Cutting: Traditions in anatomy and Thanksgiving

Yoshiko Iwai //

The three of us go around the table to introduce ourselves, smiling under our masks and glasses, warming up our fresh scrubs. I had never met either of them before or even seen their faces through Zoom. A moment of silence passes. The guy across from me offers to hold the instruction manual and swiftly grabs the anatomy atlas in his other hand. I grab the zipper at the foot of the bed and slowly open the bag, passing the zipper to my teammate on my right, and watch her make a large circle around the table. Sour, stale air presses against my face, despite the mask. Formaldehyde seeps into my pores, my hairs. The fourth member of the group joins, a green cloth mask against his thick black beard. He hovers over the table, surveying our pale naked woman.

We begin at the sternum, working through the previous incisions, peeling away layers of flesh and muscle. We lift the rib cage, which was sawed apart earlier, from the base of the neck and prop it up against her belly. It forms a right angle, but keeps falling down. We awkwardly place our elbows and forearms against the floppy rib cage, still attached to her abdomen, to get it to stand. I scoop excess embalming fluid from the thoracic cavity, disposing of it in the bottom of the bag which makes its way towards the drain between her ankles. The sourness fills the room, my face, my eyes. My glove tips slide against each other like cheap pancake syrup running between them. I watch my teammates resect the heart, placing scissors in the aorta. Snip. The heart is passed around. I hold it in my hand, and it is rock solid from what our professor hypothesizes was a pericardial effusion. I align the tip of the scalpel at the top of the heart, cutting deeper and deeper. One chamber at a time.

This was my first time using a scalpel to cut more than a banana or pig foot in a suture clinic or a rat for research. Maybe it wouldn’t feel so strange if I brought these experiences home to friends or family or weekend drinks with classmates. But instead, I find myself staring at thawed chicken meat on my kitchen counter, unable to cook dinner because I cannot unfeel the light and dark muscle fibers between my fingertips or unsee the similarities with what sits on my cutting board. COVID-19 has made me appreciative of smell and more aware of the smells around me, but tart coffee and the waft from the garbage can all yank me back to the cadaver lab. 

It is Thanksgiving week, and now these sensations have followed me into my boyfriend’s home in New York, where we will celebrate the holiday with his father. I wonder how many other medical students, health professionals, and practicing physicians will look at the turkey coming out of the oven, cut through its layers, uncouple meat from bone with family or friends, and think of their first cut. The isolation of online medical school is dawning on me—less as the isolation of performing everyday actions but of processing those experiences alone.

Thanksgiving centers around the act of coming together. COVID-19 has made this challenging, and families have mounted cameras for Zoom dinners or staggered visits to preserve some semblance of a gathering. But there are things that cannot be brought to the dinner table. My boyfriend stops me from spilling the details of dissections, but when we eat together and share the happenings of our day, these stories are often the only thing I want to share—the texture of cutting through flesh, the intricate meshwork of nerves and vessels in the neck, the recoil of the aorta, the sensation of holding a heart, an avocado coated silky pink. 

When I call my mother in Japan, and she asks me how I’ve been, I want to paint vivid pictures and convey precise details so she can imagine me going through the motions step by step. We found tumors in my cadaver, and I cannot help but imagine my own mother’s tumors, past and present, in the palm of my hand. I wonder how big or small or differentiated hers might be compared to what I’ve uncovered and held.

When we gather over Thanksgiving to update family and friends on our lives, share our concerns in living room corners over slices of pie, these are the things I want to say. But I know that these are things I cannot say, not without spoiling a meal or time that’s meant to cherish loved ones and life. I cannot say that the turkey reminds me of muscle and ribs, or that the white stringy fibers are nerve bundles, or that underneath all of our skin, we kind of look like that too. No one teaches you how to negotiate these things in medical school—that you might run into family conversation and not know appropriate from inappropriate, suddenly become repulsed by meat or the smells in your own home, look at the person you love and imagine what courses under their skin.

In my weekly research meetings, my mentor’s children are often running around in the background. Sometimes they come up to the screen and show their newest lego contraptions. My mentor is a breast surgeon, and I wonder if she thinks of her first cadaver, or her current patients, as she slices through turkey and serves her family—one type of breast for another. I wonder if her husband does the cutting at home. Or if she says anything about the similarities and total strangeness of knowing what lies beneath our flesh over family dinners. I wonder if she senses the separation of work and family life over Thanksgiving. Leave this at the hospital, leave that in lecture, leave those details for research lab. I wonder if she lets her sons cut.

I look at my mentor—a surgeon, a professor, a researcher, and an educator that I aspire to one day become—and wonder where she puts these thoughts if she cannot unload them at the dinner table. Where do medical students unload if they’ve yet to find community among their class or already feel isolated in their virtual pandemic world? Thanksgiving is about coming together and being present with loved ones, but smells and sights and textures bring me back to my cadaver, to a room full of dead bodies.

Acknowledgements

The author thanks Benji Bear for creating the image accompanying this piece.

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