Traumatic Cuts

There are specific points of our dissections that prove to be very traumatic to our cadavers.  The ones I've witnessed and/or performed in so far include:

1) The first incision.  Even if the patient (we call the cadavers "patients" because they really are serving as our first patients) had gotten surgery during their lifetime, the medical student's first incision is usually the first time this person's body is cut open for someone else's benefit.  It's the start of the student's journey to knowledge, and at the same time it is the beginning of a very traumatic series of events for this body.

2) Opening the thoracic cage. This is the ribcage, which protects important stuff like your heart, lungs, liver, and major blood vessels. I would spare the queasy reader from a detailed account of the method which we employ, but this is after all a first-year medical student's blog, and I think I would be cheating the non-queasy readers if I omitted those gory details.  So I will outline the procedure, and if it makes you uneasy (I won't make fun of you!) you can feel free to skip over it.  I'll put it in a different color, even, so it's obvious when the gruesome stuff is past.

When we were finished checking out the surface anatomy, finding the various muscles, the arteries and veins, and the ribs, we called over our instructor to get started on the thoracic cage.  He told one of us to go grab the oscillating saw. Oscillating saw? Sure. Easy enough.  Consider it grabbed. He then plugged it in and flipped it on.  It was considerably louder than my scalpel. He handed it to us and said, "Go ahead, whenever you're ready."  Ready?  To slice open some guy's ribcage?  But an instant later, the deed was done. Ribs sliced. Cage open.  Lungs, heart, aorta, all exposed, for the very first time in their 75 years of existence, blinking in the bright sunlight filtering in through the lab's giant windows. 

So, queasy folks, welcome back.  Haha, just kidding, I know you really snuck a peek anyway... but that's okay! This is something everyone would naturally be curious about, you don't have to feel dirty just because you read about it. I kind of figured most people would still read it. But just in case anybody really did have the self-control to not look, good for you! And I will (try to) continue to put the gory things in red. But no promises, after all, as I mentioned in an earlier post, nobody is perfect. 
(Yeah, I did just reference my own post, from yesterday.  Is that bad? I thought you are required to do that if you write a blog...?)

3) Hemisection. This is the one we did today.  This whole section should basically be done in red.  Sorry! Hemisection literally means cutting in half. So if you guessed that means we took out the ol' Oscillating Saw again, you'd be dead on.  But this had an added twist: the hemisection we did is from the pelvis up a little less than a foot, right up the vertebral column (through the sacrum and some lumbar vertebrae) and then off to the right, completely removing his left leg and half of his pelvis and lower abdomen. It allowed us to see the reproductive and urinary organs the way they lie in the body in relation to one another. Since today is my lab partner's birthday, we let him do the hemisection all by himself.  The weirdest part of it, though, is that it wasn't just saw cutting, he also had to use the scalpel because there is a surprisingly small amount of bone you need to cut through in that area, and mostly softer tissues, like muscle, fat, vessels, nerves, organs, what have you. (Sorry, folks, but seeing as this is a med student's blog, you have to figure that some of the best stuff will be "gross.")

These are only some of the things we do to the bodies we study from.  A lot of the larger dissections can get emotionally difficult, unless you're either a detached person by nature, or you actively block out the fact that the person who you just cut would have felt pain only a year ago (roughly).  Some would say anatomy dissection is unnecessary due to the prevalence of excellent computer simulations... but I think you can only learn so much from a simulation, or from a book.  We need to know how things look in different people. Nobody is a walking textbook, there are minor variations in everybody's form. We also need to learn how to do certain things like pelvic and rectal exams, and the cadaver is the best patient to learn these things on because they don't care about awkwardness.  And I guess I also think it's okay because as detached as we have to be, I try to remember that it is, after all, a person's body we are cutting, not some textbook.  I tried saying "thank you, Ralph" after every lab session, but it was a little too weird for me. Maybe I'm just not at that point yet... or maybe I'm already past that point. Depends how you look at it.

(Side note:Apparently, during second year, we take a class called Introduction to the Physical Exam, during which we learn how to do these exams on live models. Allegedly, it's just us and them in the room, and they (since they have had these exams done thousands of times) instruct us and tell us what we're doing wrong or right.  I hope to still be writing entries then, and if I am, I'll be sure to let you know how incredibly strange that was. Or wasn't. You really never know... in medical school, it seems almost anything is possible.)