I haven't forgotten about this blog. After we started the brain extraction, things became a bit intense and I needed to step away from all of this and do normal things. To get my mind off of it all (no pun intended).
I'll be updating this within the next day or two. There was a lot that went on, and a lot that needs to be shared.
Saturday, July 18, 2009
Thursday, March 12, 2009
Geeking out
You know you're a total geek when you take photos of clouds just because they resemble histology slides. These clouds last week reminded me of fibrocartilage, and the other ones from two weeks ago reminded me of serratus anterior muscles.
/geek
The San Diego sky at around 7:45AM on March 2, 2009:
vs. fibrocartilage:
The San Diego sky at around 7:45AM on February 22, 2009:
vs. serratus anterior muscles
/geek
The San Diego sky at around 7:45AM on March 2, 2009:
vs. fibrocartilage:
The San Diego sky at around 7:45AM on February 22, 2009:
vs. serratus anterior muscles
Tuesday, March 3, 2009
Stitches
Today, Susan and I cleared fast and furious in order to make rapid headway, and our efforts paid off. For today, I finally managed to hit anterior rectus sheath, hidden away behind a good inch and a half (at least) of adipose tissue.
Then it was back to the dirty, greasy, smelly work of clearing out more of her adipose, in order to further expose her external obliques. She has large, well developed muscles and I wanted to get to them as fast as possible so that we could begin actually study of anatomical structures on our cadaver.
I actually smiled throughout the grueling work.
My smile came to an end, however, when Kevin announced that we would probably extract her brain and not the other cadaver's, since her facial structures weren't as nicely preserved as Mr. B. I am not looking forward to the sawing and the smell of the bone dust. I will have to mentally prepare.
Meanwhile, Tammy and Andrea had the unpleasant task of clearing away her large mons pubis. Poor Ruth, in life she had such a huge mons, large enough that Andrea could not palpate her clitoris until she had the length of her fingers a good 4" deep into the labia majora. After Andrea left early, Tammy finished clearing away the rest of the adipose, leaving behind only the labia majora and the external vulva. Ruth's vagina remains deep within her body, and so far has not been touched.
I can't speak for my table mates, but I feel weirded out by what a small part of me feels is a violation of her body. I know in life she knew full well what lay ahead when her body was donated to medical science, but the moral and ethical conflicts stemming from within me, a woman, while cutting into her breasts and reproductive organs was something I don't feel I was quite well prepared for.
I do my best to squelch the voices in my head that are telling me I am doing this cadaver wrong, and as I continue on my work of cleaning up the connective tissue on her anterior rectus sheath, I find that I am getting better at objectifying my task and separating myself from something that most people find revolting. I hope this does not mean that I am losing my ability to remain compassionate and emphatic.
But however, today we were afforded a small curiosity. Ruth has stitches, which we discovered as I was clearing the last of her lower abdominal fat. The small, green and blue sutures closed a saggital section that lay distal to her umbillicus, and stop shortly above her pubis symphysis. Could she have had a cesarian section? Umbilical hernia surgery? A hysterectomy? We all wonder aloud, trying to give a human angle to it. It catches me by surprise, because I don't recall seeing a scar in her skin as we made the cut in her lower abdomen.
Hopefully we'll have an answer to the mystery of her abdominal surgery within this semester. I feel like there isn't enough time to catch up.
Then it was back to the dirty, greasy, smelly work of clearing out more of her adipose, in order to further expose her external obliques. She has large, well developed muscles and I wanted to get to them as fast as possible so that we could begin actually study of anatomical structures on our cadaver.
I actually smiled throughout the grueling work.
My smile came to an end, however, when Kevin announced that we would probably extract her brain and not the other cadaver's, since her facial structures weren't as nicely preserved as Mr. B. I am not looking forward to the sawing and the smell of the bone dust. I will have to mentally prepare.
Meanwhile, Tammy and Andrea had the unpleasant task of clearing away her large mons pubis. Poor Ruth, in life she had such a huge mons, large enough that Andrea could not palpate her clitoris until she had the length of her fingers a good 4" deep into the labia majora. After Andrea left early, Tammy finished clearing away the rest of the adipose, leaving behind only the labia majora and the external vulva. Ruth's vagina remains deep within her body, and so far has not been touched.
I can't speak for my table mates, but I feel weirded out by what a small part of me feels is a violation of her body. I know in life she knew full well what lay ahead when her body was donated to medical science, but the moral and ethical conflicts stemming from within me, a woman, while cutting into her breasts and reproductive organs was something I don't feel I was quite well prepared for.
I do my best to squelch the voices in my head that are telling me I am doing this cadaver wrong, and as I continue on my work of cleaning up the connective tissue on her anterior rectus sheath, I find that I am getting better at objectifying my task and separating myself from something that most people find revolting. I hope this does not mean that I am losing my ability to remain compassionate and emphatic.
But however, today we were afforded a small curiosity. Ruth has stitches, which we discovered as I was clearing the last of her lower abdominal fat. The small, green and blue sutures closed a saggital section that lay distal to her umbillicus, and stop shortly above her pubis symphysis. Could she have had a cesarian section? Umbilical hernia surgery? A hysterectomy? We all wonder aloud, trying to give a human angle to it. It catches me by surprise, because I don't recall seeing a scar in her skin as we made the cut in her lower abdomen.
Hopefully we'll have an answer to the mystery of her abdominal surgery within this semester. I feel like there isn't enough time to catch up.
Thursday, February 26, 2009
An Epiphany
Note: I am posting this here from my LiveJournal blog simply because it's relevant to what I'm doing, even though it's not something that's actually happening in anatomy class.
When I was young, my Mother used to play dress up with me, and often times she would make a paper hat similar to that of an old school nurses' hat so that I could wear it when we played. She told me several years later that often I would attempt to perform surgery and I would prescribe medicine afterward, handed out in the form of Jelly Belly jellybeans or M&Ms, for my patient to take. I don't recall all the small details of those days back in the early 1970s, but I do remember enough to know that I have always had that drive.
A couple of years later, when I was maybe 6 or 7, I wanted to be a painter. I wrote and illustrated my first book with crayons, pastels, and construction paper and gave it to my Mom. It was called "The Sad Clown", and I will never forget the look of pride on her face as she read it. She saved that book for many years, up until we had to go overseas for my parents' business, and everything that was left behind here was eventually lost. But between the ages of 6 and 7, my standard answer to the question, "What do you want to be when you grow up?" was always the same: I want to be an artist, so that I could paint the world in beautiful colors.
Even at that precocious age, I knew that there was something about the world that was gray and drab, and therefore sad; and to the mind of a little girl, the instant way to fix it was as simple as a few paint strokes and brushes of colorful pastels. The sad looks on peoples' faces would instantly change to the happy smile like that on my Mom's face when I showed her my first book.
As I grew older, I wanted to heal. That little girl in me, the one that wore the nurse's uniform and hat, that would overstep her boundaries and try to operate and prescribe jellybean and chocolate pills, she never went away. I suppose from an early age on, I've always had this drive to heal the world. What I saw as gray and drab and therefore sad was really illness and disease, and I wanted to cure it and make it go away. It's an overly ambitious streak in me that I know will never be met, but the drive is there. Some people never experience that sort of drive. I'm one of the few who have, but I've also spent years ignoring it and squandering opportunities that I could have, should have, taken advantage of.
I spent the latter years of high school angry that I was held back a year for being overseas and not having enough English or History classes under my belt. They felt that if they put me in as a Junior, that the last year and a half of high school would not be enough for me to catch up on 3 English classes, World History, US History, and US Government/Civics. They felt that doubling up on those classes, plus the regular curriculum classes of science, math, PE, and electives would be too much to handle, so their fix was to hold me back a year and have me repeat my sophomore year. Naturally, I spent that repeat sophomore year angry and bitter, and I spent my entire junior year (which should have been my senior year) even more angry and bitter. I didn't focus on academics as much as I should have, and I earned Cs as a result instead of my usual As and Bs. I didn't take the classes I should have taken in order to get me into a very good 4 year university right off the bat, but at that point I didn't care. Also no adults pulled me aside to talk to me about my college future; not my parents, not my high school guidance counselors, not any teachers who felt that I was gifted and had potential and were concerned with my performance. Looking back, I feel rather cheated.
I passed my SATs with a combined score of 1300, which back in 1991 was considered very good. I scored 775 in Reading Comprehension and Critical writing, and 525 in Mathematics. It was my SAT score, combined with my mediocre high school GPA that allowed two state colleges (Humboldt State University in CA, and Colorado State University in CO) to accept my applications for admission. Given the fact that I was considered behind in some classes, I made a rudimentary plan of going to Humboldt State University for 4 years to get a Bachelor's Degree in Liberal Arts, and take enough science classes then to qualify for medical school. My pipe dream was to go to UC San Francisco and then live in the Bay Area and be a doctor. I was comfortable with that dream.
But after high school, life took a strange turn. Mom and Dad's family business had gone under, and they couldn't afford to pay for college. Due to other, unforseen reasons, some which also come from the fact that my parents' credit at that point was shot, I could not qualify for financial aid. Student loan centers wouldn't touch me since I had no credit of my own and Mom and Dad couldn't be relied upon, money wise. My grades in high school were too pathetic to qualify for any scholarships or grants. My dream of going off to college was crushed, and instead I found a job locally to help pay for the bills at home, and I enrolled at a junior college.
But if that wasn't already enough, I was a barely blooming 19 year old recovering from a 3 year case of unrequited love when I met someone. His name was Jerry, and we pretty much met through his pager, although mutual friends of ours at the time had tried to set us up but I wasn't for it. I was saving myself for Jason, whom I'd known since we were 11 years old, and I had held out hope that someday he'd come around and realize that I was the one he wanted. I had dialed Jerry's pager hoping to get a hold of somebody else, and he called me back (this was in 1992, well before cell phones were widely popular. Pagers were the hip thing to have). He asked if I wanted to go out for dinner, and I said yes. Seven months later, after a tumultuous and whirlwind relationship-courtship, we were married. Shortly after we married, I stopped going to college and I started working full time so that I could help bring money in to our newlywed independence.
So that's where my dream of becoming a doctor ended. Now I'm in the later half of my 30s, with two prepubescent sons to raise, and I figured the closest I'd get to practicing medicine would be as an NP. I switched careers 8 years ago, after being laid off from a computer related job I had, and decided to test the waters of health care. I became a medical assistant. Through my job as a medical assistant I had been allowed to work as a phlebotomist, surgical assistant, and administrator of various types of shots and vaccinations. I love working in health care and I know this is the field for me, but I'm not satisfied with being a medical assistant. I know I am capable of doing more, so I started looking at nursing.
In 2004 I started taking classes towards nursing school, starting with the prerequesites, but a separation and divorce towards the end of that year put my efforts on hold. I did so badly in class due to the stresses at home, and I neglected to withdraw in time to save my grades. I ate the Ds and the Fs. Two years later, I started class again after sorting out personal issues and making sure I was mentally prepared for the rigors of single motherhood and balancing college work with a regular job. Here I am 3 years later, doing 11 units this semester, working part time, and still raising my kids, and I'm wondering if it's too late for me to switch gears again and just GO FOR IT. Everybody around me who I have spoken with in detail about this (whose opinions actually matter to me) have told me that I'm not too old, nor am I lacking intelligence and drive to do this, so why hold back?
I think it's because a part of me was scared. The forumla for me at this point to get to the coveted M.D. title looks something like this: Baccalaureate degree (preferably in a discipline involving science) + MCAT + trying to get into a medical school + 4 years of rigorous college courses through med school + finding a way to pay tuition for it all + residency + fellowship = M.D.
I think I understated the part where I said a part of me was scared.
Then a friend of mine sent me a link to another field of medicine: Osteopathic Medicine. You get your B.S. degree, you take the MCAT, you apply to the medical schools that specialize in it, you go for your 4 years like any other doctor, then you graduate with a D.O. (doctorate of osteopathy) as opposed to a M.D. and you can practice in whatever field of medicine alongside other physicians. The goal of a D.O. is to treat the person as a whole, rather than just focus on the symptom itself, and they focus on a more holistic approach than a chemotherapeutical one. One of the two colleges in CA that specialize in D.O. training is located an hour and a half away from San Diego, in Pomona, CA.
I read that and it's like a light bulb went on somewhere in my head. The clouds parted, the heavens sighed, and the angels began a rapturous chorus of Handel's Messiah all at once.
Today I went to the college counseling office at Miramar to discuss changing my degree planning. I'm about 6 courses shy of being able to transfer to SDSU or CSUSM (California State University San Marcos) with an undergraduate degree in Biology, upon which I can define the discipline. He said I could also move it to something like Liberal Arts or Fine Arts, but I said I was so in love with the human aspect of science that I might as well narrow it down to Human Biology with a minor in Anatomy. He said I've taken enough biology and my GPA overall is very nice, good enough to be able to transfer without any problems so long as I'm not flunking out of college.
Next I spoke to my parents, and with Jerry. They all agree that I should pursue this, and not waste time anymore. My parents will be helping with watching my kids as needed if I have to be in class, and Jerry says that I should enroll in whatever I need to enroll in and not wait for him to catch up anymore. The only obstacles I have now are finances, which always seem to settle themselves out, and my flagging sense of worth. Can I do really do this, or am I kidding myself?
My father is a man who loves me unconditionally, but has always been honest with me about things he doesn't like. He told me last night that he not only loves me and will support me in this endeavor, but it's about time that I came around because he always felt that I was too smart and had too much potential to settle for something that is less than stellar. Also, while there is very little in my life that he feels I should regret or redo, this changing of careers is not one of them, and he only wondered what took me so long to figure this out. He also said that he respects me and my decision to do this, and finally thinks that I'm doing myself some justice by considering this path.
The only thing left for me to do now is to go out and get this all over with.
But I'd be lying if I said I wasn't nervous about my own ability to pull this stunt off.
When I was young, my Mother used to play dress up with me, and often times she would make a paper hat similar to that of an old school nurses' hat so that I could wear it when we played. She told me several years later that often I would attempt to perform surgery and I would prescribe medicine afterward, handed out in the form of Jelly Belly jellybeans or M&Ms, for my patient to take. I don't recall all the small details of those days back in the early 1970s, but I do remember enough to know that I have always had that drive.
A couple of years later, when I was maybe 6 or 7, I wanted to be a painter. I wrote and illustrated my first book with crayons, pastels, and construction paper and gave it to my Mom. It was called "The Sad Clown", and I will never forget the look of pride on her face as she read it. She saved that book for many years, up until we had to go overseas for my parents' business, and everything that was left behind here was eventually lost. But between the ages of 6 and 7, my standard answer to the question, "What do you want to be when you grow up?" was always the same: I want to be an artist, so that I could paint the world in beautiful colors.
Even at that precocious age, I knew that there was something about the world that was gray and drab, and therefore sad; and to the mind of a little girl, the instant way to fix it was as simple as a few paint strokes and brushes of colorful pastels. The sad looks on peoples' faces would instantly change to the happy smile like that on my Mom's face when I showed her my first book.
As I grew older, I wanted to heal. That little girl in me, the one that wore the nurse's uniform and hat, that would overstep her boundaries and try to operate and prescribe jellybean and chocolate pills, she never went away. I suppose from an early age on, I've always had this drive to heal the world. What I saw as gray and drab and therefore sad was really illness and disease, and I wanted to cure it and make it go away. It's an overly ambitious streak in me that I know will never be met, but the drive is there. Some people never experience that sort of drive. I'm one of the few who have, but I've also spent years ignoring it and squandering opportunities that I could have, should have, taken advantage of.
I spent the latter years of high school angry that I was held back a year for being overseas and not having enough English or History classes under my belt. They felt that if they put me in as a Junior, that the last year and a half of high school would not be enough for me to catch up on 3 English classes, World History, US History, and US Government/Civics. They felt that doubling up on those classes, plus the regular curriculum classes of science, math, PE, and electives would be too much to handle, so their fix was to hold me back a year and have me repeat my sophomore year. Naturally, I spent that repeat sophomore year angry and bitter, and I spent my entire junior year (which should have been my senior year) even more angry and bitter. I didn't focus on academics as much as I should have, and I earned Cs as a result instead of my usual As and Bs. I didn't take the classes I should have taken in order to get me into a very good 4 year university right off the bat, but at that point I didn't care. Also no adults pulled me aside to talk to me about my college future; not my parents, not my high school guidance counselors, not any teachers who felt that I was gifted and had potential and were concerned with my performance. Looking back, I feel rather cheated.
I passed my SATs with a combined score of 1300, which back in 1991 was considered very good. I scored 775 in Reading Comprehension and Critical writing, and 525 in Mathematics. It was my SAT score, combined with my mediocre high school GPA that allowed two state colleges (Humboldt State University in CA, and Colorado State University in CO) to accept my applications for admission. Given the fact that I was considered behind in some classes, I made a rudimentary plan of going to Humboldt State University for 4 years to get a Bachelor's Degree in Liberal Arts, and take enough science classes then to qualify for medical school. My pipe dream was to go to UC San Francisco and then live in the Bay Area and be a doctor. I was comfortable with that dream.
But after high school, life took a strange turn. Mom and Dad's family business had gone under, and they couldn't afford to pay for college. Due to other, unforseen reasons, some which also come from the fact that my parents' credit at that point was shot, I could not qualify for financial aid. Student loan centers wouldn't touch me since I had no credit of my own and Mom and Dad couldn't be relied upon, money wise. My grades in high school were too pathetic to qualify for any scholarships or grants. My dream of going off to college was crushed, and instead I found a job locally to help pay for the bills at home, and I enrolled at a junior college.
But if that wasn't already enough, I was a barely blooming 19 year old recovering from a 3 year case of unrequited love when I met someone. His name was Jerry, and we pretty much met through his pager, although mutual friends of ours at the time had tried to set us up but I wasn't for it. I was saving myself for Jason, whom I'd known since we were 11 years old, and I had held out hope that someday he'd come around and realize that I was the one he wanted. I had dialed Jerry's pager hoping to get a hold of somebody else, and he called me back (this was in 1992, well before cell phones were widely popular. Pagers were the hip thing to have). He asked if I wanted to go out for dinner, and I said yes. Seven months later, after a tumultuous and whirlwind relationship-courtship, we were married. Shortly after we married, I stopped going to college and I started working full time so that I could help bring money in to our newlywed independence.
So that's where my dream of becoming a doctor ended. Now I'm in the later half of my 30s, with two prepubescent sons to raise, and I figured the closest I'd get to practicing medicine would be as an NP. I switched careers 8 years ago, after being laid off from a computer related job I had, and decided to test the waters of health care. I became a medical assistant. Through my job as a medical assistant I had been allowed to work as a phlebotomist, surgical assistant, and administrator of various types of shots and vaccinations. I love working in health care and I know this is the field for me, but I'm not satisfied with being a medical assistant. I know I am capable of doing more, so I started looking at nursing.
In 2004 I started taking classes towards nursing school, starting with the prerequesites, but a separation and divorce towards the end of that year put my efforts on hold. I did so badly in class due to the stresses at home, and I neglected to withdraw in time to save my grades. I ate the Ds and the Fs. Two years later, I started class again after sorting out personal issues and making sure I was mentally prepared for the rigors of single motherhood and balancing college work with a regular job. Here I am 3 years later, doing 11 units this semester, working part time, and still raising my kids, and I'm wondering if it's too late for me to switch gears again and just GO FOR IT. Everybody around me who I have spoken with in detail about this (whose opinions actually matter to me) have told me that I'm not too old, nor am I lacking intelligence and drive to do this, so why hold back?
I think it's because a part of me was scared. The forumla for me at this point to get to the coveted M.D. title looks something like this: Baccalaureate degree (preferably in a discipline involving science) + MCAT + trying to get into a medical school + 4 years of rigorous college courses through med school + finding a way to pay tuition for it all + residency + fellowship = M.D.
I think I understated the part where I said a part of me was scared.
Then a friend of mine sent me a link to another field of medicine: Osteopathic Medicine. You get your B.S. degree, you take the MCAT, you apply to the medical schools that specialize in it, you go for your 4 years like any other doctor, then you graduate with a D.O. (doctorate of osteopathy) as opposed to a M.D. and you can practice in whatever field of medicine alongside other physicians. The goal of a D.O. is to treat the person as a whole, rather than just focus on the symptom itself, and they focus on a more holistic approach than a chemotherapeutical one. One of the two colleges in CA that specialize in D.O. training is located an hour and a half away from San Diego, in Pomona, CA.
I read that and it's like a light bulb went on somewhere in my head. The clouds parted, the heavens sighed, and the angels began a rapturous chorus of Handel's Messiah all at once.
Today I went to the college counseling office at Miramar to discuss changing my degree planning. I'm about 6 courses shy of being able to transfer to SDSU or CSUSM (California State University San Marcos) with an undergraduate degree in Biology, upon which I can define the discipline. He said I could also move it to something like Liberal Arts or Fine Arts, but I said I was so in love with the human aspect of science that I might as well narrow it down to Human Biology with a minor in Anatomy. He said I've taken enough biology and my GPA overall is very nice, good enough to be able to transfer without any problems so long as I'm not flunking out of college.
Next I spoke to my parents, and with Jerry. They all agree that I should pursue this, and not waste time anymore. My parents will be helping with watching my kids as needed if I have to be in class, and Jerry says that I should enroll in whatever I need to enroll in and not wait for him to catch up anymore. The only obstacles I have now are finances, which always seem to settle themselves out, and my flagging sense of worth. Can I do really do this, or am I kidding myself?
My father is a man who loves me unconditionally, but has always been honest with me about things he doesn't like. He told me last night that he not only loves me and will support me in this endeavor, but it's about time that I came around because he always felt that I was too smart and had too much potential to settle for something that is less than stellar. Also, while there is very little in my life that he feels I should regret or redo, this changing of careers is not one of them, and he only wondered what took me so long to figure this out. He also said that he respects me and my decision to do this, and finally thinks that I'm doing myself some justice by considering this path.
The only thing left for me to do now is to go out and get this all over with.
But I'd be lying if I said I wasn't nervous about my own ability to pull this stunt off.
Tuesday, February 24, 2009
An abominable task
The smell of adipose tissue is revolting.
There is no nice way to say that, and I know that I have issues with fat on a psychological and physical level that I usually choose not to share with the world, but will talk a bit about below. Just a bit, not the whole, ugly bunch of details. Yet the cadaver I chose to work on when we divided ourselves into groups was that of Ruth's, who was morbidly obese at death.
To add to the irony that should otherwise be a joyous day, being Fat Tuesday (and I mean this with no pun intended, yet I feel horrible by even referencing it and I just realized while typing this that GOOD LORD JENNIFER, what did you just say?), in psychology class we discussed eating disorders. When I was overseas, between the precocious ages of 13-15, and thrust into the world of being a commercial model, the likelihood of coming down with a body dysmorphic disorder is great. At 14 I developed anorexia after a friend's cousin did something to me that is unmentionable. Add the stress of that to my work as a model at a young age in a country where you can't even speak the language and are separated from your parents, your end result is the perfect recipe for an eating disorder.
I hid it well for one thing because I wore bulky clothing, often hiding myself in a sweater or cardigan worn over my Catholic school uniform. Mind you now, this was in the Philippines, a tropical rainforest country which is ON THE EQUATOR, so wearing a wool sweater or cardigan is not something one does out of necessity due to the weather. At the time I was ill, I was also living in a dormitory run by nuns on the school campus. Thank you, St. Joseph's College, for helping me hide this from my parents.
Looking back on my childhood, I was normal weight. I became overweight recently and I'm not even close to obese, but my old, battered self esteem is beating me up for the weight gain. I am dealing with it in a healthy fashion, choosing instead to focus on getting my exercise on rather than go the binge/purge method or crack pipe method of some other women I know (all of whom will remain anonymous). I have fat issues. I am, and always will be, in recovery.
This part of my psyche ties back in with Ruth because I see myself in her as a worst-case scenario. I do not ever want to let myself go to that extreme. I have some women in my family who are morbidly obese, and I want to take them to see Ruth and say, "You need to take better care of yourself or this will be you!" I feel a sense of sorrow as I scrape away layer upon layer of adipose. I apologize to her and Susan instantly pipes up, "She's happy. Look at her, she's finally losing all of that fat! She's smiling!" I love Susan. She's got a fantastic personality and I instantly feel better.
I bring my new camera to class, a Nikon D60 (not the D90 I coveted, as I spent $600 less by going with this model), and Jerry says he'll take photos and do general assisting for both groups. Kevin likes this idea and they start taking photos of all the saved specimens. I am talking with Susan, Cynthia, Andrea, and Tammy, and I hear Kevin telling Jerry what muscles on their cadaver he wants photographed.
Muscles. The other group is already identifying muscles on Mr. B. And here we are, still clearing up fat.
I put my scalpel down. I look at Ruth and consult with Susan and Cynthia on some wild idea I have for today's clearing, and I feel like a bossy barbarian bitch by doing so. It had to be done though, and I'll take the bitch blame for it if the ladies around me today found me difficult to deal with. I am deeply concerned that at the pace we are going at, three ladies with a penchant for perfection, that by week 12 of 16 we will still be clearing through fat if we try and focus on making her pretty. Let's dig down with our scalpels, clear out the majority of the fat, and then we can spend time scraping away painstakingly afterwards. I just want to keep up with the other group, who are already to the point where they are identifying structures, far more structures, than just inches of adipose.
I call Kevin over. I ask him if it's all right for us to cut down through her abdomen and start clearing away fat. He says to go for it, the faster we get it done the better. Maybe this was a mistake, because he just gave the dark side of me the green light to go ahead and go all out. I begin making deep cuts into her abdominal skin, following the lines that were already made by her folds. During embalming, her skin had folded in such a way that it laid out the perfect blueprint for us to make our cuts. After making the initial cuts, Susan, and I start going deep into her abdomen to peel back the skin. Cynthia said that she would be working on cleaning up her face and neck, focusing on finishing the area around her sternocledomastoid muscle. Susan held up her flap of skin and I helped her cut underneath since she was not at a good angle to get at it herself. I was able to do my area on my own, but I attribute my height advantage to being able to get at a better angle for scalpel work.
The sound of our scalpels cutting away fat sounded much like layers of saran wrap being cut with a blade. It had a weird whoosh sound to it. Every few minutes we'd have to turn away, as gas pockets of embalming fluid mixed in with the odor of the adipose itself would sometimes rise up and catch us by surprise. Kevin himself had to leave the room for a breath of fresh air. Eventually I had to also. The smell was coming through my mask, and it was making my eyes water.
She had layers of fibrous fat, which was brownish red as opposed to the normal deep yellow of her adipose. Kevin couldn't tell us what it was, we just equated the consistency to gristle. Some parts were so dense that I was afraid I was cutting into muscle, but I was confident of how deep I was going, and I knew that I still had about an inch of fat to go before I hit muscle.
They say that you learn something about yourself every day. This class has not let me down in that aspect, as every Tuesday for the last four weeks I have learned something new about my resolve, determination, and ability to objectify something just to get the job done. I also learned today how good I am with a scalpel. I was clearing out the superficial fascia with quickness and a confidence I didn't know I had. I joked to my table that in order to speed things up, I was just going to go on Iron Chef speed. Sure enough, I was. Soon after I was cutting out chunks of adipose tissue in sheets roughly the size of my hand. My brain deals with the horrors of what I'm doing by injecting odd humor into the equation, and my brain had said, "Adipose steaks, cut to order."
An hour later, I have cleared out an area in her left inguinal region that is definitely one thin, connective tissue layer away from her rectus abdominus. By this time the smell of her adipose has filled the room, and Kevin tells us to start cleaning up early. It's 30 minutes sooner than we normally begin cleanup, but my table is overwhelmed and Ruth's body is starting to give up its embalmed gases. Jerry helped us bag up two full bags of fat, and later on he tells me that there's at least 15 pounds of fat in the larger trash bag that Kevin stashed the fat bags in.
I'm too dizzy to help with scrubbing the utensils. I help wipe down Ruth, wet her with the solution, and I cover her with the muslin and wet it down. Andrea and I wrap her up in her plastic, and Tammy finishes sealing up her body bag. My face has been 3 inches away from Ruth for two hours, and I'm premenstrual and have not yet eaten. Between the malodorous atmosphere and my own physical pangs (including a sore biceps brachii long and short head from lifting weights all week) I just lean up against the wall and wait for the sink.
Kevin has a rule in his class. Nobody gets sick in Dr. Petti's class. I am not one to vomit but I'm so on the verge of passing out at that moment, that I lean up against the wall and just breathe. But breathing is not pleasant with the air in the room. I wash my hands as soon as the sink is available, and I rush out the door of the prosectorium and the anatomy lab.
I take in deep breaths of air through my nose, trying to clear out the lingering odor. It won't go away. Susan comes out and I can't recall now what she said to me, but she hurries off, and as of this writing I feel bad that I don't remember what she said, or if I even said bye. I just wanted to get the hell out of there at that moment.
Jerry and I get to my place, and he has to stay and pick up the boys while I go to Livescan to get my fingerprints done. I had just been accepted to be a guide for the upcoming Body Worlds exhibition at the San Diego Natural History Museum and I had to finish the background check. I want to apologize to everybody I encounter, because they are looking at me like I smell. They do that BECAUSE I DO SMELL. The lady who is taking my fingerprints tells me that I smell very "chemically" and I tell her that I'm sorry I had no time to shower after gross anatomy lab. She finishes my fingerprints as fast as she could and sends me on my way.
I drive home as fast as I am comfortable with breaking the speed limit. I don't go over 80mph because I still try and be safe. I get home and the first thing I do is ask Jerry to stay and talk with me while I shower, because I have a lot on my mind that I need to process.
I take as hot of a shower as I can withstand, and I try not to cry while talking to him. Like I have said before, I am not one to cry, but I'm premenstrual and the events of today starting with psychology class led to this climax of brain thoughts. I realize that I am scrubbing my skin almost raw with the washcloth, trying to get rid of Ruth's embalmed adipose smell off of my body. I finally have it out of my nostrils, and thanks to the mask and chewing gum I do not have it in my throat, but it lingers on my hands. In my haste to get things done today, I cut through four pairs of my gloves.
I tell Jerry that I am wracked by guilt because for the first time since I even considered taking this class, that I am disgusted by my cadaver. I love the spirit of Ruth. She is the most benevolent human I have ever come to know, along with Mike and Mr. B (the other cadavers), and because of her generosity I am able to learn more about the human body than the majority of the world will ever get to know. I love her and appreciate her gift. I am thankful and grateful beyond words for her, but I feel like absolute shit because for a moment I am disgusted by her and what I had to do today. I feel like an ingrate, and I am crushed by an overwhelming sense of Catholic guilt.
Jerry says not to be disgusted at Ruth, but it's ok to be disgusted at the task we had to do today. It was gruesome, and on the way to the parking lot the girls working on Mr. B both commented to me that they're glad they're not working on my cadaver. They said it with a mix of sympathy and awe, and even I acknowledge that it's not a task for the light hearted or weak of stomach.
So here I am now, typing away at this entry, wondering whether I want to make it public or not. I smell clean, like vanilla soap and shampoo, and my hands do not reek of formalin. My sons come up to me and embrace me as if nothing is amiss. Rome even massaged my sore shoulder and asked me if I felt better. Jerry says he'll stay with me tonight and I say ok, since I could use the company and both talk and type therapy will help me get this burden off my chest.
I also got my period.
Physically and mentally, I am experiencing catharsis.
There is no nice way to say that, and I know that I have issues with fat on a psychological and physical level that I usually choose not to share with the world, but will talk a bit about below. Just a bit, not the whole, ugly bunch of details. Yet the cadaver I chose to work on when we divided ourselves into groups was that of Ruth's, who was morbidly obese at death.
To add to the irony that should otherwise be a joyous day, being Fat Tuesday (and I mean this with no pun intended, yet I feel horrible by even referencing it and I just realized while typing this that GOOD LORD JENNIFER, what did you just say?), in psychology class we discussed eating disorders. When I was overseas, between the precocious ages of 13-15, and thrust into the world of being a commercial model, the likelihood of coming down with a body dysmorphic disorder is great. At 14 I developed anorexia after a friend's cousin did something to me that is unmentionable. Add the stress of that to my work as a model at a young age in a country where you can't even speak the language and are separated from your parents, your end result is the perfect recipe for an eating disorder.
I hid it well for one thing because I wore bulky clothing, often hiding myself in a sweater or cardigan worn over my Catholic school uniform. Mind you now, this was in the Philippines, a tropical rainforest country which is ON THE EQUATOR, so wearing a wool sweater or cardigan is not something one does out of necessity due to the weather. At the time I was ill, I was also living in a dormitory run by nuns on the school campus. Thank you, St. Joseph's College, for helping me hide this from my parents.
Looking back on my childhood, I was normal weight. I became overweight recently and I'm not even close to obese, but my old, battered self esteem is beating me up for the weight gain. I am dealing with it in a healthy fashion, choosing instead to focus on getting my exercise on rather than go the binge/purge method or crack pipe method of some other women I know (all of whom will remain anonymous). I have fat issues. I am, and always will be, in recovery.
This part of my psyche ties back in with Ruth because I see myself in her as a worst-case scenario. I do not ever want to let myself go to that extreme. I have some women in my family who are morbidly obese, and I want to take them to see Ruth and say, "You need to take better care of yourself or this will be you!" I feel a sense of sorrow as I scrape away layer upon layer of adipose. I apologize to her and Susan instantly pipes up, "She's happy. Look at her, she's finally losing all of that fat! She's smiling!" I love Susan. She's got a fantastic personality and I instantly feel better.
I bring my new camera to class, a Nikon D60 (not the D90 I coveted, as I spent $600 less by going with this model), and Jerry says he'll take photos and do general assisting for both groups. Kevin likes this idea and they start taking photos of all the saved specimens. I am talking with Susan, Cynthia, Andrea, and Tammy, and I hear Kevin telling Jerry what muscles on their cadaver he wants photographed.
Muscles. The other group is already identifying muscles on Mr. B. And here we are, still clearing up fat.
I put my scalpel down. I look at Ruth and consult with Susan and Cynthia on some wild idea I have for today's clearing, and I feel like a bossy barbarian bitch by doing so. It had to be done though, and I'll take the bitch blame for it if the ladies around me today found me difficult to deal with. I am deeply concerned that at the pace we are going at, three ladies with a penchant for perfection, that by week 12 of 16 we will still be clearing through fat if we try and focus on making her pretty. Let's dig down with our scalpels, clear out the majority of the fat, and then we can spend time scraping away painstakingly afterwards. I just want to keep up with the other group, who are already to the point where they are identifying structures, far more structures, than just inches of adipose.
I call Kevin over. I ask him if it's all right for us to cut down through her abdomen and start clearing away fat. He says to go for it, the faster we get it done the better. Maybe this was a mistake, because he just gave the dark side of me the green light to go ahead and go all out. I begin making deep cuts into her abdominal skin, following the lines that were already made by her folds. During embalming, her skin had folded in such a way that it laid out the perfect blueprint for us to make our cuts. After making the initial cuts, Susan, and I start going deep into her abdomen to peel back the skin. Cynthia said that she would be working on cleaning up her face and neck, focusing on finishing the area around her sternocledomastoid muscle. Susan held up her flap of skin and I helped her cut underneath since she was not at a good angle to get at it herself. I was able to do my area on my own, but I attribute my height advantage to being able to get at a better angle for scalpel work.
The sound of our scalpels cutting away fat sounded much like layers of saran wrap being cut with a blade. It had a weird whoosh sound to it. Every few minutes we'd have to turn away, as gas pockets of embalming fluid mixed in with the odor of the adipose itself would sometimes rise up and catch us by surprise. Kevin himself had to leave the room for a breath of fresh air. Eventually I had to also. The smell was coming through my mask, and it was making my eyes water.
She had layers of fibrous fat, which was brownish red as opposed to the normal deep yellow of her adipose. Kevin couldn't tell us what it was, we just equated the consistency to gristle. Some parts were so dense that I was afraid I was cutting into muscle, but I was confident of how deep I was going, and I knew that I still had about an inch of fat to go before I hit muscle.
They say that you learn something about yourself every day. This class has not let me down in that aspect, as every Tuesday for the last four weeks I have learned something new about my resolve, determination, and ability to objectify something just to get the job done. I also learned today how good I am with a scalpel. I was clearing out the superficial fascia with quickness and a confidence I didn't know I had. I joked to my table that in order to speed things up, I was just going to go on Iron Chef speed. Sure enough, I was. Soon after I was cutting out chunks of adipose tissue in sheets roughly the size of my hand. My brain deals with the horrors of what I'm doing by injecting odd humor into the equation, and my brain had said, "Adipose steaks, cut to order."
An hour later, I have cleared out an area in her left inguinal region that is definitely one thin, connective tissue layer away from her rectus abdominus. By this time the smell of her adipose has filled the room, and Kevin tells us to start cleaning up early. It's 30 minutes sooner than we normally begin cleanup, but my table is overwhelmed and Ruth's body is starting to give up its embalmed gases. Jerry helped us bag up two full bags of fat, and later on he tells me that there's at least 15 pounds of fat in the larger trash bag that Kevin stashed the fat bags in.
I'm too dizzy to help with scrubbing the utensils. I help wipe down Ruth, wet her with the solution, and I cover her with the muslin and wet it down. Andrea and I wrap her up in her plastic, and Tammy finishes sealing up her body bag. My face has been 3 inches away from Ruth for two hours, and I'm premenstrual and have not yet eaten. Between the malodorous atmosphere and my own physical pangs (including a sore biceps brachii long and short head from lifting weights all week) I just lean up against the wall and wait for the sink.
Kevin has a rule in his class. Nobody gets sick in Dr. Petti's class. I am not one to vomit but I'm so on the verge of passing out at that moment, that I lean up against the wall and just breathe. But breathing is not pleasant with the air in the room. I wash my hands as soon as the sink is available, and I rush out the door of the prosectorium and the anatomy lab.
I take in deep breaths of air through my nose, trying to clear out the lingering odor. It won't go away. Susan comes out and I can't recall now what she said to me, but she hurries off, and as of this writing I feel bad that I don't remember what she said, or if I even said bye. I just wanted to get the hell out of there at that moment.
Jerry and I get to my place, and he has to stay and pick up the boys while I go to Livescan to get my fingerprints done. I had just been accepted to be a guide for the upcoming Body Worlds exhibition at the San Diego Natural History Museum and I had to finish the background check. I want to apologize to everybody I encounter, because they are looking at me like I smell. They do that BECAUSE I DO SMELL. The lady who is taking my fingerprints tells me that I smell very "chemically" and I tell her that I'm sorry I had no time to shower after gross anatomy lab. She finishes my fingerprints as fast as she could and sends me on my way.
I drive home as fast as I am comfortable with breaking the speed limit. I don't go over 80mph because I still try and be safe. I get home and the first thing I do is ask Jerry to stay and talk with me while I shower, because I have a lot on my mind that I need to process.
I take as hot of a shower as I can withstand, and I try not to cry while talking to him. Like I have said before, I am not one to cry, but I'm premenstrual and the events of today starting with psychology class led to this climax of brain thoughts. I realize that I am scrubbing my skin almost raw with the washcloth, trying to get rid of Ruth's embalmed adipose smell off of my body. I finally have it out of my nostrils, and thanks to the mask and chewing gum I do not have it in my throat, but it lingers on my hands. In my haste to get things done today, I cut through four pairs of my gloves.
I tell Jerry that I am wracked by guilt because for the first time since I even considered taking this class, that I am disgusted by my cadaver. I love the spirit of Ruth. She is the most benevolent human I have ever come to know, along with Mike and Mr. B (the other cadavers), and because of her generosity I am able to learn more about the human body than the majority of the world will ever get to know. I love her and appreciate her gift. I am thankful and grateful beyond words for her, but I feel like absolute shit because for a moment I am disgusted by her and what I had to do today. I feel like an ingrate, and I am crushed by an overwhelming sense of Catholic guilt.
Jerry says not to be disgusted at Ruth, but it's ok to be disgusted at the task we had to do today. It was gruesome, and on the way to the parking lot the girls working on Mr. B both commented to me that they're glad they're not working on my cadaver. They said it with a mix of sympathy and awe, and even I acknowledge that it's not a task for the light hearted or weak of stomach.
So here I am now, typing away at this entry, wondering whether I want to make it public or not. I smell clean, like vanilla soap and shampoo, and my hands do not reek of formalin. My sons come up to me and embrace me as if nothing is amiss. Rome even massaged my sore shoulder and asked me if I felt better. Jerry says he'll stay with me tonight and I say ok, since I could use the company and both talk and type therapy will help me get this burden off my chest.
I also got my period.
Physically and mentally, I am experiencing catharsis.
Tuesday, February 17, 2009
Breasts
From womb to tomb, men and women alike are fascinated with breasts.
They come in all shapes, sizes, colors, symmetries. The size and relation of the areola to nipple with regards to the rest of the breast can also vary, with some being as tiny as dimes and others being the size of an Eisenhower silver dollar.
Breasts to the extremely young are a means of sustenance, a way of obtaining nutrients before they are able to masticate solid food. This is not something unique to humans, as it occurs across all mammalian species everywhere in the world. To humans, and maybe some species of primates, breasts are also regarded as an aesthetically pleasing object that embodies sex. Ancient civilizations have left behind artifacts in the form of cave drawings, effigies, and statuary or idolatry depicting powerful women with emphasized breasts. Renaissance artists like Boticelli and Da Vinci had made masterpieces that focused on the female form, with their flowing hair and bare breasts. Venus de Milo was born of the sea, with her long flowing locks barely covering her ample, round breasts and her mons pubis. The new age of media following the industrial revolution gave way to what is now commonly known as pornography, but in the early days of printed nudes, most of what was revealed and captured on film was limited to the bare breast.
We are a species that is fascinated with breasts, and that's what made it very difficult for me to cut into Ruth's breast tissue as we prepared to take her body into deeper stages of dissection.
Before Cynthia, Susan and I began to cut open her breasts, we consulted with Kevin just to make sure that what we were about to do would be to his liking. Andrea and Tammy were going to stay focused on cleaning up Ruth's right leg, uncovering the musculature that lay underneath her padding of fat. The task of what to do with Ruth's breasts was left to us.
I had been working on Ruth's left side, and Cynthia and Susan on the right. Cynthia did a lot of work cleaning up underlying fascia on the right, with Susan doing a wonderful job of helping both sides with the endless amounts of scraping and scooping of adipose. It sounds crass, but that's what it is. Cynthia's class had dissected her face, and she wanted to finish what had been started but there was so much to do with the chest area that she stopped working on the face to help get us started. Call it scalpel shyness, if anything. Cynthia didn't have it.
It had been decided that since her right breast was smaller than the left, that we would cut around the areola and remove the skin surrounding the rest of her breast, leaving it intact. The left one was more substantial so what we would do is a mid saggital cut through the areola and nipple, down to the muscle. We would remove half of the breast and leave the other half intact, so that one could view it and see how breast tissue differs from the underlying muscle.
I did the initial cut through Ruth's areola and nipple. I apologized to Ruth, even though I know she felt no pain. I felt odd doing this to a woman's breast, even if she was dead and had donated her body to science so that students like me could learn to heal by dismantling the dead. I kept right on going, and by this time I was on full autopilot mode. I removed the skin from the breast to the midline, then braced myself to make the first cut into her breast tissue to remove the one half. Her breast tissue looked just like the rest of her adipose tissue, but more fibrous. I quickly changed thoughts, as I don't want to associate my own breasts with cold, greasy, yellow adipose.
With full confidence, I pushed my scalpel through the mound of exposed breast tissue. I gasped. Nothing could have prepared me for the feeling of the blade as it pushed through. It's very hard to describe, but the best analogy I can come up with is that it feels like taking an exacto knife and cutting through packing peanuts surrounded by layer upon layer of bubble wrap. I slid my scalpel halfway down her breast tissue and then looked at Susan, who was patiently scraping fat and helping pretty up exposed areas. She looked at me and I told her, "Susan, you HAVE to feel this."
I traded roles with Susan and let her finish the removal of the medial half of Ruth's deeply exposed breast. For the next 30 minutes, I scraped up fat, cleaned up exposed structures, and talked with Susan and Cynthia about how we all own a Miata. Anything to ignore the weird nagging thought in my head about cutting up a stranger's breast.
Later on Susan and I switched spots again, and I started cleaning up further below the left breast and making plans for what I wanted us to do for Ruth next week. Jerry's group was further along with their cadaver, since he was a leaner guy, and they were already at the point where a good amount of his musculature was exposed. I wanted to, with Kevin's permission of course, start aggressively cleaning up the fat on the frontal side of her body, and get to where we were also looking at muscle.
With this aggressive attitude in mind, I started exposing her left pectoralis major muscle. At first I wasn't sure that I'd gone so deep that I'd hit muscle, but as I kept scraping away fat I started seeing reddish fibers follow my scalpel. Sure enough I'd hit muscle. I started snipping away at the fibers that were stubbornly holding her adipose to the muscle, but finally had given up on the tediousness of the job. With a self taught culinary background in mind, I took one of the dull dissecting knives and started rapidly slicing away at the connective fibers. There was a voice in my head that started mocking me, in a singsong voice, "Jen is a butcher, Jen is a butcher." I had to shut off that internal voice and keep on going.
Minutes later, I'd exposed her entire left pectoralis major muscle, with the very top portion of her rectus abdominus muscle peeking out under the 1/4 inch of exposed rectus sheath. I called Kevin over to look and he simply said, "Good work." I breathed a sigh of relief. His opinion of my work in this class means so much to me for some reason, and I want to make sure that I'm not only doing his teaching justice, but that I'm also not wasting the time of my group mates, nor disrespecting the generosity and deep altrusim of Ruth.
I stood back and looked at my work. Her muscle was exposed beautifully. Ruth had large muscles underneath all those layers of adipose, and we were beginning to reveal them to the world. Soon afterwards we covered her with a linen sheet, wet her down with embalming fluid, said our thanks, and walked out of the lab one by one.
Even in death, her breasts did not fail to amaze us. We marveled over them, cupped them in our hands, and treated them as lovingly as we could given the tasks we set out to do. Her breasts taught us new things about our own, things we could not possibly have learned without Ruth.
Before I wrote this, I held my own breasts in the shower and thought about hers. Mine feel different; mine are warm, alive, still soft and pleasing to the touch. But underneath it all, my breasts are like Ruth's. I know what the breast is composed of now, in a way that most people will never understand. I have done things to a woman's breast that most people will never be able to replicate. The understanding I have gained from this experience will last my entire lifetime, but as of this moment I'm still trying to get over the weird feeling that I have done something unspeakable; that I'm guilty of debauchery.
Oh Mary, conceived without sin, pray for us who have recourse to thee.
They come in all shapes, sizes, colors, symmetries. The size and relation of the areola to nipple with regards to the rest of the breast can also vary, with some being as tiny as dimes and others being the size of an Eisenhower silver dollar.
Breasts to the extremely young are a means of sustenance, a way of obtaining nutrients before they are able to masticate solid food. This is not something unique to humans, as it occurs across all mammalian species everywhere in the world. To humans, and maybe some species of primates, breasts are also regarded as an aesthetically pleasing object that embodies sex. Ancient civilizations have left behind artifacts in the form of cave drawings, effigies, and statuary or idolatry depicting powerful women with emphasized breasts. Renaissance artists like Boticelli and Da Vinci had made masterpieces that focused on the female form, with their flowing hair and bare breasts. Venus de Milo was born of the sea, with her long flowing locks barely covering her ample, round breasts and her mons pubis. The new age of media following the industrial revolution gave way to what is now commonly known as pornography, but in the early days of printed nudes, most of what was revealed and captured on film was limited to the bare breast.
We are a species that is fascinated with breasts, and that's what made it very difficult for me to cut into Ruth's breast tissue as we prepared to take her body into deeper stages of dissection.
Before Cynthia, Susan and I began to cut open her breasts, we consulted with Kevin just to make sure that what we were about to do would be to his liking. Andrea and Tammy were going to stay focused on cleaning up Ruth's right leg, uncovering the musculature that lay underneath her padding of fat. The task of what to do with Ruth's breasts was left to us.
I had been working on Ruth's left side, and Cynthia and Susan on the right. Cynthia did a lot of work cleaning up underlying fascia on the right, with Susan doing a wonderful job of helping both sides with the endless amounts of scraping and scooping of adipose. It sounds crass, but that's what it is. Cynthia's class had dissected her face, and she wanted to finish what had been started but there was so much to do with the chest area that she stopped working on the face to help get us started. Call it scalpel shyness, if anything. Cynthia didn't have it.
It had been decided that since her right breast was smaller than the left, that we would cut around the areola and remove the skin surrounding the rest of her breast, leaving it intact. The left one was more substantial so what we would do is a mid saggital cut through the areola and nipple, down to the muscle. We would remove half of the breast and leave the other half intact, so that one could view it and see how breast tissue differs from the underlying muscle.
I did the initial cut through Ruth's areola and nipple. I apologized to Ruth, even though I know she felt no pain. I felt odd doing this to a woman's breast, even if she was dead and had donated her body to science so that students like me could learn to heal by dismantling the dead. I kept right on going, and by this time I was on full autopilot mode. I removed the skin from the breast to the midline, then braced myself to make the first cut into her breast tissue to remove the one half. Her breast tissue looked just like the rest of her adipose tissue, but more fibrous. I quickly changed thoughts, as I don't want to associate my own breasts with cold, greasy, yellow adipose.
With full confidence, I pushed my scalpel through the mound of exposed breast tissue. I gasped. Nothing could have prepared me for the feeling of the blade as it pushed through. It's very hard to describe, but the best analogy I can come up with is that it feels like taking an exacto knife and cutting through packing peanuts surrounded by layer upon layer of bubble wrap. I slid my scalpel halfway down her breast tissue and then looked at Susan, who was patiently scraping fat and helping pretty up exposed areas. She looked at me and I told her, "Susan, you HAVE to feel this."
I traded roles with Susan and let her finish the removal of the medial half of Ruth's deeply exposed breast. For the next 30 minutes, I scraped up fat, cleaned up exposed structures, and talked with Susan and Cynthia about how we all own a Miata. Anything to ignore the weird nagging thought in my head about cutting up a stranger's breast.
Later on Susan and I switched spots again, and I started cleaning up further below the left breast and making plans for what I wanted us to do for Ruth next week. Jerry's group was further along with their cadaver, since he was a leaner guy, and they were already at the point where a good amount of his musculature was exposed. I wanted to, with Kevin's permission of course, start aggressively cleaning up the fat on the frontal side of her body, and get to where we were also looking at muscle.
With this aggressive attitude in mind, I started exposing her left pectoralis major muscle. At first I wasn't sure that I'd gone so deep that I'd hit muscle, but as I kept scraping away fat I started seeing reddish fibers follow my scalpel. Sure enough I'd hit muscle. I started snipping away at the fibers that were stubbornly holding her adipose to the muscle, but finally had given up on the tediousness of the job. With a self taught culinary background in mind, I took one of the dull dissecting knives and started rapidly slicing away at the connective fibers. There was a voice in my head that started mocking me, in a singsong voice, "Jen is a butcher, Jen is a butcher." I had to shut off that internal voice and keep on going.
Minutes later, I'd exposed her entire left pectoralis major muscle, with the very top portion of her rectus abdominus muscle peeking out under the 1/4 inch of exposed rectus sheath. I called Kevin over to look and he simply said, "Good work." I breathed a sigh of relief. His opinion of my work in this class means so much to me for some reason, and I want to make sure that I'm not only doing his teaching justice, but that I'm also not wasting the time of my group mates, nor disrespecting the generosity and deep altrusim of Ruth.
I stood back and looked at my work. Her muscle was exposed beautifully. Ruth had large muscles underneath all those layers of adipose, and we were beginning to reveal them to the world. Soon afterwards we covered her with a linen sheet, wet her down with embalming fluid, said our thanks, and walked out of the lab one by one.
Even in death, her breasts did not fail to amaze us. We marveled over them, cupped them in our hands, and treated them as lovingly as we could given the tasks we set out to do. Her breasts taught us new things about our own, things we could not possibly have learned without Ruth.
Before I wrote this, I held my own breasts in the shower and thought about hers. Mine feel different; mine are warm, alive, still soft and pleasing to the touch. But underneath it all, my breasts are like Ruth's. I know what the breast is composed of now, in a way that most people will never understand. I have done things to a woman's breast that most people will never be able to replicate. The understanding I have gained from this experience will last my entire lifetime, but as of this moment I'm still trying to get over the weird feeling that I have done something unspeakable; that I'm guilty of debauchery.
Oh Mary, conceived without sin, pray for us who have recourse to thee.
Tuesday, February 10, 2009
The First Cut
Today we began the dissections.
Before I go into detail, I'm going to describe the earlier part of my morning. Maybe someday when I look back on all of this, I can deduce that some of what I'm feeling can be attributed to extenuating factors outside of the prosectorium.
I probably chose a bad day to do the requisite 12 hour fast for the blood tests my physician ordered for me, because not only did missing my morning coffee set me off on a bad note, I also had to forgo my usual breakfast of dried fruit and walnuts. Caffiene, fiber, proteins and omega 3 fatty acids baby, it's the breakfast of champions.
I was already feeling frazzled from returning late from Monday night's Kinesiology class, only to have to rush to school early Tuesday morning only to find the parking lot full. We parked over by Home Depot and practically ran to my Psychology class, which I ended up being about 5 minutes late for.
The topic in Psychology was stress. This was no mere coincidence, as I planned my semester around my Anatomy class. I would take Bio230 with Dan Trubovitz, and Bio232 with Kevin Petti, who I felt would be an extra boost, given Dan's lax teaching methods. I also decided this semester to retake Psych101, which I felt would help convince me that I wasn't sociopathic or mentally unstable for taking Bio232.
The past 3 days leading up to today, I'd been dreaming about the cadavers. It's always the cadaver of Mike, which is the one I'm most familiar with. I don't know what his face looks like, but in my dreams I see it. It's gray and emaciated, with the superficial fascia removed and only the musculature showing. The only dermal layers left on his face are the layers surrounding the orbit of the eye, and the lips. It's a ghastly sight in my dreams, but the ghoulishness is offset by his friendly demeanor. In my dreams, Mike is animated, warm, and alive... as warm and alive as a cadaver could be. Needless to say, I haven't been sleeping too well the past few nights.
After Psych class, I head over to the anatomy lab and wait for Kevin to open the doors. I lean over the railing and look out at the clear, blue sky. It's amazing how clear today was, for the past several days were filled with dark clouds, heavy with rain. It's cold and windy, and I wish I'd brought a jacket. I would lie if I said I wasn't nervous.
After Kevin let us into the prosectorium, we look at the harvested specimens once more. He says that it's up to us to be leaders and determine how we want to go about opening up our cadavers, to see if there's anything we can find that would be worth harvesting and saving. We wet down the specimens with embalming fluid and put them away.
We push Mike's cadaver aside for the meantime. We are to work on the middle cadaver (the male cancer patient with the chemo portal) and the newer cadaver (female cancer patient, obese). We split up into two groups of 5, pick a cadaver, and get to work. Kevin read us the death certificate of the female cadaver, and even though I saw her the day she arrived at Miramar, I didn't know all the details as I do today. She died in June of 2008 at the age of 60. We received her on November 4, 2008, so she's relatively fresh. She died of malignant lymphoma. We all wondered if we would see signs of cancer in her lymph nodes. We won't know until we open her up.
Kevin shows us how to score the skin before making our initial deep cuts. He shows us how to scrape the adipose from the dermis, leaving behind the honeycomb shaped structures of the dermal papillae. My group mates are Susan, Andrea (different from my Bio160 lab partner), Cynthia, and I think the last one is Natalie. Her name escapes me. Cynthia has taken the Bio232 class before and has worked on the face of our cadaver, prepping her for the head and neck seminar Kevin hosted over the winter break.
I like to say I was mentally prepared for the unveiling of her face. But it was already cut up and I wasn't expecting to see her right away, but it is what it is. You sink or swim. I was thinking we'd see her face towards the end of the semester, but I digress.
She looked like she was in pain, as if the cancer that ravaged her body decided that she would have no peace even at the very end. Her face was frozen in a painful grimace, her eyes shut, and a brownish liquid coming out of one corner, as if they were tears stained with the ugliness of death. Her lips were cut and split, and her facial skin was cut in sections so that it could be reflected from the body to show the underlying structures. I instinctively take my gloved hand and wipe away the tear-like secretion, then realize that she no longer feels any pain. She feels no sadness, she feels nothing. She has moved on.
We start to work on her torso, taking the time to reflect the epidermis and dermis, removing the adipose tissue from the underlying fascia. We chit chat with each other to ease the tension, to get to know each other, and to make this gruesome task more bearable. There is so much adipose along her sternal body alone that it takes us the better part of two hours to clear a section three inches across and seven inches down. We scrape away fat with scalpel blades and a metal scraper. It is a tiring and tedious task, and at one point Susan asked if we could use a spoon to remove the fat. Andrea and Tammy are working on her lower right leg, reflecting the skin along the anterior tibia, distal to the patella.
I ask Kevin what we should do with her breasts. She has substantial breasts, more than what usually makes it into the Miramar College prosectorium. The last female cadaver we had was a tiny, petite little thing, and she was relatively flat. Kevin comes to my group and we discuss what we can do with her breasts. I suggest skinning one of them to show what the breast looks like underneath the epidermis and dermis, and he agrees. He amends my suggestion by saying we cut around the areola and leave it intact. With the other one we agree to make a midsaggital cut through the areola and nipple, so that the breast tissue looks like what you'd see in a textbook illustration. We talk about her feminine parts as if they were objects, and not as if they were anything human at one point. I wonder if this means that I'm getting better at objectifying the tasks put forth, and learning how to separate my personal beliefs from my clinical side in a manner much deeper than I've ever had to before; or does it mean that I'm learning to be callous and uncaring?
Towards the end of our time, we have removed about 3/4 of a cup's worth of adipose tissue. I make a comment that it looks like ghee. Kevin asked, "Well, what is butter made of?" We all answer in unison, "Fat."
Somebody asked what we were having for lunch. I say anything without butter.
We clean up after our time is over, and we all head out of the prosectorium. I say bye to my classmates, and we walk out with Kevin. The first thing I do outside is look at the mountains in the distance, and inhale a large breath of cold, winter air.
I don't know what to think. I'm feeling lightheaded and overwhelmed. Jerry takes me straight to Kaiser Permanente so I can get my labs drawn, and from there he takes me to lunch. By the time I took a bite out of something it was 3:15PM. My last meal was the night before, at 10PM, seventeen hours prior. I instantly feel better, but I can't get my mind off of my cadaver.
She died young. She looked as if she were still in pain, and I couldn't help but feel that her grimace in death was also in anticipation of she guessed might be done to her body post mortem. She knew that she was donating her body to science, and I know that I should sleep in peace knowing that I'm not defiling her in any manner, and that she is being treated with reverence and respect. She was one of us, she is us, she is who we could be, and yet she is so much more than the sum of her body parts and structures. She is benevolent, she is generous, and she has given every student who steps into that room a gift that so very few are willing to give.
Great teacher, I give you the name of Ruth.
Before I go into detail, I'm going to describe the earlier part of my morning. Maybe someday when I look back on all of this, I can deduce that some of what I'm feeling can be attributed to extenuating factors outside of the prosectorium.
I probably chose a bad day to do the requisite 12 hour fast for the blood tests my physician ordered for me, because not only did missing my morning coffee set me off on a bad note, I also had to forgo my usual breakfast of dried fruit and walnuts. Caffiene, fiber, proteins and omega 3 fatty acids baby, it's the breakfast of champions.
I was already feeling frazzled from returning late from Monday night's Kinesiology class, only to have to rush to school early Tuesday morning only to find the parking lot full. We parked over by Home Depot and practically ran to my Psychology class, which I ended up being about 5 minutes late for.
The topic in Psychology was stress. This was no mere coincidence, as I planned my semester around my Anatomy class. I would take Bio230 with Dan Trubovitz, and Bio232 with Kevin Petti, who I felt would be an extra boost, given Dan's lax teaching methods. I also decided this semester to retake Psych101, which I felt would help convince me that I wasn't sociopathic or mentally unstable for taking Bio232.
The past 3 days leading up to today, I'd been dreaming about the cadavers. It's always the cadaver of Mike, which is the one I'm most familiar with. I don't know what his face looks like, but in my dreams I see it. It's gray and emaciated, with the superficial fascia removed and only the musculature showing. The only dermal layers left on his face are the layers surrounding the orbit of the eye, and the lips. It's a ghastly sight in my dreams, but the ghoulishness is offset by his friendly demeanor. In my dreams, Mike is animated, warm, and alive... as warm and alive as a cadaver could be. Needless to say, I haven't been sleeping too well the past few nights.
After Psych class, I head over to the anatomy lab and wait for Kevin to open the doors. I lean over the railing and look out at the clear, blue sky. It's amazing how clear today was, for the past several days were filled with dark clouds, heavy with rain. It's cold and windy, and I wish I'd brought a jacket. I would lie if I said I wasn't nervous.
After Kevin let us into the prosectorium, we look at the harvested specimens once more. He says that it's up to us to be leaders and determine how we want to go about opening up our cadavers, to see if there's anything we can find that would be worth harvesting and saving. We wet down the specimens with embalming fluid and put them away.
We push Mike's cadaver aside for the meantime. We are to work on the middle cadaver (the male cancer patient with the chemo portal) and the newer cadaver (female cancer patient, obese). We split up into two groups of 5, pick a cadaver, and get to work. Kevin read us the death certificate of the female cadaver, and even though I saw her the day she arrived at Miramar, I didn't know all the details as I do today. She died in June of 2008 at the age of 60. We received her on November 4, 2008, so she's relatively fresh. She died of malignant lymphoma. We all wondered if we would see signs of cancer in her lymph nodes. We won't know until we open her up.
Kevin shows us how to score the skin before making our initial deep cuts. He shows us how to scrape the adipose from the dermis, leaving behind the honeycomb shaped structures of the dermal papillae. My group mates are Susan, Andrea (different from my Bio160 lab partner), Cynthia, and I think the last one is Natalie. Her name escapes me. Cynthia has taken the Bio232 class before and has worked on the face of our cadaver, prepping her for the head and neck seminar Kevin hosted over the winter break.
I like to say I was mentally prepared for the unveiling of her face. But it was already cut up and I wasn't expecting to see her right away, but it is what it is. You sink or swim. I was thinking we'd see her face towards the end of the semester, but I digress.
She looked like she was in pain, as if the cancer that ravaged her body decided that she would have no peace even at the very end. Her face was frozen in a painful grimace, her eyes shut, and a brownish liquid coming out of one corner, as if they were tears stained with the ugliness of death. Her lips were cut and split, and her facial skin was cut in sections so that it could be reflected from the body to show the underlying structures. I instinctively take my gloved hand and wipe away the tear-like secretion, then realize that she no longer feels any pain. She feels no sadness, she feels nothing. She has moved on.
We start to work on her torso, taking the time to reflect the epidermis and dermis, removing the adipose tissue from the underlying fascia. We chit chat with each other to ease the tension, to get to know each other, and to make this gruesome task more bearable. There is so much adipose along her sternal body alone that it takes us the better part of two hours to clear a section three inches across and seven inches down. We scrape away fat with scalpel blades and a metal scraper. It is a tiring and tedious task, and at one point Susan asked if we could use a spoon to remove the fat. Andrea and Tammy are working on her lower right leg, reflecting the skin along the anterior tibia, distal to the patella.
I ask Kevin what we should do with her breasts. She has substantial breasts, more than what usually makes it into the Miramar College prosectorium. The last female cadaver we had was a tiny, petite little thing, and she was relatively flat. Kevin comes to my group and we discuss what we can do with her breasts. I suggest skinning one of them to show what the breast looks like underneath the epidermis and dermis, and he agrees. He amends my suggestion by saying we cut around the areola and leave it intact. With the other one we agree to make a midsaggital cut through the areola and nipple, so that the breast tissue looks like what you'd see in a textbook illustration. We talk about her feminine parts as if they were objects, and not as if they were anything human at one point. I wonder if this means that I'm getting better at objectifying the tasks put forth, and learning how to separate my personal beliefs from my clinical side in a manner much deeper than I've ever had to before; or does it mean that I'm learning to be callous and uncaring?
Towards the end of our time, we have removed about 3/4 of a cup's worth of adipose tissue. I make a comment that it looks like ghee. Kevin asked, "Well, what is butter made of?" We all answer in unison, "Fat."
Somebody asked what we were having for lunch. I say anything without butter.
We clean up after our time is over, and we all head out of the prosectorium. I say bye to my classmates, and we walk out with Kevin. The first thing I do outside is look at the mountains in the distance, and inhale a large breath of cold, winter air.
I don't know what to think. I'm feeling lightheaded and overwhelmed. Jerry takes me straight to Kaiser Permanente so I can get my labs drawn, and from there he takes me to lunch. By the time I took a bite out of something it was 3:15PM. My last meal was the night before, at 10PM, seventeen hours prior. I instantly feel better, but I can't get my mind off of my cadaver.
She died young. She looked as if she were still in pain, and I couldn't help but feel that her grimace in death was also in anticipation of she guessed might be done to her body post mortem. She knew that she was donating her body to science, and I know that I should sleep in peace knowing that I'm not defiling her in any manner, and that she is being treated with reverence and respect. She was one of us, she is us, she is who we could be, and yet she is so much more than the sum of her body parts and structures. She is benevolent, she is generous, and she has given every student who steps into that room a gift that so very few are willing to give.
Great teacher, I give you the name of Ruth.
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