Guts and Yuck

We're arm deep in guts and fecal matter nowadays in Gross Anatomy, as we're studying the abdominal cavity. I was talking with one of our ethics profs today, and I think what he said captures it accurately: in medicine, there's a revulsion and fascination by the body. The body's disgusting, as my tankmates and I saw so aptly yesterday. Even though we carefully as we tied off both ends of the rectum and intestine, it still didn't keep us from inadvertently smearing bits leftover feces all over our carefully dissected kidneys and abdominal blood supply.

It's really all just digested food, for goodness sake, and after having sliced open eyeballs and sawn through facial bones and done all manners of horrible things that I wouldn't have dreamnt of doing half a year ago, you'd think fecal matter would be a small thing. But it isn't. Fecal matter has its own pedestal of official yuckness. Perhaps it's ingrained in us culturally, from parents telling their small children, "No, don't play in the doggy doo doo. It's disgusting!" The yuckness of feces has a biblical stamp too. I was reading yesterday in Ezekiel that when God commanded him to cook his food over night soil, Ezekiel pleaded mercy - "Please, I've never defiled myself!" and God granted special pardon.

But what I've found really surprising about these lab dissections is really just how beautiful the intestinal system is. Compared with the mess of nerves in the armpit and the sheer minisculeness of facial muscles and arteries, once you slice past the abdominal muscles into the peritoneal cavity, it's like opening a beautiful package: large, neatly and tidily packed together, and shiny. With a layer of fat instead of bubble wrap. It's amazing how much fits in this cavity. And when we dissected the mesenteric arteries, they spiderwebbed out like spokes on a wheel (the colon being the tire). And even though we were pretty darn tired from a long day in the lab, we couldn't help but keep on dissecting, uncovering one delicate pink arterial arch after another. Who knew guts were so beautiful? Even as you could feel, inside, the lumps of semidigested food on its way to becoming feces?

Fascination and revulsion, attraction and repulsion - that captures so much of what medical school has felt like lately. My lower back has been getting pretty sick of the contours of the dining room chair I use at my desk, my throne for two-thirds of every day. It's wearying, studying so hard and yet being in the middle of the pack gradewise. It's hard to to question if I'm not wasting my efforts doing something that I'm not stellar at. I detest the first wave of formalin that washes over me when I open the double doors into the fluorescently lit anatomy lab. Is this worth it? But then there's those small moments - the small treasures you discover like little lymph nodes among a mess of connective tissue. When I can watch House and I yell at Adam, "Hey! I learned about ornithine transcarbamylase deficiency! I know what that does!" Moments when genetics is pretty darn cool, in its simplicity and mystery. When we practice patient interview scenarios in our colleges session and I just love it - I have to restrain myself from totally dominating the entire discussion.

There is something wonderful and fascinating and humbling in how medicine uncovers our common humanity. Yet there is also something that is humiliating too about uncovering our commonality. When the professor tells us that people release 2-3 liters of flatulence a day, there is no hiding. Yet we can't help but shudder at the oozing and leaking and processing that is what it means to live in a body. Our bodies - beautiful, amazing, and downright disgusting.