The Anatomist - Bill Hayes [22]
“Imagine we’re all sitting inside the abdominal cavity,” Dhillon began, sweeping his hands to indicate the entire rounded lecture hall. “See the slide projector up on the back wall there?” Everyone turned in their seats. “That is the belly button.” This got some chuckles. “The chalkboard behind me here is the vertebral column, the ceiling’s the diaphragm, the floor is the pelvic…what? Anyone?”
“Floor,” someone answered.
“Yes, the pelvic floor, very good, which keeps the poop from falling out.” Speaking above the boom of laughter, Dhillon added with faux grandeur, “Now, imagine that I”—he patted his generous belly—“I am the stomach!”
Next, he selected his cast of abdominal viscera and, one by one, positioned each in relation to himself: Gergen, the beefiest guy in the room, became the biggest organ, the liver, just to his right. (Someone gave Gergen a backpack to hold as a gallbladder.) Baby-faced Dan, tall and thin and sweet, became the pancreas and stood directly behind the stomach and next to the spleen, Denise, who peeked out from Dhillon’s left side. Right behind everyone, the inseparable gay couple, Andy and Wilson, held hands. They were the kidneys. By this point, the cluster looked like the world’s most awkward group hug, but Dhillon had just gotten started. Between the pancreas and the liver, he positioned the aorta (Amy) and vena cava (Ming), then added the ten different sections of the intestines, anus included, even though it’s technically not in the abdominal cavity (all the students in the second row were enlisted for this). Finally, he squeezed in the many interconnecting ligaments and membranes that keep all the abdominal structures stable. Spread arms and fingers worked this visual magic.
By the time Dhillon had finished, the cast of twenty-five had become a wriggling mass of simulated digestion. Somewhere in the back right, I could hear the spleen giggling.
Twenty minutes later and twelve floors up, in the lab, a dramatic scene, wardrobe, and mood change has taken place: Massoud removes the thick sheaf of abdominal muscles from our cadaver, and I, standing between him and Miriam, have rarely ever been so repulsed in my life. Lying exposed is a mass of glistening, fat-laden tissue that covers the entire abdominal cavity. This thick membrane is called the greater omentum (or, “large apron”), something I had not previously known existed. In our cadaver, it looks and smells like a rotten jellyfish. What lies underneath is grimmer.
Miriam begins by cutting open the stomach, which is not in the center of the belly, as I would have assumed, but tucked under the lower left ribs. She then reaches in, as if feeling for change at the bottom of a purse, and discovers a bolus of undigested food—meaning, this person had died soon after eating. This is the tipping point for me. My insides churn, the very definition of a visceral reaction, and I excuse myself from the table.
I am standing by the window taking in some fresh air when a squeal from the far corner of the room pulls me in that direction. Stephen and his partners have opened a gallbladder and found gallstones. “Here, Bill, do you want to feel one?” he offers.
Before I know it, I am rolling between my fingers what looks and feels like a black marble. This is cholesterol, calcified and mixed with bile pigment. These things can cause a lot of pain when they obstruct the flow of bile from the gallbladder. What’s more, people who have gallstones almost certainly have plaque-lined arteries, which is exactly the kind of life-threatening condition that can be treated by prescription drugs, in this case. No wonder Stephen, this aspiring pharmacist, is so fascinated. I tip the gallstone back into Stephen’s palm, thanking him for sharing.
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