Dissection, Session One
Monday, September thirtieth.
Two till five pm.
The dissection room smells. But strangely, not as much as I thought it might. The formaldehyde stink is a base-level, bearable, non-offensive sort of stink, where your nose is gently – but consistently – reminded of where it is. Everything about being in the dissection room makes me feel like I need to be gentle. It was as though my soul was walking on tiptoes, trying to not take up too much space. The room consists of a series of closed, rotating tables that I can only describe as cadaveric bunk beds. Two strange, capsule-like metal boxes and a lever to rotate them, bodies rest in both. We emerge into the room a sea of nervous students, tutor groups B-oh-one to B-oh-ten, with varying levels of excitement and dread. I was somewhere in between, creeping towards excitement, albeit shamefully.
Button up lab coats. Mine is small and has a red collar. Gather around the cadaver table with the rest of your tutor group. Listen to the opening remarks. Fire exits. Don’t bring your mobile phone. No pictures. Careful with scalpels and scissors. We’ve had three finger injuries already. Protect your skin, formaldehyde is carcinogenic. Don’t be pregnant. Don’t wear soft shoes. Respect the cadaver, they have given their bodies. Then the chaplain speaks. Come talk to me whenever. This is a great opportunity. Reflect on what you learn. If you feel Not Okay please come see me. Then it’s time to open up our boxes.
Our demonstrator, Charlie, introduces himself and promptly opens one flap out of the two needed to expose our cadaver. A row of us on the other side of the table are unsure what to do. I hesitantly grab the handles of the other flap and Charlie nods. I pull the other side of the box down.
Our cadaver is a woman. In the moment it is hard to distinguish, the lack of life leaving the cadaver just as empty as the word makes it seem. A grey, androgynous mass of human. I thought of myself, my mother, my grandmother. How grey we must all end up one day. I’m told it’s rare to have a female cadaver, as women tend to donate less, but it doesn’t feel like I’ve been given a collectible. Even after her death, this anonymous woman has made me feel a connection to her. I am thankful, and a little more attached. Before I stepped foot into the dissection room, I felt as though I could let go of my body easily. Now, I don’t think I could. How much courage must that have taken? How did she make this decision? How did she have that conversation? She was brave. Now she lay here, very still.
The parts that aren’t being dissected must remain covered. Arms and legs at her sides, enclosed in plastic bags and underneath; wet cloth. Her head has been given the same treatment, though this brings me discomfort that washes over me in waves. It felt sinister, I was about to see this woman’s insides without even seeing her face. I want to ask Charlie to take off the bag, but I’m not sure I could hold a scalpel to her skin after that. “Maybe next time” says Charlie, sensing our collective unease.
The cadaver tables are shaped a little like a shower floor. The surface almost imperceptibly inclines, guiding fluid to a small hole which doubtless leads to a collecting tube. Our cadaver blocks the hole and fluid puddles around her legs. I distract myself from the cadaver a little by just staring at it. We had been given guidance as to where the incisions would be made, but as I look at my team, uncomfortable and a little speechless – I am sure we have momentarily forgotten.
Charlie is the first to touch the body. He prods at her, feeling for the bottom of her ribcage. The tissue under his fingers seems frozen, like hardened plasticine. Each wrinkle and fold of skin is held in place, taught with formaldehyde. He points at the area, tracing a line under her ribcage with his finger - showing us where to cut. We are silent. He extends a scalpel at our group, asking who would like to try. None of us want to seem eager, but the shameful excitement of the medical drama has started to set in. Charlie offers to make the first cut and, gracefully, we think that may be best.
He confidently glides the scalpel shallowly across the skin, following the imaginary line he made. He is a surgical student. I am amazed at how comfortable he is around the cadaver. It is at this point that we begin to react. Up until now the body wasn’t real. Some of us inch closer to the table. Some of us retreat. Then he hands the scalpel to a girl in our group and she proceeds to carefully extend the cut. “Not too deep”, Charlie reminds us. The skin is the only layer we want to cut. The girl asks if anyone else wants to make a cut, and I volunteer. I cut a line from the ribcage to the bottom of the abdomen, gingerly circling the bellybutton. This close to the body, the odour makes my eyes water. All of us move with caution. We all doubtless understand that this woman is dead, yet it’s a strange feeling to cut someone without causing them pain, or to put a gloved hand on their body and peel them open while they lie there, motionless.
Skin sheds easily, with just a little bit of tension. I didn’t think our outsides would be so easy to separate from our insides. As we gently peel back the skin, yellow fat is revealed, clinging to the skin in chunks. I had learnt at some point that fat was yellow, but I imagined it to be dull and bland, but hiding underneath the grey skin of her body, our cadaver oozed vibrant colour. Somehow, this is more striking than the cutting.
Blunt dissection technique, I learn, involves separating, not cutting, teasing one layer of tissue from the next, and carefully scraping fat from skin, skin from fascia. This is intricate, meticulous work. Hold the skin taut. Broad strokes down remove fat. Short strokes pull the flap back. Blunt scissors, forceps, fingers to grasp. We work carefully. We are vultures, attacking this body. Arms knocking, scalpels near-missing, we crowd around a small incision. Half stand back, half work on the cadaver, two people a-side. I worry I am hogging the cadaver. Switch.
Skin is translucent. A boy in my team lifts a flap of skin and I can see her freckles from the underside, as if I were looking at her outsides from the bottom of a pool. The extra fat that we scrape off goes in a metal bowl so we can keep all her bits together.
The first dissection consists of a lot of denial. First you deny that you are in the room. Then you deny that the cadaver is real. Then you deny that your eyes sting or your hands sweat inside your gloves. Your senses are numbed with nervousness. Nothing registers properly. It’s like I am floating above my body, watching it all happen as if it were a film.
We work on the cadaver for an hour, but it feels like fifteen minutes. Time to pack up. We put the small flaps of skin back. They sort of sag now, small slivers of yellow peeking between them. Charlie covers her up with the bag, now wet with fluid. We close the sides of the box back up again. Sharps in the sharps bin, wash hands, put the lab coat back, sniff my clothes out of curiosity. I am both relieved and disappointed to be done with the session. The eight of us march back to our station to pick up worksheets for next time.
A boy in our group ventures: “Can we name our cadaver?”
Charlie shrugs, good-naturedly: “She already had a name.”