August 25, 2007


I preface this post by saying I have the utmost respect and appreciation for those that chose to donate their bodies to science so that we may learn from them. Any humor is not meant as disrespect to them or the very unique and powerful experience they have afforded us.

They say that the dissection of the human body is an important transition in medical school to the treatment of actual living, breathing patients.

I can see why.

The preserved cadaver walks this fine line between being something distinctly human and being some distinctly not. The formalin preservation process cross links proteins in the body. It makes skin feel almost rubbery. It makes joints difficult to manipulate. It distends the belly. But for all of that, it remains very, very human.

To run a scalpel through human flesh is a very powerful experience. It gives you a great appreciation for how fragile we are. But it also gives you a great appreciation of how well we are put together. Believe me, separating skin from your underlying muscle is a VERY difficult endeavor. Of our group of four, we often had two of us pulling with all our strength (yes, its that tough) while someone incised beneath. Everything is attached to everything. While we were instructed to use primarily blunt dissection to perform most of our dissection, the scalpel turned out to be our truest friend.

Funny anecdote though. Apparently there's a way that everyone holds scissors, then there's a different way that surgeons hold scissors. You have your thumb and ring finger in the scissor islets. You use your middle finger for guidance and place the index finger on top of the blade for greater control. Strangely enough, I've held scissors like that my entire life. Guess some things are meant to be.

Yesterday we got to use the bone saw to cut into the spine. The anatomy lab was like shop class. Power saws going everywhere, smoke rising up, hammers and chisels at work. And this is not a unique phenomenon to anatomy class. A lot of medicine is a lot more crude and brutal than people realize. Just last night a trauma surgeon was telling me about a time when a man came in impaled by rebar. They had to take it out of him using... a diamond cutter and monkey wrench. Guy turned out fine.

I guess that's the part of medicine that starts to get indoctrinated in anatomy lab. Working with the human body is a lot more brutal, aggressive, and messy then people realize. But thats part of what makes it so elegant, and what makes people so resilient.

Perhaps the coolest part of anatomy lab is to see the physical manifestations of pathologies. It's one thing to see a person die of spinal meningitis on the outside, where vitals slowly plummet and the person passes. It's a completely different experience to physically look at that person's spinal cord and actually see white growths of Staphylococcus pneumoniae all over it. You can read the story of the lives and last days of the people we dissect. Our cadaver died of a sudden massive myocardial infarction (heart attack). When we dissect his aorta, it will likely be sclerotic due to heart disease. His liver will tell us if he drank. His lungs will tell us if he smoked (and speaking of which, don't smoke. If you do, quit. You have no idea the ravages smoking leaves on the human body). We may find hip replacements. We may find previous surgical work.

It's a very personal experience. And really makes you marvel at medicine these days and our wealth of knowledge we have acquired.

Luckily, it'll be a while before I cut into a living person. But when that day comes, I know one of the cornerstones of what will give me the confidence to place a razor blade to another person's skin will be these days spent in the anatomy lab.

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