Beirut Medical Students: Lessons of Life and Death the Hard Way

A Koranic verse on the wall reads: “God, may you provide me with more knowledge.” A copy of Rembrandt’s celebrated painting “The Anatomy Lesson” hangs nearby. In between are 60 first-year medical students and five cadavers.

The Medical School of the American University of Beirut has opened for the fall semester, and 42 men and 18 women have begun their long-awaited study of medicine. Of 204 applicants, these 60 survived the rigors of the American MCAT, the Medical College Admission Test. They sat for the exam through a day of heavy shelling last April. Their scores--an average of 10.76 out of 15--outranked many U.S. test takers.

Last week’s anatomy lesson on the cadavers was equally challenging, but for different reasons: Few had expected a “hands-on” anatomy lesson the first day of their medical studies.

“I was shaking,” one student admitted.

They were greeted at the lab door by the smell of formaldehyde, and it followed them around for the rest of the day. One student joked that his mother would refuse to wash his lab coat.

The ratio of 12 students to 1 cadaver is not ideal, but even though violent death seems everywhere in Beirut--more than 800 were killed in the last six months alone--no more bodies are available. “People here claim their dead,” a doctor explained.

After a night of shelling, families turn up at the university hospital, one of the few in the city that has a morgue. Trying to control their fear and grief, they view the bodies recently brought in.

Of the five cadavers in the anatomy lab, two are the remains of Sri Lankan guest workers. “No one claimed their bodies,” a student said. “It’s too expensive to ship them home.”

None of the students has seen anyone killed in the war, even though an estimated 150,000 lives have been lost in Lebanon since the beginning of the conflict in 1975.

An exodus of teaching staff, most to the United States, was the principal factor in reducing the number of students by one-fourth from last year’s 80. The student-teacher ratio is now 2.2 to 1.

Holding on to the 122-year-old medical school’s U.S. accreditation is a top priority. Until 1985 and a wave of kidnapings, a team of examiners from New York state, where the university and its hospital are accredited, paid regular visits to the American University campus. Since then, the accreditation board’s continued approval has been based on reports sent in by university administrators.

The high number of combat casualties gives the medical students unmatched experience in emergency medicine, but it has also meant that their overall experience is lopsided. The New York board has judged the study of psychiatry here to be particularly weak, for example.

Although the university is situated in largely Muslim West Beirut, these 20-year-olds come from a variety of sectarian backgrounds.

Many of them have brothers and sisters or parents who are doctors. One has three brothers studying medicine in the United States, and his father is a prominent surgeon at the university hospital. Talk of the future includes a unanimous wish to study a medical specialty in the United States, and some doubt that they will return to Lebanon.

“Why should I spend all this time studying under these conditions and then treat a militiaman who has been playing Russian roulette?” one asked.