Scrub Burning (or: 10 Things I Learned in Dissection)
There are some smells that haunt you forever. For my third trimester classmates and I, one of those smells is the rather pungent eau de cadaver.
Last October I excitedly wrote about our first day of human cadaver dissection in the Gross Anatomy lab. This week we completed our final lab, dissecting structures deep within the head. Yes, it is a gruesome task by any normal standards. A year ago we kept the head covered during all our dissections, exposing only what we needed to see. Over time, though, most of us have become accustomed to the bodies and acclimated to the work. In consideration to my dad and others averse to gore, I will not write them down here, but ask any chiropractic student and they are sure to have some anatomy stories with great shock value.
Nonetheless, the whole class will celebrate when we finish exams this trimester and put away our scalpels for the remainder of our time in school. We already have a venue booked for the customary scrub burning bonfire. But taking a look back at our work- we have dissected every region of the body now- our year of cadaver lab is a contender for the most relevant experience we will have outside a clinic. Let me share a few insights…
1. It’s a system
Looking at the end product of human growth and development looks pretty random. Look at your forearm and see the net-like pattern of blood vessels. Imagine how many nerves it takes to control the 650 or so muscles in your body. Take a look at the dozens of ridges and holes of the skull.
Now know that every person on earth possesses more or less the same pattern of structures. There is variation between every body, certainly, but the general template is the same, so we can predict where to find even the tiniest nerve even before the surrounding tissues have been separated. How crazy is that?!
2. Get first choice on bodies. Medium sized is easiest.
3. A tight fit
Everyone studies anatomy at some point. I remember studying the digestive system with Mrs. Mason back in second grade. In undergrad at the University of New Hampshire, I even went into great detail regarding the musculoskeletal system and cardiopulmonary system. But looking at these systems individually, you don’t realize their relationships with each other.
I do not think I ever realized how TIGHTLY all our systems and organs are packed together. For example, the spinal column occupies a huge amount of space within the torso. In the throat, swallowed food practically bumps up on each vertebra in passing. Nerves as thick as your thumb pass between muscles, and muscles run around, beside, and even through each other. It’s nice and compact, but it is also easy to see how these close relationships can become clinically significant if anything goes wrong.
4. YES THAT’S GAS, DON’T POKE THE COLON.
5. Shares well with others
Like living in college dorms, this close proximity means not much stays private. Far from the compartmentalization you might imagine walls create, organs have an influence on their neighbors simply by being together. Tissues near the gall bladder were nearly always dyed green from the permeation of bile compounds (secreted into the intestines during digestion)- even when those tissues were completely unrelated to gall bladder function. This is not inherently a problem, but it does mean that pathology of one tissue will affect others locally. During irritation of any organ, then, the hormones and other biochemicals associated with inflammation will creep into other local tissues, nerves, skin, etc. and have an irritating influence there as well.
6. The student with the pointy probe will poke the colon.
7. Sticking together
In the past I heard chiropractors, athletic trainers, physical therapists, and other health professionals mention problems with scar tissue, but a dramatic example in one of the cadavers brought that concept to life for me (that’s about the only thing you want coming to life in a cadaver lab). The individual had evidence of chronic inflammation in the blood vessels and lymph nodes of his neck, and extracting any meaningful structure was rather difficult- all of the vessels, nerves, and muscles were thoroughly knotted together in an abnormal mass of scar tissue, often called an adhesion.
I think that understanding the functional results of adhesions is hugely important to patients, as this individual probably would have experienced considerable neck pain or muscle weakness from the muscles and nerves being unable to slide past each other during neck movement. Working early on to reduce the irritation or injury that caused this adhesive scarring could have improved his quality of life.
8. Even small structures are surprisingly tough. Until you start relying on them to survive as you frustratedly search for the external laryngeal nerve.
Despite a certain level of predictability to each individual’s anatomy, each cadaver certainly had its own personality. Some bodies were skinny, while some provided bags of fat to their dissecting groups. Others could provide perfect examples of every well-developed muscle. My group’s body had textbook nerves, but every vascular anomaly possible. Even after death, it gave each person personality and individuality. All of these changes are a testament to the human body’s ability to adapt to new activities, challenges, lifestyles, pathologies, and environments. Obviously, I am more than a little enamored.
10. Yes, I actually like dissecting.
(Oh, and by the way, nobody has thrown up yet.)
Many thanks to the individuals and families who make the dissection experience possible for health students. You can learn more at the page for NYCC’s Anatomical Gift Program. If you have tips I missed, post them below!