Sunday, September 07, 2008

First Day of Anatomy Lab


This is our bag.

Meeting our first patient in the anatomy lab is a whole host of introductions that all happen at once.

It’s a presentation of the deep privilege given to the members of our profession - the license to carefully examine the parts of the body and their behaviors, which align to create a complete person.

It’s an introduction to the skills of handling a tray full of tools to delicately manipulate the body. A strange capacity that will allow some of us to remove deranged tissues, welcome new people that might not be able to safely leave the womb, and to allow others to have an active life after trauma. Others of us will never again spend so much time working with the insides of a person, but will regularly use the three-dimensional understanding of anatomical relationships assembled in lab for the diagnosis and treatment of disease.

Perhaps most stirring of these introductions, meeting our cadaver is also an intimate presentation of the end of life that comes for you and me. Who he once was is who we are now. Who he is now is what we all will be some day.

When I was working with a psychiatry study looking at civilian PTSD, one of the general health surveys we administered asked participants to rank on a scale the likelihood that their health would get worse. Not one person in a year of interviews said that they expected to lose their good health. Though many of us are not mindful of our ultimate end, our cadaver was more than capable of refreshing my perspective.

Unzipping the blue tarp bag with our gloved hands revealed a room-temperature, naked, elderly man. Since we were beginning with the back, our first act was not an incision. Instead, it took all four of the members of our lab group and our professor to work to turn our patient over. After this maneuver, we began our careful dissection of the skin, muscles, vasculature, nerves and connective tissue of his back.

When I worked in an urban hospital in Quito, Ecuador, I assisted in a number of minor surgeries and a few highly involved operations. At times I would have to sit down, step back, or even leave the operating room when a squeamish feeling creeped in. The doctors used to joke with me saying “tengas phobia?” or “are you scared?” At the time, feeling woozy seemed to be a pretty natural response to watching someone cut another person.

Last Friday though, I didn’t have a touch of phobia. I don’t think it will ever stop being strange to work in a room full of dead people, but a profound interest in the material grossly outweighed any reservation. Beyond interest or reservation though, one feeling dominated the complex mix of emotions I felt working in the lab last Friday. I’m so deeply thankful for the rare gift that our patient chose to give our class, and that he decided to be our introduction to this new life.