The Anatomist - Bill Hayes [41]
We have to perform a blunt dissection, meaning that the focus is on the destination, not the getting-there. All that’s required is a large scalpel blade, a deep breath, and an extra-deep cut. It takes half a minute, maybe less. For this particular dissection, you just slice straight across the crease at the crook of the arm (you being me, in this case, with Kristen, Sam, Kelly, and Cheyenne looking on), then make small perpendicular incisions at either end, peel back the flesh, and—
“Wow.”
The five of us are a choral group of exclamation, though we know only one song. We sing it again: Wow.
Peeking through the crevice of mud-colored flesh is a glint of ivory, our truck driver’s elbow joint, our destination. I finger away the fascia till the joint capsule is fully exposed, then snip away its papery protective membrane.
Even in a long-dead body, a joint remains a thing of beauty. It is smooth and shiny and still gleams with synovial fluid, the clear substance that keeps the joint lubricated or, if you will, greased. In Gray’s Anatomy, Henry Gray describes synovial fluid as “glairy, like the white of an egg,” and “having a slightly saline taste,” a phrase that begs a question that is perhaps best left unanswered: did he actually put a dab on his tongue?
I take a step back as my lab mates take turns digging a little farther, exposing the three long bones that meet, or “articulate,” here at the elbow: the humerus, the single bone of the upper arm; and the radius and ulna, the two bones of the forearm. Like all joints in the skeletal system, the elbow joint is not a part per se but a place where parts come together. However, unlike the simple hinge of a knuckle joint, for example, the elbow joint is tripartite, a three-way intersection of bone. Here, the radius and ulna articulate with each other and, separately, sometimes simultaneously, with the humerus.
A joint is usually powered by muscle and nerves. This one is powered by Kelly. She pronates the cadaver’s arm, and we are all floored.
Pronating is rotating the forearm so that a palm facing upward turns downward. A person does this countless times in a day without a moment’s thought, as when you turn your hand over to look at your wristwatch. Yet, seeing the inner workings of this simple act is nothing short of profound. Kelly turns the arm again. In a single, perfect movement, the head of the radius spins in place on the humerus while the shaft rolls over the ulna. They return just as gracefully to their side-by-side position during supination, the reverse action, which again turns the palm upward. That a bit of life seems to linger in this dead body is surprisingly unghoulish.
We all take a turn, rotating the arm as well as flexing it in a modified biceps curl. Just making the movement occur, though, is not enough. Each of us is compelled to place a gloved finger directly in the elbow joint as the bones twirl and glide, to feel what can only be felt from the inside: movement at its source.
Dr. Topp, overhearing our excitement, comes to take a look. “Even after all these years,” she leans in to me and says, “I still find that really cool, too.”
I look around and see jaws dropping at every table. Celeste and her group have exposed the shoulder joint, a ball-and-socket that has pulled them into its rotation. One table down, it is circumduction of the wrist. Two over, it is pronation of the opposite forearm, the elbow dance in reverse. Students stroll around the room, table to table, watching, making, and feeling the movements. Everyone here, the living and the dead alike, has become a demonstrator of anatomy.
IF NOT IN the classroom demonstrating, he might be found in the lab dissecting. And if not in the lab, then at the hospital, whether in surgery or in the morgue or in the Dead House, or maybe in