Thursday 6 November 2014

Medical School: A Survival Guide - Part 4

Apologies for the lateness of this post, what with being a whole week late. Last week was, if you happen to have forgotten because you're a loveless monster with no regard for happiness, Halloween; the best not-really-a-holiday of the year. Now I could do the usual "let's review a classic horror movie that's been done to death a million times over", but *sharp exhalation of breath indicating both exasperation and can't-be-fuckeditude*, so...nah. Instead, to commemorate the occasion, I thought I'd share with you some insider gossip on the creepiest and kookiest part of my course: anatomy dissection. It's quite a mysterious practice, not helped in any way by the small number of universities which actually have it available, so let me lead you through the strange world of cutting up dead folks.

rembrandt anatomy lesson 5 painting
Here be I demonstrating my prowess to a gathering of identical bearded clones.
Here's the obligatory links to parts 1, 2 and 3; let's do this.

Chapter 4 - Anatomy


A short disclaimer before we get started: because of the nature of dissection and the social stigma attached to death (it's usually considered a less than palatable subject), anatomy is a very closely legally guarded profession. As such, I won't be showing any real life gruesome pictures or sharing any personal anecdotes that might be construed as disrespectful or unprofessional; I don't want to get kicked out of medical school quite yet. I will instead be using carefully selected images from pop culture and presenting humorous hypothetical situations that in no way ever happened or ever will happen. Promise. 'Hem.

childrens halloween costume bloody surgeon saw
"It's my own blood, I swear."
With that out of the way, let me begin telling you all about the nasty things we do to your body once you've donated it to medical science. The first thing that happens to you (before we students ever get near your flesh) is the joyful experience of embalming, which involves having your blood sucked out and being soaked for a while in embalming fluid. If the atrocious film Unrest is to be believed, this is done by throwing you in a formaldehyde aquarium of nightmares and poking you with a harpoon.

unrest 2006 film horror formaldehyde tank hook
We'll assume so until proven otherwise.
There's two main chemicals used in UK practice nowadays: the more traditional formaldehyde (a classic, great for the kids) and the newer thiel method, of which Dundee, where I study, was actually one of the first places for it to be implemented. Yay! As a result I've had the lucky opportunity to work on both types, and they're equally as awful.

First, formaldehyde. You know jerky? The dried beef stuff? That's kind of what formaldehyde does to you; it's really not much more than a fancier kind of mummification.
beef jerky
More like mmmmmmm-ummification.
Formaldehyde cadavers are stiffer than a nun's upper lip, extremely dry, and flaky; which is brilliant for looking at organs in situ but terrible for actually getting an idea of what living insides are like. That's not even getting to the smell; it does weird things to you. Nothing's quite like the sickening sweetness of the stuff assaulting your nostrils while you're wrist deep in intestines inadvertently making you starving. For whatever reason, when exposed to it for extended periods of time, formaldehyde gives you a major case of the munchies; so you're standing over a corpse that looks like human-shaped gammon trying oh so hard not to drool into the body's abdominal cavity. It's a rather uncomfortable situation to be in.
hungry zombie eating flesh
Pictured: me after a particularly gruelling 2-hour dissection.
Thiel, on the other hand, has luckily removed the unfortunate gastronomic sequelae of its older sibling and replaced the stiffness with a much more suitable malleability which is great for looking particularly at muscles and the like. It does however result in a lot of the structural integrity of the body being compromised, so by the end of the approximately 9 months that you have the one cadaver, half of it has gone a little...soupy. Also, with pale white, slippery skin and a bloated appearance, they look unnervingly like the necromorphs in Dead Space.

dead space video game necromorph slasher
Hmmm...maybe not with the extra set of sword arms, though.
This is all just a technicality though; regardless of what it looks like, it's still a human being. That's what you're dealing with: real life dead people, which is probably the most interesting and difficult part of dissection, and what I'm going to focus the rest of the post on. Looking for juicy stories of that time a bit of fascia flew into my mouth or when I accidentally made the cadaver's hand grasp my dissection partner when working on the tendons in the arm or when I had to snap a collar bone with a pair of pliers? Tough shit. As I said before this is kind of a touchy subject what with it being actually about life and death, so I'm going to respectfully describe what it's like to work on someone who gave their life for you to learn. Or at least as respectful as I can be, what with just comparing the look of the bodies to petrol station snacks and video game monsters... Oops.
buttersafe i am not a clever man comic screenshot
What he said.
People dying is not a pleasant thing to happen; just ask anyone who's owned a hamster or a grandparent that they had to bury in the back garden in a shoebox. It's unpleasant, and as such most self-respecting people are likely to avoid its presence when at all possible. Anatomy sadly doesn't allow you that privilege, and the experience of being face to face with something which is so ingrained in our social conscience as taboo is disconcerting to say the least. When confronted with the remains of a human being and then being asked to cut it up, you have two choices as to how you can deal with that information: pretend it's a bit of meat, dehumanising the subject for the sake of your own sanity, or bite the bullet and suffer the emotional angst of knowing you're dissecting someone's gran.

Both of these are absolutely justifiable things to do, though; the first lets you focus on the work you're doing without getting spooked by what you're doing the work on, while the second one gives you the opportunity to learn about how you handle yourself around death respectfully and efficiently in a safe environment before you have to try it for real. Hell, you can even jump between the two, knuckling down to work and stepping back every so often to appreciate the bigger picture. Just try to keep it light; there's nothing worse than getting too serious, cause you'll undoubtedly end up building everything up in your head too much and have an awful time. Have a sense of humour, but keep it respectful.

hamlet horatio skull
That means no Hamlet.
Here's a few other things you can do to get to know your cadaver (who, for most people, is also your first ever patient, so it can be a big deal):

- Give them a name - cadavers hardly look human, especially by the time you've removed half their organs, so personifying your patient can help remind you why this pile of mush in front of you is at all related to learning about sick people. Plus it's nicer than calling it "It", or "The Thing", or any other 80's horror movie title. If you're lucky, your uni might actually give you information on the donor (usually not much more than name and cause of death), so you could even use their real name if you feel comfortable to do so.

- Talk to them - this can be weird, but if you and your dissection partners are open to experimentation, talking can really add a lot to the experience. Ask Jeremy (our hypothetical cadaver is called Jeremy) about his day; practice consent and patient autonomy by telling him what you're doing; whisper sweet nothings into his ear. It makes dissection feel like more of an interaction than it would otherwise be.

- Attend the memorial service - Most universities which offer anatomy dissection will also give you the chance, at the end of the year, to really thank the person who donated their body to your learning. This is usually in the form of a memorial service with the family members of the deceased and involves aaalllll of the emotions. It may be rough, but it's entirely worth it.

If you treat yourself and your cadaver right, then all you've left to do is actually know what the fuck it is you're meant to be learning. And that, my friends, is something no-one can help you with.

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