This post is written in remembrance of my greatest medical school adversary – the Anatomy Lab. From my first voyage into the sterile, bright room housing dozens of dead bodies, to my final practical examination, this one goes out to all the medical students who have devoted countless hours dissecting and learning the human anatomy on deceased human beings. It’s a weird feeling stepping into a room with dozens of dead people inside, but the lessons learned are valuable, even if they were repulsive at times.

DISCLAIMER: This post contains graphic, written depictions of various parts of a dead human’s body. If you have a weak stomach, it might be best to pass on this article. But if you are a future medical student with a weak stomach, read it to get an idea of what you’re in for.

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Ode to the Anatomy Lab

 

Dearest Anatomy Lab,

I write to you today to recount our relationship. From the messy, confused beginning, to the mutilated end. I am now freed from your lifeless grasp, so I feel it is necessary to recount and tell you my side of the story.

Where did we start?

I knew I’d be meeting you. I knew I’d spend time with you. It was an arranged marriage, of sorts. You were a foreign entity to me. Before you, my experiences in the practice of academic dissection extended only to sharks, frogs, and perhaps a pig if I remember correctly. I had seen a few dead bodies in my lifetime – but back then, they were lying in a casket, lifeless, surrounded by flowers and the sounds of loved ones weeping for their loss. They had families, friends, and an entire lifetime before them to leave a legacy highlighted by a minister’s eulogy.

Death was terrifying to me. Where do we go? Do some soar to our misunderstood idea of heaven in the clouds? Do some free fall into an eternity of fire and brimstone? Death is not something I understand or even try to. Dead people were a reminder of my own mortality, and sadly, the terrifying realization that everyone I know and love will someday succumb to the same fate. Death was not something I was comfortable with as a person.

So when we met on that first day of orientation, I was nervous. I won’t lie. Our instructor led a group of students through your doors, which required a key card to enter. Your doors were adorned with a sign that read “no cell phones, no photography”, in order to ensure that all respected the privacy and dignity of your cold-bodied residents. When I saw you for the first time, I took a deep gulp. You are intimidating after all. Your bright lights illuminated your figure – sterile white walls and white tile flooring and white ceilings, an impressive array of television screens positioned throughout, and most importantly, the dozens of stainless steel tables.

But of course, your most striking feature was neither the walls nor the televisions – it was those tables, or rather, what rested on the tables. White plastic coverings on each table, with unmistakable shapes underneath them. Like in the movies when somebody thinks a person is hiding under the covers of their bed, only to uncover a basketball and pillows positioned to look like a human body. But you are not the movies. You are real. A sudden feeling struck me in my stomach. It wasn’t fear, it wasn’t nausea, and it wasn’t anxiety. It was reverence. It was respect. It was…. wow.

There is something inherently chilling about standing in a room with that many dead people for the first time.

Our first meeting was brief, but it was merely an introduction to our first true experience together, which was an event in itself. I walked into the men’s locker room, removed my gym shorts, stepped into my scrub pants, threw on my scrub shirt over a white tee, and put my old and beaten Nike’s on my feet with my colleagues, who I’m certain shared the same apprehension I had. I grabbed my brand new dissecting instruments, my dissection guide, put on my protective eyewear, and proceeded into your realm with a mission.

There was a chart posted on your door which listed the cadaver each of us were assigned to. I walked to the appointed table, hoping for some of my fledgling friends as companions, but instead found myself surrounded by a group of unfamiliar faces, which was okay, because I was told my group would grow close over our many hours spent in your domain. You promised me new bonds and friendships. We all introduced ourselves and shook hands, which were covered by latex gloves.

For obvious reasons, I will have to use bland pseudonyms for my partners. There was Steve (he seemed like a Steve), an enthusiastic young man who greeted everyone with a smile. Then we had Sarah, who was a shy and demure girl with a quirky sense of awkwardness. Next was Shannon, a larger, boisterous girl who was around 30 years old. Finally, Lauren was assertive, prepared, and clearly knew what she was doing. This made sense, because I soon learned that she was repeating the first year of medical school after failing her first year in the previous class. You placed us together. And together, we would learn, dissect, bond, and become pals by the time it was all over.

Your instructor addressed the class and told us of our goals for the day, gave us instructions, then pointed us towards a card at the foot of your steel bed. Each table, and cadaver, had a card. Mine read…

Name: Anne

 Age: 71

Cause of Death: COPD

 She loved to bake and spend time with her grandchildren

Each and every one of your habitants came with a similar card at the foot of their table. Name, age at the time of death, cause of death, as well as a short quip to humanize the deceased. This ensured that I knew I was not carving up Cadaver 16A, but rather I was soon to dissect Anne, the grandmother, the baker. She was a person. She was real. And she was loved.

This didn’t make things any easier between us, but I understood why you chose to add a personal dimension to your those you house under your white plastic covers. I respect you.

When it came time to remove the white veil of plastic, my heart rate spiked, my palms began to sweat, and my mouth became dry. We pulled down the covers to reveal the face of our specimen, Anne. She lied there lifeless, with grayish, dead skin – an empty form of matter which once housed a human soul.

Our first area of study in your room was the musculoskeletal system, more specifically, the back. Straight forward – bones, muscles, arteries and nerves. The vertebral column, lumbar muscles, thoracic muscles, neck muscles, their innervations and blood supplies. For some reason, you rudely had your cadavers placed in the supine position, meaning the first thing we’d have to do is physically grab your dead body and flip it over. Luckily for us, you gifted our group with Anne, who was no more than 120 pounds, so I thank you for that. Truly. Others weren’t so lucky. With the coverings removed, we all trepidly placed out hands on various portions of the anatomy, and worked as a team to flip Anne on her stomach so we could get to work.

Step two was more difficult. Step two was something I had not expected before meeting you. In our first day of spending quality time together, we were instructed to skin our body. Yes, skin the body. Makes sense. You can’t expect deceased bodies to be pre-skinned and cleaned. We had to see the muscles, the nerves, the bones and the arteries. A layer of skin, fascia, and fat rested on top of the goods, so we had to understandably remove these layers.

Lauren stood aside with her dissector guide, reading the first instructions: “make a longitudinal cut along the middle of the spine, from the external occipital protuberance to the the line of the iliac crest”. Lauren, girl, this our first real day of medical school. English please. She showed us a schematic picture – ah, so from the back of the skull to the butt. We all stood there with our new shiny scalpels in our hands, but no one jumped up to make the first incision into the human body.

I looked around at each of my team members – Sarah stood several feet away from the table, Lauren held the guidebook indicating that she would instruct rather than do, Shannon looked at the ground, and Steve and I looked at each other. “I’ll do it”. I was nervous, but ready to dip my toes into the oceanic journey of exploration of human anatomy. The first cut was most certainly not the deepest. I ran my scalpel along her back, barely scratching the surface. “Yeah, you’re gonna need to cut deeper”. I was afraid to do something wrong, afraid to cut to deep and mess up the contents underlying the skin. But ran my scalpel down the same line again, this time with more pressure, creating a true cut into the epidermis. Lauren then read, “okay, now we need to make several horizontal incisions along the side of the body”. Steve dove in. Shannon too. Sarah still stood there speechless.  And Lauren held the book, immediately assuring us that her role was to be our instructor.

We carved her. I never wanted to do this, but after the first few cuts, it wasn’t so bad. Eventually we had sections of skin cut out, and it came time to cut through the fascia to remove the pieces of skin. And there I was, with a scalpel in one hand and a chunk of human flesh in the other. I threw it in the tissue bag and proceeded.

Once the skin of the back was removed, it was time to clean. Before this day, I knew you’d make me inspect the muscles, organs, and bones of your bodies with small metal instruments. Sure, I was nervous. But I knew that it was essential to my medical education that I spent time in your house exploring the human body. But what I did not know is that you’d require me to clean. Not dusting, or sweeping, or shining, but to you, cleaning meant removing human fat from the rest of the body to expose the anatomy that lay beneath. Before we could visualize the intricate muscles and arteries and nerves, after we had removed the skin, we had to tear through a layer a whitish yellow human fat. The adipose tissue had the consistency of a more solidified jello, just the way it feels when one grabs a handful of their belly. We began by making cuts through the blubber with scalpels and using forceps to remove the flesh from the body so that it could be tossed into a grotesque tissue bag.

Then an anatomy teaching assistant came over, saw how slowly our cleaning process was going, and showed us how it was done – without hesitating, she lunged her hands into the fat and tore it off, chunk by chunk, quickly ripping flesh from the deceased corpse like a rabid barbarian and tossing it into the bag. “Don’t be afraid to get your hands dirty”, she said as she smirked and took her services to another at table.

Steve, Shannon and I proceed by following her example. Lauren still stood to the side doing nothing aside from reading and instructing us from the textbook. Then we prompted Sarah to join. She stepped up to the cadaver, started nervously cutting, before abruptly blurting, “sorry” as her faced turned pale white and she rushed to the bathroom. She was not equipped to explore you, at least not yet. You made her sick. However, the three of us continued. The fat came off the body much quicker than it did when we were apprehensively using our tiny utensils. We tore through the flub and started to expose the treasured muscles. And then it was over. We were told to finish up, squirt some fluid over the body, cover it, wash our hands and instruments, and go home to study.

Our first date wasn’t what I was expecting at all. I wanted to see the cool structures I was studying, but instead you required that the day was spent doing preparatory grunt work. Nevertheless, the awkwardness of the first date was over. One day down, many to go. It wasn’t fun. It wasn’t pretty. But I could put up with you.

I changed, washed up, and went home with a sharp sense of hunger after inhaling the formaldehyde formula for hours. I made myself a sandwich – ham, turkey, cheese, lettuce on wheat. I grabbed the sandwich, raised it towards my mouth and took a big bite. To my disgust, your scent lingered on my fingers after I’d left your presence. I wore gloves and washed my hands afterwards, but that scent didn’t leave. If the smell were a candle, it’d be called “death in a petri dish“. And when I took a bite into that ham and turkey sandwich, all I could smell was you, and all I could see were the images you showed me of human flesh. The turkey and ham, two meats I commonly eat on sandwiches, tasted like dead human body. I lost my appetite, put down my sandwich in disgust, and washed my hands with soap and hot water for ten minutes.

During that meal after our first time hanging out, I learned a valuable lesson – I needed to use better protection when entering you. One layer wouldn’t do. I had to double wrap it. While you provided immense value to my education, you were nasty. I’m sorry, but it’s true. I explored your anatomy with no less than two gloves for the remainder of our relationship. I hope you didn’t take this personally.

Once the first date jitters had worn off, spending time with you became easier. The fat was removed. We dissected and examined the erector spinae, the latissimus dorsi, and the rhomboid muscles among others. We traced their bony origins to their insertions. We quizzed ourselves on each muscle. We went home and reviewed the actions of each muscle. We found the nerves, tiny little white cords that transmitted electrical signals throughout the body to initiate physiological actions. We studied them. We studied the vertebral bones. We found the little arteries and followed them towards the muscles they supplied with blood and nutrients. We read our textbooks and learned clinical correlations of musculoskeletal back anatomy, such as the winged scapula, herniated discs, and pinched nerves. I was learning. You were the teacher and I was the student. And I was beginning to appreciate our relationship.

Before our first exam, our group exchanged cell phone numbers, and met up after hours on several nights to quiz each other. Someone would point to a muscle and another had to name it. Someone would point to a nerve and ask which muscles it innervates. Your subjects were complex, like nothing I’d ever learned, but they weren’t too difficult. You required work – studying constantly and quizzing. But I learned. I studied the textbook in the evening and saw the real-life anatomy in your walls during the morning.

You tested me. The first time you tested me, I missed some questions. I thought I knew certain structures, but when I saw them pinned on cadavers that weren’t my own, I got confused because they weren’t immediately familiar. You tricked me. Shame on you. Nevertheless, I passed with a satisfactory score.

Afterwards, it was time to celebrate this milestone in our relationship. I went to the bars with my new med school friends and got drunk. Very drunk. We all did. We had just completed our first medical exam and celebration was in order. This was the first time I brought alcohol into our relationship.

In the morning, the alcohol was still flowing through my circulatory system. My head felt heavy, my mouth dry, and my stomach nauseous. Out til’ 2 in the morning and back to you at 8 am. When we peeled back the white plastic to expose the dead body, I felt a wave of dizziness. Our next project was to flip the body on its back to dissect the upper extremities. Again, we skinned. And again, we cleaned. My brain was fuzzy and faint. After many days of moisturizing the body at the end of class, some of the fat was no longer solid blubber, but it had softened. It was like mucus. Like greenish yellow phlegm. Like the shit you cough up when you have a nasty bacterial respiratory infection. I grabbed some in my hands and threw it into the tissue bag. Steve and I were the only ones working. I looked down at the rest of the rotten fat. I stared at it and became faint. I felt that twinge of nausea in my stomach. I felt it. I involuntarily dry-heaved, trying with everything in me to suppress my body’s urge to vomit and expel all the poisonous alcohol and drunken food I had consumed the night before onto a dead human carcass. The flesh of a dead person is gross. The flesh of a dead person while hungover is sickening. I power walked toward the door, went into the locker room, splashed my face with cold water, threw my gloves in the trashcan, and sat on a bench staring at the ground for ten minutes, cursing myself for drinking so much when I knew I had an early date with you in the morning. I vowed never to mix alcohol into our relationship again.

The hours ticked by slowly that day. I hardly did anything. I was incapable of touching the body, let alone looking at it. I watched the seconds make their rounds around the clock, begging for time to speed up so I could be released from you. I went home and recovered that day. I survived, but I knew I would never make that mistake again.

Like I said, the first exam went well. I achieved a solid score. I knew what it took to succeed in your class. But after dissecting the back, we had to do the upper extremities, which contain more complex anatomy than the straightforward back. In particular, the Brachial Plexus was a challenge that you’d present to me. The Brachial Plexus is a complex highway of nerves running throughout the axilla and proximal portions of the arm. That’s another thing you taught me… Proximal, distal, superficial, deep, caudal, and so on. I soon spent so much time with you that I started using your jargon in every day conversation. Anyways, the Brachial Plexus is complex, delicate and extremely important. It was an essential piece of anatomy that needed to be dissected with care in order to avoid damaging the structures. Steve was good, but I knew I was the best at dissecting, so I volunteered to do one arm. Shannon decided to take it upon herself to do the other. Steve cleaned more along the distal arm that I was working on. Lauren instructed, as always. Sarah was invisible.

I spent hours crooned over that table, carefully dissecting the plexus with the utmost precision. After those few hours, we had a perfectly dissected brachial plexus on one arm – cleanly visible, with each nerve in tact. The instructor came over and commended me on my work.

“Shannon, how’s the other arm going?” She replied, “good”. I went over to inspect the other arm. It was not good. Not good at all. “Where is it?” she asked. Well, I’m pretty sure she cut the whole fucking plexus out of the arm. I guess I can see the roots of C5 and C6 there, and perhaps the remnants of the median nerve over there, but overall, she completely butchered the damn thing. This was a theme with her. She wasn’t good at dissecting. She usually ruined some sort of structure each time a scalpel was in her hand. I guess she could rule out surgery as a career. But at least she tried. She was actively a part of the team, even if her results weren’t satisfactory.

Compare that to Lauren, who was the self-appointed team leader. Each day in your lab, she picked up the textbook, read us the directions, and ordered us around like Bobby Knight coaching a special olympics basketball team. “Okay, you’re gonna do this. Then cut that”. She never put down that book. She never picked up a scalpel. And as time wore on, she stopped wearing gloves because she decided that she didn’t need to help, ever. And when we (and by “we”, I mean Steve and I) dissected the body, she’d make little quips that infuriated me. “Oh my gosh, thats a greaaat job, Soze. Keep up the good work Steve!” She talked to us like we were preschoolers. She had a growing condescending attitude. Perhaps it was because she had already done this class and felt that she didn’t need to participate again. She acted like she was smarter than us, while in truth she didn’t even pass on her first go-around last year. And when someone (usually Shannon) did do something wrong, she’d say something along the lines of, “Oh no, you screwed it up. Ugh”. It took every bit of zen in my body not to snap at her and say, “you don’t like it? Put down the fucking book and pick up a scalpel”. My resentment for her grew every single day that went by in your lab.

Sure, Sarah didn’t do anything either, but at least she was sweet, kind, and had a reason not to participate. She was not the type of person who could handle spending time with you. I understand that. You are a lot to stomach. Not everyone can do it. I had no ill feelings towards Sarah, although the absence of help from her and Lauren meant that the rest of us had to double our workload.

Then finally, Steve, my saving grace. Steve was intelligent, he worked hard, he was polite, and he was someone I enjoyed talking to while picking apart human flesh. I never lashed out, but every time Lauren spoke or barked orders, I never responded. I began to completely block her out and pretended she didn’t exist.

While I liked Steve, he wasn’t much of a presence outside of class. I saw him at the bars once in a while, but we didn’t have a whole lot in common aside from being hard working, friendly students. This sucked. You were supposed to give me friends. I was supposed to bond with the group you paired me with. I was supposed to go get drinks with my group and hang out with them outside of lab. But instead, you gave me one likable guy, two people who were nice but made my time in your lab harder, and one person who instilled anger in my chest every time she spoke.

Yet somehow just about every other group in your lab hit it off in the way I had hoped my group would. They hung out outside of your walls. They got beers together. They laughed. They had inside jokes. They put pictures of their groups on Instagram with the caption, “Gonna miss these people. Best lab group ever!” They enjoyed their time together, made it fun, and dreaded the thought of anatomy ending and spending less time together. Meanwhile, I couldn’t wait for it to end.

But I put up with it. I dealt with it. Because you were not an option. I was required to be with you.

After the musculoskeletal system, things became different. The year progressed. We spent less time in the lab, but your teaching’s were more complex. We were drifting apart, but our time together became more intense and your examinations became more difficult.

We had skinned and cleaned the majority of the body, but your internal organs revealed their own brand of grotesque. After removing the lung there was a mess of coagulated blood resting in the pleural cavity. Our instructor came over and said, “scoop out the gunk”. Like red chalky jello that had been sitting out on the counter for two years. “Gunk”. It was fucking disgusting. But guess who had to scoop out the gunk? Yeah.

Then we arrived at the gastrointestinal system. The liver is dope. The abdominal aorta is a neat network of vessels to learn. But you made me cut open the colon, revealing a decased human being’s shit. Brown, smelly poop. Shit that was resting inside of this dead guy for likely a year. Year-old shit. I’d rather spend ten hours studying than smell and see a dead person’s shit for ten minutes. This was not my idealization of med school. I knew there were rectal exams and all that, but never did I come to terms with the fact that I’d have to cut open a dead guy’s colon to reveal a dead guy’s shit. I thought that people shit themselves when they died? Guess not. Or not enough.

Your surprises were limitless. Yeah, in the anatomy lab, I knew I’d have to dissect people. I was allowed to hold a human heart in my hands. I could cut into and examine the spinal cord. Cool stuff. But when we learned urogenital anatomy, I naively assumed that we didn’t have to dissect a dick. But we did. A dead guy’s old, shriveled, hairy, dead penis. I had no problem dissecting muscles or arteries or even the heart, but dissecting a guy’s dick felt like a violation of dignity. I know our bodies are merely vessels for the soul. Still, the thought of dying one day and having my penis carved up by a bunch of clumsy first year medical students is not an image that sits well with me. But I had to do it. Cut the bastard right down middle like a damned hot dog.

Towards the end, I was able to smile at the thought of escaping you this summer. We were nearly done. I fondly look back upon the early days – my apprehension to meet you and my shock when I first stepped into your room containing dozens of dead human beings. I wasn’t one bit phased by dead people in the end. Shit, they didnt even resemble people anymore. They were skinned, carved up, mutilated skeletons, split open with many organs removed, and muscle that had dried to the point that it looked exactly like beef jerky.

I’ve always had a strong stomach. But you tested my limits. You made it known that becoming a doctor wasn’t easy, pretty, or glamorous. I paid my dues with you.

But it wasn’t all awful. Because, like any bad relationship, you taught me valuable lessons. You taught me human anatomy. You gave me that foundation to base all forthcoming medical knowledge on. You allowed me to understand the intricacies of the body. You gave me a newfound appreciation for miracle of our physical species. You gave me an understanding that extended beyond perfectly drawn pictures in a text book. And for that, I thank you.

However, after spending hundreds upon hundreds of hours with you, I am relieved that our graphic relationship is over. I don’t envy your future students, but I do hope that they learn as much from you as I did.

Sincerely,

Soze