Fascial Dissection/A week of once you cut if off you can't put if back

The gym move consumed so much time and effort both mentally and physically. The move also was supposed to be done way before our week-long dissection course hosted by Tom Myers (Anatomy Trains) and Todd Garcia (Master Dissector at Laboratories of Anatomical Enlightenment).  The time between was brief and we barely had time to pack and head out to Arizona.  The course is open to the public if you pay the dough.  We signed up months before, pretty much the day we saw it. The wife was a bit nervous about it and lined it all up with one final "Are you sure?". Press it now or we won't do it was my response.  It may have been expensive but, my feeling was when on earth will you ever be able to dissect a fresh cadaver? Plus my desire to see all the things I wrecked in my body, all the points I activate continuously and how they might work together, how the parts connect that you have offered so much sage advice on over the years, where all the supplements you recommend go, what the body actually looks like versus what you imagine it being-the list goes on and on.   I don't know how anyone can call them self an expert on anything in this industry, well world, after you see that.  I thought I knew a little sumthin' sumthin'. I have always said even with all my years of experience, training, learning etc.. if you put that on a scale of 1 to 10, 10 meaning the all-knowing god of the body, I would be at a 2 maybe 3. Now probably back down to 1 or less.

You have to bring a few things, lab coats, gloves, goggles, scrubs and most of all your signed wavier (permission/field trip slip). Yeah, we showed up without that part. That's how out of it we were from the move fury.   Where they hold the course is in an industrial/office park area. Yea, nope, not at a hospital or “morgue” type place just a plain old office park. Tom shows up and he is sorta a rock star of the movement world. He begins to ask for these forms. Hold on, we got there early before all the hoopla began and Todd was there. We were pretty early and walked into the locker room/ reception/bathroom area. It is about a 10x10 area where 48 of us would congregate before heading into the “cut ‘em” up area.  Todd is a very quirky master dissector (brilliant guy) tells us it is not time and basically come back later-very cut and dry guy. HA! So, we go away for a bit and come back and the gathering has begun. Tom is collecting the parent permission slips and gets to us. We decide to take our beating and tell him we forgot them and beg for forgiveness. We pretty much got that this is one of the course requirements with no joking whatsoever. The “how dare you show up at my shit without the paperwork” look was what we got. He moves on to the collecting of others paperwork and we slink back and away. Luckily one of the other attendees had a blank copy so we then had to figure out how to get copies and be back.  There was an automotive custom shop a couple of doors down from the dissection laboratory, let that sink in a bit, and we made a desperate attempt there. We walked in and I immediately saw a printer there at the guy's desk.  He was super nice and said sure to our pleading.  Permission slips obtained.  Tom only gives us a mild stink face when we give him our slips. Somehow we always seem like we are the outsiders.

We got past the doorman and into the “cut ‘em up” club.  Sweet! The laboratory was a slim room maybe 20 ft wide by 50 ft long with a couple of large freezers in the back and one or two upfront. The reality began to set in. One of the things that haunt us all is fear of the unknown. We made plenty of jokes beforehand about it between me and the wife. When we told people where we were going most of what we got was a blank stare, some disgust and “why?”.   Most people thought we were going on vacay and offered the normal pleasantries until we told them what we were doing.  I guess it is a little hard to comprehend and probably before I got in the gym business I would have thought the same way.  Given my curious nature I may have done it back then but with less fervor.

Our main dilemma seemingly was not throwing up or being sick the entire time. After all, it is a decaying body at room temperature.  Neither of us knew how we would handle it, go running out of the room, stand tall with our ninja butt squeeze technique (try it and see how it works, it is especially helpful in stressful situations or confrontations) all god damn day long.  You just don't know how you are going to do.  We had watched the Tom Myers dissection DVDs for Anatomy Trains and that was a little unnerving but doable. My biggest concern was having to look the cadaver in the eyes and keep my shit together. In the videos they had the face covered so part of me hoped for that.

We walked into the club with 48 other people from all over the world. Not kidding either: China, Australia, Poland, U.K., New Zealand, want to say Sweden and the Netherlands as well.  Plethora of peeps crammed in this room.  The interesting part was, for many, this was their second or third time around. One guy we clung to, I believe was his 4th or 5th time.  As you sat there you looked around the walls of the room and there are the tables and body bags. It was about this time, I said to the old lady, shit is about to get real.  The butterflies began to churn for me and I immediately had to NBS (ninja butt squeeze) the stitch and make sure my tummy was out and breathing into my diaphragm. This passed quick and introductions began.  The majority of the room are manual therapists, yoga and Pilates instructors. Not what I would expect. Even the Chinese were Pilates instructors although I am not a hundo percent that as true.  Not the most uptight room I have been in but a little stuffy.

You get the small folder with basically the week's outline and descriptions of the processes. It sounds like a doable process.  You think “oh they are going to show us and then we do”. No, that is not how it is gonna go.  Besides Tom and Todd, there are assistants to help when you are stuck or have questions but for the most part you are jumping off into the abyss. Like after boot camp and ready or not, here is your gun, now go to it.  Before I go further with that, let's go back to the body bags.  After introductions and instructions for the next steps of the process, the bodies are pulled away from the table and we took the bodies out of the bags. I am a team-player so I wasted no time helping.  There was a lot of looking around at who would buck up and get to it.  Plus, to me, the sooner you get your hands dirty, the sooner you get used to it.

First you get the body out of the big bag and then unwrap it like a candy bar.  There is a second layer of plastic to get to the body.  It is cold from being in the cooler.  But I got past that and tried to handle her delicately thinking I was going to break something. By the end of the week, my approach to her was different.  After we got the bodies out, we are instructed to walk around and pick the body we wanted to work on. There were 48 people and 8 bodies so 6 per table. Everyone mulled around like they were at the zoo. Some pick a body fast and knew exactly which one they wanted.  Our group came together and seemed to huddle around the lady we pulled out of the bag.  This could have been a dodge ball (the movie) moment where all the kids that want to get chosen by the best and be on the strongest team. Our band of Average Joe's seemed to all go “meh, eh” to our person. Eventually that is that and all the other teams have been filled.   We had an excellent team and in the end our cadaver was an awesome candidate.

This course is unique because all of the donor's body is returned back to the family after cremation.  You get one towel to soak up blood and fluids that gets squeezed off into a bag with all the other parts taken off. At the end of the week it is all gathered up, including the towel and placed with the body.   You also have to name your person. You are not given any information about them but you have to name them. It is a compassionate process while you get to learn.  Our girls was named Claudia. At first she didn't look like a Claudia so I called her Jesse personally.  Names varied from average to over the top as par for the teams ego I think.  Anyhow, my first thing to overcome was looking her in the eyes.  Much to my chagrin, her face was not covered as in the videos.  I faced my fear the only way, looking straight into her eyes. I tear up a bit when I realized she was a person with a life. I didn’t want her to be there dead but such is life, a birth and a death.  Still a little difficult with the reality of it but personally I had been trying to face this reality for years.  I stared as long as I could doing my NBS and then stared some more while touching her gently.   Ninja Butt Squeezes helped a lot.

Next, we got our tools with the safety protocols. You are given a scalpel and your choice - tweezers or hemostat.  They recommend the hemostat and most people took those, of course, except me, I went for the tweezers thinking with my left shoulder issues they would work better rotation wise. It wasn’t the best choice as my hand got tired fast but they worked fine.  Off to the races. Yes, that is exactly it. Oh, don't saw, use the scalpel like a paint brush. Sort of like when they told not to bear down too hard with your pencil or else you will break the tip off.

Your first day is removing the skin on the front side. They give you choices take all the layers down -epidermis, dermis and hypodermis or just the top two leaving the hypodermis. This is a much harder task and our lady did not have much fatty tissue, so we went all the way.  She was small so six people surrounding her didn't leave much room to work. Each person had to decide where they wanted to start so after the musical chairs I was left by her left shoulder and arm. I was a bit shy of tackling the head and neck, so I just stared at her arm for a minute. Suddenly I was gently slicing the upper arm.  It began to open up. Being terrified of hacking her up it was a very slow process. Little by little I painted with my scalpel. She had some fluid trapped o

r bound as Tom would say – we call it edema – that was what we saw first, and it was super weird.

I was prepared with my grape fruit oils on my mask to keep the smell away but with the mask and glasses all it did was fog up.  My mask went down quick and pretty much stayed down the rest of the week.  I noticed some people had dabbled oil on their lab coat lapel and figured out that was an easier way to avoid the smell, but my masks stayed doused in oil all week and kept my beard smelly.  I spent the morning and up till lunch break working the skin off her arm and leg.  One of the things about this work is there is no easy way to do it. You just have to lift the skin, delicately use your scalpel to separate the skin away to get to the profunda fascia which was the goal.  Some of the skin came off easily and some required extra effort and patience.  I just really didn't want to hack her up and somehow ruin the experience.  Tom and Todd and all the assistants would stop by and help us. They made it look so effortless.

Our girl Claudia, we all pretty much agreed upon, just died of old age. She had very little muscle and was locked in a position turned to her right. We surmised she was either slumped in a wheel chair or didn't leave her wheeled bed much laying on her side.  She did not lay flat and remained in the rotated position even on her back as we dissected.  As the next couple of days went on and we removed more and more skin, her body began to unfold.  She did not reach a state where she was totally flat but from where she started and ended up it was pretty amazing to watch.

Lunch for the week was the food truck.  On day 1, Tom and Todd asked if we wanted the food truck to come by.  Apparently, you have to have enough people and you have to tell them to come by, others wise you ain't a gettin' no food.  After everyone reluctantly agreed as you can imagine, you aren't really thinking about food too much when you are carving up dead people. More unknown quantity I think. Well the food truck turned out to be awesome and she came by every day.  She had anything you could imagine including real sugar Fresca and another fruity soda that was awesome. We ate light all week off the food truck. Nothing too heavy. Even though you needed to take your mind off what you did for the last 3 or 4 hours, I was not starving. Reminded me sort of meet day, I ate very little for breakfast and light snacking after the squat or bench.  They had a nice grassy front area so most of us just hung out there-each with their clique.  A picnic scene at a park.

The afternoon we, well me for sure, continued to fumble our way through the hackery. They stopped us before 5 pm so everyone could clean up and properly put away our Claudia. Probably the most important reason is most brains like ours were fried and could not take any more intense focus. All fluids are then cleaned up and squeezed off in their proper place and the body was re-bagged. This also isn't a time to be bashful as you have to roll them on the side, lay the bag down and slide Claudia into the bag. I am a trooper here and we get her in. She isn't heavy at all, just awkward with the negotiations.  We had to clean up the bag, dump our instruments in a bucket and then wait our turn to put the body in the cooler.  Yes, into the freezers in the back and front if you remember: packed and stacked.

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-recruitment patterns. Getting them to take more loads and engage when they are needed most is what I have imagined and how to do that. 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”

.

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.