Arms, Shoulders, Feet

“It started when I was having trouble walking. My feet felt numb and got in the way. I got clumsy. I got horrible cramps in my legs and feet at night. Then the pain came in the day, too. My doctor gave me magnesium and then valium but they didn’t help. When my eyes started to go I saw the neurologist,” the young woman said.
“And he said you have multiple sclerosis,” I said gently.
“At least I know what it is,” she said, starting to cry. I touched her hand.

On my first day as a medical student I joined three hundred colleagues, most of them more than a decade younger than me, in a lecture theatre. Our lecturer was a white-coated anatomy professor.

 “We hate fat people in anatomy,” he said in his introduction. “After you have dissected an arm or a leg, you’ll understand why we hate fat people.” I crossed my arms over my ample bosom and tried to focus.

“You are going to the anatomy labs this morning. If you feel faint or feel sick you should leave. Don’t vomit on the specimens.”

The anatomy lab was a warren of windowless closets. The fumes of formaldehyde were almost overpowering. The underlying smell was of decay.
Our group was forced into close proximity to a stainless steel table, where a headless, limbless torso had its leathered skin lifted like an apron from the digestive organs.

Our tutor was perhaps twenty-six, much older than all of us except me. He wore a crisp white coat and had a big red neck. He was strong and fair, looked like he played a lot of cricket. The main thing he did was lift and display the intestines, scooping his gloved hands into the body cavity.

There was a metre-high clear plastic vat with body parts floating in it visible through the doorway. On a shelf were plasticated body parts, including a hand, a foot and, most disturbingly, a head with two halves of the skull and brain removed, leaving a piece of bone and skin like a basket handle over the dead and distorted face. I felt a powerful combination of wonder, respect, disgust and horror.

“Where do the bodies come from?” I asked, when the cricketer paused for questions. “It’s mostly old people from nursing homes,” he said, as if that was a complete answer. “Are you allowed to know who they are?” I persisted. “They have labels on them when they arrive in the morgue downstairs, I guess. But by the time we get them they really are de-identified, as you can see,” he said, gesturing to the torso.

“They’re disrespectful,” I told my friend. “One of the young men picked up a knee joint and looked at a gap between the bones. ‘You could put your tongue in there’, he said. Eergh. A lot of these kids have never had sex, let alone seen a baby born or a person struggle with disability. And then they get to play with cadavers on their first day. It’s bizarre.”
We were sitting in a student lounge trying to make sense of it.
“I mean, I can understand that doctors need to be able to handle flesh confidently,” I ventured.
“Yes, but it doesn’t give them any skills to deal with the flesh when it screams because someone is in pain,” My friend said wryly.

Having finally gained entry to the medical students’ world I was deeply ambivalent about it. But still eager to learn, I volunteered for a summer school in dissection. “It’s usually only for the top students,” said the professor who hated fat people. “Since you’re keen we could find you a place.”

Photo by  genta mochizawa

I was assigned an arm to dissect. It was female, thin. Preservative had cured the skin, made the muscles firmer and discoloured it yellow-brown. It was high summer, but the anatomy lab was deeply chilled. Coming to work on the lady’s arm every day, I thought about her life as I exposed the lovely silver tendons of her wrist and hand. The tiny bones of her fingers manifested elegance. She must have been in her eighties or nineties, frail and aged, but beauty persisted in her body long after her spirit had left it.

When term resumed we worked on the muscles of the shoulder. I had a pink-brown shoulder, stark as a leg of lamb. It was detached from a torso, sawn off before the elbow, lying on the steel table in front of me. “He had well-developed muscles despite his grand age, this man. Must’ve worked hard. Might’ve been a waterside worker.” I acknowledged the spirit of the person whose body taught us.

I failed biochemistry that year, unable or unwilling to learn by rote the large volume of new words and formulae required to pass. I had to repeat the whole of first year. After all my science subjects, then repeating first year med, I was in first year classes for five years. It was a tough way to understand the basics, but thorough. Meanwhile I’d been a high distinction student in Aboriginal studies and History and Philosophy of Science, which showed I was capable of academic excellence. I loved my classes on the history of agriculture, the industrial revolution in Europe and the European conquest in Australia. I read “Guns, Germs and Steel”. I understood more about my ancestry — Indigenous and European.

When I met Mathew he was singing in a booming, unselfconscious tenor at the lounge of the Aboriginal students centre. “Here’s someone who finds no contradictions between Aboriginal and European culture,” I thought. This Wiradjuri man played piano-accordion in the Phantom of the Opera orchestra during university holidays.

“I love music. Music makes everything better.”  Mat was built like a bear, with an irresistible grin. He’d been elected to produce the medical review and was planning to appear in drag in a sequinned dress. “Do you know where I can get a feather boa?” he asked.

Mat had progressed seamlessly into medicine after completing a psychology degree at a rural university. “I did a study of the relationship between religiosity and sexual repression for my Honours thesis,” he told me. “I put sensors on the genitals of students who watched porn. The more religious they were, the more turned on they got. Especially the men looking at gay pictures. It was amazing, really.”

Mat and I sat in class together sometimes. I enjoyed his company in my perpetual first year. We were both poor. Many years later, he reminded me of a morning in the lecture theatre.

 “You’d been doing it hard with no money, Nel. You only had apples and ryvitas at home. I was going to be in some science experiment on the immune system for thirty dollars because I had no money either. So we’re sitting there before the lecture starts and there’s a young woman behind us crying so hard she can hardly talk. Do you remember?” I didn’t.

“We went to see what was wrong with her, poor thing. Do you remember?”

“No, Matty, I don’t remember at all.”

“She was upset because she couldn’t go skiing that year in Colorado. Her parents would only pay for her to go to New Zealand.”

I chuckled. “Yeah, that was our med class sometimes, eh?”

I earned a scholarship to travel to the bush and experience medicine there. I wanted to travel as far as I could on the Australian mainland and arranged to go to the dark red-earthed, turquoise-water country of Australia’s north-west, the Kimberley.

I was still pretty useless in a clinic but I had my ears and my heart open. Worried that the dark-skinned people of the north might not recognise a fair-skinned Koori, I started dropping my H’s, betraying the beautiful diction my family had carefully given me.

The Kimberley people were kind to me in spite of my pretension. I stayed at a community of 9000 people, five hours drive from the nearest town. I was useful driving patients to hospital in the four-wheel drive ambulance. I learned to drive in slick mud around huge holes in the road. Watching an eagle as we drove a pregnant woman away from her country to birth in town, I felt the eagle’s blessing and the harshness of the doctor’s decision to take her to hospital. Patients with renal failure were being flown to Perth, 2800km away, twice a week for dialysis, because the water and electricity supply were not reliable.

The house where I stayed had something weird in it. I couldn’t sleep. The light fitting had a black shadowy thing coming out of it whenever I closed my eyes. When I told the clinic staff about it, they shifted me to stay with the nurses in their house. “She could see that thing,” I heard one of the health workers say to another.

Kimberley sunsets were exhilarating. Driving back from the town one evening I thought that if medicine had brought me to this country and these people, it was all worth it.

Photo by  Andrew Spencer

Back at university, Mathew and I were studying biochemistry together at the cafeteria one day when he wriggled his legs under the table. “Look what’s happened, Nelli,” he said. Under the table, his shoes were off, his toes curled in his white-socked feet.

“Are my shoes off?” he asked.

“Well, yes.”

“See that’s the thing, Nel. I can’t feel my feet. This happened the other day, too. I can’t control my legs and I can’t feel my feet. I’m not diabetic. Do you think I have MS or something?”

“I’m sure you don’t have MS, Mat.”

“Do you think it’s Gillian Barre? That has that ‘glove-and-stocking’ effect. But my hands are all right. It’s probably not Gillian Barre.”

I didn’t know what Gillian Barre was.

“We’re med students, Matty. We get every disease we study. I thought I had porphyria last week, only because I’d eaten beetroot.”

I was cross with Mat for missing our next study appointment. I called his home several times before he picked up.

“I’m so glad you called Nel. We can’t call out on this phone, y’know. We didn’t pay the bill. I couldn’t come — I can’t walk properly Nelli.”

“I’ll come get you.”

Mat was just able to walk holding my hand. His balance was very disturbed. The campus doctor took a quick look and sent us to the hospital emergency department. “Can you stay with me Nel? I’m a bit scared. I’m not just doing this to get out of the biochemistry test, you know that, don’t you?”