South African medical students are very fortunate in that we always have access to cadavers for dissection. Many western countries, as I have been told, simply don’t have these available to medical students.
My class started dissecting in September 2009. The new syllabus is all about integration, so where in the past curricula students spent about a year almost exclusively dissecting, we now have dissection at the beginning of most bodily systems. We have now dissected just about everything except the head/brain/spine and the musculoskeletal system.
Today we started with Neuro-dissection. At this point I should mention that dissection has never really been a problem for me – so much so that that bothered me. I couldn’t equate the body lying on the table with that of a human. It seemed to be only a shell, which I suppose it really is. In my culture, at least.
Cadavers are covered in large sections of cloth, doused in formalin. So while you are dissecting the abdomen, the chest, head and legs remain covered. Firstly this prevents the body from drying out too much (a cadaver is very very valuable and we only have a new intake once a year), but I think it also serves to provide some dignity.
In today’s dissection, we needed to make incisons (to the bone) from the nasion through the bregma right to the opisto cranion. Then another incision from just above the ear, through the bregma to the other ear. We then had to reflect the all the layers of the scalp to bear the skull. I tried finding a nice picture but there were none, so this is an illustration of the different landmarks so you can get an idea of the area of dissection. It is from “Applied Anatomy: the Construction of the Human Body”, by Gwilym G. Davis:
This was more difficult than any of the other dissections. Not because of technical difficulty, but because there was no way of denying that our cadaver was once alive. We have just recently had the new intake, so our cadaver is practically untouched, save for the second years who have started their thoracic dissections.
At one point I needed to lift his head for my friend to be able to extend the cut to the occipital protuberance, and as I did my hand rested against his ear. And cold and stiffened as the rest of the body may be, his ear was soft, elastic. It felt akin to what one might feel when caressing the ear of a lover.
On a more positive note, I got to cut a little today. Last year I was, as mentioned before, not very good with class attendance. The times that I was at dissection, I was afraid of making a fool of myself and so I did not demand my fair share of cutting. And nobody is really going to offer it to you if you don’t demand it.
In the world of young medical students, experience is a most prized possession.
I was beginning to worry that I would never know what kind of pressure is necessary to reach bone or viscera. Skin is actually very thin, do you know that? And there is really not that much space between our skulls and the outer layer of skin.
Now, if you’ll excuse me… I need to get rid of this formalin smell.