Monday, April 19, 2010

The Gross Anatomy Lab

Meninges of the central nervous parts

The pending graduation of my entering class coupled with my own proclivity for reflection has me thinking about some of the formative experiences we've shared over the past few years. One of the earliest and very likely, most profound of these was gross anatomy. Although many of us had taken undergraduate courses in anatomy and physiology, this was the first time we would dissect a human cadaver.

It was not, however, the first time I'd personally witnessed death, having been present when my father and my mother's sister passed away. But what I found remarkable about working with a cadaver was how unlike death it was. Strange as that may sound, death, at least as I've seen it, is difficult to distinguish from sleep. When life slips away, it seems loathe to do so in a hurry, and leaves residues of itself in the texture of skin and fading muscle tone. The effect of embalming is such that all of these are removed, and a cadaver appears more like a mannequin than the remains of a person.

This is not to say dissecting a human cadaver isn't emotionally draining, because there are other things, nail polish for example, that remind you what you're about. Some individual or family, however, donated this body specifically for the purpose of teaching medical students. They intended us to dig deeply, they dared us to discover the secrets of the body they once inhabited. That's why it's here.

One afternoon in October, I stayed late to assist one of the professors in removing the brain for use in the next year's course in neuroscience. As he cut through the cranium with an electric saw, and I followed up with a hammer and chisel breaking the bone free to expose the tissues beneath it, I couldn't help recalling a line spoken by Dr. Leonard McCoy (Star Trek IV: The Voyage Home) regarding 20th century medicine, "What is this, the goddamned Spanish Inquisition?!"

Anatomy can be a brutal process and I told my professor so. He said, candidly, that was quite true; we don't have time to be gentle and sometimes it isn't necessary. The dura mater surrounding the brain, is as tough as garment leather. The bones forming the cranium are thick and hard; later that evening my hands ached from the afternoon's effort. Gross anatomy is hard work and it should be. It would be dishonoring to those who've entrusted us with their bodies if was anything less.

What I've noticed about students, myself included, whenever we've come back to the gross lab, is a quality of -- well, honestly, of reverence. It's more than respect, it's the recognition that this is where the rites of initiation occur. It's where we first began to become doctors. What happens here changes a person, and from what I've seen, it changes us for the better.

(Image of unknown license via Wikipedia)
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