Anatomy Summer Special

Image courtesy of http://www.tokiococo.com/gallery/lifedrawing/portfolio_arm&hand.jpg

Please let me know if these posts, about my years studying anatomy, are inappropriate or too detailed. I know that in the general/lay public there may be a clinical, non-human view of research. In writing these posts I hope to give you an insight into the student and researcher's viewpoint, and to remind ourselves that we are all human, and that the human body, in all its various forms is special, if not sacred.

Since studying anatomy, I've never looked at margarine or butter in the same way again. Read on and you'll learn why.

As a third year anatomy student I was asked to participate in a summer dissection class. Only invited students, that is, those who received the highest marks in their end-of-year exams, were given a part of a person to dissect, a person who had kindly, unselfishly recently donated their body for study and research. In making my decision about what part of the human form I wished to study closely, I definitely did not want the head (if you read my recent post on this, you will understand why). The lower limbs would have been too cumbersome to manouvre; I thought the rowers of our study group would manage these better than I. So, the upper limb it was for me.

In preparation for the day, we were asked to bring in gloves (not our usual surgical gloves, but the thick dishwashing variety that have extra grip) and lots and lots of absorbent towels. Of course from previous tutorials where we studied various parts of a cadaver there was absolutely no blood. I wondered what the thick towels would be for and figured that they may be for drying our hands post-dissection. Was I in for a shock.

That morning I was quite nervous. I tried to imagine having somebody's arm, from armpit to fingertip, in front of me, this arm that was with this person their whole life. It fed them, brushed their hair, held their children, embraced and caressed its loved ones, it signed mortagage papers, and of course, signed its own destiny to our anatomy lab.

I finally entered the cool lab and sat in my usual place at the stainless steel, raised-edge table in which a V-shape formed at its centre. I kept asking myself why I had agreed to this? I had studied pre-dissected limbs, and yes they were maybe a decade old and overly dry, and discoloured, and probably inaccurate with overuse rendering a few nerves loose. And, they no longer resembled a human form. I tried to convince myself that in doing this dissection I would see accurate blood and nerve supply. But, I still questioned what I was doing there. It was too late to back out, however.

Looking at a left arm before me, starting at its finger tips, I noticed a groove in the fourth finger that for years must have housed a wedding ring. This groove was whiter and narrower than the surrounding skin. The colourless, lifeless nails were long and had been carfully manicured into an almond-shape. I guessed this must have been the arm of a woman. Moving up to the back of a plump, freckled hand I noticed that she must have been quite a large lady. Further inspection of the upper arm and my suspicion was confirmed. She was a really large lady.

We were then instructed to start at the excision surface (that is, near where the breast would have started, called the mammary tail) and to work our way through to the nerves that lay beneath. I was specifically informed that the Anatomy Museum was short of a specimen of the nerves that supply the whole arm. This not only meant I had to start the dissection through the skin directly in the arm pit to ensure as little cutting action as possible, but I had to be extra vigilant not to make the slightest mistake. There was a donor, maybe, every one or two years and I was not about to stuff this up.

Upon turning the limb I noticed a five o'clock shadow where the armpit must have been shaven, and also, a mole as big as a lentil on the outer edge of this shadow. I imagined how many times the lady must have nicked herself shaving as a result of this mole. This made the whole task even more poignant and I knew I had to take care, to respect, regardless of whether or not I was going to have my name displayed on the front of a perspex jar that would hold this specimen.

Whilst trying to expose the nerves I had to hold back the protective flaps of skin and excess fat that had formed a roof over these nerves. This was when the thick, ribbed, rubber gloves had to be used. In pulling those very thick, taute flaps of skin back, what I can only describe as a bubbly butter-like liquid oozed through my gloved fingers. Sensing a rising nausea, I just told myself to focus on the cells, the cells and to forget the whole picture. I kept thinking about the cells and how the cell membranes must have broken down sufficiently to allow this fat to escape. I then realised what the thick disposable towels were for and quickly made use of them to absorb the yellow liquid.

The rest of the dissection flowed smoothly and took me nearly a week to finish. By the end, I was glad and proud to have taken on this task despite my initial misgivings. We discovered that this person's forearm revealed some very unusual anatomy near the wrist- an artery had pierced a major nerve to the extent that the lecturer questioned its function in life. Did this person experience incessant pain, discomfort or weakness? Did they notice anything unusual about their arm at all? Further, how was this person to know that their arm would be examined and studied by generations of doctors, surgeons and anatomists for decades to come?

Sometimes, when I get a flick of discomfort or an odd sudden burst of pain, I wonder whether that part of my anatomy is atypical, an anomaly, and I wonder what someone someday may discover.

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