Saturday, October 17, 2009

Gross Anatomy 101

The new gross lab was sparkling and pristine. It was difficult to see the far end of the room from the double door entrance; a sea of fluorescent lights illuminated approximately forty stainless steel gurneys, each harboring a body covered in a long white sheet. They were arranged systematically, every table accompanied by a pedestal designed to hold a reference book. We were divided into groups of four - four people that would spend the next six months uncovering the mysteries of the human body. The first day was a religious experience.

As I wandered over to my assigned table, I thought of the first time I saw a dead body. My father’s best friend was killed in a hunting accident when I was around six years old. His name was Marshall, and I accompanied my parents to his Catholic wake. I remember silently studying his body, mistaking his respite for a state of slumber. I waited impatiently for him to wake up and play with us, as he did when he came over to our house to visit. I listened to adults covertly whispering, “He wasn't wearing an orange vest. Someone thought he was a deer. They sure covered up the bullet holes well,” and it began to dawn on me that he might not wake up.

There was also an open casket at my grandfather’s funeral. I was in high school at the time, and was pleasantly surprised to note, while receiving communion, that two of my best friends were in pews, near the back. It felt good to have support, because nine years later I better understood the concept of death. While I didn’t cry at the funeral, I remember driving around in my Oldsmobile Toronado convertible, music blaring, crying soundlessly over my family’s loss. As I walked past his body, I noticed his waxen features, and stared at the cake of make-up attempting to cover the pallor of death. I was no longer fooled, and looked away quickly, not wanting this image to replace the memories I had of him while he was alive.

As my three gross anatomy partners surrounded the body, I studied them. I recognized each, but had not worked with them in previous labs. Grady was the tallest – his boyish face thrust out eagerly under his ball cap. He looked no older than seventeen, and resembled a boy just off of the farm. His long gangly legs were covered in stone-walled jeans and his t-shirt advertised a bar from a Spring Break trip to Florida. His strong country twang, combined with his inability to stand still, cemented my first impression.

Jeff’s European air sharply contrasted Grady’s persona. He was shorter, and wore a broadly striped shirt and tight, dark jeans. His shock of dyed blond hair against his pale skin and sea blue eyes gave him a metro image, and I was surprised to learn he had a long-time girlfriend back home. He was quiet and nervous, not one likely to take the lead in this endeavor.

Amber was the last partner. A short, plump girl with heavy brown curls and a laid back personality, she seemed, at first, much more grounded than the two boys. Her pale skin was freckled and her easy smile was reassuring, falsely, I would eventually realize. But for now, I was comforted by her calm demeanor. She took charge immediately, pulling out her Netter atlas and placing it on the pedestal.

We started on the legs. Amber pulled aside the sheet, revealing skinny, mottled, wrinkled skin; definitely female. An elderly woman, judging by the yellowed toenails. The boys hung back as Amber and I wielded the scalpel and slowly began to dissect the skin off of the muscle. A task that seemed initially daunting became easily surmountable with our industrious activity. We were a team that day, Grady reading the dissection manual, Amber and I working on the body, while Jeff stood back and watched. We uncovered the requisite parts, each like a treasure - the popliteal artery, the sural nerve, the sartorius muscle.

The next day, Jeff didn’t show up. Grady, Amber and I plodded on, oblivious to a fact we would later learn: he had dropped out of medical school. I found it curious at the time that we, his gross room partners, were among the last to learn. Gossip encircled us like fog – “He was really stressed out, he wasn’t passing his classes, he was having problems with his girlfriend.” It was surprising to me that our anatomy teachers not only didn’t tell us he was gone, but he wasn’t replaced. We moved on unceremoniously to the pelvis. Now we were three.

Grady’s immature personality revealed itself slowly. He rarely picked up a dissection tool, preferring to read the manual. Even this task was not well performed – he attention often wandered to students at the surrounding tables. As I attempted to isolate the pundendal arteries and nerves, I remembered a story from a “meet and greet” med student picnic, one I had not attended. A girl friend of mine told me that Grady had spoken to every attractive female at the picnic, barely disguising his curiosity of their dating status. He remarked on one girl’s engagement ring, “I guess that means you are going to get married, right? So you aren’t available?” and another’s date – “So are you guys here together?” Every class is notorious for the women that use medical school as a vehicle to meet and marry a doctor, promptly dropping their noble goals when they have a ring on their finger. “Gold diggers,” to use a politically incorrect term. Grady was rumored to be the male version in our class.

Sure enough, on day three, Grady had not been at our table for three minutes before he announced, “I’m going over to Shelly’s table for a minute. I’ll be right back.” He was courting her. We did not see him for the rest of the semester. They married during our third year, and were soon rumored to be fighting loudly and publicly on their walk to clinicals from their Hillcrest rent house. They were divorced before we graduated.

But presently, they were in the thralls of new love. Amber and I missed our third partner more than the fourth, but we kept at it. Until one day two weeks into the semester, Amber called me the night before gross lab.

“Um, Gizabeth? I am not going to be there tomorrow. I think I have a virus. I’m really sick.” Her phone call was a courtesy, one that I was not to receive regularly for the rest of the semester. Her illness, however, was very regular. It happened every gross lab, for the rest of the year. Once, I bumped into her in the hallway. She seemed well – and looked guilty at my quiet appraisal of her health. She stopped me and invited me to play Scrabble and Monopoly with a group of students at her house that Thursday night. I was sickened that she couldn’t support me in gross lab, but could host board games on school nights. I declined politely, and ignored her pointedly for the rest of med school, most noticeably when we were in line to graduate together, in Barton Coliseum.

The first day I was alone at the gross table, my neighbors remarked, “Gizabeth, where are your partners? What are you doing there all by yourself?” But I quickly became an accustomed anomaly, one that was ignored by the anatomy professors, and my classmates followed suit. I remember watching my friend Kay jealously – had I not taken my married name I would be alongside her and her partners in the “N’s” – she reading the gross manual as her three partners dissected the body. Many of my classmates still meet yearly with their gross partners – dissecting your first dead body is a bond not easily broken by the passage of time – but having partners was a luxury that was not afforded to me.

In residency, when I performed autopsies, after the diener eviscerated the body, I was often alone. It is easier to be alone with a body when there are not forty groups of four people around you, tackling their bodies as a team. Strange, how being isolated is less isolating when you are by yourself. I wonder what Amber, Jeff, and Grady are doing now. I don’t wish to be reunited with them; there aren’t really any remembered moments over which to bond. But I don’t hold any grudges against them, and I hope they are happy and fulfilled in whatever fields they chose to pursue.


Unknown said...

Thanks for the shout-out to the sartorius!

I've got to see the gross room next time I'm in town.

Gizabeth Shyder said...

I thought of you when I typed that!

I would love to see it again myself, I'll bet it's even more high tech than it was. We should take a tour together.