In the past, Eastern Washington University has turned to Washington State University and the University of Washington for cadavers to use with its physical therapy program.
WSU Spokane is typically the first choice, according to the university; WSU's Willed Body Program accepts body donations for educational and research purposes. If donors are unavailable through WSU, the UW School of Medicine's Willed Body Program has been a second option.
This year, however, EWU had to reach out to the University of California, Davis to meet the program's needs, as donations to the Willed Body programs at WSU Spokane and UW are both down this year.
The challenge in Cheney highlights a problem for all the region's medical students: there simply aren't enough bodies available for scientific use.
At WSU, donations are kept for up to four years for programs including pre-medical, pre-dental, pre-physical therapy, pharmacy and nursing. Beyond EWU, WSU Spokane also loans donations to Whitworth University, North Idaho College, Lewis and Clark State College and Central Washington University, said David Conley, director of the Willed Body Program.
A donor's remains are eventually cremated. Families have the option of having the remains returned to them or buried at no cost in the WSU-owned plot at Greenwood Cemetery in Palouse, where donors are honored with an annual interment ceremony. Roughly 75% of families choose the first option, said WSU's John Lagerquist .
Lagerquist said the program was averaging around 20 donations per year when he started at the university 10 years ago.
"We're super grateful to those individuals. We couldn't do what we do without the thoughtfulness and the foresight of these donors. It's a remarkable thing," Conley said. "For every body that's donated, we train dozens and dozens and dozens of students. It's a one-of-a-kind experience that they'll always remember."
Between 2016 and 2020, the highest annual number of donations received by WSU Spokane was 34 in 2018. The lowest was last year with 26.
While the university did not provide a year-to-date number of donations for the current school year, Conley said the program has enough to meet WSU Spokane's needs, but barely.
"We've had to say no to some of our partners that have requested donations at other universities," he said. "That happens in every donation program. Some years they have surplus donations. Some years they don't. There are times we've had to tell our partners that we can't fulfill their needs and they'll go elsewhere to obtain loans.
"Our program is probably at the bare minimum in terms of meeting our needs right now," Conley continued. "We could always use more donations."
Donations to UW's program are also down over the past five years.
Donations were as high as 188 in 2017, according to data provided by Catrin Pittack, director of UW's Willed Body Program. The university has received 107 this year as of early October.
Remains of donors that aren't returned are buried in the university community plot of the Evergreen-Washelli Memorial Park in Seattle. This year's memorial service, just as it was last year, has been canceled due to COVID-19 concerns.
In supplying donations, Pittack said UW prioritized the university's partner sites in the WWAMI program, the School of Medicine's five-state medical education program with schools in Washington, Wyoming, Alaska, Montana and Idaho. The Willed Body Program also provides donations to clinicians seeking to use them for research or practice purposes.
"We've tried to make sure all of our long-term clients were serviced, and then we had a few that were more shorter-term, like we had just taken them on," Pittack said. "Some of those we were unable to supply because we were worried."
As institutions adapted and went virtual due to the COVID-19 pandemic, Pittack said the Willed Body Program saw a downturn with the need for donations that has since started to rebound.
When donations were down last year, it wasn't much of a problem since most medical schools were not conducting in-person dissections anyways, said Thomas Champney, a professor with the University of Miami School of Medicine.
"I don't think there's any consistent data of 'everybody's got too many' or 'everybody's got too few," said Champney, who manages the University of Miami's Donor Program. "It's a really variable thing depending on each individual donor program and if they shut down, when they shut down and how many programs underneath their auspices were taking bodies or not."
Neither the UW or WSU program accepts COVID-19-positive donors.
"I would say just in general the pandemic caused us to get fewer calls. Everybody this whole year was scrambling to stay home and stay well," Conley said. "It could just be a consequence of people not thinking about contacting the program."
While dissection is the "cornerstone" of anatomical education at WSU Spokane, Conley said the school supplements that work with options such as 3D modeling through the Complete Anatomy software program. He said the school also has a virtual simulation center where students learn using mannequins.
UW also uses the Complete Anatomy program.
Pittack said she believes the pandemic helped further development of lifelike synthetic body parts that can be used for clinical practice.
"I don't see simulations replacing cadaveric dissection for students," she said, "but I could see a model knee that is very lifelike being used for clinicians to practice and improve their techniques and try new instruments out on the research side. I could see that involving not real specimens anymore, but models instead because you can use them over and over."
Prior to returning to that in-person lab setting last fall, the program relied on cadaveric images, incorporating those with quizzes and self-assessments. Pittack also made videos from the lab, mindful to omit any identifying features with any images.
Virtual materials are still prepped today just in case a student comes down with COVID-19 or has to quarantine, she added.
"As good as they are, I believe that no matter how good virtual tools are, they're not going to teach what you can see in a cadaver," Pittack said. "Students, like medical students, who need to know anatomy really well ... they need to know where things are, how they're placed and how they all fit together, and I don't think there's a virtual program that goes that well enough. It's too idealized."
Conley similarly described donations to the Willed Body Program as "vital" for a student's education.
"Almost indispensable," he said. "You can see the effects of aging and disease. You can see the effects of pathology. You can see variations of the bodies. There's so much to be gained by putting your hands on a real donor. There's a humanity to it. Many students haven't experienced being around death and the deceased, so it's part of their training and the professionalism as well."
