The Anatomist - Bill Hayes [6]
Peering down, I can see why the thorax was once known as the “pantry” of the body. It is a deep, squarish cavity packed full of various objects, one of which Gergen must now remove: a lung. He slips his left hand into the cavity and feels for “the root of the lung,” a short, fat tube that is not at the bottom of the lung, as one might imagine a root should be, but toward the top, connecting it to the windpipe. “Now what?” Gergen asks.
Laura, who is as small and slim as Gergen is large, scrambles to find the next instruction. “Let’s see here—‘Cut through the root of the lung superiorly and continue inferiorly through the pulmonary ligament.’”
“Translation?”
“Top to bottom—slice it off—I think.”
Although Gergen does the actual cutting, the rest of us, in spirit at least, help him hold the scalpel steady: Laura, Amy, Miriam, and Massoud are the fingers folded in around him, and I, opposite them, am the thumb. Gergen then steps back, indicating to Laura that she may do the honors. Biting her lower lip, she reaches into the thoracic cavity and, after a little tugging, frees the right lung. The size of a wadded-up T-shirt, it looks like a wet mound of gray taffeta. All six of us wear identical triumphant smiles, as if we have delivered a baby.
But it turns out our baby is ugly. Dr. Rohde returns and points out that the cut was “too lateral,” which means the bronchus (an offshoot of the windpipe) is not clearly exposed. But she immediately tries to reassure us. “The only way you learn is by doing it, by making mistakes. Anyway, there are a lot of bodies here to look at, and, luckily, you’re not being graded on your surgical skills.”
Before moving on to the next table, Dana instructs us on the next task: resection of a half-foot-long section of the phrenic nerve, a narrow fiber running through the thorax, a portion of which is visible now that the right lung is out of the way. Explaining the nerve’s primary function in the living, she breaks it down in simple terms: “If it’s damaged, you can’t breathe.” Likewise, if you sever your spinal cord above the level of the phrenic, she adds, you lose all use of this nerve. “That’s what happened to the actor Christopher Reeve, which is why he had to spend the rest of his life on a ventilator.”
At this moment, everyone at our table is having the same illogical reaction: terror that we might render our dead body a quadriplegic. It is halfway through our first three-hour lab, and none of us feels any detachment whatsoever.
Massoud, taking over from Gergen, does not wear the expression of a lucky man, and yet the opportunity before him—to dissect and, yes, even make mistakes—truly is a privilege. To put this into perspective, Hippocrates, the “Father of Medicine,” for instance, never dissected a human body because the practice was forbidden in ancient Greek society. Aristotle, too, never broke this taboo, and, jumping ahead to the second century A.D., neither did the revered Greek physician Galen. Galen, whose writings remained medical gospel for fourteen hundred years after his death, had gained his knowledge of anatomy from dissecting pigs and cats. Brilliant but mistaken, he believed that animal and human anatomy were often interchangeable. And like a dropped figure in a checkbook registry, this error only compounded with time.
Human dissection continued to be forbidden in virtually every society on through the Middle Ages. Not that it was not done, I’d wager—the dead body of a stranger surely must have proved too tempting for some unscrupulous practitioners—but how would you share your findings without implicating yourself? In parts of Europe, even dissection of animals eventually fell into disrepute because of its association with sorcery. In the year 1240, however, a radical change in policy took effect. Frederick II, emperor of the Holy Roman Empire, decreed that, for the sake of public health and the training of better doctors, at least one human body would be dissected in his kingdom every five years. For this