• Choose a category
• All
• Classic-Fiction

By Root 974 0

this dissection, I need to think more like a pharmacist, I tell myself. I need to see like a pharmacist. I also have to remember that being a pharmacist does not necessarily mean working at a Walgreens, Duane Reade, or Rexall. While some of these young people plan to become traditional community pharmacists, working at a neighborhood drugstore (or, as in the less traditional case of Andy and Wilson, opening their own), many will use their degrees as stepping-stones to larger plans. Stephen wants to go into drug development and join a major pharmaceutical company. Amy, on the other hand, is simultaneously earning a master’s in public health and hopes to work for the FDA. Theresa, who already has a master’s in criminology, plans to specialize in forensic pharmacology. Her entire focus will be to determine when drugs are a cause of death, whereas Miriam, who intends to become a clinical pharmacist, will work in a hospital as part of a surgical team. To all of these students, wherever a pharmacy degree may take them, this dissection will form the bedrock of their future work. The alimentary canal is, after all, the route traveled by every pill, tablet, capsule, elixir, syrup, or substance that can be swallowed, and knowing this part of the body backward and forward is essential to understanding how drugs are absorbed, dispersed, metabolized, and eliminated.

Back at my table, Massoud and the others are stuck in the mass of confusion known as the small intestine. Gray describes this part of our anatomy as “a convoluted tube,” as if he, too, had gotten lost here once or twice. The group backtracks to the stomach and begins again. It is easy to find the first part of the small intestine, the duodenum, because it is the first ten inches (twenty-five and a half centimeters) off of the stomach. (Duodenum comes from the medieval phrase meaning “intestine of twelve fingerbreadths.”) Here is where most ulcers occur. The remaining nineteen or so feet (six meters) of the small intestine is composed of, first, the jejunum, followed by the ileum, which eventually leads into the large intestine. Had we tipped our cadaver to the side, the intestines would not have just poured out, and neither could we have simply pulled them out, foot by foot, the way you see in gory movies. Connective tissue keeps the twisting mass contained in the abdominal cavity but able to roil freely during the digestive process.

The large intestine, about five feet (one and a half meters) in length, frames the small intestine on three sides and comes in four main sections: the ascending colon up the right shank; the transverse colon across the abdomen at the level of the bottommost rib; and the descending colon down the left, which then turns into the S-shaped sigmoid colon and feeds into the rectum. By any name, bowels are bowels and unbeautiful, but serve a necessary purpose. Within these coils is where water is extracted from what has been digested and what remains is turned into what will be flushed.

“Oh, Bill, did you see this?” Miriam asks, nudging a pinkie-sized flap of tissue that, in fact, I had not noticed.

“The appendix,” she says at the same moment I recognize it.

I love it when an anatomical term comes with a built-in mnemonic. True to its name, the appendix is appended to a corner of the large intestine. A handbreadth away is an organ that’s completely unmissable, the liver, filling the upper right abdominal cavity. Whether viewed in situ or displayed on a specimen tray, the liver is an impressive sight, large and smooth, with perfect lines and a broad surface. It almost looks sculptural. One can see why early philosophers and physicians were fooled by its appearance. Plato, in a dialogue on natural science and cosmology from the fourth century B.C., asserted that the liver played a key role in the maintenance of the soul by keeping the organs of the abdomen in line. The liver did this through its smooth, shiny surface, which reflected images sent from the “divine psyche,” the immortal source of rationality housed in the head. Six centuries later,