, 2018). Most profoundly, participants engaged in the process of creating art in the lab begin to recognize and connect to their emotions, be present, and express their emotions with the protective distance of looking and drawing. At a very early and critical point in their education, this process parallels the ability to balance empathy and compassionate concern for patients while maintaining clinical detachment for the sake of self-preservation (Grogan & Ferguson, 2018).

Upon cursory review, there does not seem to be a record of what the experience of cadaver drawing is like for art therapists or mental health care providers. Perhaps what may have made this experience particularly meaningful for me is my professional identity as an art therapist. My writing is an autoethnographic account of what it was like to draw in the lab from my perspective and identity as an artist and art therapist.

Parallels could be drawn between the methodologies of the anatomist, the artist, and the therapist in how each professional makes observations, asks questions, develops problem solving strategies and conducts research. When viewing the color palette in the bodies, I would make choices of what pastels to use each week to get closer to what I observed. I witnessed how each body was dissected in the same methodical way and noticed the differences in how they appeared. I noted how my peers decided to draw with very different choices of style, medium, surface and scale. In fine art classes throughout the years, I was taught to render the human form with some clinical detachment, to view a person as shapes, contours, lines, light and shadow. During my time at the lab, my artwork demonstrated a deeper connection to the human form and my ability to render it. This shift was visible in my illustration of more abstract forms as well. My engagement with what or who I was drawing changed me. I am interested in how my experience relates in similarity and difference to that of other art therapists and healthcare providers.

The collective trauma experienced due to the Covid-19 pandemic has changed how we encounter illness and death, therefore, demanding our implementation of different learning strategies when training healthcare professionals. Instructors and students have lost family and close friends tragically and suddenly or they have experienced the vicarious trauma of personal loss. Prior to the pandemic, it was assumed that many medical students may begin their program without having had the experience of personal loss. The experience of cadaver drawing presents a safe context to be amidst death and mortality (Grogan & Ferguson, 2018). My experience of difficult emotions related to grief, chronic pain, and health anxiety were affected by the experience of cadaver drawing. I encountered sudden loss, death, and grief in my personal life at an early age. Grief has changed for me over the years, and I have grown with it. Concurrently with the cadaver drawing sessions, I began a self-initiated project to create an art installation in remembrance of my father. Creation of this artwork seemed to originate spontaneously and instinctually, the elements and steps involved were led by intuition. I found myself engaged in a multimedia installation involving layers of techniques, spanning years of my practice as an art maker. In retrospect, now trained as an art therapist, I recognize that I was propagating post-traumatic growth; I had tilled some space for peace within myself and the healing process.

Cadaver drawing achieves more than an increase in our understanding of anatomical structures. Could cadaver drawing fulfill the role of a tool that encourages introspection and composure, in the effort to train well-rounded clinicians with a greater capacity for empathy and humility in their work?

As healthcare providers, it is our responsibility to ourselves and the recipients of our care, that we continuously broaden our own capacity for self-awareness and actively address burn out. I am inspired to teach a curriculum featuring cadaver drawing sessions in a gross anatomy lab designed specifically for art therapists and counselors in training as well as any provider being trained for direct patient contact. I can envision opening cross disciplinary sections of the course as an opportunity for art therapists to create alongside medical students and other healthcare providers, the universality of the artmaking experience is common ground. In my work as facilitator, and researcher, I plan to invite participants to contribute artwork and narratives. I anticipate the data will yield information to originate art therapy assessments. I would like to measure the professional process of building empathy and concern for patients while learning to practice enough clinical detachment. The goal of the research is to train resilient, empathetic, trauma-informed medical professionals and to manage burnout in the helping professions. This work would contribute to the literature in the creative art therapies in an original way and could potentially help in predicting retention of healthcare professionals in the field beyond their education, exposing gaps in healthcare provider training and may also contribute to improved patient care.

References

Ferguson, L., Grogan, K. (Eds.). (2017). Art & anatomy: Drawings. University Of California Medical Humanities Press.

Grogan, K., & Ferguson, L. (2018). Cutting deep: The transformative power of art in the anatomy lab. Journal of Medical Humanities, 39(4), 417-430. https://doi.org/10.1007/s10912-018-9532-2