14 minute read
Story of Anatomy
from RCSI Alumni Magazine 2021
by RCSI
Eithne Jordan RHA, “Anatomy Room I”, acrylic and gouache on paper, 2017.
For visiting alumni, the unique aroma in the Anatomy room at RCSI stimulates the limbic system, and brings memories ooding back. Above the skeletons, dissections and models, hangs a collection of artworks, donated by students and visiting artists. Professor of Anatomy, Clive Lee recounts the remarkable story of Anatomy at RCSI
The Department of Anatomy is almost as old as the College, with the first Professor appointed in 1785. Twenty-nine Professors and 236 years later, it remains the oldest chair of anatomy in continuous existence in Ireland. Professor John Halahan began by teaching from his own premises, but in 1789, a two-storey house adjoining Mercer’s Hospital was purchased for the Schools of Anatomy and Surgery. The theatre, museum and preparation room were on the upper floor, with the dissecting room on the ground floor, enlarged in 1796, and there was ready access to Goat Alley for the discreet delivery and removal of cadavers.
Halahan was also the Professor of Anatomy to the Hibernian Society of Artists and, from 1789, held the RCSI Chair jointly with William Hartigan. Hartigan was notable for carrying a pair of kittens in the pockets of his great-coat and, along with William Lawless, wrote A Syllabus of a Course of Lectures on Anatomy and Physiology in 1796, comprising 103 lectures delivered between October and April. Hartigan treated the fatally injured Lord Edward Fitzgerald in 1798, while Lawless fled to France to join Napoleon’s army and was expelled by the College. His successor, Richard Dease, was even less fortunate, as he died of septicaemia acquired while demonstrating anatomy in 1819. In 1824, a similar fate befell the Curator of the Museum, John Shekleton, and it was not until 1867, and the discoveries of antisepsis by Lister, and formaldehyde by von Hofmann, that dissection became safe.
One RCSI student in the 1790s was not impressed by the systems-based teaching approach. Hartigan and Lawless’s syllabus began with osteology followed by myology, angiology, neurology, respiration, digestion, secretion and the urinary organs, and nally generation. It was, the student later wrote, like attempting to: “explain the mechanism of a watch, by taking it to pieces, and giving a separate description of every particular wheel and spring without a erwards attempting to show by what contrivance the one moves the other … the student who has been shown the venous, arterial and nervous systems of the arm, does not know how each of them lies with respect to each other.”
This is student feedback, but it was written when Abraham Colles was already in the Chair, having been the first graduate so appointed in 1804. Colles’ book of 1811, A Treatise on Surgical Anatomy, also provided the solution – to teach anatomy topographically, region by region: “to describe the relative position of the parts and to point out the subservience of anatomical knowledge to surgical practice”.
In 1810, the College moved to St Stephen’s Green, and the plans for the dissecting room were altered during building due to “the great increase in pupils”. In 1812, the construction of “extensive” dissecting rooms was underway, and this is now the south aisle of the Anatomy Room, the remaining top-lit aisles being added in 1891-2. In 1826, when the Chair was jointly held by Colles and Charles Hawkes Todd, 224 pupils attended. The Lancet described the behaviour of the students at one of Colles’ packed teaching sessions: “But the bell rings – Mr C’s carriage is at the gate – the benches ll – confusion in all its fantastic forms of juvenile levity prevails throughout the scene. The whole artillery of confectionery, from canister lozenges to the heavy grape-shot of spice nuts, is flying on all sides – while other aspirants for anarchical reputation eagerly contend for the aromatic ammunition. On another side some musical amateur amuses the audience with the fashionable song or quadrille of the day. Thus everyone contributes something to increase the scene of unphilosophical tumult. Here, I must cease – the folding doors open – and in hurries Mr C – with a slip of paper, twisted round his index finger – a simultaneous burst of applause greets his welcome entry, but modestly declining the honour intended him, he instantly proceeds, without even returning the salute, ‘Gentlemen, at our last meeting’ …”
A student of this period was Dominic Corrigan, of aortic incompetence fame, who later published this account of body snatching, “Reminiscences of a Medical student Prior to the Passing of the Anatomy Act”, in the BMJ: “We moved with our hands the recently deposited clay and stones which covered the head and shoulders of the coffin – no more was uncovered; then a rope about three or four feet long was let down, and the grapple, an iron hook with the end attened out attached to the rope, was inserted under the edge of the coffin-lid. The student then pulled on the rope until the lid of the coffin cracked across. The other end of the rope was now inserted around the neck of the dead, and the whole body was then drawn upwards and carried across the churchyard to some convenient situation … awaiting the car that was to convey it to some dissecting theatre.”
The Anatomy Act of 1832 provided for bodies to be obtained legally and stopped the practice of body snatching. By today’s standards, dissection of human remains without the explicit consent of the person themselves, or their next-of-kin, is unacceptable. Robert Harrison, who published The Dublin Dissector, and Arthur Jacob, who described the layer of rods and cones in the retina, were both appointed in 1827. Jacob served for 40 years and was the “uncompromising champion” of the RCSI Medical School. In 1844, he addressed the new students: “This College, although called a College of Surgeons, is, as you all know, just as much a College of Physicians. We have the same corps of professors, or even a larger one; we require the same course of medical studies, or even a more extended one; and we examine as carefully on medical subjects as they do in the schools of medicine. In fact, this is a College of Medicine and Surgery, and the Diploma you receive from it is universally accepted as evidence of your tness to practice every branch of the healing art.”
In 1837, a Chair of Descriptive Anatomy was founded and its occupants included John McDonnell, who used ether anaesthesia only ten weeks after its introduction in Mass General, and Sir William Thornley Stoker, brother of the author Bram. Bram Stoker’s composition notes for Dracula show that he consulted his elder brother about the medical scenes in his novel. Stoker collected antiques, furniture and objets d’art. Oliver St John Gogarty quotes the author George Moore, who examined a Chippendale chair and inquired: “A cancer, Sir Thornley, or a gallstone?” in reference to Stoker’s habit of buying “a museum piece” after carrying out a major operation. The first fulltime professor was Daniel Cunningham, who went on to write Cunningham’s Manual of Practical Anatomy, the successor to The Dublin Dissector. He was followed by Alexander Fraser who wrote a pioneering neurosurgery text Guide to Operations on the Brain. The departures of Edward Dillon Mapother and Stoker in 1889, and the amalgamation with the Ledwich and Carmichael medical schools, led to the establishment of the Chair of Anatomy first held by Frederick Nixon and Francis Heuston.
Auckland Campbell Geddes was the first Professor of Anatomy as we know it. A Boer War veteran appointed in 1909, he introduced a number of reforms, literally cleaning up the Department. He founded the RCSI Officer Training Corps at the students’ request – the rifle range was in the basement, beside the embalming room. Geddes briefly served as Dean, before resigning to take the chair at Magill University in Montreal in 1913. An extraordinary career saw him serve as Brigadier General and Director of Recruiting in the War Office (1916-17), MP for Basingstoke (1917-20), Minister of Reconstruction (1919) and President of the Board of Trade (1919-20). He was appointed British Ambassador to the United States (1920-24), Chairman of the Rio Tinto Company (1924-47) and was elevated to the peerage as Baron Geddes of Rolvenden in the County of Kent in 1942.
Evelyn John Evatt served from 1913-1947, with a break for active service in the Great War, earning the DSO at Gallipoli. Evatt enjoyed teaching in the Anatomy Room, regarding it as “a fountain of perpetual youth” and among his students who won the Stoney Memorial Gold Medal were two future Registrars, H O’Flanagan (1936) and WAL MacGowan (1945). The 1st Med prize medal was subsequently named after Evatt, and he appointed Billy White as Technician, a role Billy held up to the 1980s.
In 1947, Evatt was succeeded by a surgeon, AK Henry, who had served in the army medical corps of the Serbian, British and French armies in the Great War, being made a Chevalier de la Légion d’Honneur for his services to France.
He was Professor of Surgery in Cairo and at the Postgraduate Medical School at Hammersmith and wrote the classic applied anatomy text, Extensile Exposure Applied to Limb Surgery. He instituted the College canteen, which was named after him on two occasions in different locations, the first in the basement of 123 St Stephen’s Green and the second on the First Floor of the 1970s building, beside the Exam Hall. He was also a patron of the boxing club and a ring was erected between the pillars of the Anatomy Room. Henry recognised the unique teaching talents of Tom Garry, who had disagreed with the examiners in UCG and came to live in York Street. Garry’s aphorisms were legendary – the appendix as an organ of no fixed abode – and most of the mnemonics used in the Anatomy Room – 1,3,5,7, 9,10, 11 for the spleen – are linked with this original Surgeon Prosector.
Gilbert Marshall Irvine, another military man, succeeded Henry in 1959. According to Terry Byrne, he would stand on the landing overlooking the Anatomy Room, shout “Byrne”, and Terry would be expected to come running. On the day of Terry’s retirement 48 years later, we tried this out again – he enjoyed the joke. Irvine was joined, and then succeeded by Brendan Rooney in 1969. Academics Jim Doyle, brother of Stephen, Moira O’Brien and Anne Legge taught during this period, assisted by Technicians Terry Byrne, Peter Kellaghan (recently retired after 47 years) and Eric Clarke. Following Dr Legge’s tragic death in a car accident, graduate and Fellow, Krikor Erzingatzian, returned to the Department.
Surgeon Prosectors, including Jock O’Hanrahan and Michael McCormack, and more youthful Demonstrators, taught in the Anatomy Room. ‘Card Signings’ were major events. Over time, these have evolved from the signing of a card confirming that a region had been satisfactorily dissected, to a tutorial where the student identifies structures and answers questions on the area they have been studying in the presence of their peers – then it is their classmate’s turn, so they learn from each other. Student feedback indicates that they regarded such ‘Card Signings’ with trepidation at the time, but look back fondly on them as they learn a lot, become skilled at thinking on their feet and appreciate that they helped keep them up to date. That said, some graduates still complain about getting a B on the Thorax.
The appointment of Stanley Monkhouse in 1988 coincided with an almost complete change of teaching staff. Harold Browne, Seán Hanson, Max Ryan and later Kamal Sayed joined as Surgeon Prosectors and Pat Felle and myself as Lecturers. Stanley’s approach was straightforward – what do medical students need to know and what is the best way to teach them? He transformed the anatomy curriculum with his Blue and Pink books and text books on Cranial Nerves and Clinical Anatomy, and histology online. New lecturing staff included Skantha Kandiah, Gloria Meredith, Tom Farrell and Alice McGarvey. Stanley introduced our Service of thanksgiving for those who so generously donate their remains for medical teaching and research. It is held every two years and is an opportunity for our staff and students to meet and thank the families of our donors. Stanley was a very successful Vice-Dean, and briefly Professor of Physiology, before returning home to England and ordination as an Anglican priest.
When I took over in 2002, the aim was to continue the successful teaching programme, but changes in surgical training had made Anatomy Demonstratorships unattractive to surgical trainees. The answer was to recruit more Surgeon Prosectors including Dan Kelly, Eddie Guiney, Brian Lane, Ray Fitzgerald, Paul Farrell, Arthur Tanner, Frank Keane, Henry Osborne, Alec Blayney, Freddie Wood, Bill Quinlan, Frank Thompson, Jim Griffin, Michael Earley, Parnell Keeling, David Charles, Catherine Riordan, Tom Gorey, Patricia Eadie and Cara Connolly, now a Clinical Lecutrer.
They have received excellent technical support from John O’Brien, Vincent McDonagh, Katie Reeve-Arnold, Bob Dalchan, Andrew Lynch and Patrick Conlon. In the Division of Biology, Peter Stafford supported Alec Elliott, Brendan Kavanagh and Jacqueline Daly. Brendan, Tom Farrell, Alice McGarvey, Jane Holland, Cathal Kearney, Emmet Thompson and Oran Kennedy have all won President’s Teaching Awards, while Tom, Oran, Cara Connolly and myself have won national Teaching Hero Awards.
Student course books now cover the entire rainbow and everything from Postgraduate Courses in Surgical Anatomy to Physician Associate Studies. Two students, Jamil Ahmad and Matthew Inwood, created dissection videos and this was extended by Farhad Kheradmand to create an online Dissection Guide. Valerie Morris followed suit with an online Surface Anatomy Guide – try Googling ‘RCSI Surface Anatomy videos’. Central to this were Anil Kokaram, an Oscar-winning engineer from TCD, and artists Mick O’Dea and Una Sealy from the Royal Hibernian Academy.
Fergal O’Brien was the first engineer appointed to the Department. He had done his PhD in bone biomechanics with us before embarking on a Fulbright to MIT. On his return, he set up the Tissue Engineering Research Group, and its alumni Garry Duffy, Cathal Kearney, Oran Kennedy, Caroline Curtin, Aamir Hameed, Ciara Murphy, Olga Piskareva, Claire Conway, Shane Browne and Fabio Quondamatteo have successfully combined teaching and tissue engineering research. Fergal now has a personal chair and is RCSI’s Director of Research and Innovation.
The importance of both teaching and research is reflected in our 2019 renaming as the Department of Anatomy & Regenerative Medicine. We have been very fortunate to have excellent administrative support provided by our Department Secretaries, from Margaret McCarthy and Annette Sweeney, Sinead Byrne, Mary Brennan and Amanda Campbell to Lorraine Harte and Laraine O’Brien.
In all of this, we have tried to keep the interests of our students paramount, to ensure that they can learn the anatomy that is essential for clinical practice. The unique and priceless gift of the human body from the donor provides a source of knowledge that is the foundation of medical education and research. A former President of RCPI, John Donohoe, used to say that students remember their teachers with great clarity and varying degrees of affection. To this I add that teachers remember their students with great affection and varying degrees of clarity. So if you are in Dublin, do drop in to say hello. We’ll bring you into the Anatomy Room, where the unique aroma will stimulate the limbic system and bring the memories flooding back. From the dado rail down, all will be familiar – skeletons, dissections and models – but above hangs our collection of artworks, donated by our students and visiting artists, some of which are shown here. We look forward to welcoming you. ■
