The Final Cuts

Only one more week of gross anatomy lab, and it definitely feels like the last six miles of a marathon. Part of it is the daily monotony of two hours lecture, two hours lab; part is the tediousness of picking through tissues to find the needle in the haystack; part is the incessant need to memorize a vast amount of information. I believe the biggest reason for the struggle however is that we have come to the only part of Larry’s body that has not yet been dissected (although when you look down at his body, a more appropriate word would be destroyed). Yes we have finally opened up his neck, face, and head.

The day we were to start on the face, our professors told us that this may be the hardest part of the dissection, and that it was OK to leave the room for a break. As I looked around the lab, it didn’t appear to me that anyone was having a hard time. I think by now we have been so desensitized to the brutality of our dissection, that it has turned to mere scientific study. Even so, I still apologized to Larry as I picked up the scalpel and started to remove the skin from one side of his face while my lab mates worked on the other. I have gotten in the habit of talking to Larry throughout the dissections. A lot of apologizing and thanking him for his sacrifice, but also a lot of compliments regarding the wonder of his body.

After a day of studying the nerves, muscles, and salivary glands of the face, we moved on to the day in the lab that will forever stick in my mind, a day that I wished I could do the work without being there. Here is what our lab instructions told us to do that day:

“The skullcap (calvaria) will be removed for this lab. If the calvaria is still intact on your cadaver, make saw cuts as shown in Fig. 7.17. The first cut connects the superciliary ridges (anteriorly) with the external occipital protuberance (posteriorly). Apply MODERATE pressure and back out as soon as the saw clears the bone. Continue to circumnavigate the skull until reaching the start point. Use a chisel to pry the calvaria free. The dura may strongly adhere to the skull and resist removal of the calvaria. If so, carefully work a chisel between the dura and internal surface of the calvaria to free and remove it. Do not remove the wedge of occipital bone as instructed in Grant’s Dissector. Examine the meninges and calveria. Only faculty or a MS IV student should remove the brain. There are many objectives today so move as quickly as possible.”

Did your imagination create this scene? – A cacophony of buzzing saws, shouts of the students, and faculty over the incessant sawing, (which lasted for the whole lab since there aren’t enough saws for each to have their own.) A strong bone burning smell accompanied the noise, and the baby blue masks we had over our mouths and nose, which were an improvement over not using one, did NOT stop the smell from entering your mouth and nose. So many of the students have said that they will NEVER EVER forget that smell. Remember the smell of the dentist tunneling through your tooth when you have a root canal, and then amplify that smell a hundred times.

The visual scene matched the surrealness created by the other senses. There is nothing casual or cautious about removing a person’s skullcap. To suggest that the dura (the tissue that covers the brain) may be adhered to the skullcap is a grand understatement. It didn’t take my lab mate very long to make the saw cuts, but it took at least a half an hour to pry the cap off with the chisel. I made the comment that Larry must not have wanted us to see inside his head. It was as if he was making his last effort to stop the invasiveness of our dissection. His final push of humanity – to attempt to keep that part of himself intact that is most associated with who he really was. The face is so personal, the eyes the window of the soul, and the brain the conductor of that symphony we call life. Sorry Larry, but once again, our metal tools eventually did what needed to be done. I had to look away as the skullcap was finally pulled off, the chisel successfully liberating the roof of his brain.

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