Introduction: Medical students often describe the gross anatomy course as both stressful and a rite of passage. Research differs as to whether the stress it engenders is significant or transitory. This qualitative study of first year anatomy student reports on the use of optional creative projects to promote reflection and reduce stress. Methods: Over a three year period, 115 students, or 38.72% of all eligible students, opted to complete 1-2 arts or written creative projects during the anatomy course. Of these, 34 students gave us permission to analyze their projects, while 12 project completers and 12 project noncompleters were interviewed to determine their views about the projects. Researchers developed coding schema and interview schedules that were used to assess and interpret the data. Findings: On average, over a three year period, a little less than 40% of students selected the creative project option, with approximately equal numbers of male and female students represented. Comparing types of projects, art works were more celebratory and less reflective than written works. Comparing phases of projects, initial projects appeared more conflicted, while later projects showed more desensitization, appreciation, and satisfaction. Students expressed anxiety and ambivalence about anatomy and employed various defense mechanisms to resolve their feelings. Students completing projects reported that they both reduced stress and caused them to develop a richer appreciation for both anatomy and medicine as a whole, while noncompleters acknowledged that viewing the projects helped them to better understand their own experience of anatomy. Conclusions: For some students, creative projects may offer a more reflective and introspective way of wrestling with the ambivalent emotions anatomy raises than simple desensitization strategies of exposure.