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The Ojo and Death Project Study Tour in Taiwan

The Tzu Chi Silent Mentor Program

In 1996, the first batch of medical students at the newly created Tzu Chi Medical College in Hua Lien took their first Gross Anatomy course. Gross Anatomy is an essential class in advancing from basic medicine to clinical medicine. However, the Chinese and Taiwanese traditions of gmaintaining a whole bodyh and gbeing buriedh have always meant a lack of cadavers for medical study. When the Tzu Chi Medical College opened their program, they faced this problem, and their founder, Master Cheng Yen, responded by trying to shift this traditional culture to a new one grounded in the Buddhist ethics of compassion and self-sacrifice. She notes that, gWe do not own our lives. We only have the right to make use of themc. Turning the useless corpse into teaching materials is a liberating experience from life and death as well as the wisdom of knowing how to teach selflessly.

From this appeal, in February 1995, Mrs. Hwei-Ming Lin made the first willed body donation to Tzu Chi Medical College. However, Tzu Chi Medical College does not simply collect these bodies and use them in the typical way that most hospitals and medical schools use cadavers. They have instituted a highly creative and systematic method of putting teachers, students, bereaved families, and the bodies of the donors in intimate contact to encourage the development of what they call ghumane doctorsh. Using the cadaver as a basis for not only imparting medical learning but also emotional and spiritual learning, Tzu Chi has coined the phrase gSilent Mentorsh, a concept summed up by Prof. Guo-Fang Tseng of the Department of Anatomy, gI have been teaching anatomy with my mouth for my whole life, yet I am going to teach my last class with my body.h

At the beginning of each semester of the Gross Anatomy course, an opening ceremony of gratitude is held that includes the families of the donors. A Buddhist funeral rite is conducted at this time in order for the bereaved family to have peace of mind and for the donors to rest in peace. The ceremony is then moved to the medical operating classroom for surgical simulation, where the donorfs bodies are uncovered, and the bereaved family members may face their departed loved ones for the last time. The medical students are actively involved in this moment, learning to be present and to comfort these families. In turn, the family members may also ease the nerves of the young students by reminding them of the vow of their loved ones to be used for this very purpose. This personal connection with the donorfs bodies and their families is meant to emotionally move and thus encourage the students to develop themselves as more humane doctors.

In many ways, this is the culmination of the project that first takes place with a person voluntarily donating their bodies before dying. Many of these donors are Tzu Chi volunteers or involved in other activities within Tzu Chifs wide variety of social works. In this way, they have already developed a spirit of service in their lived lives and often see donating their bodies as a continuation of their volunteer work. Their commitment is evidenced in that some have had to go against their familiesf wishes for more traditional funeral and burial, while others have insisted on dying at Tzu Chifs Heart Lotus Hospice and Palliative Care Unit to ensure the timely delivery of their bodies to the medical school. Still others have given up chemotherapy so that their bodies would be better suited for medical study.

Before beginning the Gross Anatomy course, students will visit the families of the donors on whom they will operate to learn more about their lives. They look at photos and listen to stories by the family members. Afterwards, the family members provide a photo of the donor, and the student writes a short biography of the donor, both of which are posted on the programfs website, in the hall outside of the dissection room, and in front of the dissection table itself. These biographies and student reflections are eventually published in a book. The students will use this one personalized cadaver for the whole semester. Then, at the end of the semester, the students sew up the bodies, redress them in clothes and shoes, and place them in coffins. A public funeral ceremony with the coffins is held in front of the medical school attended by Buddhist nuns, the school president, faculty, students, volunteers, and the bereaved families. After cremation, the students and the families attend an internment ceremony for each individualfs ashes at a special shrine called the Great Giving Hall housed within the medical college itself.

The comprehensive nature of this program shows the great meaning that can be created from building not just Buddhist but general spiritual mechanisms into the often alienating, secular culture of modern medicine. The program clearly has a powerful effect on the students who are deeply exposed to the emotionality and spirituality connected with medical work – an aspect that is usually totally neglected in modern medical education. The effects clearly span out further in: 1) providing the dying with a sense of meaning to their deaths and personal value that will extend beyond their deaths; and 2) providing bereaved families a sense of continuing value to their loved onefs lives as well as offering them a very profound form of extended grief care through participating in the program. Their extended interaction with the medical students who are encouraged to get to know them and their departed loved ones personally may provide deep meaning in the extended process of grieving.

individual shrines in Great Giving Hall

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