The Anatomist - Bill Hayes [34]
Though we have gotten our skinning technique down, the rear torso proves difficult because there is less subdermal fat and the skin is more tightly enmeshed with the muscles of the back. The skin comes off in pieces, not panels. Ninety minutes later, though, our cadaver shows an impressive-looking vest of musculature, and all we have left to do is clean up our table. But this raises a somewhat uncomfortable question. As Kelly bluntly puts it, gesturing to the pieces piled on paper towels, “What do we do with all this skin?”
The short answer is, we throw it away, and I cannot help recalling how troubling this had been for one of the pharmacy students, a young man named Edo. After the second lab, as he and I left the building together, Edo had something of a meltdown. “We’re just tossing out parts of a human being,” he said. “Into a wastebasket!” He seemed in shock at what he had been party to. “It just feels wrong. That’s going to be us someday.” I understood what he meant. And yet, as I told him, I think there’s another way to look at it. Aren’t we treating the body with respect by using it for its intended purpose—to learn—and shouldn’t properly disposing of the remains be part of the ritual?
I point out to Kelly the large red medical waste receptacles placed throughout the lab. “We put it all in those,” I tell her and the others, “—skin, fat, anything from the body.” The material is saved and later cremated along with the cadaver. At the end of the academic year, the school holds a memorial service in tribute to those who gave their bodies to the program.
Kelly nods thoughtfully. “I’ll take care of it,” she says. The rest of us divvy up the remaining housekeeping duties, and, soon after noon, day one comes to a close.
The physical therapy class is small enough that, by the second lab the next morning, I’ve had a chance to meet all of the students. I am surprised by the range of specialties my fellow dissectors are considering once they have earned their PT degrees. Some, including Sam, plan to go into sports medicine, helping athletes get back in the game after career-threatening injuries, while another few, Cheyenne among them, are interested in working with individuals who require a much longer and more gradual course of rehabilitative therapy, such as victims of stroke or spinal cord injury. Kelly and a few other students plan to specialize in postsurgical PT, helping patients recover from mastectomies, for example, in which the loss of tissue and muscle requires relearning basic movements. One woman told me she hopes to work with pediatric patients, another with the elderly.
Whatever their chosen field, working with muscles is in all of their futures—and the body has some 650 to study. Today, we have to identify just 15, the major muscles of the back and shoulder, which, in the abstract, sounds quick and simple, but in reality, not so much. What makes it challenging is that musculature in an actual body rarely looks like musculature in an anatomical illustration, where each muscle is helpfully differentiated with shading and texturing. In the body, individual muscles often lie or fold so closely together that it is hard to tell where one stops and another begins. To identify them, we will need to find what look like seams between the muscles—“fascial planes,” these are called—and tease them apart with our fingers.
Our group is luckier than most, for our cadaver has an unmissable trapezius, the diamond-shaped muscle extending from the very top of the neck to the middle of the back and from shoulder to shoulder. It is so large and well developed, in fact, that the five of us wonder aloud what this woman could have done for a living.
“Probably a nurse,” offers Kristen, “you know, having to lift patients—”
“No, I’ll bet she was a truck driver,” muses Cheyenne in her Fargo accent.
“Yeah, a truck driver,” Kelly agrees, “and that might explain the stroke: too much fast food.