A Med School Memoir

My dissecting partner has put me off to any number of foods recently.  First, when we were removing the subcutaneous fat from our cadaver’s back, he noted the fat’s resemblance to undercooked scrambled eggs.  That comparison was so spot- on that I couldn’t even think of eggs without gagging for a little while.  This week, when we got into the heart, we cut away part of the aorta and set it aside.  “How about some bacon with your eggs,” he said.  Luckily for me, I don’t eat bacon, or that one would have been ruined as well.  All we need to do is find something in the human body that looks like a pancake, and we can make a cannibalistic Grand Slam Breakfast.

If it sounds to you like we’re being disrespectful or unprofessional about dissecting a human body, you’re probably right.  But I would also suggest you try taking a hammer and chisel to the spine of someone who resembles your grandmother, and hearing the bones crack, and feeling them give way from your blows, and then get back to me.  I defy you to do that without throwing up about 1,000 primordial defense mechanisms, because I say it can’t be done.  So yeah, we make some jokes about how her back fat looks like coconut creme pie, and we laugh, because really, we’re all traumatized as shit by having to mutilate a dead person every day.

So yeah, I cut open a human heart with a pair of scissors the other day.  Let me tell you, it sounds way more badass than it actually is.

My cadaver (”Dorothy”) was a pretty big lady (let’s just say she liked her McDonald’s).   She died of heart failure, and her heart was enlarged–probably a result of hypertension, which would not be not surprising considering that she was obese.  In addition, her heart was covered in a thick layer of fat that we had to dissect through to find all the intrinsic vessels of the heart.  I don’t know about you, but I’ve always thought of the heart as this solid, firm organ, kinda tough, but ultimately resilient.  I mean think about it–this thing beats millions of times in a normal person’s life–is more active than any other muscle in the body.  How could it be anything other than durable–that’s kind of the definition, right?  Able to withstand a lifetime of use?  Holding a heart–literally–in your hand, you realize just how fragile the thing really is.  I’m finding the same to be true of pretty much everything we dissect in lab–everything in the body.  It’s kind of startling to think how much work goes into building a human body–thermodynamically, chemically, etc.–that is so easily and irreversibly destroyed with one deliberate swipe of the scalpel.  It took this wonderful woman an entire life to make the body we now find splayed out in front of us in lab, and within a few hours, we’ve stripped her of her skin, or we’ve sawed through her chest and removed her lungs, or we’ve chiseled our way into her vertebral column to expose her spinal cord.  The net effect of all the cuts we make in a normal day in lab would most definitely kill a person, if they weren’t already dead.  It was tough to come to terms with this at first.  But you also know that you’ll never learn any of ten thousand things you have to learn if you don’t get in there and dig until you find it.

There is something very zen about picking away through layers of fascia for long stretches of time in order to find a tiny little nerve, no thicker than a spaghetti noodle.  And then, when you finally do find it, you must exercise the utmost caution not to apply too much pressure, or it will snap.  In a living person, severing that nerve might lead to irrevocable muscle atrophy, or paralysis of a limb, or loss of sensation to some portion of skin.  And if the same thing were done in a living person, it would never heal.

We are such intricate, delicate beings.  Life, in and of itself, is an amazing thing, and I think that goes without saying.  What’s also remarkable, and often under appreciated as the miracle that it is, I think, is that we can not only be born alive, but that we can be born healthy, and stay in relatively good health more or less until we die, riding the crest of a lifetime of subtle physiological equilibria that can usually keep things working as they are supposed to.  Knowing that so much can go wrong, sometimes it’s amazing to me that we aren’t always sick, all the time, and I’ve become hyper aware of my own health.  It’s not much fun.

A lot of cadavers in our lab had severe lung problems when they died.  Let me tell you, seeing firsthand the damage that smoking can do to your lungs will make you never want to touch a cigarette again, and regret the fact that you ever smoked at all.  The lungs of these smokers–the lifetime, pack a day habit smokers–they’re just so much worse than you can imagine.  We’ve all seen the pictures of the smoker’s lungs, dark and cruddy looking.  Well, that’s nothing.  The cadaver at the table next to mine died of lung cancer.  He had little meatballs growing in his lungs, but otherwise his lungs looked fine.  What is troubling are the other ones–the ones who were lucky enough to not get cancer, the ones who never had to quit smoking.  Their lungs are tiny little sacks of black tar, shriveled to less than a third of their normal size.  And they smell–even in a lab full of dead bodies, you can make out the smell of a stale ashtray wafting from these lungs.  And when we open up the trachea, we find congealed black mucous.

I used to smoke.  In college, I probably smoked a pack a day for a while, and even in the last couple years, though I have cut back significantly, there have been plenty of times when I smoked a pack over the course of  a weekend at the bars and then vowed to quit again on Monday.  But that’s all over now.  I’m done.

Tags:   Cadaver · dissecting · Gross Anatomy · M14 Comments