Each anatomy dissection table has acquired little facts of celebrity around its cadaver. Near us is a body with an abdominal aortic aneurysm. There’s another body with a cervical prolapse. There’s a really clear inguinal ligament, a gossamer long thread of a phrenic nerve. To be honest, you don’t really realize something is different about the cadaver you are assigned to, that you spend 3 months dissecting, until someone else tells you. That’s how our table found out that our body has a particularly large heart, an “insanely” large colon, and a particularly large amount of fat.
Her heart is indeed large. I notice it when I walk to other tables and mentally compare its size to others. Students and TAs walk by and comment. We are told by a TA that she likely had chronic hypertension, which slowly increased her heart’s size. It’s funny, because I think back to watching The Grinch as a child, associating a large heart (“It grew three sizes that day”) with a story’s happy ending. Everyone looks simultaneously disgusted and awestruck at the bulging segment of sigmoid colon, 3 inches in diameter and filled with feces (which will still smell, perhaps even worse with the formaldehyde, if we accidentally slice through it, so we have to be careful). It’s so big, but moments ago, before we dissected this deep, we had no idea that it was abnormal.
Have you ever flipped a person? A dead person? This is something we all have to do in medical school. We pause for a moment, the four of us, look at each other with mildly panicked eyes. There are no instructions in the lab manual on how to best flip. We just do it. For a moment, when you flip her, her back is resting on your arm, the curve of her hip under your fingers, and you are almost carrying her. You feel like an accomplice to something sinister. Then the person is flipped, carefully in our case. The skin on the back is flattened and hard from lying supine for so long.
We cut through the yellower fat of the back and buttocks, with the smell of oily fat undeniably rancid. After we had flipped our body in order to dissect the posterior pelvis, one of our preceptors walked by and simply commented, “Big buttocks!” Somehow, I take it personally. I cannot help but think what I would look like on that table. I cannot help but think of the long tradition of body-shaming in life, perpetuated by school bullies and magazines, now carrying over into a post-mortem anatomy lab.
Sometimes we get caught up in what we want to see. We were told in lecture that pelvic muscles that are easier to see in younger bodies. Are we supposed to hope to see them, to hope to have a younger body to dissect? When we see an amazingly clear dissection on a different group’s cadaver, what do we do with the unbidden feeling that we have failed the body somehow, or worse, that our assigned body has failed us somehow? When fat gets in our way of a clear dissection, is it okay to resent the fat? Should we catch ourselves when we marvel, with a certain strain of excitement, at the remnant of a clinically devastating fact?
When we do pelvic anatomy, our professor says it is usually the females in an anatomy group who can stomach slicing the penis to get a cross section. It is indeed unsettling to cut, probe, and slice parts of the genital regions. But it’s funny that the acknowledgement of this comes at this specific moment, rather than others—like when we dissect the face, break the ribs, see the hands for the first time. All of the slicing in anatomy can bring up an element of self-destruction, a vision of the same cut happening in my body. The resulting internal shudder is not necessarily paralyzing—sometimes it makes me more careful and thoughtful as I proceed, which can yield a more detailed dissection.
There’s a chance of the hero complex emerging in us even before we become doctors. We were told we are performing an autopsy on our cadavers, in a sense. We know the condition listed on the brief page about them was likely a cause of death, but they could have been living with multiple chronic conditions. We start to assess our cadavers based on the clinically relevant things we uncover. Ours likely had chronic hypertension, issues in the colon, surgical removal of a kidney, and obesity. We know she had cancer, and that she had metastases. We comment on these things in class with a sense of detachment, like these are things we and our loved ones will never face. Like we, if sliced into one day, would not have hypertensive hearts, large colons, fat spilling out. We act like we wouldn’t ourselves be ashamed to see what’s inside.