homecoming

I'm not even sure how to begin. 

I had described to a friend at lunch on Thursday how I'm seeing the work and the forms everywhere I go: the knife at dinner and the tree being trimmed on Sacramento and the building being demolished. Life is the lab. 

"So it's kind of like you're on drugs. All the time," she said. And we laughed, because yes, it's kind of like that. Except it's crisp and clear and awake and there's no sobering up. 

In the final two days anything was possible as we all took to our own projects, sometimes with the help of classmates, sometimes solo; sometimes working diligently with no end in sight and sometimes flitting around the room peeking in on the new worlds others had discovered; sometimes listening and watching Gil as he talked and narrated dissections of the brain and penis and uterus, sometimes tracking him down to shove a heart or pelvis or pituitary gland in his face to show what we found. Skulls were cut clear open and brains pulled back to reveal the optic nerves. Hearts were unfurled to trace the path of blood flow through the chambers and touch a semilunar valve. Colons were plunged in a bucket of water to watch the epiploic appendages float and wave like a coral reef. Laminectomies were performed to remove the entire central nervous system intact and held high to a roomful of spontaneous applause. Eyeballs were extracted to hold the lens on a fingertip and gently squeeze out the vitreous humor. And chances were good that if you found yourself not having time to explore something in particular, that someone else in the room was already all over it and was happy to gift you with a full walk-though of what they were doing and what they had discovered.

As for me, I spent an entire day with Rose's left lung. The entire day, scratching at the tissue with a scissor tip to expose the branches of the heartlung tree. Arteries, veins, and bronchi appearing separate at their large roots that had lay in the mediastinum became as entwined and commingled as could be once they plunged into the airy, fleshy sponge. The entire day. I had imagined stopping at one lobe, but it wouldn't let me go. Imagine exhuming the root system of an 81-year-old tree, trunk giving way to a massive clump of earth, and gentling out the dirt to free each root, and each branch of each root, and each branch of each branch of each root, until the roots became so small that you lost them to the dirt you were gentling out. The entire day. When it was finished, I sat there with it, no words, as Gil and Julian came by. And they stood there with me in my silent tears. And we smiled.

I'm on my way home. I've said goodbyes, given thanks, and paused to honor gifts given. The three-legged red eye back, transitioning between ground sky ground sky ground sky ground, and wake sleep wake sleep wake, feels like a necessary reentry protocol after my last three weeks as full-time somanaut. Thoughts of massive whirlwind cleanup and cardboard box coffins topped with tealights are still fresh. Exhales and rest and thoughts of daily routine are settling in. Whatever happened in San Francisco is still happening, going strong. Inner space can't be left and can't be forgotten. It's where we reside. And like outer space, it's ever evolving, stars being birthed and stars burning out, and no clear line drawing one from the other. It's all just happening. No inner or outer, just this.

empty

I'm a little concerned about coming home and having nothing to say. 

I have nothing certain to offer after all of this except the life I already live.

In one sense, what I've been doing has been no big deal. My life hasn't been any different than yours, except that I've been dissecting cadavers. Seriously. I eat and sleep and pee and shower and floss and go places and go home and interact with other people along the way, processing this life as it unfolds and exposes me at every turn without knowing where it's going. Isn't that what you've been doing?

And I'll come home in a couple days, and continue to do the exact same thing. Except I won't be dissecting cadavers. The end.

I don't say these things to diminish the gift I've been given the past three weeks. I'm beyond grateful for this opportunity and everything that's gone in to making it happen, from every direction. 

We're getting closer to there being no body on the table. Today we eviscerated Rose's abdominal and thoracic cavities, leaving an unmistakeable emptiness. Liberating her viscera and lifting them up and out of her to be placed on our nearby prep table, I distinctly saw that I didn't know where Rose was. She wasn't the organs we removed, and she wasn't the skeleton and nerve tree and muscle remnants still on the workbench. It's interesting how we've called her Rose to love her and acknowledge her, and yet in naming her we've perpetuated the biggest story of all: that Rose was even here to begin with. 

And so in another sense, what I've been doing has been utterly remarkable. Rose is revealing, in the most miraculous, eloquent way, that there is no body, just as there is no thing. That all the somebodies and somethings we tell stories about are cases of mistaken identities. They're the stuff of dreams that we mistake for the Beloved, and yet they're the Beloved dancing all the while.

And when that is seen, what more is there to say? 

That doesn't mean I won't write, or I won't have stories to tell. But if you see me and ask me what I learned in California? I'll likely tell you, "Nothing." And I'll mean precisely that.

limits

With bags broken open to the light and air of day, we take the morning to tour the contents of the abdomen, each rooted to the One via peritoneum that in one place we call the falciform ligament and in another the mesentery and in another the mesocolon and so on. It's in these places that the organs appear to be suspended in the living form, but it's arguable whether that suspension is even needed, as pressure differentials and fluid dynamics of the internal environment in vivo create a levity and buoyancy in which the guts slip and slide and float and play. Their true nature is free, and yet they're held, tenderly and snugly by the One that, to some eyes, appears to limit their freedom.

We all want freedom, and yet I'd venture to say we all want containment too. We want to fly in freefall, and yet we want to feel held and safe like it all began in the womb. We think that one precludes the other. And we couldn't be more mistaken.

Out of the six female cadavers in lab, all but one is without womb. Rose is in the majority, having had a complete hysterectomy. Her greater omentum--a meandering, adipose-rich, apron-like poultice that nurses infection and trauma in the gut--hangs from the transverse colon and stomach per standard issue, but it's migrated down into the pelvic cavity from whence her uterus was removed, and tenaciously rooted itself in the funnel with firm, fibrous adhesions. With the omentum traveled the transverse colon, found not to be so transverse at all, but prolapsed and "V"-shaped in its route until it climbs back superior toward the spleen. Why have most people never heard of the greater omentum? I have no idea. There's a lot of things we don't get told, that remain secret even to our most intimate self, even though they're there, plain as day.

I'm cooked. The viscera are doing a number on me, and exhaustion rolls in after the morning of running the bowels and an afternoon of noodling around the heart center and the biggest of its branches. I've been stoked the past two days about the guts, perhaps the most I've been in the entire three weeks, and I think my psyche is processing way more than I'm giving it credit for. I'm cradling hearts and unfurling intestines and cupping lungs with my bare hands as Peter inflates them through a tube plunged into the trachea, for Christ's sake. I'm freaked out by Rose's chunky thyroid and grossed out by the fluid spilling out of the pericardium. I'm feeling sensitive and exposed in my own throat, which I now cannot unsee as one with the heart and lung tree below. Gil points out how the wings of the thyroid hug the bottom edge of the voice box. "It cares what you have to say," he says, tugging on the butterfly-shaped gland. I nod. "It does," he reiterates.

It's interesting, finding a voice in this blog, especially since anyone can read it. That's part of the deal, about blogging, and any illusion of anonymity is just that, an illusion. I can't control who reads this and who doesn't, and that's edgy for me. It's exposing, to just speak to what's happening. It's amazing what I'm learning by simply watching how you respond, and how I respond to how you respond. It's like being plunged repeatedly into freefall, or just becoming repeatedly aware that freefall is already happening, and then freaking out about it, and then realizing it's totally safe. That there's still something holding, but nothing limiting. 

I sleep for two hours after returning to the hotel, and I could sleep for twenty-two more.

guts

"The caves, the caves...is there resistance to the caves? Or are you willing to go in?" We're heading into the viscera today, he declares. Some, including myself, are eager. Others are hesitant. We're continuing to dig in a grave, and the guts are typically where we get a clearer picture of death. In other words, the cause of death isn't typically apparent in the layers we've seen thus far. It's in the enlarged, discolored, tumored, displaced, adhered, bubbled, fibrotic lungs and livers and spleens and colons and mesenteries and other such entities that may be awaiting our eyes.

With cadavers supine, we tidy up and clear out the remaining musculature and break into joint capsules to disarticulate the clavicles from the sternum, and then I scrape my scalpel along the backside and inside of the costal margin, cutting through the double layer of the pleura to allow the diaphragm to settle away from the anterior ribcage, creating a narrow window into the thoracic cavity. The fibers of the diaphragm, now visible, are clearly running perpendicular to--and in the same plane as--the fibers of transversus abdominus, with edges of those two muscles basketweaving into one another. I slide my entire hand into the cavity in the horizontal plane, palming the diaphragm, which itself is palming the liver. And then I slide in on the frontal plane, the back of my fingers grazing the ribs, my fingerpads and palms touching the viscera. I'm speechless, extending my fingertips as far as the neck, seeing the movement of my own hand through the fleshy intercostals. My hand is literally on her heart and lungs, still beneath the birdcage of the ribs, and I'm in awe. I'm also in mild panic for a second, realizing I could potentially get stuck where I've wedged myself in, but then I realize there's nothing to be scared of here. Nothing to be scared of.

adore, Tom Bedel, anatomical collage art

We come back from lunch, and I grab the garden clippers to snip, snip, snip up the lateral ribcage so we can reflect Rose's breastplate. The sound and the feel of the soft crunching between the blades is enough to make hair stand on end and eyes focus in, and soon the armor is off in one beautiful butterfly of bone and fiber and flesh. Speechless. Her lungs feel fairly dense and a little crackley, and upon palpation Gil speculates that they'd become not just fluid-filled, as is common with pneumonia at the end of life, but also fibrotic, which wouldn't exactly make it easy to breathe.

There's lots of talk of lungs, these trees of the heart, and 12 distinct pairs of lungs to behold. I feel the linebacker's and they're like pillowy clouds. Another man's are blackened clear through. One woman's are riddled with tumors. I can't help but think of my own lungs and my own breath, wondering if there are adhesions in the pleura, wondering if fibrosis has developed in hidden places after 35 years of struggling to breathe. I wonder, but I'm not afraid, and I can't tell if the absence of fear is authentic or a result of compartmentalizing the task at hand from my fear of suffering, which perhaps is neatly tucked away in its own little box at the moment. The fact that I'm not sure makes me pretty clear it's the latter.

We learn from the paperwork that Rose was 81, and that she died from respiratory failure. "That doesn't really tell us a lot. So, she died because she stopped breathing," implying that, well, that's why we all die, isn't it? At the table with 97-year-old Sakura, the little cherry blossom much smaller than myself, her lungs are soft, her liver and spleen are appropriately sized, and her intestines look fluid and happy. "Cause of death?" Gil queries. "Tired of birthday parties."

It's been a full day. Again. I only scratch the surface as I write here, content to not attempt the impossible task of recounting every minute, though the minutes today were some of the most memorable so far. But in a way this actual experience is just scratching the surface for me. It's an undoing that's waiting until I'm long gone from California to fully develop and to root. That's my gut sense, at any rate. Just like bodywork, the "work" continues (or sometimes just begins) after the client is long gone from the table. I don't see why that would be any different with Rose, and soon she'll leave our table with no trace. It's impossible for me to see that as an end, even if it will mean the end of the course. What it will begin, I have no idea.

yes

When I go home, there'll be a homeopathic remedy awaiting me at my doorstep, mailed from a lab that prepared it from a script delivered by a homeopath I saw on Saturday in Los Gatos. He's supposedly the best in the country, one of the best in the world, and homeopathy is one of the only therapies I haven't explored in an attempt to unravel my lifelong struggle with breath. The remedy he settled on is rare, and how I respond remains to be seen. 

What's totally seen, however, is that soon I won't be drinking coffee anytime in the foreseeable future, as it's apparently an antidote to the remedy, along with camphor and a couple other random things. So with a final week remaining in the lab, so coincides the final week of my relationship with coffee. My mission? To exhaust all my coffee options before next Monday, as frequently and in as many forms as possible. So on the bus to Blue Bottle after a day of work I sit next to a man in his early 60s who tells me of how he was born and raised in San Francisco and how he loves it and loves riding the bus. "I like it on top though. Better to be on top than on the bottom, know what I'm sayin'?" For a second, I have no idea what he's sayin' because I'm reading his words as a sexual innuendo and ready to find a new seat. That's how much we've talked about sexuality and sensuality in the context of anatomy in the last two weeks, that I'm suddenly thinking this man with a cane next to me is a total perv. An instant later I realize he's talking about above-ground versus below-ground bus routes. And about living and dying. "I sure hope I still got plenty of time to be on top before they put me down below [pointing down toward the ground, laughing]."

"Eventually, I'll be way up top [pointing up toward the sky]," he says, "with the big 'G'. Or whatever your own version of that is. That's my version." It's crazy that he doesn't even know what I'm doing here and yet in a 4-minute ride he's delivering a monologue about life and death and beyond. 

Much like the bus, we're full speed ahead as we enter our third week, with a lot to move through before we reach the viscera. The pace quickens to sever flesh from bone, and I have a new respect for butchers after seeing how easily meat can be made a total mess. I'm likely underselling our skills by saying that though, as Scott is carefully exposing the star of the suboccipitals, Joe is peeling back the iridescent tendinous ribbons of iliocostalis, and Wendy and I are preserving the sciatic nerves and major blood vessels down the entire length of the thigh and leg and foot. Comparisons from cadaver to cadaver abound, and quadratus lumborum is a particular curiosity--it's big and thick, or small and thick, or thin and small, or big and thin, depending on where you look. In several it's laying flat in a frontal plane, and in several more it's on an oblique angle. In most, it's clearly like a triangular sail more than a quadrilateral, having little to no leverage on the 12th rib, which is not how it's depicted in anatomy books. Piling the layers back on top of QL after its debut, it's clear how little of it is even accessible in a living form. Not diminishing the value of intention, it's simply a reality check about what we're actually touching when attempting to "work" QL as a therapist. You're likely not anywhere close to having your fingertips on it, my friend; more likely is that you're on the edge of the erectors (which are surprisingly robust in Rose) or the posterior fibers of the external obliques; even more likely is that you're in superficial fascia and not touching muscle at all.

And that's by far not the only illusion collapsing. The bodies are the teachers and we're all being schooled by the terrain we think we know so well. I've never been with such a large group of people who were so authentically willing to be proven wrong. It's nearly impossible to cling to being right when we're all being shown in every moment that there is no right. There just is. These bodies have no preference. They don't wish their variations and anomalies to be like the body across the room, and they don't wish the metal parts and pieces and staples and scars to not be there. They reject nothing. There's room for it all. There's an implicit acceptance, a constant, unwavering "yes" that they're whispering to us, the living among them. And there's absolutely no effort required from us to whisper back to them, and to each other: yes, yes, yes. 

holy

Easter was my favorite holiday as a child. I liked the dogwoods of the spring and the ceremonial hype of Holy Week and the 3-hour vigil mass on Holy Saturday that began in the dark and ended with trumpets and hallelujahs and baptisms in a fully lit sanctuary. It was a breeze of hope gone as soon as it arrived, but I think it was enough to carry me a little further. 

"We're writing an Easter poem here, folks. Welcome to the tomb," Gil says. Good Friday in the lab. It's a tomb if there ever was one, full of life waiting to walk forth. The irony isn't lost on the circle as Lazarus' drug pump sounds and the entire room takes the cue to stretch and breathe deep. These past two weeks have been a pushing away of the stone to see clearly that nothing has died. Except, perhaps, for beliefs about what was there to begin with.  

It's a different day, evoking different energy than the one before, and the one before that. We're continuing to fluff, and beginning to reflect, or to peel back, the most superficial layers of muscle. Trapezius, when unleashed from the midline and flopped upward toward the head, forms wings that are completed when the lats are reflected laterally. Levator scapulae is a fancy spiral staircase twisting up the cervical spine. Gluteus maximus looks like a beef brisket, and I seriously have visions of putting it in a roasting pan, overlapped by a subtle, barely-formed thought of "what's the big deal about cannibalism?" I mean, if you have to. 

The day whizzes by, but not without me finding time and means to secure a ticket to Rufus Wainwright at the Palace of Fine Arts for Saturday night. It's serendipity at its finest the way everything falls into place. And on this Easter vigil, entering the performance hall awaiting his haunting voice feels as holy as entering an incense-filled cathedral awaiting the coming of the Lord. It's. All. Holy. And therein lies the resurrection, I think. The seeing beyond the dream that those two things are any different. Or that there are even two things there at all. I listen to his sweet sister Lucy, and then to him, and feel like I'm the only one there. I close my eyes and feel his vibrato humming in my own throat, and there's nothing else I'm needing to feel complete. 

I sleep.

And I awake to a sunny, warm Easter Sunday. There's one more week for me here. I wonder what remains to be unveiled.

legwork

A classmate shared that after lab yesterday she went to a therapist who specializes in work with the pelvic floor. It's an area of interest for her as yogini, woman, and mother, and fitting that her session followed our classroom discussion of the female genitalia. As she described the intensity of the work, a wave of nausea and overwhelm caught me off guard. It's familiar, and it also hasn't happened in a long time. I mentally checked out and in and out and in of the circle shortly thereafter, and for the first time got a bit weary of the conversation being had.

Muscle fluffing, day two. Simple enough, it seemed, as I began at Rose's belly to scoop and slide my fingerpads down the posterior side of rectus all the way to the pubis, feeling the soft peritoneum on the backside of my hand. Fluffing the external obliques from internal obliques from transverse abdominus, making my way not-so-artfully around her hernia at the linea alba superior to her belly button. I've been hanging with her torso a lot, leaving her arms to the others, and all but ignoring her lower extremities since the first incision I made in the skin of her right thigh.

After lunch we turn our ladies and gents over and watch a demo of fluffing the hamstrings, and I take a break, and a seat, to watch on one of the screens. Except I'm not really watching. I'm sitting away from others and I even have my phone out, pissing around with it for no reason in particular when we're not even supposed to be using them in the lab. The words he's saying and the images on the screen and the other noises in the room and the thoughts in my head all blend together and it's like a weird dream sequence that I'd have a hard time recollecting in detail later. Nothing is clear or memorable, except that I'm absolutely avoiding something. I'm sure what he's saying is inspiring and important and none of that matters, and I shame myself for half a second for wasting the opportunity to really listen and watch and learn. But this is all I'm capable of in the moment.

Anna's Legs,  Ephraim  Rubenstein, 2004

So when I go back to the table I pretend to face my discomfort by heading straight to her left posterior thigh to begin fluffing, melting the filmy fascia between the muscles. I have no idea what I'm doing and I can't remember anything about the muscles I'm working with. My mind is fuzzy and blank and spacey and I'm manhandling her with so little care and such disconnectedness it's hard to admit. Like it's just meat. It looks like a complete mess to me, and I'm about ready to give up when Gil comes over and begins talking about the glutes on the opposite side and other things I can't remember and didn't pay attention to. Because I couldn't. And I have absolutely nothing to say. Nothing intelligent or insightful or curious or revealing or funny or even honest. Because I'm mostly not even there.

I take refuge in the torso again, liberating the left lat and trap, until something takes me to the calf. I'm not doing myself any good by avoiding it, so I start to work with it, more carefully and more slowly than the hamstrings. It's so uncomfortable and upsetting and no one is noticing. I'm silent and looking downward and my eyes are so full of tears that I'm only feeling my way through tissue. I'm trying to stay with it, and I don't want to say anything, and I keep hearing myself say in my head, "I have a hard time with legs." And there's no one to say that to. 

On autopilot I drop my tools on the tray on our prep table and go sit on the far side of the lab, forehead in my fingertips to gain composure but not wanting to leave the space. But the waves come, and come, and come and I'm taking off my lab coat and heading to the door to the hallway to the bathroom to the last stall so I can cry, until I'm able to go gather my things. What the fuck. Why did it take the muscle layer to bring this out. I kind of just want to sit in the lab for a while, just to be in the space, but it doesn't feel like that's able to happen. I leave for the day, walk to the park and hunch over numb as I sit in the grass. I hear the parrots, and I think of Uly. And I get up and walk again, wishing my legs didn't have to be a part of the walk.