A Somanautic Journey

My friend Nicole Lamartine is an amazing woman. Really, amazing doesn’t really cover it. We met when she sang for a time in Conspirare. We got to know each other better when we roomed together on one of the away gigs. These days, we keep up on Facebook. She is a phenomenal choral conductor in addition to being a fine singer, and she is a choral mover and shaker in the West/Northwest area of the country. As if that weren’t enough, she’s also a champion weightlifter with the moniker “NiLa-Tiny Hulk.” Like I said, amazing.

While keeping up with her on Facebook, I came across a series of posts chronicling a recent experience of hers while on sabbatical this semester. Her mother posted, “Although much of her work during this time has involved adjudicating different choirs around the West, sharing her expertise with other conductors, and participating in her professional choral groups, this past week she was in San Francisco to participate in a long-awaited event. She joined one of Gil Hadley’s classes on dissection of forms (human cadavers).”

As a former would-be physician, I have always been fascinated by the human form. As a singer and voice professor, I am completely interested in the way our body supports and facilitates music-making. I asked her if I could share her reflections and if she would tell me a little bit about how she came to this experience. She writes:

 This journey was like nothing else I have experienced in my life and I am truly seeing people for the first time. And in the seeing I am loving. It is so deep... Yes, please share. I feel like I have so much more to say, but lack the words to express it. I have always been fascinated with anatomy and this human form that we call our instrument as singers and conductors. About 15 years ago, I took two week-long intensive courses on Laban Movement Theory and Bartenieff Fundamentals. This changed my life. I realized that in movement, whether singing or conducting or dancing or simply being, we communicate, both intentionally and unintentionally. We have this power at all times. I wanted to know more and see inside this beautiful and profound instrument, but was frustrated that I had to be a med student to truly explore our fundamental physical humanness. My husband found Gil Hedley on the web, and his dissection videos... I watched some and wanted to be a Somanautic myself...exploring inner space and all of its beauty. That’s how I came to it!

The following words are all Nicole’s and I thank her for sharing them with me and, by extension, with you. I hope you find them as useful and beautiful as I did.

My Somanautic Adventure begins...

Day 1: Integral Anatomy Dissection Lab with Gil Hedley

When I have described my intentions for Somanautic Adventure many have replied with a simple “why?” The reason: To explore the inner being (both physical and spiritual) and learn from a reflection of myself.

Gil set a beautiful tone for the day with a palpable sense of gratitude and respect for the forms. Our beauty as human beings is reflected back to us by the “intelligence of nature.” Our greatest teachers would be the forms (bodies) in/on which we would explore.

The form is simply a representation of a human being. It is no longer animated.

All five forms for the class (2 women and 3 men) were arranged in a circle with heads together and covered in a sheet. After the unveiling, we simply walked and observed, noting this particular embalming style. All of the bodies looked similar after the 5 gallons of fluid had been pumped through the system: bloated with swollen faces, obscuring the individualized facial characteristics. We simply touched and palpated, noticing that the flesh texture was somewhat more firm, but that the forms would become mobile with gentle movement.

We were given the task to assign ourselves to a form and name it as a group. I was particularly drawn to one gentleman whose abdomen rose like a mountain off the table. My table-mates and I named him Grandpa Buddha and came to understand that he was 85 and died of heart failure. Grandpa B. showed no signs of trauma save for some bruising on his arms and ankles. There was a scar on his left shoulder. No tattoos. A hand placed on his cheek felt the gray stubble on his face.

It was a profound moment when, after meeting and naming our forms, we stood two of them upright— a true reflection of self and the intelligence of nature.

The first part of the dissection involved separating skin from superficial fascia (adipose layer), which is quite difficult and time consuming. The skin thickness and texture are so different from the fluff of the superficial fascia, but the scalpel understands the layers. After we dissected off the skin of the entire front side of Grandpa B. we put it back on to see the form as we first met. Then, peeling each section of skin away, we revealed Superficial Fascia Man, with his glorious layer of fluffy protection from self and environment.

The skin is an amazing organ, and drastically different between people. One form, 95 year-old Venus, had skin about 0.5-0.75 inches thick...on every surface of her body. Compare that to Grandpa B., whose skin was paper thin at the wrist, but very thick and leathery on the shoulders, butt, and thighs. The cranial skin is also incredibly thick– 0.3 inches thick on Grandpa B.

Tomorrow we finish the back side and explore superficial fascia and deep fascia.

Yes, the process is juicy. Yes, the form is heavy. Yes, the formaldehyde is strong. Yes, there are 7 people and 7 scalpels at my table. Yes, the lab coats get “schmutzed.” Yes, it is very physical work.

And yes...it is totally worth it.

Day 2: Superficial Fascia

Grandpa B. taught me so much today, and I am continually reminded of the amazing gift he has given to me.

The body’s layered organization is stunning, like peeling back the layers of an onion. With each layer, a new world is exposed. With the observation, differentiation, reflection, and finally removal of each layer, we get to experience each glorious layer only but once.

The skin, I think, is the first physical element of our being that communicates. It is our first meeting of another’s emotion. Today we went beyond.

The superficial fascia is largely a shaping layer; that which gives us our morphology. The muscle shapes underneath can be expressed through it, but we mostly observe one’s outward shape as the expression of the superficial fascia. The superficial fascia, or what many understand as “fat,” is actually a fibrous and spongy web containing nerves, blood vessels, lymph nodes, and fat. It is a world unto itself. The superficial fascia is that which protects us: from the elements as an insulator, from harmful substances stored in the fat, and sometimes from ourselves. The matrix is at times hard to follow, and will often cross and reorganize into the deep fascia of the muscles. The attachments of this fascia range from fibrous strings to the web-like “fuzz” that can be separated with a finger stroke.

Grandpa B.’s general shape did not change on his belly after removing the 3-inch thick superficial fascia. The 2-inch thick fascia on his rear, though, is actually responsible for the shape. Once this was removed, the glutes are actually flat.

This ever-fascinating journey continues tomorrow with skeletal muscles.

Day 3: Deep Fascia and Muscles

The brain must compartmentalize to understand things. It categorizes, names, and files in the appropriate drawer. Grandpa B. challenged my understanding of muscles as independent movers.

The deep fascia is membranous bag which surrounds each muscle. Sometimes it is a delicate gossamer, and others a fibrous sheath. Held up to the light, one can observe the structure which gives this layer such strong integrity: the fibers run obliquely to each other in many cases, and in others, parallel fibers remind the observer of strapping tape.

I spent the whole day focused in on the left abdominal area. By the end of the day, each muscle layer was visible and relationships between them had been separated to reveal the most amazing layers, that each muscle morphs into the next, and that the deep fascia acts as the structural integrity. I had revealed and reflected each belly of the rectus abdominis away from the rectus sheath, the external and internal obliques and the transverse abdominis. I was amazed how the lower fibers of the pectoralis major blend, without much distinction, into the upper fibers of the external obliques. We are truly connected in ways I never understood.

What was even more fascinating was the fact that both the superficial fascia and the deep fascia are strong and sturdy. They do not rip when pulled, but the muscles fibers themselves disintegrate easily at touch and their structure is lost very quickly once the deep fascia has been removed.

The superficial fascia gives context and structure to the muscle tissue we think we know. The deep fascia holds each muscle carefully, like a hammock, making sure it can glide through space as needed.

My exploration of inner space continues tomorrow.

Day 4: Muscles and Viscera

Today I observed rivers, trees, and opalescence. The muscles of the hip to the knee meander like a river. The vascularity of the small intestine creates a forest of trees. The structural deep fascia swirls and straightens with its collagenous fibers. The wonder of the fifth quadriceps, the feeling of the abdominal muscles sandwiched between my hands, the trapezius, lats and rhomboids in all of their anchoring glory. The levator scapulae as a meaty body joining head and scaps, the sciatic nerve as it uncommonly split in two to divide the pectonius, and the wonder of the internal organs.

The diaphragm reveled itself as a thin, membranous muscle whose deep fascia meld into the transverse abdominis. Held up to the light, one can observe the fascial layer with diaphragm fibers running down while almost contacting muscle fibers of the transverse running across. Each muscle is indistinguishable at that junction. I was reminded of the unity within the body.

The wonder of the intercostals contains fascia strapping tape and muscle fibers running in opposite directions. The accordion action of the ribs and intercostals was illuminated while backlit.

Upon opening the visceral “bag,” a new and alien world emerged. The lungs feel like foam with structure and one can easily see the three lobes on the right and two on the left. The intestines meander, but are more like 10 or 15 feet...rarely the 22 feet length mentioned in books. They can be gathered like a bouquet in the hands and lifted from their origination point at the lumbar spine.

The greater omentum originates from four fascial surfaces, two from the transverse colon and two from the stomach. It represents as a sheet/blanket of fluffy, vascular, lymphatic, and adipose [tissue] that acts as a vacuum for toxins in the body. It can move within the abdomen in response to inflammation and tends to cover those areas which are sick. This is a spectacular sight to behold and has become my favorite discovery of the abdomen.

I am ever thankful for Grandpa B., and am reminded of my responsibility to honor him in his amazing gift to me.

Day 5: Viscera, Thorax, and Other Projects

I have found great appreciation for what each of us carries in the belly. It is where we gather and process all of the outside food to provide energy and life force. To hold the intestines in a bouquet and sever their bodily connection at the mesentary root, I was able to appreciate the centralness of the intestines to the body itself. Then, in spreading them out on the table like a coral-shaped fan, I could see their beauty echoing though shapes familiar to me in nature.

The breath lives on, even in the cadaver form: with a turkey baster and by sealing the mouth and nose, air filled Grandpa B.’s lungs in a steady rhythm demonstrating the massage that the lungs give to the heart and liver... 20 thousand times a day.

The blood vessels in the mid body are huge, about the diameter of a quarter. With each beat of his heart, blood flowed through these superhighways until his last day. The blood vessels have sturdy integrity and are not easily broken.

After evisceration, we could clearly see the relationship of the psoas muscle to the lowest fibers of the diaphragm. I have always thought of the psoas muscle as the great connector in the body...joining breath life force to body and global movement.

I was able to dissect the floor of the mouth (including tongue and mylohyoids) and release it through the mandible while still attached to the larynx and retaining the structure of the pharynx. This view of our human instrument was profound for me: to stare down the tube of his larynx and think that every word he spoke or note he sang originated from this tiny house.

I held a uterus on my hand (in situ) and was surprised at how tiny it was. I followed the fallopian tubes to each side to the bean of each ovary.

Other projects continued around the lab: removing the arm to study joint articulation, more muscle finding, illuminating the diaphragm with light to observe its fibers, opening the cranium, comparing livers and kidneys.

Tomorrow we open the heart and I will open the larynx.

Day 6: Various Projects and Closing

Time and time again I witnessed the “infinite fractal community of branches.” The teams revealed the wondrous worlds within the body— each part echoed by patterns we see every day in nature: trees, webs, branches, flowing water, rivers. Words cannot express the awe I have for each part of human body.

The heart’s cross section revealed a forest of branches inside each chamber and thick muscle walls. Lung tissue was scratched away to reveal the beautiful tree of bronchial tubes and vascularity within each lobe. The eyeball’s lens was a small, thin, and tough piece on top of the jelly filling the structure, and the iris muscle fibers travel around the inside of the eye. The convoluted surface of the brain is very much a mushroom-like texture, but the cerebellum is like a ball of string fibers. The ear bones are but tiny specks of white, easily lost in dissection.

There are only two places in the body where 3-D spiral motion is possible: the spine and the forearm. This movement in the arm is part of what makes a conductor expressive. Today I put my fingers on and witnessed the rotating head of the radius as it crossed over the ulna. My finger fit just inside the carpal tunnel.

My biggest project for the day was to dissect the larynx. After freeing the tongue and removing the esophagus, the hyoid bone was clearly seen in its lack of relationship to any other bone in the body. The removal of the epiglottis allowed easier access to the actual vocal folds and arytenoid cartilages. I split the larynx posteriorly and had to crack the thyroid cartilage to open up the gift. The folds were swollen and the tissue immovable because of the preservation process, but the sight and palpation was still fruitful. I was able to free and clean one arytenoid cartilage.

As we finished the day, we cleaned heartily then came to a circle of appreciation surrounding all five forms, now nestled each in its own cardboard box for cremation. Upon Grandpa B.’s box we placed a flower and greenery. Our physical closeness presented human flesh on each side of me...a stark contrast to the week. I was overcome with a deep sense of gratitude for the gift I had been given by a man (and his family) who I will never know and never have the opportunity to thank. I have been changed in a deep and profound way. Thanks, Grandpa B.