I carry my slides through the hospital from the pathology suite on the fifth floor to my laboratory on the first floor of the medical laboratories building. I smile as I pass people in the hallway, gently turning the slides over on my tray, so no one can read them. They belong to someone’s mother, someone’s grandmother, someone’s wife. They belong to someone’s friend.
I silently place the slides under the microscope one at a time when I arrive at my laboratory. I look at each one carefully, inspecting every speck to decide whether it is real or artifact. I do not want to make a mistake because this family deserves answers. All families deserve answers. I open my dotting pen and make a mark next to a Lewy body, a sign of Parkinson disease. I write a note on their workup sheet then continue to scan the other slides for clues. Clues to explain the loss of their life.
When I am satisfied I have found everything for a diagnosis, I begin to write the report. I start with their name and age, what brought them to our department. I write about their brain, a cold mass sitting on a table in the morgue, no longer reminiscent of who they once were. I write about its size and shape, the way its grooves and ridges have shrunk, leaving behind the thoughts and feelings that once thrived vibrantly through the spaces. Everything that makes us who we are, boiled down to 3 pounds or less. In this case, much less.
I want to write about how I feel when I see this brain, sitting there on a table in the morgue. I want to write about the immense sadness I feel. How I am drowning in the grief of my own recent loss, like a shipwreck in a storm. I am being pulled under by wave after wave, hitting me unrelentingly from all directions. And when I finally come up for air, it is like nothing ever happened. The other boats rest peacefully in the harbor, unaware of what I am facing.
I want to write about how lost I feel. How I am no longer grounded, like a tree ripped from its roots. I am searching for a place to be replanted, but there is nothing to tether me to the ground. Other trees change with the season, and I remain frozen in time.
I want to write about the emptiness I feel. How I am no longer whole, like an unraveled tapestry. I am in tatters, little shreds of my life splayed about on the floor. They are memories. Memories of times I will never get back, memories of joy that feel foreign amongst the ruin.
I want to write about how I feel when I see this brain sitting on a table in the morgue, but I write about our findings instead. I am detached, I am doing my job.
Somewhere in another state, someone else is doing their job. They are walking through their hospital, carrying the slides of another person. Another mother, another grandmother, another wife. Slides of another friend. I imagine them sitting down at their microscope, dotting pen in hand to mark what they find. Like me, they also put a dot next to a Lewy body. Like me, they are searching for answers for a family. My family.
Just like my report, theirs will be detached. They will write about their findings. There will be no feelings. But something inside me hopes that they can feel my sadness, my grief. That they will take just a little extra care with this brain, a little extra time to make sure they get it right. Because the brain on the table in their morgue was my grandmother. My mom’s mother, my grandfather’s wife. She was my friend.
And as I am writing my report, hoping that someone else doing their job somewhere in another state is moved by the gift our family has given them in the midst of our sorrow, I remember. I remember that I am someone doing their job with a family hoping I am moved by the gift they have given me in the midst of their sorrow. Someone’s mother, someone’s grandmother, someone’s wife. Someone’s friend is out there, feeling like a shipwreck in a storm that no one else faces, feeling like a tree ripped from their roots, feeling unraveled.
I pull a slide from the tray and place it on the microscope. I look a second time. This time, I am not silent. I am talking to my slides. The slides that belong to someone’s mother, someone’s grandmother, someone’s wife. The slides that belong to someone’s friend. I am making them a promise that I will do good, that I will encourage others to do good, too. A promise to never forget them, to never forget the feeling of sadness and grief I feel today for their family and my own. A promise to exude kindness for the next family I will face, the family who will give this same gift. The gift they gave. The gift my grandmother gave.
When I am done, I put the slides back on the tray. I am finished with the report: Parkinson disease dementia. I let the pathologist know it is ready for review. I carry my slides through the first floor of the medical laboratories building to the pathology suite on the fifth floor of the hospital. I smile as I pass people in the hallway. My slides belong to someone’s mother, someone’s grandmother, someone’s wife. They belong to someone’s friend. When I arrive in the pathology suite, there is a new tray waiting for me in the box. I say goodbye and thank you to my slides under my breath, then I pick up the new tray.
I carry my slides through the hospital.
The author thanks all donors and their families for the generous gift of brain donation. Neuroscience research simply would not advance without their commitment to creating a better world for those who will come after them. Informed consent was obtained for all information provided in the manuscript.
The Article Processing Charge was funded by the author.
Submitted and externally peer reviewed. The handling editor was Associate Editor Heidi Moawad, MD.
- Received December 5, 2022.
- Accepted in final form April 24, 2023.
- Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.