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Home Our Missions Mission of Education The Making of a Tzu Chi Surgeon - A Tzu Chi exclusive

The Making of a Tzu Chi Surgeon - A Tzu Chi exclusive

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Article Index
The Making of a Tzu Chi Surgeon
A Tzu Chi exclusive
simulated surgery training course: days 1 and 2
A cadaver’s busy new life: days 3 and 4
Retrospect—end of day 4
All Pages

A Tzu Chi exclusive
In 2001, Tzu Chi University added simulated surgery to its medical school curriculum. Donated cadavers are used for med students to practice surgical techniques and procedures on. The cadavers are fondly referred to as “silent mentors,” (literally “great body teachers”) whose collective wish for those who operate on them can be summed up as: “Make as many incisions and mistakes as you need on me so you don’t make even a single wrong incision on a living patient.”

Over the years, numerous trainee surgeons have practiced on 81 silent mentors. It turns out that the beneficiaries of the silent mentors’ benevolence include not only medical students, interns, and surgical residents, but also highly skilled surgeons. Dr. Li, for one, certainly has greatly benefited from and at the same time enriched the program.

Li once had to get ready for a liver transplant from a living donor. Instead of going through those highly complicated operations only in his head as he had done before, he now had the benefit of silent mentors. A living donor liver transplant involves operating on two living human beings consecutively: harvesting a piece of liver (usually the right lobe) from the donor, removing the damaged liver from the recipient, and finally implanting the good liver in the recipient. If all goes well, the implanted piece of liver, with its remarkable regenerative power, will be fully functional in 30 to 45 days.

Dr. Li practiced the entire sequence on silent mentors, not just once, but four times, before he actually did the surgery on the two real, living patients. In all, he performed operations on ten persons: first, he practiced on eight cadavers from Tzu Chi’s simulated surgery program, and then he operated for real on two living patients.

What a touching story! No expense, effort, and love were spared here—love and effort from eight body donors, one living liver donor, a persistent surgeon and his whole team—just to enable one recipient to have another chance at life.

Body donors
Shi Qing-xiu (施清秀), a Tzu Chi volunteer from Kaohsiung, told his family again and again: “When I pass on, don’t bother chanting ‘Amitabha’ for eight hours [as many Buddhists insist on doing to comfort the soul of the deceased and help send it to the Pure Land of the West]. Instead, rush me to Hualien so my dream of becoming a silent mentor can come true. Many people undergo surgery so they can live. I’ll undergo surgery when I die so, hopefully, many others can live.” He was in the terminal stage of lung cancer. He wanted to make sure that his body got into Tzu Chi’s simulated surgery program.

When he passed away, his family called an ambulance and rushed his body to Tzu Chi University in Hualien, where his body was checked and disinfected and put into a freezer to be quickly frozen and kept at minus 30° Celsius (-22°F).

Through October 2008, of the 23,161 people who had signed body donation cards for the silent mentors program, only 594 bodies had been taken into the program [most of those who have pledged are still living, and some deaths didn’t meet the program’s selection criteria]. And of those taken into the program, 295 had been, with the consent of their families, in turn donated to other medical schools to alleviate their shortages. Tzu Chi has used 179 corpses for anatomy classes at its medical school and 81 for its simulated surgery program.

The Tzu Chi Medical Simulation Center
In September 2008, Tzu Chi opened the Medical Simulation Center. The center is located in a building in Tzu Chi University, which is in close proximity to the Hualien Tzu Chi Medical Center.

At the Medical Simulation Center, an operating room is dedicated to the use of simulated surgery. Since the room is intended first and foremost for training, it has all the things that a standard operating room requires, such as dressing rooms, scrub areas, and supply rooms. In short, the room is identical to a traditional operating room in all respects but one: It has eight operating tables as opposed to one, and therefore, eight sets of almost everything else. Therefore, the room can accommodate eight concurrent operations.

Now Tzu Chi University holds regular simulated surgery courses three times a year, in March, July, and November. Three days before a course, silent mentors are taken out of the freezer to thaw. The cadavers, quickly frozen earlier, thaw and become an ideal teaching and learning tool. They are supple and almost identical to living patients except for the absence of heartbeats, blood pressure, bleeding, and breathing.

An auto mechanic thought that changing a car’s engine is like a heart surgeon changing a patient’s heart. So, he asked the surgeon why they did similar work but he only earned a fraction of the doctor’s pay. The surgeon looked at the mechanic thoughtfully and said, “You turn off the engine and change it, but I have to keep the heart pumping while I’m at it.”

Operating on a living patient is infinitely more complicated than operating on a cadaver, making the former so much harder for a newcomer to learn and do. Simulated surgery on cadavers provides a controlled, realistic, but much more gradual and forgiving environment that facilitates quality learning.

Dr. Sun Zong-bo (孫宗伯), head of surgery at the Hualien Tzu Chi Medical Center, pointed out one of the benefits of simulated surgery on cadavers: “For one thing, the surgery can be stopped and resumed at will for instructors to explain a point or for students to correct mistakes and practice repeatedly.”

At some medical schools, medical mannequins and animals like dogs, rabbits, and miniature pigs are used in simulated surgery. The trouble with this is that they are not humans and they have different characteristics. At some other schools, pre-frozen corpses are used in their simulated surgery programs, but they use only body parts instead of whole human bodies. Whole bodies, as it turns out, make the Tzu Chi simulated surgery program stand out from other similar programs.

Dr. Lin Yuan-qing (林元清), an orthopedic surgeon from California and a TIMA member, said of the Tzu Chi Medical Simulation Center, “I’ve visited six or seven simulated surgical centers in the United States, but none is as big and well-equipped as this one. And none offers whole cadavers.”

Some surgeons even praise the center as a world leader in simulated surgery. The center director, Dr. Zeng Guo-fan (曾國藩), plays down the kudos: “We incorporate simulated surgery into our regular curriculum, and we offer whole cadavers for surgery. Both are unique in the world. That’s all.”

At Tzu Chi University, it is part of the curriculum requirements for the persons scheduled to perform a simulated operation to get to know the life and family of their silent mentor. They read up on the body donor’s life and spend time with his or her family. By the time of the surgery, the students already know much about the person on the operating table. The cadaver in front of them is of someone they know and respect—a whole person who had a name, a life, a family, feelings, and emotions—not just a lifeless body, and certainly not just a body part like a wrist or a knee from an unknown source.

It is no wonder that Tzu Chi trainee surgeons conduct the surgery with utmost care and reverence. This intimate patient/surgeon relationship truly sets the Tzu Chi simulated surgery program apart from all the rest. Though the corpses are cold, the kinship is warm and personal. The surgeon therefore performs the surgery as if on a loved one. This warmth later radiates from the surgeon outward to future patients. This is yet another example and manifestation of Tzu Chi’s somewhat vague and highly impalpable ideal of bringing up not just competent, but also loving, surgeons and physicians.


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Jing-Si Aphorism

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