Dissection: Part Deux

There is something so exhilarating about standing over a body wielding a circular saw and cutting through the side of a partially dissected chest, feeling the individual ribs crack under tension. It almost feels like a small power-trip; only one immeasurably desensitised by previous demonstrations and practicals, and heavily regulated by the Human Tissue Act. What it essentially boils down to, is yet another rite of passage – a freak show in this circus of medical education.



To begin with we were given a few words of warning, reminded of the rules of respect and engagement, informed about the assessment and sent off to meet our cadavers. Fortunately ours was of fairly slim build, making the process and technical requirement a lot less demanding. No trepidation this time round, getting straight on with the task. After a while it felt completely natural. In fact, it became therapeutic. Making cut after cut, peeling away layers of muscle, skin and fascia. That may sound somewhat contrived, yet it was a most satisfying and mentally purging experience - and before we knew it, it was lunch.

The anatomy itself was far easier to identify this time round. Pectoralis major, pectoralis minor, serratus anterior and then ribs. A far cry from the bizarre mishmash of upper and lower limb muscles of the first year.

In our posse there was for some unknown reason four to the cadaver, with eight to a cadaver around the rest of the lab. Equally bemusing was that I’d somehow been put on the register twice, supposedly on two separate tables. Needless to say, with four to a body it meant pure unsolicited cutting the entire day. A rather undesirable consequence of thoracic dissection is the copious amounts of fluids that collect in the body cavity, which later slowly soaked into the arms of my lab coat.

But the highlight of the day had to be cutting around and removing the rib cage. Clean out, pleura a little torn and lungs lying dormant asking to be provocatively poked – the ultimate in stress relief is the peculiar bounce and return to form of the lungs recoil. Yes, it’s going to be an interesting week.

At your cervix

With legs forced wide apart, screaming ferociously as is humanly possible as a catheter funnelling between your legs runs straw-yellow. You shit yourself, with the paracetamol suppository making an untimely cameo – hello old friend. Finally your most intimate and sensitive area rips under pressure, all to the tune of “Grade-I tear, we’ll stitch that up in a moment”. This taking place in front of a crowd of midwives, doctors, husbands and of course, students. Yes, that’s the miracle of birth alright.

I was woken at some ungodly hour after about thirty minutes of sleep, my scrubs covered in meconium (bilious-green newborn baby shit to the layman) and blood from the earlier emergency c-section. “Come quick! Her cervix is 10cms dilated and she’s about to push!” I’ll be the first to admit, there are a lot nicer things to wake up to. Bleary-eyed I made it to the delivery room to see another mother go through what looks literally like a living hell. I think todays modern society has sanitised just how disgusting, painful and undignified child birth really is.

In fact, I’d go as far to say that none of the deliveries I witnessed had anyone particularly elated for the best part of twenty minutes after birth. The fathers looking fairly pale were exhausted from several hours of relentless screaming and hand-crushing culminating in what could be literally described as a bloodbath, as their loved ones are torn in two. The mothers being told “come on now, just one or two more pushes and it’ll be all over”, which sounds about as comforting as being told to expect just one or two more hits to the crotch with a sledgehammer and it’ll all be over. Anyway, in reality that isn’t entirely true as it’s then followed by a second, fairly disgusting ‘miracle’ of afterbirth as a sizeable placenta is gently teased out.

I did get the opportunity to scrub in at 1am for an emergency c-section. I’ll almost shamefully admit that I got a kick out of the added drama of rushing to theatre. The actual process of getting the baby out was over in minutes, and as the uterus was cut open a torrent of blood, amniotic fluid and meconium covered me whilst I stood there retracting and suctioning up blood. At which point there were a few screams from the cyanotic bundle of joy and everyone gasped a sigh of relief. The surgeons stitched her up as I continued to suction whilst trying not to get in the way, and I held a kidney dish catching rhythmic spurts of blood from the vagina as the surgeon pressed down on the belly after closing.

Another time during that night I was taking observations for the midwife when I got asked about the CTG (a clever machine that monitors foetal heart rate and contractions simultaneously). Yet I found myself in an uncompromised situation where I could reassure the mother and tell her that the reading was completely normal (which it was) or worry her by running off after the midwife, because we as students are not supposed to give out medical advice. So I settled for both options, saying I was almost certain there was nothing wrong and getting the midwife to double-check. I’m not sure if it was because I was the only guy on the ward that evening, assuming that everyone has this 19th century Dickensian attitude, but a lot of people assumed I was the doctor that night (which I corrected, over and over).

O&G is probably the most disgusting specialty I’ve seen so far, and also the most fun. So much so that it’s one I’d seriously give consideration for as a potential career.