Sunday, September 23, 2007

What I Do For Fun

Sometimes, Chancho, when you are a man, you wear stretchy pants, in you room. Is for fun. Well, perhaps I don't don red briefs over baby blue tights and a cape. Instead when I 'm not hunched over Netter and NetAnatomy.com and my syllabus, I play the piano. Sometimes Mindy helps me, but usually it's just me. It's a lot easier to sit down and practice now that I'm not six. Plus, since I'm not paying for lessons, I don't practice if I don't want to. I get the fun of playing without the drudgery of playing etudes over and over. That''s pretty much the only constructive thing I do for leisure. If I'm not doing that I usually just sit around and try to let my brain unwind.
Speaking of brains: we removed the brain from our cadaver two weeks ago. We cut the head in half above the eyebrow removing the calvarium (top half of the head, roughly speaking). Two dissections later, we cut the remaining half again, this time in the coronal plane (the plane between your ears) down past the larynx in order to expose the pharynx and larynx. After that, we cut from the nasal cavity through to the palate to expose the sinuses. By the end of that block, the upper half of our cadaver was bareley recognizable as human.
Why do I mention this? Until the early 20th century, medical dissection for learning by students was taboo. Yes, dissections were social events during the Enlightenment, and to some degree in the Renaissance as recorded by Rembrandt in his famous (but anatomically erroneous) painting the Anatomy Lesson of Nicolaeus Tulp. The subject in those times was a publically executed criminal for whom the post-mortem dissection was the final step in his shameful demise. At our school we have over 400 bodies donated annually of which the MS1's get to use 28 for dissection. In October we have a memorial service for them to which the families of the deceased are invited. It's a great thing to be able to dissect a body and learn from it. There is no substitute in my mind, since atlases and even 3D computer models are only partial views.
Some authors claim that the cadaver-student relationship is preserved in the modern age of CT, MRI, 3D model etc. in order to familiarize the student with the nemesis of their chosen profession, death. The dead body in front of the student supposedly serves as a reminder of what will ultimately come to pass for every patient, regardless of short term interventions. I can't speak to this, since I have virtually no experience in clinical medicine. Frankly I didn't view the intial incision down our cadaver's back (which I made) as particularly cathartic. Yes, it was a little odd to cut the skin of another human being, but I have been sticking foreign objects into the living for 3 years. Frankly the hardest dissection for me was not the face, that was more of a pain and challenge than anything emotional. Dissecting the hand was a stranger experience. The hand is uniquely human, and the cadaver on which I was working still had on nail polish, which made it more difficult to distance myself from her humanity. She still had the poke marks in her fingertips from the blood sugar lancets, marks which I inflicited thousands of times as a phlebotomist.

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