Five Ways of Seeing

Note: in catching up with posting, here is one I started writing when anatomy finished in November.

It's hard to describe the process of gross dissection. We were split into groups of four to each cadaver and armed with four sets of tools, a dissection guide, and an anatomy atlas. No part of the body was unexplored.

Our Lady, of no religious affiliation, was old and thin. Her toenails were painted pink. She had graciously donated her body for us to learn the intricacies of our tissues and vessels. As morbid as the thought may be, she was our first patient, the first person whom we had responsibility over her care although it was far from treatment.

As the class progressed, we found ourselves almost protective of Our Lady--of all our classmates and instructors, we knew her best. No, of course she wasn't a smoker. No, she had no evidence of cardiac heart failure. We received no personal or medical history, and even with the help of a pathologist at the end of the course, we were unable to determine the cause of her death. Strangely, it left me with a feeling of lack of closure.

Working in a group was absolutely essential. We would read aloud instructions from the manual, we had to hold while another cut, and we continuously checked each other to see how comfortable we were both mentally (identifying all the different parts) and emotionally (not feeling nauseous from seeing all the parts).

The eight weeks of anatomy flew by as time does when I feel like I am constantly playing a game of catch up. The last lecture caught me almost by surprise. One of our course directors took the time to step back and recount all the knowledge we had encountered. She characterized the course as the "five ways of seeing." Her metaphor stuck with me as a reminder of how much we had learned and how much we still had to master.

The first, most central way was through gross laboratory. Three of the remaining four were introductions to technical fields intercalated with the dissection.

Histology was the skill and art of examining tissues through microscopes. What initially looked like a piece of modern art could be interpreted as lung or liver or another vital organ.

Radiology was a true practice of specificity; our lecturers would be able to identify body parts and make diagnosis from blurry black and white graphs.

Embryology traced the formation of these organs from a single fertilized egg.

These three ways of seeing the body were exercises in trying to extract arcane knowledge from figures, pictures, and specimens. While it was impossible to forget the significance of our gross dissection, it was maybe too easy to forget that in each CT scan we saw, each specimen we examined, represented a person.

This is an issue I think many of our courses have tried to address--the reduction of human life to a molecular pathway or an interesting radiograph finding. In anatomy, our course director framed it as the fifth way of seeing. It was personified by the few patients that visited our class sessions where they would be interviewed by a physician in front of a full lecture. Families with children who had been born with congenital defects and people that had experienced significant surgical repair came to share their experience and advice.

As constructed as these sessions felt, they were still a reminder of the patients that we will serve using our training in seeing.