A Place Where Empathy Is Tangible

Published in Dome - September/October 2017

It was once an in-between space, a strip of lawn unnoticed by passersby hurrying to the Armstrong Medical Education Building, The Johns Hopkins Hospital and the employee parking garage.

Now it’s an invitation to visit. A small garden beckons with two benches, a brick labyrinth, wind chimes, flowering vines, roses and Russian sage. A granite plaque bears the words of the medical students who championed the creation of this place:

This garden memorializes the people who in life or after death contributed to our medical education and thus to the care of our future patients.

Anna Goddu, one of the students who led the effort, considers the garden to be a “striking reminder of the humanity of the patients whose lives we hope to support.”

The project took shape two years ago when Goddu and other first-year students were pondering how best to honor the anonymous people whose bodies were donated for their human anatomy course. Although it was already traditional to hold a memorial service at the end of the eight-week session, the students sought a permanent, and public, form of recognition.

At the same time, they wished to show appreciation for the generosity of volunteer outpatients who helped them learn how to take patient histories and conduct physical exams as part of their first-year Clinical Foundations of Medicine class.

They devised a plan to fashion a living tribute on a portion of the lawn west of the medical education building. This garden would also serve as a place for reflection, where all members of Johns Hopkins and its surrounding community could find “moments of serenity.”

The idea was met with enthusiasm by leaders: Rob Shochet, director of the Clinical Foundations of Medicine course; Christopher Ruff, director for the human anatomy course; Roy Ziegelstein, vice dean for education; Landon King, executive vice dean for the school of medicine; and Paul B. Rothman, dean of the medical faculty and CEO of Johns Hopkins Medicine. In the end, the newly landscaped area cost about $20,000 and was paid for by institutional funds and donations.

Pam Guevarra-Johnson, interim director of design and construction for the school of medicine, oversaw the work. “I’ve not had a project this heartwarming in a long time,” she says. “It was a very collaborative effort. Everyone was interested in this and passionate about the students’ mission to honor these folks.”

Goddu says that the idea was shaped by difficult conversations that began when the class discovered that not all the bodies in the anatomy lab had been willingly donated.

The Maryland Anatomy Board, which provides cadavers to medical schools, receives the majority of its bodies from individuals who fill out consent forms before their deaths. However, roughly a third of the bodies that come to anatomy labs in the state are unclaimed, meaning that they died without an estate, insurance or will, and that their family members could not be located or were unable to take custody of them. In such cases, the anatomy board can decide to dedicate the bodies to medical education.

“When we [the class] realized that not all the bodies were donated voluntarily, we felt shaken to our core,” Goddu says. “We had adopted this perspective that allowed us to think the dissection was mutual, that we had permission to look into the literal depths of somebody’s body.”

Wondering which cadavers were donated and considering the ethical framework of human dissections motivated students to create an e-lecture on the history of medical anatomy courses as well as a way to recognize generations of anonymous individuals.

“There are buildings all over Hopkins named after donors, and I am forever grateful for their financial contributions,” says medical student Jason Theis. “Yet this group of people, whether they chose to or not, had their bodies donated to us. There has been no permanent memorial, until now, that acknowledges their gift.”

One of the living volunteers this garden honors is Ruth Cronheim. A retired analyst for the Central Intelligence Agency—her area was Soviet strategic military affairs—she works with first-year medical students who are trying to learn how to communicate well with patients.

As a participant in the Clinical Foundations of Medicine course for the past eight years, this longtime Johns Hopkins patient has shared her medical, family and social histories with hundreds of young women and men who are sometimes so shy that they resist looking at her directly.

By the end of the course, however, Cronheim says that students have not only learned how to listen to their patients but also how to instill confidence in them. “Johns Hopkins works at building what I call tangible empathy. They make it something that you can literally touch,” she says.

What does she think of the way in which the institution is showing its gratitude?

“I am so not surprised,” she says. “This garden is most definitely an example of tangible empathy—and it’s deeply, deeply touching.”

Learn More: Watch an an e-lecture made by anatomy students about the history and ethics of cadaver use.