I read about a British documentary last year that showed the process of embalming. A 77-year-old woman’s body was laid on a table, her chest cut open into quarters, and her skin peeled back. All the while I couldn’t help but think: Is the same thing going to happen to my grandmother?

During Chinese New Year in February my mother, father, grandmother, and I drove to Suzhou’s Shangfangshan National Forest Park, in eastern China’s Jiangsu province. It was undoubtedly one of the worst times to visit — considering that it was both a national holiday and flower season, the park would surely be swarming with tourists. Thoroughly put out, I had turned off my brain and was absent-mindedly staring out the window.

“We can drop by the memorial wall,” my grandmother suddenly remarked. “It’s just around the corner, and my headshot will appear there after I die.” The abruptness of this comment awoke me from the holiday dullness. “Memorial for what?” I asked.

“For body donors. I think I was the first one to sign up in Zhangjiagang back in 2008,” my grandmother answered glowingly .

Zhangjiagang is a small city under the jurisdiction of Suzhou. The entire city only has 105 registered donors — one of them being my grandmother. She turns 86 this year.

She continued nonchalantly: “Because of a lack of cadavers, my sister was forced to dig up buried corpses with her classmates when they were training to become doctors. They would transport them back to their facilities, scoop out all the organs, study them, put them back in and sew up the bodies, and then move them back to the cemetery afterward. So I thought that when I die, the least I can do is give something I no longer need back to medical students.”

Digging up corpses? My soft-spoken great-aunt had done that? It made my stomach churn, but I became rife with curiosity. “Has anyone in our family disagreed with your decision?” I asked.

Not one of her three children was supportive in 2006 when she announced her intention to donate herself after death. In China, people are generally either cremated or buried after death, and mutilating a body is considered disrespectful. It took two years of persuading before she finally received their blessings.

This car ride got me interested in the entire industry of body donation when I returned to Shanghai. “Do medical students still have to dig up graves?” was one of my first questions to my friend Chen Ye, a postgraduate student at the Shanghai Medical College of Fudan University.

She was born in the same year as I was — 1992 — and has also never heard of medical students being forced to steal cadavers. However, she also told me that donor sources aren’t necessarily voluntary — many are picked up as anonymous bodies at police stations. In addition, some medical schools buy their cadavers, but donations make up the majority of the bodies their department receives.

I was relieved to learn that people of my generation no longer have to go through the awful experience of my great-aunt. But a scarcity of bodies nevertheless remains a serious problem for medical students.

Speaking to Sixth Tone’s sister publication The Paper in 2015, Li Minglei, deputy president of the Shanghai branch of the Red Cross Society of China, said that while Fudan receives about 40 percent of body donations in Shanghai, the remainder are split between the rest of the city’s medical schools — where 15 to 20 students are often forced to share one body. This is far less hands-on experience than trainees need to become doctors. 

The Shanghai Red Cross chapter has been fighting negative attitudes toward body donation. Every year in March they organize a memorial day in Shanghai’s Fushou Garden cemetery, when medical students and families of donors gather and give thanks to those who donated their bodies for science.

The number of those willing and registered to give their bodies to medicine after death has been steadily increasing over the past decade. However, simply registering doesn’t always ensure that your body will be delivered after death — especially if your family stands in the way.

It is crucial for the relatives to report the death to the recipient hospital as soon as possible to prevent decomposition, but many families instead send on the bodies to be cremated or buried. This is sometimes just a mistake in cases where families were unaware of the donation pledge, but is also too often done with the full intention of going against the dying wish of a relative. In 2015, only 646 bodies were successfully donated out of a possible 2,466 registered donors.

The day we were driving in the car, we never ended up finding the wall where my grandmother’s picture would be displayed. My father made a comment as we were leaving: “Let’s not bother. Your headshot isn’t up yet anyway.”

I remember a surreal feeling, as if she had already passed away and all that remained was a headshot on a wall that nobody could find. I imagined her body cut open by a cold, sharp scalpel. “Wouldn’t that hurt?” I wondered.

It was then that I came to a realization: It’s impossible to frame the argument as one of morality versus personal emotion. We can’t simply blame the disapproving relatives who are unwilling to donate their loved ones because it goes against the grain of our culture.

However, for a family to fail to keep their promise or to lack education of donation procedures is another matter, and is actually one of the dark sides of Chinese culture in my opinion.

To tackle the huge disparity between registered and successful donors, the Red Cross and other entities must step up their awareness campaigns. And although it may break my heart to do so, I pledge to ensure my grandmother’s wish is fulfilled.

(Header image: Doctors show respect by bowing to a body donor in a surgery room in the Second Affiliated Hospital of Kunming Medical University, Yunnan province, July 17, 2013. Hao Yaxin/VCG)