The Anatomist - Bill Hayes [102]
I slip away to take a last walk around the lab. In one of the back corners, I meet a fourth-year med student, Barry, whom I’ve never seen here before. Barry, the kind of heavyset, apple-cheeked guy you might call roly-poly, explains that he is doing a monthlong elective in dissection as preparation for his upcoming surgery internship. Splayed out before Barry, who’s seated on a low stool, is the upper half of a cadaver, transected at the waistline. He has slit open the abdominal cavity, revealing half the stomach, the small intestines, and half the liver. At this moment, he is examining the ducts of the gallbladder. “Getting some practice,” Barry tells me. “I’m planning on being a general surgeon, and taking out gallbladders is your bread and butter.”
Something about his food metaphor doesn’t quite sit well with me, given the gruesome sight laid out before him, but I know what he means. “Of course,” Barry adds, “in the OR, it won’t be anything like this. With laparoscopic surgery—which is how gallbladder surgery and a lot of procedures are now performed—you don’t need to cut open the whole abdomen. You just make tiny incisions into the stomach, thread in the cameras, snip out the organ, and you’re done.” Barry glances at the disemboweled cadaver with a rueful look. “Hardly ever see things like this nowadays. In fact,” he points out, “transplant and heart surgeries are some of the only times you’ll ever open up a body like this.”
I ask if he remembers learning a lot in his first-year gross anatomy course.
“Well, the thing is, you don’t really learn it till you have to use it. Before that, you’re just memorizing great bodies of information without being able to apply it—”
“But that’s not all that studying anatomy is about,” I counter, a bit more emphatically than I had intended.
“Yeah, true, there’s a ‘rite of passage’ to it—going through someone’s body with your hands. Your own two hands. Almost a ceremonial aspect to it.” Hundreds of years ago, he adds, they didn’t even wear gloves. “Students had to dissect bare-handed.”
“Well, I’m glad I missed that era,” I admit. As for Barry, he doesn’t look quite so sure.
I cross to the other end of the lab, where Matt, a classmate who’d worked at table number 22, is studying by himself with a lower limb prosection. I ask Matt how the class had gone for him.
“Fine, I think I’ve done all right,” he answers reflexively, then pauses and gives it more thought. “It’s amazing you can get into medical school and not know what side of the body the liver’s on,” he says—by “you,” clearly meaning himself. “Or how big the lungs are—”
“But now you do,” I say.
“Yep.” Matt, blond and blue-eyed, the epitome of a midwestern all-American boy, shakes his head sheepishly. “And now I know, if someone has a pain on this side”—he jabs at the left of his stomach—“well, it sure isn’t appendicitis.”
I ask him what kind of medicine he’s planning to study.
“Pediatrics, probably.” He glances down at the prosection. “Definitely not surgery.”
I wish him luck and go over to the sink to wash up. All around me, from every corner of the room, I hear the sound of teaching, the clear, impassioned voices of the instructors and TAs: “The radial artery goes through the snuff box and gives rise to the…” “Also, your thenar eminence performs this motion….” “There are eighteen intrinsic muscles of the hand, but they’re in groups, so they’re easy to…” “What’s the mnemonic for the rotator cuff? Right, SITS….”
And rising above the clatter of voices, I hear the distinctive sound of my first anatomy instructor, Dana, the passionate anti-mnemonicist: “‘Why?’ Well, first of all, you can’t ask why,” she is saying in a high-pitched stampede. “It just is. That’s how we’re made, but…”
Smiling, I head for the back corner to retrieve my bag. Just as I am gathering up my stuff to leave, a group of students converges around table number 24. “Okay, now the three muscles that attach here at the pes anserinus?” the TA asks them, pointing to the knee dissection I had performed.
“Sartorius, gracilis, and biceps femoris,” I