Fascial Dissection Part 2: A Week of Once You Cut it Off You Can't Put it Back

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  • By Marc "Spud" Bartley
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Fascial Dissection Part 2: A Week of Once You Cut it Off You Can't Put it Back

Day 2 was the backside skin removal. My brain was still fried from yesterday's action. It is really mind blowing and circuit exploding as you take apart another human.   I got locked in on a foot and calf and that is pretty much it for the day.  The wife was on the other side working away. During the days, you take numerous breaks and go visit everyone else's table. Some with lots of experience are way ahead of you and yours and some are right where you are.  This roaming is encouraged and expected by Tom and Todd.  At this stage with most of the skin off you got to see that we all look alike on the inside, but you also begin to see cancers, what fat really looks like (and its structure) and other things. One of the tables which elected to leave the hypodermis intact, actually demonstrated how strong the fascial support mechanism is here by lifting the whole layer of fat up as one unit.   This gave me further evidence for some larger athletes that your does make you stronger by absorbing and returning forces from a movement standpoint.  This is contradictory to a lot of lean ass faces who say otherwise. There is a law of diminishing fat returns, I believe, but that is to be determined by each individual not ass faces.

 

 

Short realizations aside, Day 2 saw some wonderful work by both Todd and Tom. We watched as Todd sat down at our table and separated Claudia's tiny lat, pec major/minor teres major. They all at first seemed glued to her body and hidden but then a few minutes later and some beautiful strokes, they appeared.  It was mesmerizing to say the least. The separations of the muscle groups was amazing and really can't be put into words.   After he left, feeling caught up in his magic, I worked on the other side trying to repeat his performance. I think it was safe to say I gave it a full kindergarten effort. It was not graceful at all and in the end the bottom of the lat was hacked and dangling off.  Later in the week, Todd came by and started looking at my side of philly steak and picked up the dangled lat. My only thought was of all the things you can look at, this was it. I went back to the foot.

 

 

Day three saw Claudia flipped over and on her back again.  The goal of the day was the evisceration of the internal organs. This was probably one of the scarier thoughts early on after watching so many movies with guts flying out. After learning that the outline of the abs is just fascia and actually seeing this in real life your definition of six packs takes on a whole different view. Tom gave out great tidbits of knowledge and some of his theories which were mind blowing to think on. For instance, six pack abs he stated that this was left over from having multiple stomachs and walking on all fours.  Ya, think on that shit.   Cutting the abdominals away was a delicate process that was made to look extraordinarily easy in order to get to the transverse abdominis (you know your own virtual weight belt).   Sue made an attempt and well next thing we got a hole in ole Claudia looking at her internies. She stopped there, and we waited for some assistance on that. It is a thin tough piece of fascia but not the weight belt I was thinking of and told it was in other classes.   Once we got down to it, we were then told to pull on it and see its toughness.   Todd told of a story where a Swedish crew had got to this part and then totally pick the body up off the table by the transverse. That is how tough it is. We did not think Claudia's was that tough, so we did not attempt the suitcase carry with her.  It was strong though.

 

 

We spent the rest of the morning working on the profunda fascia. Essentially a giant sheath that encompasses the body. Sorta like a clear compression sock holding everything in.  I had always imagined all these things in the body taking, absorbing and utilizing loads and movement. But this really brought it home as I imagined her moving and how the movements flowed through her body.  This added even more to the story of how strong the fat is with the fascial structures that surround it. You add all these layers and you have a body that can take way more than the sum of its parts would say.  The fascia also supports neural, lymph and blow flow just to name a few things as side notes.  The fascia is just now getting recognized for its many roles in the body

 

 

After lunch, it was time to cut away the transverse and reveal the insides. I was not sure how this would go or smell but as the curtain was pulled back there were just more mesmerizing things to behold.  At first, afraid to touch them for fear of explosion to then grabbing them, moving them and identifying them.   We would not get to pull them out today as scheduled as the day did not go that way. We did get to watch Todd eviscerate a body that was riddled with cancer and all the organs were adhered together.   He then laid them all out on the table as they were on the inside of the body.  They do not separate from each other but stayed together pretty much as a unit.

 

 

Being able to touch and feel these is quite incredible.  Tom was always full of fun things to say and came by and showed us which side of the intestines that farts came from. Obviously, the putrification side.  After poking and prodding the insides we went back to our places getting down with the profunda.  We went to put Claudia away like we had been doing after the day was done. Since we did not take the organs out I was not sure if we packed her a certain way or not.  Nope slid her in and put her up.  Even with our guts opened up we are still durable.

 

 

Day Four was the evisceration of Claudia.  Ours was a more difficult process requiring the awesome help of Super Todd.  Claudia had what Tom called the “largest cecum he had ever seen”, a small sac-like structure at the beginning of the large intestine, he had ever seen. With this issue, Todd felt like the only way to eviscerate was to take the anus all the way out with the internal organs-all of the tooter. That is just what he did. Masterfully as expected meaning no cecum breakage and no tooter leakage.  Her guts were literally laid out on the table. Many times, during the days, we were asked to stop and observe each of the cadavers in the room.   After milling around and observing you understand that not everything can be reduced to its simplest parts and explained away. I am generally that type of person, a reductionist, I oversimplify as much as possible as it helps me to understand it.  You can't really do that here.  We did look at as much as possible: kidneys, liver, arteries with calcification, sciatic nerve which is the size of your pinkey finger generally. The ovaries which you think are some huge structure like a palace if you may, but no, hers were about the size of a lima bean.

 

 

After that we flipped her back over and worked the profunda fascia off the hamstrings and calves.  We were supposed to do heart and lungs as well, but time ran out and that will have to be some day 5 action. We both got home to the hotel and were really bummed we only had one more day. We felt like we could do 1 or 2 more days at that point.  Before this week started I thought it was going to be the longest week ever but it was not at all.

 

 

On to day 5.  We had heard the last day was the most fun as the afternoon is pretty much a free for all. By this point most of the cadavers were close to being in pieces and by the end of the day they were.  But we had some heart, lungs and brains to get to first. The heart and lungs were first. I assumed we would be using some fancy tools for this but no, fancy is not needed.   To open the chest cavity, the tool of choice is garden shears. Yep, garden shears.  You go in on the lower part of the rib cage and simply cut a square out of the chest.  Blunt work I am good at. Most everyone was a little gun shy here but not me. Hand me 'dem shears and off I went. The first couple of crunched and snaps of the shears are weird to feel and watch but after a few I rolled on.  One of our team wanted in for a bit so I handed off the shears and let her get some of the action.  There it was, the whole kit and kaboodle.  Same as the internies, all came out together and we observed them as is on the table.  At one of the tables they cut a hole in the trachea, sat the cadaver upright and one of the assistants put a straw in the trachea and then inflated the lungs with many “oohs” and “ahs”.  More absolute amazement to me as this is an organic apparatus that is inflating, and deflating sealed up and protected from the world in its own compartment by several layers in many "bags" as Todd and Tom would say.

 

 

After the last truck lunch, it was time to cut come skulls open.  Todd had asked earlier who wanted to open it and how they wanted too.  Only a few tables volunteered, one being ours, Time came, and he then asked how. You can go all the way around or you can cut the sides off leaving about an inch to inch and half sliver on top. We went with the ridge down the middle. I had checked the outline guide the night before and bone saws were mentioned and how to cut.  Sounded pretty simple until I looked over at the Chinese contingent who had broken out the hacksaw. She sawed away from every angle she could even climbing the table a bit until she realized that might end up with her on the floor. Didn't really slow her down at all. She would saw and make a tiny bit of progress then move on to another part after a brief saw as hard as you can until exasperated. It was amusing to watch, and that skull wasn't slowing her down by God.

 

There were skilled and experienced teams in the room and you could tell their methodic approach. Each team member working their assignment diligently all seemingly trying to have it all taken apart. The Chinese team by the end of day 5 had nothing pretty much left to take apart along with a couple of other teams.  We on the other hand took apart a lot but only having the one really experienced member did not get near as far.   That is what was cool about it.  If you wanted to see something it was somewhere in the room.

 

 

Back to the bad brains.  After our not as spirited volunteering of our cadaver, Todd broke out the bone saw and headed towards our table.  He was probably sensing our “deer in the head lights” look on all our faces. Not that I would not try but it would end up being more of a mess then the amazing process it turned into.  Me, being the trooper and guy who likes to get up close and personal on things like this, piped up when he need someone to hold the skull up in place.  It is a very precise job and I had to hold her head up, like it was a bowl that you weren't trying to spill anything out of. We would get our answer later on that.  Todd's touch was so delicate with the bone saw.  Once he sawed as much as he could get to, there were corners where a chisel and hammer were needed to complete the final cuts.  After the cut, he would pull the skull part and you could hear an audible sucking sound.  Once you got the skull pieces pulled away we saw a very think connective tissue called the dura matter that protects the brain. There is also one that separates the hemispheres of the brain.  It reminded me of shrinky dink material.  This process all told took about 30 mins-maybe 45 mins. I could not tell as all I was focused on was his cutting and keeping the glass from tipping over. My arms were cramping, and my awesome left shoulder complained and tried to leave the room several times. Every time it was cramping and wanting to quit I would see something so cool and forget about the pain. The other funny thing during the process was that I did not have my mask on when it started completely focused on my part here. About 10 minutes in I realized this. By that time bone dust was flying all around the area. I breathed in a good portion of Claudia bone dust so there is that. I quietly looked at my wife and moved my mouth a few times probably making it look like jaw twerking. She got the hint to pull my mask up.

 

 

Once Todd cut away the dura mater, there were the brains.  After the body lets go and the animating spirit has left, the brains are gooey, almost pudding with little form.  It is not like Hannibal where he is pulling the skull cap off Ray Liota and cutting off a piece of his brain to fry up and serve. As both sides of the skull are now off, Todd instructed me to bring a plastic bag, which we place in front of her face. He then instructed me to lean her head over and out go the brains into the plastic bag. They are so gooey, they spread out in the bag. At this point I had a lot of thoughts, one being this is where all the magic is supposed to be and yet brains spilled out on the floor has the meaning it was probably supposed to really have.  Todd continued to disconnect the brains.  Once the brain is out and we got to see the brain stem and then he proceeded to hack saw off the skull at the upper palate to expose the vagus nerves coming into the brain which was pretty magical and fascinating.

 

 

Some other highlights of day 5-cutting open the pituitary gland, the spinal cord (reminded me of the old computer cables that look like packing tape-thin with many wires flat about an inch or so in width), the eyeball and all of  the fatty protective tissue surrounding it (she had a cataract lense as well), scar tissue in its actual environment and knee replacements. They looked brand new.

 

 

Obviously, there were many, many more experiences  to talk about but it would take a very long book to write.  It was truly a spectacular experience to behold and indescribable. As I stated earlier, I thought I knew a good bit but after that marvel of a week, I don't know near as much as I thought.   I understand the fragility of life much better.  Fun part though, when I look at people now, I image what they look like on the inside reflecting what I have seen at this course. Even though the five days was perfect for this type of immersion, I can see why people come back again and again.  The course is so open and non-judgemental.  I think everyone is so busy trying to get to see what that they don't have time to be assholes so much learning is attained but at the same time, a jillion more questions.

 

I will add this one thing though and it is so hard to describe that it may not come out right. One of the guys from Poland, whose name sounded like an X-files character: Woytek (YOY-tek), was there to really test his theory on friction and directional force (not just linear) between muscle groups. He inserted rods to measure force but unfortunately, he could not locate them as precisely as the Doctor in his prior test where he was unable to record the way he wanted with ultrasound I believe.  So, he found another way to test it. After the cadaver hamstrings, adductors etc were dissected, he placed push pins along each particular muscle designated by the color of the pins: magnus adductor/blue for example.  After he was done placing the pins, he did some testing where he lifted and straightened out the leg.  Remember all the muscles are separated from each other. As he straightened the leg out, you could see which pins/muscles move first, how far they move, which pins/muscles kick in and move later as the leg ascends up upwards.  I stand in amazement as I realized one of my long-standing thoughts about training and strength was happening right before my eyes.   My theory has been that every inch/moment in time of a lift/athletic movement is that, if you can get each muscle group to contribute more fully at that moment in time you would be much stronger/faster/powerful. Limiting factors like mobility in a particular muscle, dominating patterns of engagement by surrounding tissues (all of them, fascia included), adequate system activation (CNS and others) etc.  Basically, you got the parts that take most of the load and some that don't take as much of the loads as they could. Getting them to take more loads and engage when they are needed most is what I have imagined. Oh, and in unison.  So, in essence, what I was watching unfold was what I had epiphanies for myself many years ago. I had a conversation about my “ah ha” moments with a good friend awhile after the course. He was asking me about it and when I tried to explain this to him, he dropped a little back to his tortoise shell talking the CNS being the main driver, etc.  I said yes, a huge factor but after watching that and seeing the bodies all week, I said there are a lot more forces at work here that take, manage and move loads throughout the body.  As I have said, I also explain shit terrible in real life so that may have been the real issue. He is pretty opened minded about things, so it was probably my poor “splainer”

 

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That experiment was pretty cool and under any other situation would have awed the shit out of me but the WOW continued on around the room.  If you read this whole thing, realize it is only a fraction of what we saw this week. It will most certainly be a redo at some time in the future.  I want to thank Tom Myers of Anatomy Trains and Todd Garcia of Laboratories of Anatomical Enlightenment for allowing us to attend such a marvelous opportunity.

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