Cause of Death

Our final unit of Physiology block is GI and reproductive physiology. Physiology in general is full of more specific details about organ functions that although mundane at times, are at the very core of the understanding required to treat diseases. As exciting as anatomy was, knowing locations of nerves, vessels, organs is only helpful to a certain extent - knowledge of how they work and more importantly - what goes wrong when they stop working is crucial in trying to treat and heal.

GI Fun Fact

As much as I would love to share all the minute details we've learned so far in GI physiology, here's just one fun fact: did you know your intestines have taste buds? But why don't we taste food in our intestines? Because once broken down, you realize that taste is nothing more than the detection of molecules - pH detectors cue us in as to whether the food we're eating is sour/acidic and so on. Combinations of different molecules create wonderful tastes detected by our brains as such. When I say intestines have taste-receptors - it just means that they detect molecules like pH in our food in order to absorb necessary nutrients. How cool is that?

Penny's Peculiar Colon

So, upon reaching the GI/Reproductive portion of physiology, I realized I never blogged about dissection of the abdomen from anatomy block. Basically, once we'd finished the thoracic cavity dissection, we moved down into the abdomen. We cut the surprisingly thick diaphragm muscle separating the thoracic from the abdominal cavity and used our by-now expert scalpel skills to cut apart the skin and muscle over the abdomen. The most prevalent organs here were the small and large intestines - neatly sprawled across the cavity just like you'd see in an anatomy book. We found the pancreas, kidneys, very large liver and followed the path of a bolus of food from the esophagus all the way down. It was interesting to note that Penny's stomach was significantly smaller than other cadaver's stomachs. She had very distinct rugae (folds) within her stomach and the stomach was higher up - pushing into the abdominal cavity than it was supposed to be. Some surgeons walking around deduced that she might have had a procedure done to reduce the size of her stomach or maybe she hadn't been eating enough. We remembered that Penny didn't have a belly-button - most likely taken out during a similar procedure. (Although we had our fun convincing some gullible first-year medical students that her lack of belly-button was because she was born without one as a test-tube baby).

When we reached the lower-part of the colon, a surgeon helping us dissect, pulled out the entire lower part of the large intestine and showed us a rock-hard portion of the colon that wasn't supposed to be there. 'She must have had colon cancer' - he told us. We all took turns holding the mass in our hands - harder, stiffer than the rest of the intestines and very large - the size of a small fist - it was sticking out of the lower part of Penny's colon. We wondered if this was what had ultimately claimed her life.

'I feel like a serial killer'

In the next anatomy dissection unit - we dissected the pelvis. This was a fairly intense dissection - we had to saw down the middle of Penny's body (using a handsaw - see photo) separating the top half and the bottom half. And then the bottom half was further sawed in half to separate the two legs. This was the point in our dissection unit, where Penny was nothing more than the sum of her parts - body pieces placed all over. Sometimes, when we needed a better dissection angle, we would place her leg on her chest - so surreal.

Missing Parts
We dissected the pelvis and found out that Penny had had a hysterectomy - a surgery to remove her uterus. However, her cervix was still intact - and upon our initial inspection we concluded that her colon cancer had invaded her cervix as the large solid mass was taking up such a large portion of the area where Penny's uterus should have been. We wondered whether this was the reason her uterus had been removed.

Cause of Death Revealed
The last day of Anatomy class - we were supposed to find out the age and cause of death of our cadavers. Our group was fairly convinced that Penny had had colon cancer which had spread to her cervix. It turned out that it was the other way around - Adenocarcinoma of the cervix. The tumor in her cervix had spread upwards into her colon - because we had dissected the colon before the pelvis - we'd assumed it had been the colon first. It was a bittersweet kind of day - through clues we learned of during our dissections we had pieced together parts of Penny's life - and here just like that we had discovered the reason for her death. Another interesting fact we learned that day was her age at the time of death. We'd always assumed she was in her early 50s - 60s. She had lean muscles, albeit with a certain amount of fat, incredible calves telling us she must have been an athlete - her heart was in good condition, and her overall appearance was a fairly healthy one. It turned out she was 89 years old - one of the oldest cadavers in our entire class. Impressive, huh? Penny must have taken really great care of herself - and I'm proud to have had this interaction with her.