I had two goals for my first day of gross anatomy. First, don’t faint. Second, don’t puke.
I’m a first year student in a PhD program that requires coursework in medical school, rather than graduate classes in our home department. In a class of 150 medical students, there are three of us who aren’t working towards an MD. While we are well integrated into the medical school, we stand out a little. It’s probably not surprising that until I chose to attend this program, my life to-do list did not include “dissect a cadaver.” So for the first day of what was to be a three-month expedition into the human body, I really didn’t want to be that PhD student who puked.
We had spent the prior month thinking about enzymes, genes, and signaling gradients. Suddenly we’d jumped up in size and were talking tissues and organs – organs packed in a human being lying 12 inches in front of us. Earlier in the week, one of our professors had walked us through the course – how cadavers are obtained and preserved, what the structure of the course would be, what gloves to buy. At the end of his spiel, he asked us what we were worried about. I can only assume he was looking out onto a lecture hall full of squirming students desperately trying to avoid discussing, in front of classmates and professors they’d only known for a month, how they really felt about dissecting a cadaver.
The first cadavers obtained for the education of physicians were usually stolen from graves. Nowadays, almost all cadavers used in medical schools are donated from patients who have graciously agreed to assist in the education of medical students years before their passing. However, a small fraction of cadavers are from patients whose bodies are not claimed after their deaths. For privacy reasons we’re told very little about our cadavers – only their ages and causes of death. When I realized my cadaver had a different colored tag than all the other cadavers in the room, I worried that perhaps my cadaver hadn’t agreed to let us dissect her head-to-toe.
After what felt like a dangerously abbreviated explanation of how to load a blade onto a scalpel, I watched a team member make the first incision in our cadaver’s abdomen. I’d like to tell you I was keeping a close eye on the first dead body I had ever seen, but it turns out it’s not trivial to load a sharp blade onto a scalpel while you’re constantly evaluating the contents of your stomach. Five minutes later I was cutting on my own. What they say about desensitization is true – it happens faster than you think.
No matter how little of it there is, fat smells bad post-mortem. This, combined with the fact that smaller bodies are easier to manipulate, can make smaller, thinner bodies more ideal for dissection. We often remarked how lucky we were that our cadaver was so petite. It was strange how quickly we came to feel possessive of a cadaver we knew next to nothing about.
So for the first day of what was to be a three-month expedition into the human body, I really didn’t want to be that PhD student who puked.
I remember the day we came across the tumors responsible for taking our cadaver’s life. It was almost disappointing how tiny they were, especially in comparison to the rest of her body. It made me realize how critical it is that every part of our bodies functions properly. We learned a lot of anatomy, and sometimes it just felt like a list of things that can go wrong. At the same time, my anatomy experience also made me realize how resilient the human body is. That billions of cells can come together to produce a living being seems to me an incredible feat of engineering. There’s a lot that has to go right to create and sustain a breathing, thinking human being. When you realize how long that list is, it makes you wonder why we aren’t all walking around with diseases.
Every human is unique, and so every cadaver is unique. Because it is so easy to get caught up in the dissection of your team’s cadaver, we quickly learned that one of the keys to passing the exams was to go around and look at the other cadavers. Sometimes we would look for a blood vessel for 30 minutes only to have the instructor take a quick peek and tell us that this body simply didn’t have that vessel. It wasn’t removed surgically, and it wasn’t a congenital malformation. It just wasn’t there. It’s surprising how adaptable our bodies are – some people live perfectly healthy lives without such unusual configurations ever coming to attention.
One of the blessings of human anatomy is that we have two of almost everything. This comes in handy when, despite our best efforts, we destroy the exact structure we were looking for in our search for it. While the instructors could rapidly perform textbook-quality dissections, our work looked more like a kindergartener cutting with her eyes closed. The future surgeons liked to brag about the quality of their dissections, but the honest truth was that at any given moment half of us had no idea what we were doing. This was a three-month long course, and only three times were our dissections so nice that a professor told the classroom to look at our cadaver. One of those times the professor forgot it was actually his dissection he was marveling at.
By the time they arrive on our tables, the bodies look much less like people and much more like cadavers. I expected our cadaver’s insides to be bright red and sparkling white, when really the preservatives turned them dilute shades of red and grey. This made it maddeningly difficult to differentiate blood vessels, nerves, and ligaments. One afternoon my partner and I were trying to locate all the major nerves in the forearm. It took us one confusing hour and our instructor barely five seconds to realize the largest nerve we were basing all of our identifications off of was actually a tendon. Our second guess had been an artery. Hint: if pulling it flexes a muscle, it’s probably not a blood vessel.
Sometimes the more jarring dissections also gave us the most unique perspective on the human body. The first really discomfiting dissection we faced involved separating the spinal column. I assumed there would be a fancy, shiny, expensive medical saw for us to use. It felt a little medieval when they handed us tools you can get at any hardware store. Still, without that dissection it would have been much harder for us to understand the physiology.
Every human is unique, and so every cadaver is unique.
In order to best preserve the tissue throughout the course, body parts that aren’t currently being dissected are kept covered with cloth. Thankfully, we didn’t dissect the face until a month into the course. My team hadn’t even peeked at our cadaver’s face until the day we had to dissect it. In retrospect, it probably wasn’t the best idea to leave our first look at one of the most humanizing body parts to the same day we had to dissect it.
Then there was the day we had to dissect the genitals. There’s something I never need to do again. The atmosphere of the room wasn’t much different from that of a classroom full of middle-schoolers being lectured on the birds and the bees – a little bit of disgust, a lot of giggling, and most people pretending they already knew all this stuff.
I was often asked by my fellow classmates what in the world I was getting out of taking anatomy when I want to be a scientist that studies the molecular basis of life. I would have had the same question a year ago. I could tell you that learning for the sake of learning is always worthwhile. Or that maybe one day I’ll remember something that will give me that eureka moment. Or – and frankly, this is the most unlikely – maybe someday I’ll remember something that could actually help someone who is sick or hurt. But anatomy was at its core an incredible experience. It was nerve-wracking, hilarious, terrifying, and amazing. It gave me a totally different perspective on biology, life, and my research than I could have ever gotten from a textbook, a classroom, or a lab.
During one of our more unsettling dissections, one of the professors told us, “Remember this day, because you will probably never get this view of the human body again.” While I don’t yet know where the rest of my career will take me, I know that he is likely right. I sincerely hope that my cadaver’s family knows how much I learned and how much this experience meant to me. Death is in no way glamorous, and neither were the dissections we did. But learning about the complexities of the human body through direct examination of the (formerly) working parts was one of the most rewarding experiences of my education.