Anatomy Lesson

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"The Gross Clinic," by Thomas Eakins, 1875. By zpeckler, http://www.flickr.com/photos/zpeckler/3508677341/

Editor’s note: Rebecca German is a Visiting Fellow and Officer of Harvard University where she took gross anatomy as a student, and is now about to begin teaching anatomy to first-year med students at Johns Hopkins. In this guest post, she looks back at her own education at the hands of a cadaver.

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Dissecting a cadaver is a somewhat frightening rite of passage for first year medical students. When I took Gross Anatomy at Harvard Medical School, it was the first course of the first term of the first year. I had been a math major and had avoided much of the wet and mushy bits of biology in my education so far. But I was ready for it. I wanted to learn. I wanted to dissect. And, surely, dead bodies weren’t going to faze me.

I had my shiny new surgical tools, my brand new lab coat and scrubs, clean books, and what I thought was an open mind. The first lecture was orientation and introduction. Lab was more introduction, more orientation. I met my lab partners, they seemed decent sorts, mates who would pull their share of the work. I was impatient to start. This was going to be real. I was going to see what bodies were made of, how they were put together. I would see some pathology, and really know what was under the skin.

We had lengthy instructions (it seemed to me) about opening the bags, unwrapping the bodies. How to wet the skin, how to cover it up. In the beginning all we needed to expose was the chest. This is how you hold a scalpel. This is how you cut.

The first thing that hit me was the smell of embalming fluid. It was strong and made my eyes water. I was disappointed that the head and the limbs were wrapped in greyish gauze. The skin was a weird color of brownish-pinkish-grey. There was no way I could tell the race of this cadaver from the skin. It was hard and rubbery. One of my lab partners, a broad guy, who really cared about people, was turning green. I couldn’t see why – there wasn’t anything more than a very generic looking, oddly colored chest that seemed not quite like a real person.

scalpel By aesop, http://www.flickr.com/photos/andreweason/268627274/I made the first set of cuts, a standard H-shaped trio. The first one from left to right at the very top of the chest, under the clavicle, the collar bone. The next, straight down the midline below the end of the ribcage, and the last, horizontally across the bottom of the ribcage. It took more pressure and a firmer hold on my scalpel than I had imagined. But I was excited. I was holding a scalpel! I was dissecting. I separated skin from underlying tissue. I lifted the skin flaps and saw muscle, bone, blood vessels. We were lucky in having a cadaver without much fat so everything was easily visible. The rest of that hour vanished without my knowing it. There were structures to free from tissue, arteries to identify, muscle fibers to trace. I learned anatomy feeling it in my hands.

The second class was better than the first, and the third was better than the second. Our lab group worked hard together, meeting after class to build a structure of words and concepts upon which we hung the tissue and organs from lab. The semester was flying by, and anatomy filled my waking hours. I had forgotten the about the smell of embalming fluid. My tools weren’t so shiny, and my books certainly weren’t clean. We opened up the thorax and I marveled at the heart and lungs. They were city lungs, and partially black. This is the organ that pumps blood, this is where oxygen goes into the blood stream. The abdomen amazed me, it seemed complicated, a set of greasy loops in no order. But, in understanding that it starts as a simple tube, then grows and twists prenatally, the complex pathway that food takes through the body I saw as a feat of bioengineering. We dissected the pelvis, and saw the ovaries and uterus, which looked a lot like the cartoon pictures from 8th grade. Our lab group had a moment of laughter and told stories about early sex ed. We all agreed how much more interesting it was to see the real things. But laughter was rare because my lab group was getting tired. Not everyone had my enthusiasm. We had started as four but one left the program, and then another, a Ph.D. student, got permission to delay anatomy for a year.

When it was time to dissect the limbs there were only two of us remaining to do all of the work. I needed to come in one night, because I was behind on my share of the dissection. I was doing the upper limb, and my lab partner was doing the lower one. We started proximally, near the center of the body, and worked our way out from arms and legs to hands and feet. It was wintertime in Boston, and starting to snow. The lab had big windows, and I could see the flakes looking pinkish-orange in the sodium lights. I laughed because one of my roommates asked me if I was scared about being in a room of dead bodies late at night. How could I be scared? I was still loving anatomy, and still packing the information into my head.

Nail polish and knitting By TheKarenD, http://www.flickr.com/photos/karen_d/4663721198/

I sat down and unwrapped the even more greyish looking gauze from the right hand of the cadaver. And I stopped. The body I thought of as “my body” was a woman with beautiful hands. She had graceful nails with coral colored polish. Her hand was gently curled because the muscles that close the fingers are stronger than those that straighten them out. But it seemed as if she was reaching to pick up a hairbrush. I held her hand, and she held mine. This hand had held other hands. These fingers had written shopping lists, and dried children’s tears. I straightened her hand to start work, and could feel resistance in her fingers. It was just rigor, but I felt as if she was squeezing my hand. She was giving me permission to learn from her and have this one last anatomy lesson.

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Image Credits:
Photo 1 via Flickr / zpeckler
Photo 2 via Flickr / aesop
Photo 3 via Flickr / TheKarenD

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Guest Blogger Profile:
REBECCA GERMAN is a professor of Physical Medicine and Rehabilitation and of Functional Anatomy and Evolution at the Johns Hopkins University School of Medicine. Primarily a biomedical researcher, she studies the potential interactions between biomechanics and neurophysiology, focusing on her lifelong fascination with how things work in the living world and the evolution of biological function. Her ultimate goals are to significantly enhance our knowledge of dysfunction as the basis for developing rehabilitation strategies, particularly for children.

Dr. German received a Senior Fulbright Fellowship to work at the University of Western Australia where she still holds a Visiting Senior Scholar appointment and returns as often as possible, to work with her favorite animals, marsupials.

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