The Anatomist - Bill Hayes [33]
Kelly returns to the table with a rectangle of thick gauze, which, in a respectful gesture, she places over the cadaver’s genitals. Sam begins to read aloud from the lab guide. The main assignment for the week is to study the muscles of the upper body, but, first things first, we have to strip the torso of its skin and underlying fat. Step one: remove the skin from the chest.
Taking the lead, Kristen, positioned on the right side of the body, makes a crosswise incision from the top of the sternum to the small bump of bone where the shoulder blade meets the collarbone, the acromion process. (Every one of our body’s “bumps,” as the art student had referred to them—or processes, as they are technically called—has a name.) Without a word, she hands the scalpel over to Sam, who makes an identical cut on the left side. Sam passes it to Kelly. She slices straight down the middle of the chest to the naval, and Cheyenne continues with a cut to the outer right side of the abdomen. Next is my turn, which, for me personally, is a major milestone. This will be my first incision.
Wanting to get a better feel for how Gray and Carter had jointly performed the dissections for Gray’s Anatomy, I had asked Dr. Topp earlier if I might participate, not just observe, during lab. “Well, that’s a first,” she had responded with a warm laugh, noting that she typically gets the opposite request, students asking to be excused from dissecting. She said I was welcome to take part but reminded me that the PT students would be graded on their dissecting skills. I promised not to ruin anyone’s GPA.
The blade’s tip sinks easily into the skin and meets no resistance as I pull it across the cadaver’s abdomen; it feels as if I am slicing a soft piece of leather. I’d feared that I might cut too deep and damage underlying muscle, but in my cautiousness, I only give the cadaver the equivalent of an eight-inch paper cut. I retrace my line, then set down the scalpel. Though it is only ten after nine, Kristen, Kelly, Cheyenne, Sam, and I have already become a team.
With the double doors incised, we now have to pry them open, then off. Working in rotating pairs on each side of the body, one person grasps a tiny corner of skin with forceps and lifts while a partner slices the underlying fascia—connective tissue—with a scalpel. To do it cleanly is slow, painstaking work. When on scalpel duty, I find that using a gentle sweeping motion, as if wielding a miniature scythe, works best. Another helpful tip comes courtesy of the lab guide: after you have peeled back several inches, make a buttonhole in the skin—yes, that’s the word used—and hook your finger through it; this allows a better grip than with forceps. One thing I will not soon forget is the sound of skin being pulled off, a tearing sound, like old Con-Tact paper being torn from a shelf. With the removal of the skin, what remains on the torso is a lumpy coating of bright yellow fat. It does not just scoop off; it has to be either cut or plucked away with tweezers. Along with the fat, we carefully remove all of the cadaver’s breast tissue.
The atmosphere in the lab is very different from the pharmacy class, which often had a jovial buzz. There is no chattering here, no laughter. If anyone is squeamish, they are doing a good job of keeping it to themselves. But I do hear lots of sniffles, and at my table, everyone is teary-eyed, as if listening to Sarah McLachlan on an endless loop. This is the classic reaction to formaldehyde fumes. The farther we get into the cadaver, the harsher the smell.
Once the front of the torso is skinned and defatted, the musculature is exposed from the collar to the waist. We now must do the same to the back. The body is a good 170 pounds and the very definition of deadweight.