Around me, the room slowly filled with an uncomfortable silence as one by one the students stopped talking. We had all prepared for this day with such excitement — so proud of our new lab coats, our very own surgical gloves, the little dissection kits we had bought according to our printed instruction sheets — but now we realized how unprepared we really were.
As the conversation quieted, I could hear the low rumble of the exhaust fans sucking the heavy formalin fumes out of the air. Across the room, someone bumped into a stainless steel container and a half-opened lid crashed down. The sound bounced off the tile floor and echoed through the room like a gunshot. Everyone jumped and then laughed self-consciously.
Having opened the containers, the instructors then pulled back on huge stainless steel levers at each end of the vats to lift the bodies up out of the fluid, raising them to table height. I watched transfixed as my group's cadaver rose up slowly, horror movie style, to break through the surface of the oily liquid. Her hair fell back like a swimmer's would while rising out of a pool and then there she lay, stretched out on a perforated steel sheet, the formalin dripping off her body down into the vat. I had the feeling that her most intimate secrets were being revealed: the muted old surgical scar that marked her abdomen; the coarse, dark stubble running up and down her legs; her long, split, and dirty nails. When our instructors told us to flip our cadavers onto their stomachs, I was relieved that I wouldn't have to look into her face any longer, at least not for a while.
It took me a while to overcome the sense that I was trespassing, staring at this woman's most intimate bodily secrets. I was grateful when the instructor started giving instructions on how we were to begin our dissections. Now I didn't have to feel like some sleazy voyeur — I had a purpose for examining this woman's body.
My strongest reaction was that the cadavers were shockingly gray and stiff, so far from the lifelike multicolored tissue I'd expected to explore. During my childhood of hunting and fishing with Dad and my brothers, I had cleaned and dressed plenty of fish and game, and I'd been expecting our specimens in human dissection to be more like that freshly killed tissue — soft, pliable, brightly colored. Working on this washed-out corpse felt like abandoning color TV to watch in black and white. The cadavers' grayness did help with the queasiness of working on a human, though.
We started the dissection by removing the skin, which felt like cold, stiff, waterlogged shoe leather. It had simply not occurred to me that I would have to skin a human being. At least the gray, rubbery covering of our cadaver didn't look or feel anything like real human skin. Of course, I was wearing rubber gloves, which added to the eerie sensation. I didn't know it at the time, but I would never touch dead human soft tissue without the feel of latex stretched taut across my fingertips.
Despite the medical touch added by the gloves, I felt as though I were violating this woman. To combat this sensation, my fellow students and I did what we could to depersonalize our cadavers. We didn't give them names, and we referred to each one as “the body” rather than as the “dead person.” When I became a forensic anthropologist, I would have to learn how to reverse this line of thought, remembering that each dead body was actually a person with a story to tell. But I wasn't so philosophical back then. Instead, I was consumed by my fascination with the human body. My only response to this dead woman was excitement at the prospect of all she was about to teach me.
My fellow students and I were totally silent as we took turns making the incisions on the woman's back that would allow us to open the skin as if opening a book: first a long cut down the backbone, then a right-angle cut across her shoulders, then another right-angle cut at the base of her spine, just above the crack in her buttocks, to make a giant letter “I.” The skin on her back was several layers thick, attached to the tissue underneath with hundreds of little fibers that we had to cut through.
Having spent so much time with my dad's textbooks, I expected to be able to look at a real body and see all the parts clearly, but I soon discovered this wasn't possible. Indeed, that's why medical illustrators are necessary. A medical illustration needs to show fully detailed anatomical structures, something that a surgeon might use to navigate an actual body. But neither the illustrator nor the surgeon ever really sees those complete structures, not all at once. We had to be able to see each layer of the body as we dissected it, then imagine what it all looked like when it was intact and in place.
That's why our instructors insisted that we cut into the body with the “I” shape they had chosen. They wanted us to be able to open the body, remove the organs, and then fold everything back exactly the way it was. If we just cut things out and discarded them as we went along, we'd never see the whole picture. Instead, we had to learn both the parts and the whole, both the individual structures and the way they fit together, so that we could someday make illustrations that would enable doctors and surgeons to have their own limited view of the body while visualizing the whole.
The medical students were going through a similar process. It was the only chance they'd get to see a body in layers, or to cut out an organ, trace its blood supply, and then put the dissected pieces back together like some three-dimensional jigsaw puzzle. During actual surgery, their goal would be to disturb as little of the body as possible, imagining — with the help of our illustrations — what they could not actually see.
After we had finished exploring the muscles, nerves, and blood vessels in our cadavers' backs, our instructors finally let us turn them face up. (My group immediately put a paper towel over our woman's face, covering her staring eyes and grinning mouth.) As we cut into the abdomen, I again expected to see what I'd seen in my dad's textbooks: the abdominal organs revealed as separate structures, each with its own unique size and shape. Instead, what I saw was that every organ was molded and folded tightly onto its neighbors, like one of those amazing Irish stone fences, in which a collection of separate stones somehow fit so closely together that mortar isn't necessary.
Sorting through loops of intestines, I realized that they are not just one long tube, like a garden hose, folded over to fit neatly into someone's belly. Instead, they are connected to the body's main blood vessels by huge, flat membranes, which, if torn or twisted, can rob the gut of blood and lead to someone's death. Then I was struck by how huge her liver was — about the size and weight of a wet, tightly folded bath towel. I knew that if I slipped my fingers around the liver's narrow edge, I'd find the gall bladder, tucked up underneath one of the liver's lobes. Since gall bladder removal is a pretty common surgical procedure, we students eventually made it a game to see whether we could tell by feel which cadavers had had that type of surgery.
The nervous system was particularly difficult for me to learn. Among other things, nerve pathways cross and crisscross at specific places in the brain and spinal cord. When the pathways are disrupted — from disease, stabbing, gunshot wounds — the whole system can be short-circuited. It took a leap of faith for me to understand that a gunshot wound that completely pulverized one section of the brain might leave the victim alive but severely disabled, while another gunshot wound that cut cleanly through the brain stem meant instant death as the diaphragm and heart quit forever.
Although at the time I was merely learning the architecture of the human interior in order to draw it accurately, one day this training would be vital for my work in forensics. Years later, while testifying in a murder trial, I became recognized as a court-qualified expert in gross anatomy as well as forensic anthropology — a rare distinction for a forensic anthropologist, and one I could not have achieved without my early studies at the Medical College. The case in question hinged on a minuscule cut in the victim's neck bone no bigger than an eyelash. I was able to prove that the tiny trace mark indicated a fatal knife wound when I demonstrated that in order to reach the bone in question, the killer's knife had to work its way through the victim's windpipe, esophagus, and a critical group of arteries, nerves, and veins.