Today marked the third day of dissection. Every day, for the greater part of a month, we enter the gross anatomy lab at 8 am and spend the next two and a half hours palpating bodies, cutting through skin and subcutaneous fat, slicing fascia, probing superficial and deep muscle layers, and searching for nerves and blood vessels. We started with the back, a relatively impersonal region with well-defined, thick muscles. We then stayed with the donor prone, moving to the posterior upper and lower limbs during subsequent labs.
As expected, unexpected things have surprised me about anatomy lab.
Before our first day, our anatomy professor spoke briefly about the special (and privileged) experience we were about to undergo. It sounded almost sacrosanct: "You will remember where you were standing. You will remember where your lab partners were standing. You will remember the first cut."
Though I write with less than week between that first cut and me, what I can say is that that cut was not our first interaction with the cadavers--and it was also not the most memorable one. After we unzipped our body bag, we saw that our cadaver wasn't lying on its stomach, prepared for our incisions on its back. We would have to flip it. For several minutes, my labmates and I struggled to lift the heavy man--literally dead weight, and filled with gallons of embalming fluid--and carefully turn him onto his stomach. I grabbed a left arm, a left leg, to steady the body, and I felt slightly sick. Physically manipulating a dead body, feelings its contours, struggling with a rigid unmoving object, turned out to be much more crass and jarring than making restrained surgical incisions through his skin.
What I found throughout lab was that the worst, most disturbing moments were the most familiar ones--the ones when the body resembled a living human's. To position the arm for cutting, I had to twist it carefully. The elbow joint still worked, and the flexion resembled a living person's--not the stiff unbendable limb I had imagined. Brushing against the man's fingernails--grime still underneath them--was unpleasant in its familiarity. Seeing toughened skin and hair on the man's arms and legs gave me the same feeling.
It was the new, the unrecognizable, that unsettled me least. Never having seen anything beyond animal muscle, seeing human muscle and its surrounding fascia fascinated me. Pulling on a certain muscle to move the cadaver's thumb felt like a surreal version of a marionette--but still too unnatural to elicit a strong reaction. Cutting away human fat, an inherently unpleasant task due to its color and texture, only vaguely differed from cutting away animal fat during dinner. Rolling up the skin and subcutaneous fat like a carpet after we had removed it was still too far removed from reality to make me shudder.
Before I entered the laboratory, I was fairly certain that the experience would feel laden with emotion and that I would not be comfortable if my labmates treated the situation with anything other than intense seriousness Again, surprisingly, this attitude changed fairly quickly. I realized that "respect" didn't stem from how we felt or what we said--it came from our deeper attitude towards the task at hand.
What would I want if I donated my own body to science? What would upset me? What would satisfy me? I can't presume to know the donors' motives, but I can say that my own would be to teach someone something unique. I wouldn't particularly care whether students put on a--perhaps artificial--air of solemnity during dissection. I would rather they treat my body as a specimen, something they could learn a whole lot from. The worst form of disrespect, in my view then, would be wastage--students rushing through procedures, not being prepared to identify structures, and worst of all, not caring about what was in front of them.
To help further classify my feelings, I divided them into several categories: 1) unpleasantness from something that would disturb me if seen on a living person, 2) unpleasantness from something that reminded me of death but wasn't directly related to the body's appearance, and 3) unpleasantness stemming from the appearance of the body itself. I believe only category 3 is particularly sad and something I would like to lessen.
These classifications have helped me hone my idea of "respect" for the cadavers. Our instructors talked quite a bit beforehand about this concept. We were told not to give them names (they already have names; we just don't know them). We were told nothing of their age or cause of death. (There are many arguments about whether this dehumanizes the cadavers or protects their status and anonymity.)
Today, when we palpated the gluteal muscles, feces emerged from the cadaver's anus. This happens sometimes, and it's not particularly common or uncommon. Should I feel embarrassed that I was thoroughly disgusted? I certainly would feel about the same way about a living person, and I'm not ashamed to admit it. It is really any more respectful, then, to hide a feeling of disgust when the subject happens to be dead? (This falls into category 1 of aforementioned unpleasantness.)
Similarly, I was fairly horrified the first time I held the cadaver's cold hand for an extended period of time. Probing my feeling, I found that it wasn't the hand itself that repulsed me; it was that it very explicitly symbolized death. It was inhuman. This, also, I don't feel is particularly disrespectful--to have a visceral reaction against death. (Category 2 of unpleasantness.)
What about making small jokes, at no one's expense (including, and especially, the cadaver's)? I surprised myself by laughing during lab. When we dissected down to the trapezius muscles, I mentioned that it was cool to see the muscles that felt so good when they were massaged. My labmate gently squeezed them and said, "Yeah, it's like he's getting a really deep massage." It felt okay.
So what wouldn't I want if I donated my body to science? It's not an easy question to answer. Clearly, we want our sacrifice to be taken seriously--though not to the extent that emotion renders us less effective learners. I realized that I would be bothered if people were disgusted by my remains. Not of my feces, not of my cold hand, but of the natural processes that my body undergoes as a result of being dead--that is, category 3.
It would sadden me, for instance, if someone saw my long toenails, or squished backside, or flaking skin, and as a result, saw me as less than human. I don't mind if people see my feces as disgusting, or as death itself as disgusting. I suppose I do mind if people see what I've contributed as repulsive. It's a dehumanizing feeling--to repulse someone--and it would put me on a separate plane from my dissectors. We are no longer the same species; I am alien. They cannot see themselves in me. Understandable, of course, but sad nonetheless.
Tomorrow we dissect at 8 am. It may be serious, but hopefully not too serious. It may be enjoyable, but hopefully not distracting from all we need to accomplish. It may even be disgusting--but hopefully for "better" reasons.