I’m sitting on the rooftop of my 31-floor apartment building looking down on a laughing couple drinking White Claws. Looking on like a creep–or maybe like an ever-watching god. Is there a difference?

On an adjacent rooftop, a man probably my age is smoking a cigarette and crushing a six-pack. He’s been staring at the sunset above the Hudson now for over an hour. Something’s clearly on his mind.

Below him I peer into a window and see a woman crying over the phone. I hope it wasn’t bad news about a sick loved one.

It’s early in the evening, one of those ambiguous New York evenings in which autumn has passed but winter hasn’t quite yet begun. The time is perfect for reflection. For the most part, I’m just another first-year medical student with intermittent bouts of imposter syndrome and sleep deprivation. But on this rooftop, I am empowered and see the world clearly, just for a moment. I am uninhibited, I am significant, I am more than just a conglomeration of vibrating atoms. Or so I think.

I apologize to the bugs flying near me because I reek of formaldehyde and whatever other chemicals are found in embalming fluid. An hour earlier I was in anatomy lab breaking open my cadaver’s skull. Just saying that phrase gives me pause: “my” cadaver. 

Today was the day we looked at the brain for the first time. Everyone had perused the lab manual. It read more like a cookbook. “Step 1: Put the cadaver in the supine position. Step 2: All skin and underlying fascia must be removed from the top of the head superior to the line shown in Figure 5.1. Only bone must remain. Step 3: Use a saw to cut along the line indicated. Be careful not to go too deep.”

It’s difficult to describe the visceral emotions I felt to those who have never been intimate with the preserved body of a dead middle-aged man. He rested on his back upon a metallic table, illuminated by an overhead stage light. You could tell from his well-groomed goatee and pristine neck stubble that he had shaved the day before his death. His skin looked and felt like that of a sweet potato, not a raw one, but one that had been baked in an oven for one hour at 400 degrees. I didn’t know his name. 

If you karate chop your head above your ear and keep your hand glued there, this is the latitude at which I started hacking away with the bone saw. Specks of tissue and bone debris flew like cigarette ash in the wind. “Step 4: Use a mallet and chisel to break remaining connections between the calvaria and inferior part of the skull.” 

I think my classmates would agree with me when I say that we all felt like Michelangelo putting the finishing touches on David’s head, but instead we were adding the finishing touches to accomplish just the opposite.

Brains are deceptively heavy and this man’s brain definitely caught my hands off guard when I first held it. It looked like a caricature of packaged ground beef, only with more disorderly ridges and grooves. I felt both incredibly powerful and vulnerable at the same time and was inundated by questions I wished I could ask him. Did it hurt when you died? Did you have any regrets? Who did you care about? Who loved you?

It was unclear if he had abnormal brain pathology, but tearing into his abdomen revealed an enlarged cirrhotic liver, one of the largest livers our professors had ever seen. “Looks like he was a chronic alcoholic,” one of them hypothesized. His abdominal aorta also looked like it might have had an aneurysm from potential atherosclerosis and hypertension.

With the setting sun on my legs and no longer hugging my back, I look across the stretch of neighborhood that is Washington Heights. “Who’s next?” I ask myself. Statistically, the residents of this neighborhood are more likely than most to develop the conditions that possibly plagued my cadaver. Who’s the next alcoholic, the next smoker, the next diabetic to be hoisted onto those metallic tables and explored by next year’s amateurs?

I once thought that all facets of life are suspended on a rooftop, enabling you to strive for nirvana and enlightenment. If anything, though, rooftops provide only transient episodes of empowerment and relief. After the initial ecstasy of escapism dissolves, you begin to realize how insignificant you really are. The no-names and irresolvable faces trudging by—they could be anyone, they could be you. Just a few moments ago, that WAS you. In just a few moments, that will be you again. Beyond the expansive views and heightened sense of omnipotence, rooftops act very much like those distorting mirrors found at carnivals. The more time you spend on them, the harder reality will come shattering down on you afterwards.

The sun has officially set and all the other rooftop denizens have retreated back inside. My rooftop begins to grow cold and I too start to make my way inside. Until next time.

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Max Lauring is an MD/PhD student at Columbia University Vagelos College of Physicians & Surgeons. He resides in Washington Heights.