Gross Anatomy: A Cadaver's Tale

EDDIE

About the Author

As a graduate of The University of Utah School of Medicine, Doctor Stucki practiced urology in St. George, Utah, for over thirty years. During that time, he served as chief of surgery, chief of staff and as a member of the hospital governing board. Though working full-time, he also managed to pen and publish six novels: Boy’s Pond, Hunting for Hippocrates, Sagebrush Sedition, Hemorrhage, Mountain Mayhem and The Reluctant Carnivore. Presently, he resides on a small horse ranch in southern Utah with his wife, his horses, and two Labrador retrievers.

Dedication

For my wife, Linda, who puts up with my moods and is always my first line

of defense against the omnipresent hordes of grammatical mistakes.

Copyright Information ©

Warren Stucki, M.D. (2020)

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher.

Any person who commits any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

This is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental.

Ordering Information

Quantity sales: Special discounts are available on quantity purchases by corporations, associations, and others. For details, contact the publisher at the address below.

Publisher’s Cataloging-in-Publication data

Stucki, M.D. Warren

Gross Anatomy: A Cadaver’s Tale

ISBN 9781647505103 (Paperback)

ISBN 9781647505097 (Hardback)

ISBN 9781647505110 (ePub e-book)

Library of Congress Control Number: 2020920303

www.austinmacauley.com/us

First Published (2020)

Austin Macauley Publishers LLC

40 Wall Street, 28th Floor

New York, NY 10005

USA

[email protected]

+1 (646) 5125767

Acknowledgment

I would like to thank Diane and Rodger Bland for their encouragement and assistance with proofreading. A nod to Nick Adams who also helped with proofreading and plot suggestions. Also, I would like to express my appreciation to Wolters Kluwer/Lippincott, Williams and Wilkins for granting me the rights to include excerpts from their excellent book, Grant’s Dissector.

Chapter One

EDDIE

YOUR FIRST PATIENT—The opportunity to dissect a human body is a once-in-a-lifetime opportunity. The cadaver that you will use for dissection was donated by a person who wished to make a contribution to your education as a physician. It is not possible to put into words the emotions experienced by that individual as he or she made the decision to become a body donor. It goes without saying, the gift the donor has made is invaluable, and can only be repaid by the proper care and use of the cadaver. The cadaver must be treated with the same respect and dignity usually reserved for the living patient. For you, the student, this is a solemn trust.

Donate your body to science, huh?

Ha! What a laugh. What does that phrase even mean? Is it meant as some kind of an inside joke? If so, I fail to see the humor.

No, no, more than likely it is not meant as comedy, but used as some kind of a sneaky smokescreen, or a seductive sugarcoating. A sweet, but disingenuous euphemism.

Or perhaps, it simply represents a deflection, a seemingly benign diversion, a harmless white lie.

But on the other hand, could it possibly be more calculated—a staged and choreographed sales and marketing ploy? A slick Madison Avenue production?

Or conceivably, it is even more sinister, designed to intentionally defraud or scam the naïve and trusting public. A sly bait-and-switch scheme.

Or—well, I’ll just blurt it out. Could it possibly be a deliberate bald-faced lie?

For me, this personal fleecing began a few years ago when I read an article in the Salt Lake Tribune about body donation in the great state of Utah. The reporter made it sound gallant, even a patriotic thing to do, and equivalent to organ donations for surgical transplantation. I don’t remember the entire article word for word, but I do remember part of a quote from the director of the University of Utah Body Donor Program. And I paraphrase: Donors are vital to medical advancements—everything from the developing new surgeries and procedures to the creation of artificial organs and limbs.

That sounded okay to me, maybe even a bit noble, a sensation I hadn’t experienced in a very long time. Without giving it enough thought, I signed up, just as I had previously registered with South Salt Lake Plasma Center to donate blood and the Murray Infertility Center to donate semen for their commercial sperm bank. Or comparable to when I enrolled as an organ donor by just checking a box when I applied for my Utah driver’s license.

To be honest, at that time of my life, I would have donated to anything that reimbursed me in U.S. greenbacks. Blood and semen paid pretty well, but unfortunately, I’ve yet to receive a dime for donating my entire body for this so-called advancement of science. Not an Abe Lincoln penny! And at the time, I desperately needed the money. What an all-American rip-off!

Anyway, I’m sorry; I apologize. It seems my emotions get the best of me and I digress. Please, let’s move on.

Donate your body to science, huh? Well, I don’t see much sciencing going on down there, and nobody seems to be doing any innovating either. I see no one researching a novel cure for cancer, or developing a revolutionary new surgical technique, or bioengineering a marvelous new artificial organ. What I do see looks more like an amateur hour auditions at the community playhouse, or improv at the local comedy club. And without question, I feel no overwhelming, or even a trace of gratitude for my ultimate gift, and no heartfelt respect, none, for my once beautiful body.

Okay, okay, I’ll admit to being a little overdramatic. And my reason for donating may have been a little less than altruistic, and might not have qualified as selfless or noble either. Perhaps, it could even be construed as selfish and/or self-serving. And it is entirely conceivable I was a bit hasty, not giving it enough thought, or asking the right questions. But in my defense, when things started going bad, I had to do something and do it fast. When you are losing badly at the game of life, you hedge your bets. That’s what I did; you would have too.

Now, understandably, I am having second thoughts—donor’s remorse, maybe even feeling a little sorry for myself. I’m beginning to think this impulsivity represents yet another blunder on my part. Another miscalculation, one of many that has made up the checkered fabric of my life.

Well, enough of the poor-me routine, let’s get back to the present. Below, I see at they are drawing lots to see who gets me and the other lifeless stiffs. A tacky game of chance. And apparently, I get no choice in the matter.

But I will say this much, if those super-hormonal kids down there represent serious medical science, then count me out.

That, of course, is a figure of speech. There is absolutely no way to count me out, or for me to leave, or to go back and change history, or alter the course of my life. Regardless of Einstein’s General Theory of Relativity (suggesting time can be bent by gravity), it appears, for better or worse, probably for worse, that celestial time flows only in one direction. As a consequence, it seems I am stuck here. However, let’s be clear about this much; they may be happy with me, the best-preserved and youngest cadaver in the lab, but I am certainly not happy with them.

You may ask, isn’t it a little premature to judge those kids, to condemn, to criticize? You might also suggest that at the very minimum, I give them a chance.

Well, let me say this. I do know a little something about ineptitude—at least enough to recognize incompetence when I see it. And after working in the tourism and hospitality sector for most of my life, I’m a pretty good judge of character—enough to know these kids will never amount to much.

Okay, okay, that’s enough of my personal venting, this—this—what do you call it? Oh, yeah, this stream of consciousness. Perhaps, we should get right to my story and let you, the reader, decide.

Chapter Two

KEITH

GROSS ANATOMY—As opposed to histology, gross anatomy is the study of human structures that can be seen at the macroscopic level, visualized with the naked eye. Histology, on the other hand, is the microscopic study of tissues. For medical students, the dissecting of the human body is a centuries-old rite of passage and for many, it will be their first time seeing a dead body. The anatomy lab is where future surgeons will make their first cut with a scalpel, thankfully without the pressure of life and/or death hanging in the balance. It is also where the ability to visualize organs and study their spatial and functional relationships will be honed. Lastly, it is the place where medical students begin, for better and for worse, their long, and perhaps necessary journey to desensitization and disassociation.

The zipper made a metallic unclipping sound as Ron worked it downward. Through a small, but steadily expanding V-slit, the body was exposed. Almost instantly, a strong odor escaped the vinyl body bag, rapidly mixing with the stale air of the laboratory. It was a compound-nauseating odor undoubtedly created by mixing caustic preserving chemicals, decomposing human protein, and oxygen. For those in the know, it was the unmistakable stench of death.

Ron continued to slowly work the zipper down.

First to appear in the enlarging triangular window was a rounded closely-shaven cranium. Due to the short butch cut, hair color was difficult to determine, but perhaps a sandy blonde. The upper-middle part of the forehead, just below the hairline, appeared next. Common frown lines were present, but they were not many and those present were shallow, most likely indicating youthful skin.

As the window expanded, now a bit asymmetrically, the tightly closed lids of the right eye appeared, including the inner corner of medial canthi. Almost simultaneously, however, it became apparent the left eye was missing, as well as some supporting skeletal structures. Gone were the roof of the bony orbit and some of the frontal (forehead) bone, as well as the overlying blanket of skin. The area had been scrubbed and cleaned, but nevertheless, there remained a yawning bloodless crater in the skull.

Hey, wait a sec! Ron stopped unzipping. Hey, this guy was shot!

As if drawn by a super magnet, Abby and Keith leaned forward for a better look.

Sure enough, positioned four centimeters above the right auricle (earlobe), roughly in the center of the temporal skull, was a small entry hole. Even though the wound had been cleaned and scrubbed, it nevertheless looked a bit surreal. Perhaps it was the lack of blood, or the absence of boney shards, or the lack of brain tissue debris that made it appear so strange. Somehow, it looked too clinical, too sterile.

The exit wound, however, was much more destructive. Apparently, the bullet’s path was not true perpendicular but directed more anterior or forward. The resultant damage not only included the missing left eye and the surrounding bony orbit but also about a third of the face, somehow sparing the nose.

That’s gross, Abby exclaimed, but nevertheless maintained her position leaning over the body.

That’s why they call it gross anatomy, Ron quipped with a grin.

Shaken, Keith quickly looked away from the gore; instead, he concentrated on his newly assigned lab partners. First, his eyes settled on Abby Gates, then flitted to Ron Haas, then back to Abby Gates.

Looking a bit like a female Tom Sawyer, complete with frayed blue jeans and a faded sweatshirt, Abby Gates was the kind of girl that you could pass over once, but more than likely would return for a second look. A natural dishwater blonde with pale blue eyes, she wore very little makeup and looked fit and trim. Undoubtedly, she was a former high school or college athlete.

Ron Haas, on the other hand, was a handsome six-footer you couldn’t pass over. He had bronze-colored skin, harvest gold hair (obviously bleached), and commanding dark eyes. His burnt orange Ralph Lauren polo shirt failed to hide his impressive six-pack abs, and somehow he had managed to squeeze his large frame into ultra-slim Armani jeans. From his Adonis build and facial features, undoubtedly he was of Polynesian heritage.

Taking a deep breath, Keith forced himself to look back at the cadaver. His now mostly exposed face was contorted and permanently frozen in a grimace. A grimace of what? Well, obviously of angst. And the horrifically defiled head was almost too—

—Suddenly unnerved, Keith recoiled at the macabre sight. Stumbling backward, he tripped over Abby’s purple Nike-flex sneakers. With arms flailing, he somehow managed to windmill himself upright, and fortunately, the flailing had carried him far enough away he could no longer see the cadaver’s head.

Instantly, he was ashamed of his reaction, his over-reaction, but he didn’t speak of it. He couldn’t. He was too busy trying to contain a shudder that had emerged from his lumbars and was trying hard to push upward.

Too late! It escaped. His whole torso shook, like a dog shedding water after exiting a swimming pool.

At that same moment, a tiny black spot appeared deep in the center of his frontal cortex and was threatening to expand. Not only to expand, but it was in position to become large enough to blot out both optic nerves, his visual windows to the world. And to make it worse, waves of nausea boiled and churned in his stomach, biting at his esophagus.

Suddenly, Keith felt the blood rush from his head, like water swirling down an unstoppered drain. Now without a supply of oxygenated blood, the back spot ballooned, then everything went black. From somewhere out in the unseen periphery, just outside the big black spot, he could faintly hear his father’s words, "Keith, if you can’t take the heat, stay out of the kitchen."

Maybe you better sit down, Abby said, seemingly from miles away. Grabbing a red plastic desk chair, she scooted it under Keith.

He collapsed, slumping forward, still desperately trying to preserve the last filament of consciousness. Like old-sweating dynamite sticks, copious beads of perspiration squeezed through his pores and dotted his forehead. Frantically, Keith searched for an anchor, a mooring, something to divert his mind away from the reeking body and the shattered skull, and away from the aggressive black spot now threatening to snuff out his consciousness. Trying to think of ways to stop it only seemed to make it worse. He had to concentrate on something else.

For a few seconds, his mind wandered erratically, like a lost child in a big box store, then he noticed a small tactile sensation arising from his left hand. With supreme effort, he lifted it to eye level and tried to focus. What was it? Oh, yeah, nothing but a scrap of paper. A scrap of paper? Why was he holding a scrap of paper?

He tried to concentrate. It had the number 7 scribbled on it and nothing more. What did that mean? Where did that come from?

Oh, yeah, the drawing, the lottery. Wait a second, what lottery? Then it all came back, flooding in like a breeched Mississippi levee during a hurricane storm surge. Now, at last, Keith had mooring, small as it was, and he tried to focus on the scrap paper. How did it get in his hand? Slowing, reversing gears, his mind flashed back—

—Initially, Doctor Horatio Hashimoto had divided them into teams of three. It was nothing more or less than serendipity, or at least the order of the alphabet, that the three of them were teamed together. Hashimoto systematically went down the class roster, alphabetically dividing the freshman class into dissecting teams of three. He, Keith Furness, was paired with Abby Gates and Ron Haas. There was no allowance given for personal requests and no pairing with friends, and no discussion.

Next, Hashimoto held his Dodger baseball cap high, or at least as high as his five-foot-six-inch frame would allow, then he had a representative from each team step forward. Representing their team, he had insisted, was Ron Haas. Confidently, he reached into the baseball cap, which was just barely above his eye level, and retrieved a folded scrap of white computer paper.

Right after he’d selected their lot, Ron turned his back to them and fiddled, almost like a magician preparing his trick, then he pivoted back around.

Shazam! he proclaimed, gleefully waving the scrap of paper in their faces. Here it is. Our lives for the next nine months.

So, what’s our number? Abby Gates asked, trying to rip the slip from his fingers.

Ron simply held it higher, out of her reach. Seven, he answered, grinning, lucky number seven.

What’s lucky about number seven? Keith asked.

Didn’t you ever play craps?

No, Keith shrugged.

Humpf! Then just take my word for it, it’s lucky.

W-which one is s-seven? Abby asked, a nervous twitter to her voice.

Well, let’s go find out. Ron started for the first row. A natural leader, he expected others to follow and they usually did.

The three of them marched up one row of bagged bodies and down the next, looking at the numbers written on full sheets of computer paper and taped to the body bags.

Over here, Ron called, placing his scrap of paper adjacent to the body bag’s larger sheet. Here it is, seven and seven.

So it is, Abby nodded. Now let’s see if it’s lucky.

Oh, it is, Ron assured them, handing the scrap of paper to Keith as he confidently reached for the zipper.

Slowly, almost dramatically, he worked the zipper downward. All three of them leaned in for a closer look—

You okay, Keith? Abby asked as she dabbed the moisture from his forehead with a white handkerchief.

Yeah, Keith replied gruffly, I’m fine. It’s just that I’m battling a virus.

A virus, my ass, Ron snickered. That’s what called a vasovagal reaction, undoubtedly brought on by seeing a dead body. You might have chosen the wrong field, Bub.

Nah, I’ll be all right. Keith attempted to stand but instantly got glassy-eyed.

Again, Abby gently re-directed him back to the chair. Give it a minute, Keith.

Maybe, Ron said sarcastically, we should call an ambulan—

"Let me have your attention, please!" Dr. Hashimoto suddenly boomed from a podium positioned in front of a large wall-sized whiteboard.Please settle down now and let me have your attention.

As Keith tried to concentrate on Dr. Hashimoto’s words, his mind slowly began to clear. Finally, he’d found that anchor.

Dr. Hashimoto’s facial and body features were unquestionably ethnic Japanese, so Keith half-expected him to speak with an Asian pidgin accent. He did not. He sounded like every other middle-aged man in Utah.

However, Hashimoto was not like every other man in Utah. Actually, he was quite extraordinary. Not only was he ambidextrous (on the whiteboard he could draw lifelike anatomy with both hands simultaneously), but he was also a renowned general surgeon who had a very successful surgical practice in a large multi-specialty clinic downtown. After spending a couple of hours each morning teaching gross anatomy to freshmen medical students, he shed his laboratory scrubs, showered, and changed into dress shirt, tie, and slacks. Then after donning his signature white lab coat, he headed off to his real job.

Please do not touch or unzip the body bags, Dr. Hashimoto said, then added, Now that you’ve located your cadavers, we need to go over the ground rules and a few special instructions before we get started. And as soon as I’m finished, he paused briefly to check his notes, after that I need to talk to Keith Furness, Abigail Gates, and Rongo Haas in my office.

Being as inconspicuous as possible, Ron re-zipped the body bag, while looking over his shoulder to make sure no one had noticed. Apparently, no one had; all heads were directed toward Hashimoto.

With just that simple act, the pale, reeking, and defiled head disappeared. Now it was nothing more than a non-specific bulge in the white plastic bag. It could represent almost anything. Nothing too eerie about that. The closing of the bag further helped Keith to clear his head. Turning away from the vinyl bag, he again focused on Dr. Hashimoto’s words.

"First, let’s go over some important housekeeping items. You are responsible for the upkeep of your cadaver. Remember, it has to last you for two full semesters. If you care for it properly, that should not be a problem. Each day after you are finished dissecting, it is imperative you dip towels in formalin and cover the entire body before zipping up the body bag. Even when you’re dissecting, only uncover the portion of the body you are working on, while keeping the remainder covered with the formalin towels. Do not—and I repeat, do not—let your cadaver dry out.

"If you do, I can guarantee by the second semester you’ll literally have to scrape a forest of fungi off each day before you start. This will eventually disfigure and distort the anatomy, making dissection much harder if not impossible. And the smell! The smell will be so powerful you’ll have to wear gas masks and the rest of the class will chase you and your cadaver out of the lab. So, a warning to the wise, take care of your cadaver. And show respect for your cadaver, that’s the least you could do. You won’t get another and to pass the course, I expect you to know how to dissect and how to identify human anatomy.

"Right now, there are no formalin towels on the cadavers as they were just taken out of the preservation vat. When you are finished today, however, please cover the entire cadaver with the formalin-soaked towels. Lastly, there will be no taking of body parts from the lab, absolutely none. If you do, you will be summarily expelled from medical school.

Well, enough of that. I realize I’m probably preaching to the choir. You are all responsible and intelligent human beings; otherwise, you wouldn’t be here.

Hash’s statement was accompanied by a smattering of snickers. Someone from the back shouted, Don’t count on that, sir.

Now to change the subject, Hash continued, we will be going through material fairly fast and you may find you do not have enough time to do all your reading and dissecting in the time allotted for this laboratory. And on occasion, you may have to miss a day with sickness or for other reasons. However, I would try to keep those to a minimum, but on occasion, you may find you need more laboratory time. Therefore, I have arranged with security and housekeeping to keep this room open on weeknights till 10:00 pm and on Saturdays till 6:00 pm. It will not be open on Sundays. So, feel free, anytime you have a few spare minutes, to pop in and work on your assignments. But, and let me re-emphasize this, you must take care of your cadavers. Hash paused, then added, Any questions?

Why will it not be open on Sundays? a kid with a tough Boston accent asked.

Well after all, Hashimoto smiled dryly, this is Utah. Any other questions?

Where will we get the formalin? a curly redhead girl asked.

There will be barrels of formalin available in the lab at all times, Hashimoto explained, as well as a stack of towels. Any other questions?

There were none.

"Fine. Your assignment for today is to familiarize yourself with anatomical terms, such as medial, lateral, cephalad, caudad, superior, inferior, etc. and to learn surface anatomy. This will be chapters one and two in your Grant’s Dissector manual. Tomorrow, we will actually pick up the scalpel and start cutting. Again, Hashimoto paused and looked for questions. There were none. Okay then, get to work. Oh, and I do need to see Furness, Gates, and Haas in my office now."

The first day, Ron whispered, suppressing a snicker, and we’re already in trouble.

Abby ignored him, instead focusing on Keith. You okay?

Gingerly, Keith stood up. Fortunately, this time his head remained clear. He nodded he was ready and the three of them, with Ron in the lead, of course, followed Dr. Hashimoto from the expanse of the laboratory down the hall to his much smaller private office.

As they entered, Hashimoto circled a gray metal desk and claimed an old but comfortable-looking captain’s chair, leaving Ron, Abby, and Keith to fight over the two remaining companion chairs. Immediately, Ron grabbed one. Keith deferred the other to Abby. Rather than contesting for a chair, he chose to remain standing. Wedging between Ron and Abby, he leaned back against the concrete-block wall.

As Hashimoto sorted through a handful of manila folders, Keith surveyed the room. If he were limited to a single word, he would have to choose, unpretentious. The office was small, windowless, and painted a light beige. Other than the military-surplus desk and chairs, the only other furniture was a matching three-stack file cabinet. Various framed diplomas adorned the wall directly behind the desk. On the left wall was a large framed photograph featuring several unpainted board shacks and was titled TOPAZ—1943. And on the desk was a gold-plated scalpel fastened to a wooden pedestal and a smaller framed photograph of a pretty ethnic Japanese woman and two small children.

Initially, Hashimoto did not look up as he thumbed through the folders. After a few seconds, he apparently found the file he wanted.

Rongo P. Haas. Rongo, that’s a curious name, Hashimoto looked up and smiled. And you don’t look like a Haas either. You look more like a Kamaka, Finau, or Taausamoa.

Yeah, Haas agreed, then proudly added, my mother was Hawaiian.

Then Rongo is a Hawaiian name?

Yeah, it means God of Rain and Fertility, but everyone calls me Ron.

My family was originally from Hawaii too, Hashimoto said. Then before that, Japan. Are you from the Bay area?

No, why?

As I recall, there was a Haas who was credited with saving the Levi Strauss Company out there.

Yes, we’re distantly related, Ron nodded, to Walter A. Hass, but I’m a native Utahn.

Oh, yes, Hashimoto looked at the file again, it says right here you’re from Utah, over in the Vernal Basin.

Yes, sir, Duchesne.

That’s oil and natural gas country, Hashimoto said, if I’m not mistaken.

Yes, sir, Ron nodded again. Duchesne and Uintah counties are the largest producers of natural gas in Utah.

Any of that come from fracking?

Ron shrugged indifferently, Sure, probably a lot of it.

Hashimoto frowned, but changed the subject, What about your family? What do they do?

My family were some of the original settlers of Duchesne County, Ron replied. We’re ranchers, but we also have gas and oil holdings as well.

Oh, yes, Hash smiled, now I’ve got you placed. The Haas Chemical Engineering Building must be named for your family.

Yes, sir, my father donated the money.

I see, Hashimoto said, dropping Rongo’s folder, picking up another. Abigail Marie Gates, you are from Texas—Austin, Texas. Tell me your story.

Uh—uh, Abigail said, I usually go by Abby.

Then Abby it is, Hashimoto smiled. Tell me about Austin.

Well, actually, it’s Round Rock.

Round Rock?

Yeah, I’m really from Round Rock, Abby explained. Round Rock is kind of a suburb of Austin.

I see, Hashimoto said. I love that name for a town. Very descriptive. So what’s your story, Abby Marie Gates?

By story, do you mean how I got to Utah?

Sure.

Well, I must admit the University of Utah was not my first choice; it was actually my third behind Baylor and Texas A&M.

Okay, we’ll forgive you for that. What about your family?

Unlike Ron’s family, mine is not rich. My father is a Texas Ranger and my mother works in the county assessor’s office.

Texas Ranger, huh? Like in baseball?

No, Abby laughed, like in law enforcement.

Oh, yes, the original and legendary Texas Rangers. I didn’t realize they were still around.

They most certainly are, Abby replied. They’re a division of the Texas Department of Public Safety.

I’ll bet your father has some stories to tell. Hash dropped Abby’s folder and picked up the last one, Keith Eugene Furness, another native Utahn. Says here you’re from St. George. Tell us your story.

Uh—uh. Keith turned red and looked down at his shoes.

Come on, Furness, Hashimoto said gently, this is not a trick question.

Uh—uh, University of Utah was my first, and—and my only choice.

And why was that? Hash asked.

Uh—uh, I couldn’t afford to pay out-of-state tuition.

Good reason. And what about your family?

Uh, my mother’s dead and my father works for the BLM.

BLM? Abby looked confused.

Yeah, the Bureau of Land Management, Keith explained. It’s a government agency that’s part of the Department of Interior.

Abby shrugged, I’ve never heard of them.

That’s because, Hashimoto explained, there is very little government land in Texas, but almost two-thirds of Utah is federally owned.

Works for the BLM, huh? Ron said disdainfully. What does he do there? Range management?

No, Keith shook his head, he’s more into mechanics; he services their vehicles.

Sounds like you have a problem with the BLM? Abby said, turning to Ron.

Yeah, I sure do, Ron said tersely. We’ve had our battles with the Department of the Interior.

Well, none of that matters here, Hashimoto quickly stepped in. We’re happy to have you all here at the University of Utah. Now for the reason I called you into my office. He paused, got up, and re-filed the folders in the metal cabinet behind his desk, then sat down again. I want to tell you a little bit about your cadaver before you get started. You probably don’t realize it yet, but you’ve got the best cadaver in the class.

Abby and Keith fired daggers at Ron, but he simply mouthed, "I told you so."

Oblivious, Hashimoto continued, Your cadaver was a young man when he died and was in pretty good shape. There is no wrinkled or prune skin, and no muscle or organ atrophy, or obesity either, as there is with most of the cadavers. He will make anatomical dissection easy and there is no reason you shouldn’t do well. From time to time, I may ask the rest of the class to gather around your table to demonstrate anatomical structures that may not be so obvious on their cadavers. Any questions?

Yes, Abby nodded, how did he die?

Officially, he was ruled a suicide, but the medical examiner still wants a certified autopsy of the head and brain when we dissect that area. I have the necessary forms that will need to be filled out when the time comes. Hashimoto paused and eyed the three of them.

Why didn’t they do the autopsy first? Ron asked.

A couple of reasons, Hash replied. One, the cause of death was fairly obvious, a suicide, and two, he’d signed up as a body donor. If they had performed an autopsy, it would have made the cadaver useless for our purposes.

Ron nodded.

Abby, however, voiced what Keith had been thinking, But I really don’t know how to do an autopsy.

Don’t worry, Hash said, I’ll give you an autopsy manual and I will help if you need it, but I’d rather you try it on your own first. In this case, it should be fairly straightforward. Just document the structures of the brain the bullet passed through and the resultant destruction. Any other questions?

I don’t suppose we get to know his name? Ron asked.

Reflexively, Hashimoto glanced at his file cabinets, then back at Ron. Absolutely not, he said firmly, that’s confidential. That’s an inviolate part of our agreement with the family and with the Utah Body Donor Program.

Can we at least know his age? Abby asked.

Hashimoto thought about it for a moment. I really can’t think of a good reason why not. He was barely 19 years old and was a student. After a moment of silence, Hash stood up. Well, then, you have a lot of work to do, he checked his wristwatch, in the next one and a half hours.

Well, I guess that’s our cue, Ron also stood up. Let’s go learn some anatomy.

Once again with Ron leading, the threesome returned to the lab and gathered around their cadaver.

How do you want to do this? Abby asked.

Well, let’s just dig in, Ron replied. Each of us can work at his own pace.

Wouldn’t it be more efficient if we worked as a team, Abby suggested, rather than everyone doing their own thing and getting into each other’s way?

Keith nodded his agreement.

Ron thought about it for a moment. Yeah, okay, Sugar, you’re right. Let’s have one be a reader and the other two find and point out the structures—

Don’t— Abby said coldly, "don’t ever call me Sugar again!"

Geez, Ron looked surprised, don’t be so sensitive. I didn’t mean anything by it. That’s a compliment where I come from.

Well, it’s not where I come from, Abby snapped, then added more softly, So, who wants to be the reader?

Initially, nobody volunteered.

Okay, Ron took charge again, someone has to do it. We’ll draw straws.

No, Keith stepped forward, I’ll do it.

Great, Ron smiled sarcastically, if you’re looking at the manual, then we probably won’t have to pick you up off the floor.

That was totally uncalled for, Abby said.

Keith shrugged and reached for Grant’s Dissector manual. Opening it to the first page, he began silently reading.

Geez, Keith! Ron snapped. Read it out loud!

Oh! Keith turned red. Oh, of course. He found his place again and began reading in a steady voice: Nomenclature is essentially the systematic naming of things. In the past, over 50,000 words were used internationally for the naming of human body parts. In 1895, the German Anatomical Society met in Basel, Switzerland and compiled a list of some 5,000 acceptable terms to replace the effusive, confusing and often contradictory terminology, which had developed and—

Geez, Keith, Ron interrupted, skip the historical stuff and cut to the chase, the actual words we need to learn.

Keith started to protest, Well, this is kind of interesting—

If you like it so much, Ron cut him off, then read it on your own time.

Keith looked at Abby.

Yeah, she shrugged her shoulders, we do have a lot to cover today.

Out-voted, Keith skipped to the next page and began again reading from the manual. Glossary of terms. Dissect—to cut apart. Blunt dissection—to separate structures with fingers, a probe, or scissors. Sharp dissection—dissect by the use of a scalpel. Clean—to remove fat and connective tissue by means of—

Geez, Keith, Ron growled again, skip that too. We already know that stuff. Get to things we don’t know.

Keith flipped to the next page, Okay, we need to know these anatomical positions.

Finally, Ron said.

Anterior and posterior, Keith continued, unruffled, then waited for Ron and Abby to demonstrate these terms on the cadaver.

Cephalad and caudad.

Read the definitions, Ron said.

Caudad pertains to the feet, Keith read from the manual, and cephalad pertains to the head.

With pen in hand, Abby dutifully pointed to feet, then the head.

Medial and lateral.

As Abby also pointed out these general positions on the cadaver, Ron leaned in and rested his hand on her shoulder.

She turned, grabbed his hand, forcefully removing it, I’ll thank you not to touch me.

Geez, Abby, Ron looked wounded, most ladies like that.

I guess I’m not like most ladies because I don’t like it.

Okay, okay, Ron stepped back, holding his hands up as if to show there was nothing in them.

Thank you, Abby turned back to the cadaver.

Ron then focused his ire on Keith, Come on, Capt’n Keith, keep reading. We don’t have all friggin’ day.

Prone and supine, Keith said calmly, but privately had a growing sense of foreshadowing, of the impending.

Though Keith continued to read from the manual, in his mind’s eye he was back at the ranch, before his father lost it. He and his older brother, Eddie, were assigned to take a couple of dudes up in the Pine Valley Wilderness for the fall deer hunt. Storm clouds suddenly appeared, coming in fast from the north. At that time of year and at 10,000 feet, that did not mean rain. The Whipple Trail, sporting multiple switchbacks and tricky rock chutes, was difficult to navigate under normal conditions, but with a foot of snow, it could be downright treacherous. The dudes argued loudly for waiting it out, as neither had yet filled their deer tag. When told to break camp, they refused. Keith could still see Eddie’s face, contorted with anger, and superimposed on a backdrop of dark storm clouds. Now, damn it! he thundered above the wind. We’re getting the hell outta here now.

Today, right here in the gross anatomy lab, Keith could again see Eddie’s face, and once again it appeared superimposed on an angry tide of fast-approaching storm clouds.

Chapter Three

EDDIE

GRANT’S DISSECTOR-PATRICK W. TANK - 15THEDITION

INTRODUCTION—Upon entering the laboratory, you will find the cadaver has been embalmed with a strong fixative. The veins are sometimes full of clotted blood and sometimes empty. In some schools, the arteries are injected with a red dye. The whole body has been kept moist by wrappings or by submersion under a preservative fluid. Desiccation of the cadaver will quickly render the specimen useless for study because once a part has been allowed to become dry, it can never be fully restored. Therefore, only expose those parts of the body to be dissected. Inspect every part of the body periodically and moisten the wrapping during each dissection session.

I’ll freely admit to partial memory loss. Not all of it, just pieces, sometimes large chunks. It’s kind of like reading a novel when every third page has been ripped out. Or like my grandfather before he died; his remote memory was much better than his recent. So, it is with me. Undoubtedly, it’s from the huge hole in my head. Some of my memory storages cells must have been damaged or completely blown away. I hope it will get better with time. I feel uneasy not knowing my full story.

But this is incredible! In spite of the foregoing disclaimer, I think, maybe, perhaps, one of those super-hormonal kids might be my younger brother, Keith! This realization came to me slowly, and I still am not absolutely sure, but just the idea nearly blows me away. I’m speaking figuratively, of course. It appears I can go nowhere. I have tried. Apparently, I am securely anchored right here.

My boundaries are pretty well defined and impenetrable. I appear to be confined to roughly 20 x 10-foot space over my body and a height of no more than ten feet.

But back to Keith, if indeed it is Keith. What are the odds? I didn’t even know he was interested in medicine, but then again I haven’t seen him in quite some time and when I did live at home, I didn’t talk with him all that much. I was much