4. The Greater Omentum

The smell of formaldehyde or formalin (the chemical compound used to preserve the bodies) “is quite unique. It has its own name: odor of formaldehyde. It is inexpressible in words. You just have to smell it—but carefully. It’s not like a fine wine, attractive, sweet, or interesting. The odor of formaldehyde is repulsive, nose-pinching, throat-grabbing…” 

—James Gaidis, PhD Chemistry, University of Wisconsin–Madison (1967) 

In 2004, a few years after graduating from my studio’s two-year yoga teacher training, I’m teaching close to a dozen classes a week. My Thai massage practice is gaining momentum and I manage my internal environment by keeping busy. With an ever-growing curiosity surrounding the mechanism of yoga, I travel to Colorado for a thirty-day advanced teacher training. My struggles with the emotion of practice have not yet let up, and the intensive immersion I am now embracing has a larger emphasis on yoga philosophy and history. As part of our anatomy studies, we are invited by a private lab to view a dissected cadaver, which of course thrills me. An opportunity to dive into the objective bits and escape the mythologies I’ve been struggling with feels perfectly appropriate. I have no idea what to expect, but I know this is a special invitation, and what we are about to view is something few people ever get the opportunity to see. The lab cannot accommodate all of us at once, so we divide into two groups that will visit separately for a few hours over two days. I am so enthusiastic I make sure I am among the first to arrive on day one. 

We gather outside over nervous small talk, preparing for the unknown of looking at a dissected body. By the time our host brings us in, our group’s energy is scattered and uneasy. The small lab is sterile and bright. There are two tables covered in white plastic sheets. Underneath, presumably, are the cadavers. For a long time, we stand around one of the tables, acclimatizing to the space, the smell, and the emotion of the initiation that lies ahead. 

The lab is equipped with a powerful filtration system to keep the chemical fumes at bay, but, depending on several factors, the smell can quickly go from ambient to offensive. This is a first for all of us, and I can’t decide how I feel about the toxicity of the air. I don’t know if it is subtle or overpowering. I feel a little faint, which I realize is my emotional response to the fear in the moment. 

The two donors, we are told, have been in the lab’s possession for about a year and possibly spent a year prior to that in storage. Some students in the room are sensitive to the formaldehyde, and I wonder which is more noxious—the smell or the deeply invasive and emotionally nauseating act of looking at the innermost parts of a human being. I’m not sure any of us have really considered, until we are standing right there, what we have signed up for. We are coming onto the scene of a human dissection that has been underway for nearly a year. The donors under those sheets are not whole, but we’re told this viewing of their bodies was their dying wish. 

We surround one of the tables, holding hands, and I search our circle for evidence that I am not alone in my fear. Many of my comrades stand there with wide eyes and skin tones ranging from bright red to pale gray to sheet white, confirming that the visceral response I am experiencing is not unique. We take a few deep breaths, and the first sheet is slowly folded back. 

Oh. My. God. 

I am horrified. 

I don’t know what I expected to see, but it was not this. Under the sheet is not the wax-like hands of my dead father, nor the made-up face of a body before a funeral (or a face at all). It’s the well-picked-over carcass of a Thanksgiving turkey at the end of a meal. Bones are exposed and joints are bent at strange angles. The muscles are gray and resemble the dark meat of an overcooked turkey. My face must be giving away my horror because our host, without skipping a beat, mindfully acknowledges that we should feel disrupted by what we are looking at. That our bodies, for the most part, are so quickly discarded, and this rare sight, void of a societal norm of acceptance, is full of an intangible flurry of feeling. A few students step out to collect themselves again as the discussion advances until we all feel a bit more at ease and ready to continue. 

As a group, we quickly recover and get our gloved hands into the amazing landscape of the human body. The energy of the room shifts once we are palpating and pulling back muscle, exposing anatomy rather than a corpse. Between the two donors, both women, we view a hip and knee replacement, muscle growth in places where muscle isn’t expected, and even get to examine the pineal gland deep in the brain. I haven’t a clue what the pineal gland is or what it does, but I already know I will be returning to the lab with the second group the following day. 

With the shock out of the way, I am able to take in a bit more of the immenseness of the human body. There are so many unfamiliar structures that propel me toward deeper anatomical study. As I look at all the strange shapes in the abdominal cavity, it’s the greater omentum that seduces me into a future of dissection. 

Basically a blanket of fat cells, the greater omentum lies overtop the digestive organs, encloses the transverse colon, and is full of blood and lymphatic vessels, making it a great contributor to the immune system. It acts as an insulator and has been known to isolate and limit infection by wrapping blanket-like around areas of concern. How cool is that? Having never encountered this structure in any of my anatomy books, mostly unaware that anatomy goes beyond muscle and bone, I am humbled by the human body. 

Over the years of dissection, each time I peer into the abdominal space, I am returned to my first discovery of the greater omentum. We find it doing all kinds of interesting things. In some, it’s dense and heavy. In others, it’s delicate as a doily. It can be found just hanging out looking cool or all bunched up somewhere, pointing out some pathology. I am not alone in my ignorance of this fantastic structure; I witness others in the lab eagerly meeting the greater omentum for the first time. 

The greater omentum has made me want to understand how our internal structures silently work with an acuity far beyond any intellect to keep us in good health. 

I leave that small lab in Colorado with a photocopied schedule of all the six-day dissection courses offered over the coming year. I know it won’t be long before I meet my first uncut cadaver. 

I am honored to learn that someone like me, a health clinic manager and yoga instructor who dabbles in Thai massage, is eligible to enter a medical lab and participate in dissection. The use of medical labs and the acquisition of donors is afforded by the high tuition fees charged to participants, but it is our facilitator’s reputation that opens the otherwise bolted laboratory doors. Gil is a trusted guest in each hosting facility, and we are fully aware of the importance of upholding the standard of conduct he has promised on our behalf. 

Upon returning home, I reengage in the monotony of daily life, dipping in and out of the challenges of personal growth while daydreaming about being in a dissection lab. Before the year is up, I gather the courage to fill out a lengthy application and have a phone interview with the course founder. Gil is not concerned about what I do or do not know about anatomy; he emphasizes the spirit of discovery over academia and accepts me into my first six-day human dissection workshop. What I have yet to realize, having just learned what the greater omentum is, is how the complexities of the body will lead me deeper into self-discovery over the years to come. 

I did not excel in my early years of schooling. My parents held me back in third grade because they felt my math and spelling skills were not adequate. I was encouraged to embrace my artistic talents, content to be relieved of higher academic pressures; it left me feeling like everyone thought I was stupid. I guess I believed it too and never explored biology or science in high school—but I was obsessed with watching “The Operation,” which aired complete surgical operations on The Learning Channel while I was finishing up high school. My mother encouraged me to pursue a career in graphic design, and following two years of study, I received an advanced diploma in the subject but never found professional success. I knew from a young age that the traditional nine-to-five job was not for me. 

My work life, while not exactly conventional, has provided enough to cover all the regular bills while still allowing me to participate in the expensive teacher trainings that have led me to my body, deeper healing, and, inevitably, the lab. 

With the emotional aspects of my physiology officially on hold, nervous and excited, I pack up my anatomy books and head into my first full dissection with one hundred nitrile gloves, a crisp new lab coat, the printed workshop manual, and a belly full of nerves. This time I will lift the cover off a body that has never been cut. What’s it going to be like to cut into the skin for the first time? Will they look like the bodies in the caskets at the funerals? Will I cry? 

Upon meeting my first donor, our beginning task is to give her a name. Her dense, curvy frame reminds me of my mother, but she looks like no one. She is bloated, as donor bodies are, from the infiltration of embalming fluid, her hands and feet swollen to the point that there are no visible skin creases at the folds of the ankles or wrists. Shapes I recognize from my mother’s body, whose skin is stretched creaseless and padded over the bony protrusions of these same joints, only her puffiness is due to fat cells that are very much alive, not formaldehyde. Immediately, I begin to see how this endeavour will be an intensely triggering journey. It’s already sparking an emotional link between the life all around me and the death that will forever threaten that. 

We spend some time thinking about how old the donor might be and consider how the years, her place of residence, her family, and time through history shaped the curves of her body. Unable to separate the mother from the sensual being, we name her “Venus-Mary.” 

The first day in the lab is slow-moving. Typically, we gather as a group in the lobby of the medical lab that’s hosting us. Those of us who return year after year reunite and chat about our plans for the week or what has happened since we last met. The newbies buzz with a nervous excitement, and soon we make our way as a group to the anatomy room. The course takes place at several locations around the US in hospital morgues, university labs, and occasionally private facilities. The spaces are often hidden away in windowless laboratories in the basements of otherwise busy buildings. On occasion, and in my favorite lab, we get to ascend to a higher floor, where windows without blinds look out onto the brick wall of a neighboring building. Natural light is a real gift when you spend long hours on your feet, but you can see how a windowless room helps keep private what goes on behind lab doors.  

The lab is under tight security, and we all have access badges that open the door. Each time we scan our pass, our name pops up on a security panel somewhere that places us at that location in the building. This is all to protect the privacy of the donors and preserve the programs that provide the bodies for our learning. Because of the history and stigma around the use of cadavers for learning, the smallest disrespect could strip us of this profound privilege. No chances are taken with access. If you are not enrolled, you are not permitted entry. 

Some of these labs have artifacts that indicate a rich history of human dissection. In one, deep, enameled, cast-iron sinks from another century line the walls. Recessed wooden cupboards layered with paint keep sealed specimens of hearts and embryos that could be as old as the historic buildings that house them. An old framed fire-exit plan hangs near a door in one lab located in a modern city neighborhood. The contrast between the new die-cast plastic teaching skeletons and the yellowing paper of the typewriter-drawn fire route alert me to the fact that I am among the one percent of curious minds who have stood in these institutions peering into the human form over thousands of years. 

We are greeted inside by a circle of chairs. A few tables separate our circle from the circle of donors covered in white plastic sheets. Their presence is ominous. There is no mistaking what we are about to do, but there is a great distance between us and them. Both emotionally and physically. 

We are a unique group of people who share a common interest in the body. No one has forced us into the anatomy room, and we are taking up the tools of dissection as a means to deepen our comprehension of not only anatomy but humanity. Although there may be a small amount of trepidation involved, we have no doubt the experience will provide a unique depth of new understanding of what we are seeking. 

In our circle—some of us dressed in our regular clothes, some in scrubs—we begin the mental preparation. The space is clean and bright. Only the faintest smell of chemical preservative hangs in the air. In the far corner of the room are stacks of cardboard boxes the approximate size and shape of coffins. That’s exactly what they are, but they are empty, as our donors lie covered on the tables, waiting to fulfill their final act on earth. 

Meanwhile, we make the long, slow round of the circle, learning our classmates’ names, where they arrived from, and what sort of work they do or what brought them to the lab. Most are bodyworkers and movement specialists of some kind. Massage therapists, Rolfers, structural integrators, physiotherapists, and yoga and Pilates instructors are just a sampling of the professionals who hope to expand their knowledge base through dissection. On occasion I have met nurses, a naturopath, a dental assistant, an anthropologist; sometimes writers, artists, midwives, musicians, and even a pilot. Most of these people are at the top of their profession, and it’s one of my favorite aspects of this kind of study: meeting the others who have been drawn to the macabre exploration of real anatomy. We have the most amazing conversations while we work, and no subject is off limits when you are standing over a corpse with a scalpel in your hand. I have several lifelong friendships that have formed through these gatherings. 

Once our introductions are through and we have our lab coats on, we move to the other side of the tables to meet our subjects. The words used to frame the work we are doing demonstrates the respect we have for the donors. But there is something about the word cadaver that, to me, does not do justice to all that a non-living body has to offer. When I think of a cadaver, I imagine an empty vessel, which is not what we are working with at all. If it were empty, I certainly would not have any reason or desire to return year after year. Although many in the lab will use this word, more often you will hear the bodies referred to as donors, forms, teachers, or by the personalized name each group has given its corpse. 

There may be two or five donors in the room, depending on student registration and donor availability. Typically there are seven or eight students assigned to each body. It sounds like a lot, but there is no shortage of work to do, and six days—forty-two hours—is not very much time. 

There is a quiet acknowledgement that together we are embarking upon an incredible journey, a personal one that is really a collective one…and perhaps universal, for those of us willing to go there. Forming a standing circle around the tables, we hold hands and take in the sight of the bumpy mounds beneath the sheets. We draw three collective breaths to calm a nervous system that has already figuratively marched forth to peek under the plastic covers. Reining in the mounting anticipation and imagination, we stomp our feet to ground ourselves in the present moment. It’s a vibration and sound that will be repeated spontaneously as the week progresses. As the sight of dissection changes, excites, and overwhelms for a moment, the stinging slap felt through the soles of the feet reverberate through my living body, effectively reuniting it with my easily distracted mind. 

Together, we uncover the bodies one at a time. We know nothing about them at this stage, but we begin to draw mental pictures right from the first viewing. Each of these people chose to leave their body to science, their families carried out their wishes, and now we must take all we can from this precious gift in the short time we have. 

The ritual of meeting the bodies takes up half the day, and it’s more than just an introduction to the dissection. It’s a transition from mind to matter. We arrive in the lab with a head full of excitement, fear, and anticipation. The hours leading up to the first cut help orient us to the reality of dissection in a way that softens the story the mind manufactured about the experience before we arrived. 

When we meet the donor for the first time, they are lying face-up, arms by their sides. They are bloated from the gallons of embalming fluid pumped into them, a detail I constantly return to because of the way it objectifies their bodies as something distinct from me. 

The embalmer will impose upon the circulatory system by making an incision at the neck to lift and open the carotid artery and jugular vein. A cannula is placed in the artery to introduce the embalming fluid, while the opening in the jugular allows for drainage of any blood that may get pushed through the system. In this way, the body and blood are perfused with preservative, giving them their bloated look. Embalming incisions are indelicately repaired and stitched up with butcher’s string, a little Frankenstein-like. The image jars us into the reality of the dissection ahead. Once a body is embalmed, it no longer requires refrigeration, and the lab temperature is no different from that of any other room in the building. There are times when our emotional processes are elevated and mirrored by the room’s temperature fluctuations. The room and all it contains, living and dead, become a single living organism through the course of the week. 

The excess of fluid gives the body a look that does not represent the donor or anyone we know. Their heads are shaved to avoid masses of loose hair at the dissection tables, and possibly to deter mold—or as an aesthetic choice, with a view to depersonalizing or anonymizing the donor. For the most part, they all look a little like one another. Their heads are round, lacking the bumps and grooves of personality around the cheeks and eyes. Lips and eyelids are puffy, and the skin is a pale interpretation of gray, regardless of race. The shade of gray correlates with the shade of whatever skin pigment the flesh once portrayed, light or dark. 

We gather around, hands gloved, moving from table to table, we touch and squeeze the skin of our donors. We observe scars, bruises, joint positions, and, almost always, someone asks about the thin creases around the hands and ankles where the bloating is absent. Each body is stored wrapped in a cotton sheet underneath a clear plastic protector, then enclosed in a thick vinyl body bag. The layers keep chemicals from oozing out into the cardboard box that houses them until arriving in our lab. Extra wrapping is used around the hands and feet to prevent them from dehydrating and the string keeping the wrap in place creates a slight dam where the fluid cannot spread as easily, leaving a crease in the skin. Venus-Mary did not have these marks because she was embalmed and presented to us within a week of her passing. The lab technician who embalmed her knew her family and shared this information as he passed through the lab one day. 

Sometimes donors may be stored for a year or more—an embalmed body can be stored for up to six years with no signs of decay. Following one of my labs, I stay behind with a few classmates to assist in preparing the next group of donors for the upcoming batch of students. It is an arduous job to remove all of the plastic, untie the strings, unwrap the sheets, and sponge off the body. It takes several of us to move the weight of each donor out of their box and onto a freshly cleaned dissection table. I consider how many times each body has been tended to in this manner since its death. How many times and what distance has the donor traveled? How many people have been its guardian? The cadavers arrive in pristine condition for our dissection, and the care taken to transport, clean, clip, and prepare the body for embalming, wrapping, and storing feels deeply ceremonious. I am honored to be part of the process. 

We’re already hypothesizing about how they died, what surgeries they had, how old they might be. Often areas of very superficial skin have begun to flake away. A living body is constantly shedding skin, and although there is no life left in this skin, it was ready to be sloughed off even as the body was dying, but death halts the acts of living tissue. Once dead, there is no more active shedding of anything. All becomes passive. So the topmost layer of skin that was ready to be shed comes away from the rest of the skin when the body is moved, squeezed, turned, and transported. Sometimes we see areas of bruising, and the discussion turns to whether it was the result of an event of life or whether it occurred afterward by the settling of stagnant fluid. 

Many of the donors are older and died while there was a medical intervention taking place. In these cases, we see bruising on the arms and hands where IV needles may have been present. Although visibly void of life, the bodies represent an important intersection between life and death. Dissecting them will be the closest we get to seeing our own hearts and brains in the flesh. We are working to reconcile the intricacies of life while looking at death, and in this moment there is no mistaking the difference between the two. Details like nail polish and tattoos nudge us back to the questions about who they were while they walked this earth. 

After visiting all the donors in the room, we silently develop a preference for the one we want to work with. We will flit about the room to see what others are doing all week long, but we commit to working on one donor with the same group. 

Before making our final choice, we stand them up. To me, this is a terrifying and thrilling task. The bodies with all the extra fluids, weigh at least 250 pounds each, and although their joints have some flexibility, the fluid restricts how much. They become rubbery yet stiff. Standing one up takes on average five people. After the body has been pivoted until the legs stick out from the side of the table (typically they do not hang), two volunteers are responsible for anchoring the feet and knees so the rest of the body becomes erect overtop of these joints. The other three volunteers support the spine and grip the arms for extra stability. Through all my years of dissection, I volunteered for this task only once. It confirmed for me the horrifying fear of being stuck under a cadaver accidentally dropped. Such an event has never occurred (not in my presence anyway). 

It is incredible how a donor comes to life when standing. They show themselves with greater command when you can observe just how much space they took up in the world. Were they tall or short? Look at how the weight is distributed, top- or bottom-heavy. Something happens to the face. In this state, the skin is not responsive to gravity, but looking at them face-to-face rather than standing over them gives their appearance an unmistakable humanness. Suddenly the form before you becomes a “person” you really cannot wait to know. 

Having thoroughly examined the outer aspects of all the donors, now we must separate from the group and focus on the one we will completely unwrap. Within seconds we are scrambling around the room, hopeful for a vacancy at the table we are coveting. Inevitably, there are disappointments and polite arguments when too many dissectors gather around one body—usually the most handsome cadaver or the one with all the scars, which says something about being average in death. Someone has to sacrifice their spot and move on to allow the process of dissection to begin. Somehow it always turns out, the person who had to move finds something they couldn’t have hoped for if they had gotten their first wish, and average on the outside says nothing about what is found within. Now that the room has settled, we discuss and choose a name for our donor, which can be tricky. Real human names are an obvious go-to, but we are conscious of avoiding names shared by living friends or relatives. I personally prefer more fantastical titles that don’t remind me of any particular person. We have given these symbolic forms inspired names such as Venus-Mary, Star, Lazarus, Rock Watson, Proud Mary, and Mobe. 

Prior to any dissecting, we sit down to lunch. People are always curious about eating during lab weeks. Here’s the short answer: we eat a lot! 

In my first lab, where we dissected Venus-Mary, I was astounded at how much I ate. It was as if I could not keep up with my brain’s demand for calories. A few foods resemble some of the textures and colors from the lab, but for the most part, there is no loss of appetite to be had. When you are spending eight hours holding an instrument designed to cut through flesh, and eight of you—many of whom have never used a scalpel before—are in close quarters, low blood sugar is not ideal. And no, I have never seen any (serious) scalpel injuries in the lab. 

Our method of dissection is unique in that we approach the body layer by layer. This way we can peel back the skin and discover how it relates to the fat beneath. It is a slow, precise process of discovery. We are forced to be present with each unique layer and its relationship to everything above and below. By maintaining the continuity of the skeleton, we ensure the donor remains a person to us and we are rarely looking at just a leg or lung. We observe the parts as a whole, and when we discover scars or pathology, we can search for their extensions throughout the body as we delve deeper. 

Instructions on how to use a scalpel are brief. Surprisingly, the learning curve of mastering this physical tool of dissection is much less severe than the one involved in my emotional inquiries. There is no misunderstanding around the certainty that this blade will cut flesh. While holding a scalpel in one hand, the other must also grip a hemostat, the scissor-like instrument with a locking handle and flat-ridged pincers where blades would be if they were scissors. The hemostat is used as fingers that hold the tissue, while the scalpel cuts. To keep from accidentally cutting your living flesh, Gil emphasizes, any time you have metal in one hand, you must have metal in the other. I’m not sure if there is a comparable safety strategy for protecting against the ways in which my yoga practice subtly sliced into my emotional layers before I ever stepped foot into an anatomy lab. 

The first cut into the flesh initiates us into the incredible world of human dissection, and we wear our badge with pride. The intimacy with which we touch, view, and map the body is now forever changed. Our descriptions of what we uncover in this vast, internal landscape are not what you will find in anatomy journals or scientific studies, because our study is specific to each of us and to the donor we are engaged with. My interests are found in the complex intersection of mind and body, where one concept bleeds into the other and, I believe, they create a whole.