Six years ago, Belmont woman Merrilyn Stone gave a gift to thousands of people.
When she died of breast cancer in 2009 at the age of 58, her body was donated to the University of Newcastle's School of Medicine and Public Health in New South Wales.
Ms Stone's journey with breast cancer started in 1990.
Despite having a mastectomy and eventually being given the 'all clear', she was re-diagnosed with breast cancer in 2001 and was given three to five years to live.
But she outlived the prognosis, and over the next eight years, Ms Stone discussed her desire to donate her body to science with her family.
"She loved teaching, and I think the fact that she wanted people to be able to learn from her, not only in life but in death says a lot," Ms Stone's 65-year-old widower, Darrell Stone, said.
"I think I did a lot of my mourning for her during those eight years I was looking after her. It gave us time to talk about things.
"It was tough. Being a carer 24-hours a day, seven days a week progressively became worse."
The process of body donation
In the week before her death, Ms Stone signed paperwork with the university formally allowing her body to be used for research and education, initially for four years.
"She had no concerns with it [and] I had no problems with it, because I knew somehow or other, her body was going to be dissected in all sorts of ways," Mr Stone said.
"So what's the difference between getting cremated and being cut up for research, or to teach medical students?"
Within hours of her death, Ms Stone's body was taken to the university laboratory.
The anatomy laboratory has a cold, sterile feel to it.
Twenty long steel benches are assembled in neat parallel rows, with fluorescent lights casting a soft uniform glow on the room.
Model skeletons dangle next to each row of benches, alongside plastic anatomical models.
Dressed in a white coat and navy trousers, the anatomy laboratory manager Douglas Gillespie, 61, has worked at the university for 15 years.
He had always been fascinated by the human body.
"We need to get [the body] reasonably quickly to do an embalming process to preserve the tissue," he said.
Twenty litres of formaldehyde mix is injected into the body via the femoral arteries, in a process that takes up to two days.
"[The embalming fluid goes] pretty much wherever the blood goes, because it's following the same route," Mr Gillespie said.
"It gets through all the little vessels, capillaries and into the tissue.
"In a funeral home, you embalm for aesthetic purposes because people want to view the body.
"In the university, we're embalming to make sure all that tissue is fixed and will not deteriorate further."
The bodies are then dissected, in order to reveal organs and bodily structures.
Each year the laboratory accepts about 20 bodies, which range in age, but are predominantly 70 to 90 years old.
When prospective donors sign up there is no guarantee that when they die their body will be accepted.
For example, if the person had an infectious disease at the time of their death or was obese or emaciated, the university may not accept the donation.
People also need to have died of natural causes.
The body donation process is heavily regulated by NSW Health, with meticulous records kept and thorough annual inspections carried out.
The university can store 64 full bodies in large cool rooms, as well as up to 150 dissected organs and body parts for students and researchers to study.
Anatomy class can be confronting
In the first university semester of the year, about 1,200 students file in to the laboratory every week for anatomy class.
Four years ago, Dominic Ku, 23, was one of those medical students arriving at the lab for the first time.
There was a sense of nervous excitement in the air as the students assembled before class.
Despite the veil of enthusiasm, Dr Ku tried to mentally prepare himself for what was ahead.
"You're confronted at first by a sense of mortality. You're reminded that people age, they get sick, and they do pass away in the end," he said.
"I guess not all of us are mentally prepared, but when you're in the lab, you realise it's a great privilege to be there.
"A very special aspect of medicine is that you do confront life and death issues, daily. That's something we all forget about when we happily stroll along the beach."
Each week students study a different aspect of the body.
Dr Ku said without anatomical classes, it was difficult to appreciate the body's complexities.
"When you go into the lab every week, it reminds you of how transient and how little time there is to human life," Dr Ku said.
"Much of learning in anatomy labs is disassociating yourself from the specimens.
"Sometimes it's difficult. When you see a human face or the brain, that is very confronting.
"I'm not sure if I've pushed through that, and I think that's a good thing that you don't completely disassociate yourself and see that as a specimen.
"It is someone's human body, so that respect needs to remain."
Five years after his wife's death, Mr Stone wanted closure and contacted the university to have his wife's remains returned.
"All the tissue that's been taken from the body during its dissection process, and then all the parts of that particular body go back into a coffin," Mr Gillespie said.
"The coffin is then cremated.
"Ashes can then be returned to the family, or sometimes they're just scattered on a memorial garden, depending on the donor's wishes."
For the Stone family, the process did bring the closure they desired.
Body donation gives a fresh perspective on life
Dr Ku is about to enter the workforce as a hospital intern and said working with donated bodies had helped shape his medical education.
"It gives you the perspective that much of medicine is to improve and prolong life," he said.
"[Body donations] contribute to the future of human knowledge.
"These labs do grow you as a person [and] allow you to think about our human bodies in different ways than what we used to."
Mr Gillespie said the Newcastle laboratory had enough donors at present, but the situation could change.
He said working with human anatomy had been an enriching experience.
"You appreciate life," he said.
"You're always aware of the fine line between living and dying.
"If anything, it really should make you think to make the most of every day."
Article by Robert Virtue from 1233 ABC Newcastle. All photos by 1233 ABC Newcastle: Robert Virtue.
Researchers say they now know some people can die of a broken heart and are trying to understand more about what triggers such deaths, and develop prevention strategies which might help people most at risk.
Angela Kucia, an emergency department cardiac assessment nurse in Adelaide, told 891 ABC Adelaide broken heart syndrome had only been medically identified fairly recently.
"It's something that has been like folklore — everybody knows of someone who has actually died of a broken heart or thought they had after the death of a loved one," she said.
"But it was difficult to imagine what the mechanism for that would be — do they stop eating, do they stop doing their normal activities?
"Now we know that it's the heart and the brain together that actually cause people to die of a broken heart after a sudden stressful event."
Ms Kucia, who is a senior lecturer in nursing at the University of South Australia, said a research team in SA was trying to understand more about the syndrome.
"I do think we need to look more closely into anxiety disorders," she said.
"I do frequently see people who come in with chest pain related to anxiety that is put down to a panic attack, but I do think we need to look at this more closely.
"We have had some reports of young women with a cardiac arrest after, for example, an argument with a boyfriend, but it does tend to be in older women."
The nursing researcher said dying of a broken heart still seemed to be a rare cause of death.
"Luckily it's a relatively rare phenomenon when people die ... in the past 20 years we've seen the condition predominantly in post-menopausal women," she said.
"It was first discovered by Japanese researchers in around 1990 in women who had suffered an emotional event such as the death of a spouse.
"It was difficult to get any interest in it in the west because at that time it was thought to be something to do with an Asian population [being] seen as more prone to this.
"Now that we know what it is and we know what to look for, we're seeing around 2 per cent of patients, women particularly, who present with symptoms of a heart attack but actually do have this broken heart syndrome."
Adrenalin response can be 'toxic'
Ms Kucia said researchers believed adrenalin was a key factor.
"We do know that the biggest player in this condition developing is what we call adrenalin-like hormones that we get in response to stress," she said.
"You hear people talk about the flight-or-fight mechanism if you get a sudden fearful event ... your body actually produces more adrenalin ... but in large doses it's quite toxic to the heart.
"Some people don't seem to handle it as well as others so we know that this adrenalin plays a part in getting the heart not to pump properly."
She said some people seemed to suffer stress from life events which other people might consider quite trivial.
"We do know that one of the main things that can predispose someone to this broken heart syndrome is a sudden emotional shock or anxiety, but the severity of it varies," she said.
"In the people that we've seen come to our hospitals here in SA, it might be something like the death of a spouse, or a bushfire ... almost anything that causes stress to an individual can cause [broken heart syndrome] no matter how trivial it seems to some.
"Yet other people who deal with great stress or anxiety don't develop it. We haven't got the answer to that yet."
Palliative Care Council of SA chief executive Tracy Waters said her organisation was well aware of cases of people apparently having died of a broken heart.
She said the council had run cafe workshop sessions for the past year at which people spoke of experiences relating to death or preparing to die.
"We run 'die-a-logue' cafes where people come together and share their experiences," she said.
Ms Waters said nearly 60 people attended a recent session at North Adelaide and one woman told of someone who cared for a husband with motor neurone syndrome.
"He died, just a week later she did too," she said.
"We talked about exactly that, did she die of a broken heart?"
Source: 891 ABC Adelaide
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