One of my roommates, a medical student at UCSF, asked if I’d like to attend an anatomy class with her. It was the end of the semester and guests were welcome as long as they could withstand a sight guaranteed to look nothing like a classic funeral home display. Without hesitation, I said yes.
The cadaver held center stage in a cramped, white tiled room that vaguely resembled a food service kitchen. Under greenish fluorescent lighting, it rested on an oversize exam table with a top like a large stainless steel baking pan. Along the sides were anonymous remnants of tissues and fluids. A thick rubber sheet covered the bulk of the body and was rolled to the foot of the table when class started, exposing the yellow gray carcass of a middle-aged transient man found dead on the streets of San Francisco. An acrid mix of formaldehyde, bleach, and decay etched every breath of this experience into my memory.
The intact skeleton was randomly exposed between patches of flayed muscle and flesh. Lungs and liver, loose but resting in place, were moldy purple green testaments to lifelong abuse. Every tissue had the consistency of vulcanized rubber. The head, though, was relatively untouched with a slight smile on the lips. This might be the most comfortable this guy had ever been, I thought.
The head had actually been saved for this final lesson, to demonstrate how the brain was wired to the rest of the body. The professor asked for volunteers to complete two tasks. The first task was to saw open the skull to expose the brain and the second, for extra credit, was to dismember the body at the end of class so it could fit into a state approved cardboard box for shipment to a crematorium. The container was about three feet by two feet by one foot with a plastic lining like meat packing boxes I’d seen stacked in butcher shops.
The professor chose the first four volunteers who raised their hands. She told them to take turns opening the skull with a power tool much like a standard skill saw except its oscillating blade would only cut through bone. The blade entered the skull just above the eyebrows and each of the student volunteers brought it a quarter of the way around the skull in a bowl shape. The professor then helped them use a small crowbar to pop the bowl off the brain. It made a sucking sound as it came free.
The image of a wrinkled gray-green cortex, protruding from the top of a skull, embedded itself in my own mind for weeks afterward. I couldn’t help visualizing everyone I saw as a specimen with brains blowing in the wind just above the eyebrows. I don’t remember anything else about the class after the skull popping and I didn’t stay for the dismemberment.
A few years later I was on a film crew at Stanford University Medical School recording surgery on a three year old boy who had a rare congenital condition that caused his skull to grow apart from the center of his face, broadening his nose and forehead while pushing his eyes to the side of his head. We were documenting the surgery because of the rare condition and also as a history of the many corrective procedures this boy would undergo in his lifetime. The objective of this first step was to split his face down the middle, extract the extra bone, then wire the two halves closer together.
The plastic surgeon began by removing the boy’s skull in the same way I had seen with the cadaver. This time, though, the brain was pink and vital and served as an immediate barometer of the boy’s condition.
The surgical team stitched the boy’s eyes shut and carefully flayed the skin from his face in one piece so that it resembled a soft vinyl mask. It was then rolled up to rest just above the eyebrow line where it remained attached to his head. The front of the skull was split done the middle from the forehead to the jaw. About a quarter inch of excess bone was removed, then ground to a fine paste the surgeon used to build new features from those that had grown distorted.
Through a close up lens on a remote camera, I watched the surgeon flip the flesh mask back and forth over the boys skull as he sculpted the foundation of the new face. An image of the transient entered my mind. This Stanford surgeon probably trained on a cadaver much like the transient, I thought, preparing him for work on "the real thing." For a moment it all felt like watching a beautifully woven movie. Then reality whispered, "but they are both the real thing".
Fickle luck had landed both bodies on cold steel tables surrounded by strangers. One for the worthwhile deconstruction of a life that ended before death. The other for the hope of reconstruction to make a life worth living. Meanwhile, the delicate spark of animus keeps cycling through the frame.