Human Dissection

A Neurotic

We had our first human dissection this week. Nobody in the class was too badly affected - in fact, I was probably the worst. At first, the smell made my stomach turn and I had to leave twice, afraid that I was going to throw up in front of everyone. I hung back from the main action and tried to hold my breath as much as possible.

My discomfort peaked when a friend of mine in my group got a small squirt of bodily juices around and possibly in his mouth. That was something.

After that I got more into it, and even managed to tolerate the smell. Had good fun poking around the back, figuring out the muscles and bones and whatnot.

Any other first years have their first dissection recently? How did you find it? Older medics, do you remember yours? It's such an interesting aspect of the course...

mardybumbum

A Neurotic wrote: »

Any other first years have their first dissection recently? How did you find it? Older medics, do you remember yours? It's such an interesting aspect of the course...

I remember my first anatomy practical too.
I think it was the muscles of the back we were studying.
Twas grand, didnt have a problem with it at all.
It felt a bit weird this year when we had to dissect the face, but it is really the best way to learn anatomy so stick with it.

sam34

yeah, i remember my first day in the D.R. - had to assist in pulling one fo my friends form the room after he fainted (we still tease him about it to this day, poor eejit)

the smell can be overpowering at first, but you quickly get used to it.

dissecting the face was the bit i found hardest, as it seemed so personal. the whole experience can be quite humbling, imo, as you realise how unselfish the donors have been.

it's a great way to learn anatomy, and i think it will be a huge loss if med schools do away with it.

Des23

In UCC they brought us in to have a look on the first day and we were getting stuck in the next day. We have two 2hr lectures in the DR every week. Its the most interesting thing we do, so far anyway.

I was surprised how no one seemed too bothered, we all just got on with it.

GradMed

No one in my class had any major problems when we started dissection. We're quite lucky with the dissection room in UCD, the upflow and downflow air systems mean that there is very little chemical smell.

Must Have Music

I remember I was terrified I'd be freaked out and faint when i had my first dissection, so i went along to a dissection with a friend of mine in radiography (they started it the term before us) - once you stop thinking about the fact that it's actually a dead human being, it's okay. If you overthink it, much like surgery, it's impossible.

me2gud4u

i remember my first dissection in ucd, was grand, sure the smell of formaldehyde isn't that bad at all because the anatomy labs are still very new.That said, we were recently doing our GIT dissection and the deeper we dissected, got to admit, the smell was pretty strong. Never been repulsed though but I will agree with other posters, dissecting the face is probably maybe the first time you realise "this is a human and not just a cadaver", I know that may seem very clinical but you do become very detached. That dissection was pretty "thought-provoking" i guess.

Larianne

A Neurotic

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tallaght01

MedGal

I totally agree Tallaght.

Didn't appreciate them posts at all. While I'm sure there was no malice intended, posting such experiences on forums for all to see is wrong.

PhysiologyRocks

The thing that hit me hardest was the fact that these were all people. I hadn't thought about it too hard before we went in. We had one fainter alright, but he was fine after that one time.

I think we're all really lucky that the colleges haven't resorted to using plastic models. It's so interesting to see what we're really like inside, and great to see all the variations and similarities.

Piste

<snip>removing my post to be on the safe side, lest anyone from college comes on here</snip>

GradMed

On the topic of discretion.
I remember after coming out of hospital, after been shown a 1980's video on childbirth, I started talking about how unpleasant the process of childbirth was. That was until a classmate pointed out having this conversation in the main entrance to the national maternity hospital probably wasn't appropriate. Thankfully I don't think anyone outside my classmates heard this.
As Tallaght said, we have to be careful at all times in what we say and do.

Here's an jama abstract "Online Posting of Unprofessional Content by Medical Students"
http://jama.ama-assn.org/cgi/content/short/302/12/1309?home

Of the medical schools that responded 60% found

incidents of med students posting "unprofessional" content online, including "use of profanity" (52%), "frankly discriminatory language" (48%), "depiction of intoxication" (39%) and "sexually suggestive material" (38%).

So what one would normally expect to find on social networking sites but it was also found that

Violations of patient confidentiality were reported by 13%

which is rather serious.

P.s Just seeing your post Piste. The word used to describe the dissections is inappropriate. You may feel like it is an accurate description but it has connotations of animal slaughter and could be misinterpreted as an equation of animal and human life. Say inexperienced dissection technique and leave it at that. The memorial service for the families of those that donate their bodies was mentioned, if a family member asked would anyone here use that word to describe their dissection experience. If you wouldn't use in that situation why would you use it here?

tallaght01

GradMed wrote: »

P.s Just seeing your post Piste. The word used to describe the dissections is inappropriate.

+10000000. If you wouldn't say it to the family, you shouldn't say it anywhere else.

I'm not speaking from the moral high ground here. In 1st year our group got bollocked by the anatomy tutor when he heard someone say something inappropriate. It's just about the madness of the situation, as hardly anyone else in the population will find themselves in a situation like that. And it happens when you're only 18. The vast majority of people who have it pointed out to them will realise they made an error of judgment.

When posting about dissections, try and imagine the person's family finding the thread before you say what you are going to say.

ZorbaTehZ

The content in some of the posts here is shocking. Clearly the demonstrators have not properly educated you on the importance of discretion regarding the dissection room - although a bit of common sense ffs to be perfectly honest wouldn't go amiss.

I just hope for your sakes that the heads of your respective anatomy departments don't come across this thread - I remember a similiar incident occuring in NUIG in my first year, and their were serious repercussions for the individual involved, and in fact it forced huge change there.

Larianne

tallaght01 wrote: »

Guys, I'm in the process of being un-modded, so I'm not going to do anything. But, as a medic, I find these posts really out of order. I know no malice was meant. BUt the people who donate their bodies for your training, for no reward, should be treated with absolute respect. I don't think you should say anything about them that you wouldn't say to one of their family. Especially in a public forum. It gives out completely the wrong message.

Like I said, I know their was no intent. But now that you're in a career where discretion is going to be very important, you're going to have to start being careful what you say.

I've reported both posts. But the proper professional thing would be to delete them yourselves.

EDIT: A neurotic removed his post, so I'm deleting it from my post.

Yeah, I actually thought about this today but I didn't get a chance to log on until now.

tech77

DR is definitely one of things you remember about med school.
Never understood the fainting thing though.

Head and neck is the most interesting (and complex obviously).
Still have trouble with the brain/all those cranial bones/foramina. :P

Larianne

Hi everyone,

I just wanted to reply properly to what I wrote previously. I totally agree with all the criticism given about the inappropriate post I made. It was a case of lack of thought on my part - wrong use of words definitely.

I have the utmost respect for people who donate their bodies for medical science and show this at all times in the dissecting room. It is a gift for the world of medical science and something I hugely appreciate being afforded to. (I was talking about this yesterday with a classmate).

So apologies to all, and thank you for giving me a kick up the arse.

OT, I don't dissect but I'm finding anatomy my favourite part of the course. It's just amazing to see the different parts of the body and being able to touch things,figure out what's what. Gives you such a better understanding of how everything works than by just reading a textbook. The Human Body is really an amazing thing.

Piste

Ok I've edited my post for anyone who's overly-sensitive. I don't think we should limit our discussion of anything to what we'd say to a family member though, some doctors complain about patients on this forum (obviously never giving away any information to identify them) in a way that they never could to the family or patient themselves.

tallaght01

Piste wrote: »

Ok I've edited my post for anyone who's overly-sensitive. I don't think we should limit our discussion of anything to what we'd say to a family member though, some doctors complain about patients on this forum (obviously never giving away any information to identify them) in a way that they never could to the family or patient themselves.

Though it would be very rare for anyone to give out about patients on here, sometimes patients do bad things, or unreasonable things. Bodies for dissection don't.

Plus you've posted the name of the med school that you're at several times. How many bodies are there? Not many.

mardybumbum

tallaght01 wrote: »

Sometimes patients do bad things, or unreasonable things.

I found this comment a bit strange. What has a patient done to you/ or a colleague that you would find unreasonable?

Piste

tallaght01 wrote: »

Plus you've posted the name of the med school that you're at several times. How many bodies are there? Not many.

Actually that's a very good point. Might as well completely delete that post to be on the safe side.

tallaght01

mardybumbum wrote: »

I found this comment a bit strange. What has a patient done to you/ or a colleague that you would find unreasonable?

Well, a guy squared up to me in work about 8 or 9 months ago. Recently, a very posh deputy principle of a school gave me a barrage of abuse, the like of which I've never experienced in work. Most people who go off on one are just scared. But he was just a horrible man.
A junkie once went mental at me because I reversed his opiate overdose, and told me he'd have to go and rob another flt to pay for more heroin now.

All kinds of things. Happens quite a bit.

Though I doubt I've ever mentioned those stories on here, as it reflects badly if we give out about individual patients.

bythewoods

I do agree that discretion is essential and all the rest, but I'd just like to say from my experience of anatomy practicals (one lol), most of the people in my group were trying to picture the body more as an inanimate object than an actual person.
I know that's a bit horrible, but it does make it a lot easier to see the body as more of a... I don't know, model or whatever than to think of it for what it actually is.

So I can see how fellow med students could make the mistake of seeming overly crude, because I'm sure I could be guilty of the same.

Anyway, more OT, the anatomy practical (I've only done one, was meant to have my second one this week but I've been out sick) was definitely the most interesting aspect of the course thus far for me anyway.
It was a little bit horrific at first, but once I got into it I did really enjoy it. Also, the smell of formaldehyde didn't really bother me that much... although there was this one guy in my group who was totally FREAKED out by it and had to leave to dry heave several times...

sam34

mardybumbum wrote: »

I found this comment a bit strange. What has a patient done to you/ or a colleague that you would find unreasonable?

i've been assaulted by patients (some of whom were genuinely mentally ill, being assaulted by them is sometimes understandable, but others were just scumbags)

a colleague of mine had a patient turn up on the doorstep of his private home and threaten him and his family

ive been threatened many times

ive had my wallet stolen by a patient

mardybumbum

sam34 wrote: »

i've been assaulted by patients (some of whom were genuinely mentally ill, being assaulted by them is sometimes understandable, but others were just scumbags)

Christ almighty Sam, Im really sorry to hear about that. Sounds pretty scary.

The line quoted above is what I was trying to get at. Where would you draw the line with a patients behaviour. ( I understand that the area of medicine you specialise in is a lot different to tallaght's )
So many patients worries manifest as anger. When do you stop being so understanding and decide its time to walk away.
Personally, anything physical (even grabbing my arm ) and I'd be gone.
I think I would tolerate verbal abuse as long as it was related to my job, and didnt attack me personally or my family, friends, e.t.c.

I was reminded of DrThunders post in "two weeks on a trolley" referring to an "indignant" mother who was worried about her child.

sam34

mardybumbum wrote: »

Christ almighty Sam, Im really sorry to hear about that. Sounds pretty scary.

The line quoted above is what I was trying to get at. Where would you draw the line with a patients behaviour. ( I understand that the area of medicine you specialise in is a lot different to tallaght's )
So many patients worries manifest as anger. When do you stop being so understanding and decide its time to walk away.
Personally, anything physical (even grabbing my arm ) and I'd be gone.
I think I would tolerate verbal abuse as long as it was related to my job, and didnt attack me personally or my family, friends, e.t.c.

tbh, in psychiatry, it's an occupational hazard.
we have to do a self-defence course when we start psych, and then have to do refresher days in it every year.

if someone is genuinely mentally ill, and is assaulting me because they are psychotic or manic, then i dont really mind. well, i mind, obviously id prefer not to be assaulted, but they are not doing it out of badness, or knacker-ism, they are doing it because of genuine fears they have. they cant help it. you cant really walk away and abandon them, they need to be treated and often need that decision to be taken out of their hands because of their lack of insight. i'm not saying i stay in teh room to get thumped further, but you cant let them walk out of teh hospital, you have to sort them out with admission and meds.

if it's someone who is not psychotic, but who is supremely worried/stressed and just venting a bit, i adopt a very firm approach with them - say something along teh lines of "i understand you're worried, and i know it's difficult/stressful for you, however, there's no need to shout/be abusive towards me. i'm happy to try and address all your concerns, but i would appreciate if you were not abusive towards me." - that calms most people down, and generally leads to an apology.

the pure knackers though, often dont respond to that. if i have an inkling someone is going to be dodgy, i ask security to have a visible presence around teh interview room. if there's nothing wrong with them, or nothing serious, i tell them i will be prepared to see them when they are prepared to be civil to me. if they assault me, i get security to remove them from the hospital.

thankfully, for me, the latter situation is quite rare.

of all teh times ive been assaulted, most (prob 95%) have been by those who were psychotic or manic. i can shrug that off, and thankfully i have never been seriously hurt.

mardybumbum

sam34 wrote: »

but they are not doing it out of badness, or knacker-ism.

This is a question I would be interested in hearing your opinion on.
I would have described a lot of people as knackers when I was younger, I am certainly guilty of that.
But aren't "scumbags" really just people with problematic behaviours exactly like the patients you would encounter in your days work?
Does the fact that the "scum" walk around freely on the street, rather than in an institution make their intentions any less forgivable than psychiatric patients?
I really haven't been introduced to psychiatry in any major way yet so I may be way off the mark but surely there are patients in psychiatric units whose sole intent is to cause harm?
Im sorry for dragging this thread way off topic but it is something I am quite interested in.

tallaght01

There's a group of people who you'll meet (though not very often in paeds!) who just use intimidation to get what they want all the time. Subtle threats, or shouting and screaming. It's not a personality disorder, but it's a learned behaviour.

I once had a guy headbutt a balloon in his rage with me while I was talking to his wife lol. I just completely ignored him. I wasn't particularly afraid of him, and I wasn't going to fight him, and he wasn't someone I could reason with, so I just figured I should ignore him.

It sent him into an interminable rage, which didn't help the situation. But it was much more satisfying :P

sam34

mardybumbum wrote: »

This is a question I would be interested in hearing your opinion on.
I would have described a lot of people as knackers when I was younger, I am certainly guilty of that.
But aren't "scumbags" really just people with problematic behaviours exactly like the patients you would encounter in your days work?
Does the fact that the "scum" walk around freely on the street, rather than in an institution make their intentions any less forgivable than psychiatric patients?
I really haven't been introduced to psychiatry in any major way yet so I may be way off the mark but surely there are patients in psychiatric units whose sole intent is to cause harm?
Im sorry for dragging this thread way off topic but it is something I am quite interested in.

there's a vast difference between psychiatric patients and scumbags (not saying that someone cant be both, but generally they're not, thankfully).

what i was alluding to in my above post about psych patients are the people who are acutely psychotic and who, because of their delusions, are terrifeid beyond anything you or i can imagine. they might assault you because they've incorporated you into their delusional system, or simply because you're trying to keep them in hospital and they believe they will be in danger if they're not able to do x/y/z. or, a manic patient may be so disinhibited that they lash out in irritability. those patients generally cant help doing that. they're not just shoving their weight around or being pricks for the sake of it, they really cant help what theyre doing. thats why i tolerate it. these are people who would never behave like that when well. it is their illness causing them to do what tehy do.


with scumbags and knackers, it's different. there is no mental illness causing them to do what they do.they do it because they think they can intimidate and frighten and manipulate others into doing what they want. it may be a life long pattern of behaviour in them, and it may be what they grew up witnessing, but that doesnt excuse it or make it acceptable. if they engaged in that behaviour out on the streets or anywhere else, they might well end up facing criminal charges. indeed ive often considered ringing the cops, or wished that that was teh done thing in hospitals when assaults happen.

look, i understand that when people are sick, or a loved one is sick, people are frightened, scared, feel helpless and inadequate, are panicked and floundering. i've been there myself, it's not a nice place to be. but that doesnt mean they can act like pricks, stamp their feet and expect hospital staff to jump fo rthem.

finally, i dont see what you mean about there being patients in psych units whose sole aim is to cause trouble??

mardybumbum

sam34 wrote: »

with scumbags and knackers, it's different. there is no mental illness causing them to do what they do.

It may not be a mental illness that causes them to do what they do, but their behavior has been reinforced/conditioned from a very young age, right?
I may not have stated it clearly in my previous post but what I was trying to ask was why people who are born with "troubled" behaviour are treated more favourably than those whose behavior has developed from a very young age?

finally, i dont see what you mean about there being patients in psych units whose sole aim is to cause trouble??

Its just that in your previous post you said that you could tolerate being attacked by a psych patient because they do it out of genuine fears. Would you meet any patients whose sole intent is to cause harm?

sam34

mardybumbum wrote: »

It may not be a mental illness that causes them to do what they do, but their behavior has been reinforced/conditioned from a very young age, right?
I may not have stated it clearly in my previous post but what I was trying to ask was why people who are born with "troubled" behaviour are treated more favourably than those whose behavior has developed from a very young age?

i suppose it comes down to what is and isnt under your control. those who are behaving that way because it is just something they've always done, and because it works for them, are able to control that behaviour. they know it isnt normal acceptable behaviour but they continue to do it, they dont give a ****. if someone grows up in a family where the parents are criminals, and they turn out to be a criminal themselves, they are still responsible in a court of law. its teh same principle, just on a less extreme level.

mardybumbum wrote: »

Its just that in your previous post you said that you could tolerate being attacked by a psych patient because they do it out of genuine fears. Would you meet any patients whose sole intent is to cause harm?

well, yeah , i would see people like this. i think you're getting at people who have no mental illness as such, but who are just "bad" - those who are psychopaths. thankfully, they make a small proportion of psych patients, and the general aim would be to keep them out of the service and hospitals in particular.

i think i've answered your question? if not, let me know!

mardybumbum

sam34 wrote: »

i think i've answered your question? if not, let me know!

Thanks for responding, but I guess its impossible to really answer my question. Seems like a huge grey area. Anyway, we digress.

Back to dissections.
My anatomy project this year is on the contents of the orbit. I am going to need to remove the eyeball. Whats the best way to perform an enucleation?
I need to try and preserve as many of the muscles as possible.
I was thinking of boring a hole through the supra orbital fissure wide enough for my pinky and then popping it out.
Has anyone here ever done this before?

candlegrease

mardybumbum wrote: »

Thanks for responding, but I guess its impossible to really answer my question. Seems like a huge grey area. Anyway, we digress.

I would say they are treated differently because you would have to change their whole culture and way of life to change their behaviour. Sure if you helped one "scumbag" he might get it for a few days but eventually he would be roped back into his "behavioural problems" unless he was removed from the influence of other "scumbags" completely, and even then nothing is guaranteed.

So ya, I think they have behavioural problems like other cases, but they are just not as treatable, and besides, if you did one scumbag, you would have to do them all and good luck with that! :P

Prime Mover

mardybumbum wrote: »

Back to dissections.
My anatomy project this year is on the contents of the orbit. I am going to need to remove the eyeball. Whats the best way to perform an enucleation?
I need to try and preserve as many of the muscles as possible.
I was thinking of boring a hole through the supra orbital fissure wide enough for my pinky and then popping it out.
Has anyone here ever done this before?

If you are getting out the power tools I think you should leave the eyeball in place and take out a triangle of bone from the floor of the anterior cranial fossa. Look at Netter 4th ed plates 85/86 on the Orbit and contents. Scoop out the retrobulbar fat to expose the nerves, muscles and vessels. On the second eye, maybe you could just remove the tarsi and orbital septa for a different angle.

clartharlear

Fascinating thread.

With regard to the inappropriate comments (which I did not read, and I'm sure they were rightfully removed), I see two interesting aspects.
Firstly, the use of black humour, unto obnoxious remarks, as a coping and distancing mechanism for medical students first encountering human dissection. Secondly, the psychology of the "in-joke" and the strong taboo on breaking the bounds of the in-circle. Posting publicly on-line violates the bond of the blackly-humorous in-jokes and falls under the remit of "what you would say to the family", but I do believe there should be different rules on "what you could say to a fellow medic".

I don't have a subscription to the BMJ, but it looks like there are a few interesting papers on similar topics.

virtus

I have been doing dissections for a couple of weeks now and I have to say that everyone acts with respect and professionalism. I was actually quite surprised, as I am usually used to people dossing around chemistry labs. When someone has made such a sacrifice for your education you are going to make the most of the opportunity they have given you, and it seems that most students who have the luck to work with cadavars think likewise. I think its more disrespectful to not use your time with the cadaver well, or to hinder those who are trying to.

With regard to feeling queasy, I had my first experience of it today. Lets just say my lab coat was rather smelly from the week before.

Would many people here consider donating their body?

imported_guy

how are the cadavers obtained btw?, and are they ever returned to their famlies for burial etc?, do they use new cadavers every week/month/year? do the college pay for them? to the family etc?

Larianne

imported_guy wrote: »

how are the cadavers obtained btw?, and are they ever returned to their famlies for burial etc?, do they use new cadavers every week/month/year? do the college pay for them? to the family etc?

People decide to donate their bodies for medical research/training. They ring up the university and they are then talked through the process and sign a form. When they die it's made known that they are donor bodies and the relevant college is notified. The body get embalmed at the university and I think they cannot be used for a while... the cadavers I'm working on are 2 years old. I think the ones we're working on will be for the whole year. The college doesn't pay for them as they are donated. But the college provides the burial for them.

(That's what I gathered from my first day in anatomy but I could be wrong on some points.)

drkpower

tallaght01 wrote: »

When posting about dissections, try and imagine the person's family finding the thread before you say what you are going to say.

Interesting discussion.
While I can see the difficulty when someone who is clearly a present student at a specific medschool (and has identified that previously) comments (negatively or perjoratively) about dissections, I wonder whether the reality of dissection (and how students approach it) shouldnt be a matter for honest and robust discussion on sites such as this.

Certainly there is a possibility that a family member of someone who gave their body for dissection might seee and be offended by such a discussion. But the issue is surely worthy of a warts and all discussion (particularly in a forum like this) even if it might appear distasteful at times. I would have thought that the opinions of people like yourself would be helpful to those going through the process now who maybe dont realise the debt they owe the donators. I certainly recall that I had a fairly relaxed and immmature attitude to dissection when I was an undergraduate and probably could have done with a forum like this at the time!

Piste

^well said!


I was in the anatomy room studying for the anatomy test we had on friday and some people were in there removing craniums(crania?) with saws for the 2nd year anatomy practicals. I noticed a weird smell in the place but didn't think too much about it until one of the guys I was studying with said "I think that's the bone bust we're smelling". Suddenly it went from being a tolerable smell, to being the most disgusting thing I'd ever encountered, it's a horrible idea that you're inhaling somebody's bones (albeit tiny particles). Then later that day when I'd been out of the anatomy room for hours I noticed the smell had clung to my hair.

It was an experience to say the least!

Actually, out of interest, a guy in my anatomy group and I were wondering could any health issues arise from inhaling bone dust? Probably not for us as we were a few metres away from the bodies, but for the people using the saws who were right up close? They weren't wearing masks or anything.

GradMed

There is no issue with having a “warts and all discussion”, there is simply an issue with some of the language used.

tallaght01

Yea I certainly had an immature attitude to it all when I was an undergrad, but I needed someone to tell me it wasn't acceptable.

I think our duty to show the public that we have respect for donors of bodies is greater than our duty to encourage students to say what they like about those donors.

sam34

i think nearly all students underestimate the huge sacrifice made by the donors.

when you consider the cultural beliefs here about death, the after-life, sanctity of the body and soul etc, it is a phenomenal thing for someone to donate their body to further the education of complete strangers.

it is one of the most, if not the most, altruistic thing i can think of.

as such, the donors deserve major respect, as do their families. remember, the families have been denied the ritual of burial and having a grave to visit, both of which aid in teh grieving process.

distasteful, flippant comments have no place in any discussion about such people. they are not just cadavers lying on tables, they are peopel with families, loved ones and histories.

i know, and remember well, that human dissection is a hard thing to do, and that as a coping strategy people try and distance tehmselves form the human side of it. thats ok, while you're around teh table actually dissecting. but, imo, it's not ok outside of the DR and certainly not ok in casual discussions. the bigger picture should never be overlooked.