It was to be the last time that we saw his body on the table. In the intervening weeks we had come to know his features with intimacy and respect. Outside the wind had turned fierce, whilst the clouds, a deep shade of grey and pregnant with snow, streamed across the sky as winter proper closed in. The Medical Teaching Unit had largely emptied over the past week, the last teaching week before the Christmas break. Only the aspiring human osteologists and palaeoanthropologists now remained and filled the cavernous light blue coloured room. With glistening scalpels and silver probes, the last examination of our beloved participant took place. Pairs of nervous eyes and trembling hands ran through what we had been taught. We touched and felt the cold body as we reeled off the list drilled into us by the 12 weeks of dissection classes. Each muscle, its attachment; insertion; action; nerve; blood supply; ligaments and tendons, were ticked off, one by one. Each major actor in the human musculoskeletal system was to be identified and admired. Just as in field archaeology, as in the body. There are layers, superficial and deep, to be uncovered and appreciated, and then to be reflected back as we investigated further.
It had taken some getting used to at first, the chemical smell and the sights of the MTU. The individuals who had donated their bodies were to be found wrapped up on their metallic trays, waiting with eternal patience in the centre of the room. I couldn’t help but notice the sad fact of the bodies different lengths, from adult to child. It was a hive of activity, bristling with groups of medical students crowding around different individuals on their cold slabs. The medical students commandeered the central space every week, as they deconstructed the body to heal it. Tucked away in the side of the main room, we learnt about the intricacies of the fleshed body; how movement is dictated by flexion and extension of passive and active striated skeletal muscle groups. Each week we would start with a new aspect on our adopted individual and help uncover that week’s muscle group.
The first exam had been taken some 5 weeks before, and we now stared at the second, a mere day or two away. Our focus this time was the lower half of the body, from the pelvis down to the toes. The almost fan-like gluteal muscles provided a staunch launching pad from which to run down the thighs, past tensor fascia latae and the iliotibial band on the lateral aspect, to curve with the sartorius on the anterior aspect, as we reached and admired the complexity of the knee joint. As we uncovered and cleaned each section free of adipose fat, we unveiled the vastus, adductors and hamstring muscle groups. Whilst running a discussion on what constituted the delicate femoral triangle, I couldn’t help but think of my own numerous surgeries. Of the many times I have had a scalpel part my skin on the lateral aspect of my thighs. That scar tissue, on my body as a permanent fixation, serves as a reminder that I too have been laid on a table, ready to be examined and explored; that ultimately, there is no difference between the living and the dead- it is just a different state of being, of matter in the universe.
We had already uncovered the startlingly array and complexicity of the upper body in previous dissection sessions. The human body, like any living creature, is a marvelous machine developed over millions of years of evolution. Nothing is perfect however. Homologies from a common ancestor, ‘the same organ in different animals under every variety of form and function’, are to be found throughout the animal kingdom, and the human as a part of this, has many. They are well documented, and I shan’t digress here. However, it is important to note the expected variation within species and between species. The detailed analysis of fossil hominids depends on this fundamental approach, even as new batteries of investigations are used.
And now, the week before Christmas, the main hall stood empty. No bodies lay on their metallic tables, and there was no crowd of bustling medical students hunched over, investigating and desiccating the minutiae of life. It was as if even the bodies had gone home for the bleak mid-winter break. As we finished testing each other on the soleus or the gastrocnemius, we carefully de-bladed the scalpels, washed all of the tools, and placed them back inside our student dissection kits for the last time. We silently thanked the individual’s generous bodily donation, and placed the plain cloth over the body and carefully tucked it in. As I made my way to a nearby exit, my fellow colleagues were already outside breathing the fresh cold winter air. As I opened the exit door I was accompanied by a lonely radio playing a mournful 1950s song. Knowing that I would not be back in this place again, I closed it and bid the room a fond farewell.
The University of Sheffield MSc Human Osteology program is the only UK based University that offers the teaching and education of human musculoskeletal anatomy by first hand dissection. Other UK Universities offering Osteological Masters degrees only teach musculoskeletal anatomy in the lecture theatre. I firmly believe that my education was enhanced by this opportunity. At all times the people who donated their bodies to the Medical Teaching Unit were respected and treated with dignity. The staff displayed professionalism and esteem, and encouraged us all to smile and to learn about the wonders of the human body.
Related and Further Information:
- The Chirurgeon’s Apprentice has an interesting article on vivisection in Early Modern England, and the medical advances and reactions to this method of dissection.
- An article in the Lancet by Lindsey Fitzharris (2012: 108-109), author of the above blog, discusses the effects of human dissection on early modern doctors and today’s medical practitioners .
- Guardian article citing the difficulties of obtaining skeletons for academic study, and the difficult process of donating bodies for medical and clinical science, with quotes from Dr Tim Thompson and Dr Piers D. Mitchell
- At the Museum of London, there is a current exhibition on ‘Doctors, Dissection and Resurrection Men‘ (until April 2013) detailing the excavation of 262 burials from Royal London Hospital with extensive evidence of dissection, along with faunal remains. The exhibition “reveals the intimate relationship between surgeons pushing forward anatomical study and the bodysnatchers who supplied them; and the shadowy practices prompted by a growing demand for corpses” (MoL 2013).