Head and Neck

My name is Derrick Antoniak, and this is my blog about the first year of medical school.

Well, we've moved on to unit two, head and neck. It just so happens that yesterday was Joanna's birthday, so I had some people asking me questions about school, and I also talked to my cousin Tom on the phone, and he was asking me how things are going. People really react to the things we are doing in class right now, so I thought I should write about some of them here.

Monday began the face dissection. My group gave me the privelage of making the skin incisions, which involved cutting our man with a scalpel from the center of his forehead at the hairline, down the forehead, down the center of the nose, through the center of both lips, down the center of the chin, all the way to the base of his neck. Then I cut around both eyes, his nose, and down the sides of the head just in front of the ears, and we skinned all but the nose to expose muscles, arteries, veins, and nerves. After lab, the instructors went back in and cut off the top of everyone's skull to expose the brain. Being the over-achievers that we are, Tony (a group member) and I were in the lab later that night and had the good fortune of witnessing this process on a few cadavers. They use a power saw to get most of the way through the bone, but, in order to not damage the brain and its covering, the last layer is broken off with a hammer and chisel. The smell of the bonedust and the sound the skull makes when cracking under the chisel are by far the worst things I have witnessed in the lab yet.

Tuesday we returned for a dissection called 'cranial cavity'. We really spent most of our individual time trying to straighten out the muscles of the face, waiting for the instructor to come remove our brain. The brains have to be used in the spring semester, so rather than let us remove them and risk damaging something vital, the instructors come to each table and systematically remove them, starting in the front and working their way forward, pointing out, and then cutting, each cranial nerve in reverse order. Between the mangled faces, handling the brains and pieces of skull, and the rather large amount of juice left behind in the cranial cavity, it was too much, and for the first time (that I know of) we had people going to the locker room to get sick. Kylee (another of my group members) had a pretty forceful gag (that only by the grace of God did not have any vomit behind it) that sent her to the locker room and sent me and Tony laughing so hard that we both were crying.

Wednesday's dissection was titled 'orbit', and the first line of the lab manual directions had me cutting bone with chisel in order to get into the cavity of the head that holds the eye. There is a 'superior approach', in which I had to cut through the roof of the orbit (part of skull), and expose many of the nerves, arteries, and muscles that make eye movement possible. In the 'anterior approach', Tony had to cut through the eyelids, dissect some of the structures involved with tear production and secretion, and, ultimately, remove the eye itself. Kylee was able to juggle the directions for both of us at the same time, and at the end she wanted to be the one to remove the eye and cut it in half to get the lens out. I am stating everyone's role because I fear that our group of four may become a group of three. Our other member didn't seem (to me) like she was ready to quit, but she has been absent two days in a row, and I know she has a young baby at home. We feel like we didn't even have a chance to try to help her work through it. We'll see.

In other develpments, we still hadn't named our cadaver. Towards the end of lab today, our guy was laying face up, with his head sort of propped up on a piece of wood to facilitate working on his skull. For some reason, with his face in the condition it was in, he looked like the dad from Pirates of the Carribean, (Bootstrap Bill Turner) so we decided to call him Bootstrap (this is not a disrespectful practice; it is an affectionate name for a man to whom we inevitably feel extraordinarily close).