Tuesday, February 16, 2010

Mazie and Vivian and snow...no pictures ;(

No pictures because I forgot to send the camera.

It snowed about 3-4 inches here last Friday. Mazie and Vivian stayed with their Nana and Poppy and made snow angels and drank hot chocolate and played with Reuben (the Staffordshire terrier). They tried to make a snowman, but the snow was too powdery so it ended up being sort of a snow pile. Mazie, ever optimistic, exclaimed, "Hey, Vivian! We can sit on it!" Pragmatic. Herman Miller snow chair. Now available in...white.

Going to Nana and Poppy's is fun. They did a ton of fun things, watched no small amount of television, and ate as they pleased. I asked them what their favorite thing was on Saturday, expecting it to be something snow-related. Vivian's favorite thing of the day is almost always dessert-related, by the way. Mazie tends to choose activities or special events. Anyway, Mazie's favorite thing was, emphatically, making snow angels. But Vivian enjoyed making Valentine's cookies (courtesy of Nana) more than she enjoyed making snow angels.

It's been a fun winter. I'm glad dissection coincides roughly with winter because, as surreal as it is to be in the basement with cadavers, there would be more opportunity cost if it were also gorgeous and warm outside. As it is, it's sort of fitting in a dark night of the medical student's soul sort of way.

(Those with a weak stomach proceed with caution. What follows is not meant to be disgusting, just frank reflection...)

Today we started dissecting the orbit and eye. This is by far the lightest dissection, workload-wise (hence, the time for a blog post about it), but also by far the most tedious and delicate. The nerves we're finding are like hairs in some cases (although some others (optic) are quite large). We begin the dissection from the brain side of things. The team before us dissected the brain and face, so the brain and calvarium (skull cap) have been removed and now tidily reside in a plastic bag within the larger blue body bad that holds our cadaver. The brain-ectomy paved the way for us to chip through the floor of the anterior portion of the skull (imagine a shelf just behind your eyebrows) so that we can have access to the eye socket from "above" (though our cadaver is obviously horizontal, so it's more like the side). We do this because this point of access allows us to dissect the muscles of the eye and most of the vessels and nerves without actually removing the eye...one gets a good sense of relationships that way.

Lab was a little cacophonous today. None of our dissections have involved bone power saws (other teams have had to use them), but in this dissection, everyone was looking around for a spare mallet or chisel. I haven't used a mallet and chisel much, but I think I could definitely get used to it. In this case, we had to take care not to damage the soft tissue underneath the bone as we chipped through. The lab was a chorus of "Tink. Tink. Tink-tink." Girls and boys alike looking a little bewildered with their tools. Then there was some scrape scratch scrape as we used...whoops forgot the type...long toothy hand saws to cut slices through the skull roughly at either end of the eyebrow to chip this portion of skull away for the sake of better access.

The actual eye structures are embedded in a lot of fat. It's really fun to get through the fat to the structures hidden within. It's like candy in Easter grass. ("Oh look, another jelly bean!") The only problem is that if you're too cavalier with your grass, you destroy your candy forever. A miracle of development, growth and function plucked into obscurity. That raises the stakes a little, I admit. My shoulders ache at present with the effort of it, and my right hand is sore from tweezing. But it was really, really cool!

All the basic structures are our old friends by now, found on a miniature scale in the orbit. Arteries are round, firm, and squiggly. Nerves are like wet strands - fibrous and discrete. Veins are tired, limp versions of arteries (owing to having much less smooth muscle in their walls). The muscles of this dissection are amazingly sensible. For example, the muscles on the superior aspect of the eye contract and, voila, the eye looks up. There are six, total, and their functions are very intuitive - some are even pulleys!

Anyway, I could go on and on. Today was what I imagined anatomy dissection to be: intense, revelatory, and detailed. No queasiness (actually, the first two minutes that I'm in lab require a mental shift, but it keeps taking less effort). And now I'm on to review Interstitial Lung Diseases. Tonight will definitely be one of those nights where half-sleep is littered with brightly lit, burned-on images of picking through fat. It happens to about half the people I've talked to. For most people, myself included, the anxiety is somehow related to cadaver fat getting on your face, in your hair, or on your skin. Weird but true. Luckily, the troubled sleep disappears when we stop dissecting :).

Theme: Medical school is intense. Lots of responsibility, lots of challenge, lots of privilege. Who gets to dissect an eye? Most people wouldn't want to, most of the rest never get to, and those who do probably do it once in their lifetime. It's very cool and I feel very lucky.

No comments: