Dissection Classes
My first exposure to what I would like to call alternative or extended anatomy, was when I first saw Gil Hedley’s videos in 2006.
Watching them, my view on everything that I had been doing as a hands on bodyworker for over 20 years shifted in an instant and life was never quite the same from then.
In 2007 I attended my first Integral Anatomy dissection with Gil in San Francisco and started to follow the rabbit hole downwards into a way of thinking that I have never come back from. Until then, I was reasonably confident in my anatomy. Thousands of books on the same subject, all agreeing with each other, couldn’t be wrong. Could they?
To suggest that anatomy is wrong is a huge leap and one that has garnered me plenty of criticism over the years that I have been dissecting and teaching, so perhaps a more kindly approach would be to say that it is, at best, incomplete.
Anatomy teaches, by reason of an academic imperative stemming from a religious conviction that the body is composed of a series of systems. Digestive, central nervous, skeletal, circulatory and so forth. We learn these systems and the names of the parts they contain and kind of assume that’s the whole picture. On an intellectual level we know everything is connected, and even have a song for it. But from a functional perspective, that’s where it ends.
Looking at the way the body was dissected all those years ago, made me realise that the way anatomy is talked about, written about and taught, entirely missed the nature of connected function. We know the muscles of the shoulder, what nerves drive them and what they do, but we have no idea of the functional relationship of the shoulder to the opposite knee. If anything medicine leans towards denying that there even is one, with the result that we focus solely on presenting problems and fail to understand the reason for failure in treatment.
Anatomy is not function, but is the study of the body. The process of dissection brings this study into focus in a way that is remarkable, but if it is not extended into a wider understanding of how the living form functions as a whole, it fails in its potential.
The dissection process, if taught properly and from the perspective of understanding joined up function, bestows on the student an incredible gift akin to X-ray vision. Once we have felt the continuity of structures and seen the strength of the relationships in a three dimensional way, we can start to appreciate these in the living client and build a pattern of movement, previous experience and injury with a confidence of knowledge that would otherwise be unimaginable.
Let’s be clear about one thing. Anatomy isn’t wrong and there is no suggestion that we don’t need it or should somehow stop learning it. But it doesn’t describe the living human adequately and ignores the basics of physics and the concept of the human condition. A dissection class with me doesn’t fix that, but it does start to address the lack of joined up thinking and moves away from purely anatomical and takes the confidence and application of the average therapist to another level.
Only For Doctors?
There are some who might feel that dissection is something that only medical trainees should undertake and this is a view which merits some mention. Let’s be clear about one thing, we don’t just let anyone in to a dissection class and there are clear terms and conditions for those that we do.
I believe that the UK has an incredible health care system, which is the envy of many around the world. It is free at the point of delivery, staffed by dedicated, skilled individuals with incredible knowledge and expertise. But we all understand the pressures and demands it faces and the last few years ave stretched the resources of the NHS to unimaginable limits. The UK citizen can be reasonably confident that in an emergency, the NHS will be there and will perform a fantastic job. However we also understand that if we get a pain in our back or neck or a twinge in our shoulder, we could be facing a very long wait to get seen by an NHS physiotherapist.
Many people therefore seek out other forms of treatment or therapeutic exercise which has in turn has created an enormous industry of massage therapists, osteopaths, chiropractors, Bowen therapists and so forth, who combined are seeing hundreds of thousands of clients a week for day to day aches and pains. Pilates instructors, Yoga teachers, personal trainers and so forth have never been in greater demand and studios and gyms are seemingly bursting at the seams.
This industry is for the most part completely unregulated. Whilst chiropractic, osteopathy and physiotherapy have been regulated in the last few years, there is no oversight at all on the thousands of complementary therapists putting their hands on people. The degree to whether this lack of regulation is a good or bad thing is debatable, but the need to provide education and professional at the highest level is a priority.
Therapists need to ensure they are fully engaged with the learning process and committed to developing a deeper understanding of the tissues that we claim to be affecting, professional bodies need to create standards and other, established health care providers would do well to engage with this sector that creates an enormous safety buffer for a fragile system. After all, imagine if every massage client with back pain suddenly turned up at their GP or ER!
By engaging with and supervising training in areas such as anatomy, greater safety for the general public and better standards are clear and direct benefits to every stake holder. A hands on therapist is going to use his or her anatomical knowledge every working day of the week and the better their training is, the more benefit will accrue.
Academic Attitudes
The last few years have seen an apparent shift in the attitudes of Medical Schools in the UK towards accepting therapists in to dissecting room. My own personal experience has been one where I have been singled out for an extensive campaign of what can only be described as bullying from within several areas within the UK anatomy field, instigated by the actions of one influential anatomy professor or rather former professor.
Having started teaching in 2007 at St George’s School of Medicine, with the express encouragement, support and mentorship of Professor Ceri Davies. When he then moved to Imperial College London, he asked me to take my classes there from St George’s where in addition to teaching hundreds of students myself, I also taught alongside Professor Davies who at the time I considered a friend and colleague.
At his personal request and with his proposal, I joined the Institute of Anatomical Sciences – The IAS and was tasked by the council with bringing more members into the Institute from the therapy sector and was subsequently given a place on the council where I ran the website for some years.
In 2016, for reasons which to this day are still unclear, Professor Davies launched an about face and in doing so effectively ended my ability to run hands on dissection classes in the UK and Ireland. Using his position as Inspector of Anatomy for Ireland, he prevented a fully booked class of mine happening in Cork, presenting an interpretation of the Anatomy Act that was fanciful, without declaring his previous relationship with me.
Later his friend and colleague Professor Gordon Findlater, the Inspector of Anatomy for Scotland, elected to terminate my classes at St Andrews School of Medicine following correspondence with Professor Davies. Davies also brought complaints against me to the IAS and the Anatomical Society falsely accusing me of criminal behaviour for which he provided no evidence. During proceedings the Anatomical Society, the committee was presented with the evidence of Davies’ blatant untruths, at which point he admitted he had indeed lied. However for reasons best known to his long term colleagues in both Institutions where he had served as president, his poor relationship with the truth and his inability to provide anything factual, seemed no barrier to unquestioning support.
This resulted in me being removed from the council of the IAS who concocted an imaginary conflict of interest and causing me to resign my student membership of the Anatomical Society. From here the doors appear to have closed and with the size of the anatomy sector in the UK being what it is, it seems likely that for no reason other than on the word of one individual, my name
In the nearly 20 years I have been running dissection classes, I have had nothing but overwhelmingly high praise for the standard of the teaching, the incredibly respectful manner in which my students conduct themselves, the way in which the facility is cleaned and occupied and the overall attitude that I bring to the dissecting room. There has never been a single incident or complaint regarding any of my classes or students and members of universities who have been present during my classes have declared them among the best they have ever witnessed.
In 2023 Imperial College London took the unusual step of removing Professor Davies from his position of Chair of Anatomy for reasons that have not been made public. It is generally uncommon for a university to remove an established professor from a prestigious position such as the Chair of Anatomy without substantial reason. It is not clear in this instance whether the reason relates to specific complaints made by students or staff or whether other reputational factors played a part of the decisions taken by Imperial College.
The reason I explore this aspect here is to highlight how specific cultures and attitudes can permeate and spread when influence from established figures is brought to bear. This could be said of any academic field, but the UK anatomy sector is small and Ceri Davies’ , with his somewhat singular approach to management and his exuberance in social settings very well known. Professional standing and the ability to influence others carries with it certain obligations that, when not observed, present a complicated dynamic for those who navigate the same professional corridors. I have no standing and no influence in any sector, particularly that of the anatomical or academic forum and thereby enabling and perpetuating toxic behaviour at my expense is understandably easier than confronting layers of authority and the complications this might bring. A ‘quiet word’ in the right ear is sometimes all it take to shut things down.
The anatomy world has long felt the need to be defensive in the name of discretion. The ‘resurrectionists’ of the 18th and 19th century, who robbed graves to provide anatomists with much needed cadavers, created scandal and brought the medical profession, who seemed to at the very least turn a blind eye to what was going on, into disrepute. The handling of the dead has always been sensitive and thereby excluding anyone outside of the immediate control of the medical establishment is an easy way to reduce risk. Wayward medical students can be struck off and shame heaped upon them and this cudgel is sufficient threat. Without it, what would happen if someone behaved badly?
It strikes me as being somewhat backward, when the first line of defence is the threat of sanction. My delegates, from the first point of contact have respect to the donors ingrained into them. The culture is one of honouring the donors and their gift and as a result this impacts on their behaviour. It would not enter into anyone’s head to behave inappropriately and leads one to perhaps consider that poor behaviour may be from poor institutional standards. I have lost count of the number of times I or my delegates have picked up material from the floor of dissecting rooms, dropped there casually by staff or students.
But for the moment I am an anomaly, and seemingly a pariah, at least in the UK. I am indeed unique in the anatomy world, not employed within higher education and effectively freelance. I am also not teaching standard anatomy or dissection, but am extending the traditional model to make it more inclusive and appropriate for the therapy sector where the demand for anatomical study is extremely high and woefully unmet. I am also unique in that there is no-one that I am aware of in the UK that has the experience or knowledge to teach anatomy within a dissection room that I do, as well as the desire to do so.
I firmly believe in and have proposed many times, a collaborative approach to anatomical teaching that could widen and improve the teaching of anatomy, increase the acceptance of donors who are rejected by universities and improve the use of dissection facilities at times when students are not present. It’s a win win for everyone concerned and all that is required is a truce to be called and for dialogue to ensue.
There is an enormous opportunity to raise the standard of anatomical education within sectors that are desperate to learn more and improve the quality of care for their clients, as well as raise the profile of the sector in general. It may take a bold step by a new generation of anatomists and DIs, but everything is in place, including donor consent and HTA rules. Were it to happen that would allow this to happen in a way that would not just enhance anatomical education, but boost public health outcomes. How likely are we to see a shift in attitude from those within the anatomical sector? It will probably need to come from someone other than me as a recent experience illustrates
At a meeting of the IAS in September of 2024, the first I had attended for some years, every person in attendance ignored me and chose not speak to me or engage with me in any way. People I had thought of as colleagues and friends, people I had worked on committee with and socialised with, sat in meetings with and in many instances confided in; not one of them acknowledged my existence. What heinous crime I had committed to warrant being bullied to such a degree has yet to be defined or explained, but the price for stepping out of line was made abundantly clear. I look forward to the next meeting immensely!
The Donor Gift
A dissection class is more than just experiential. It directly benefits those who are on a daily basis, suffering pain and discomfort. The donors who donate their forms, do so in order that others may benefit from their gift. In my eight years of running dissection classes, I can honestly say that every donor gift has done exactly that.
It is often thought that there is a shortage of donors for anatomical dissection and this is far from the case. Anatomy programmes in medical schools require a certain uniformity in the donors they accept for anatomical study. Those donors who might have undergone extensive surgeries, be overweight or underweight, have structural deformities or any number of other issues, may well be turned away by the medical school and returned to the families.
Where possible we ask donor programmes to reserve donors who would otherwise be rejected by the university, thereby fulfilling the last wishes of the donor, but also avoiding any of our classes from taking away material that could be otherwise used by the school. If anything, it is the unusual, overweight, problematic donors that we prefer. We want to see differences from the norm and how these have affected the body. It is not just anatomy we are looking at in these classes, but how one structure might inform another and anatomical variation is going to help this enormously.
Ultimately we are hugely grateful for every donor gift we ever work with, and acknowledge the huge honour that it represents to be able to explore another human when they no longer need their form. Every class holds the donor as the most important person in the room and honours them as our teachers.
A Functional Fascia dissection class hold the donor and the facility as the most important element in the whole class. As well as respecting the donor form at all times, we spend time each day cleaning the lab and at the end of the week scrub every surface and work space from top to bottom.
This is our way to acknowledge the extreme good fortune we have had to explore these forms and we leave the lab as clean or cleaner than when we arrived.
The whole process is incredibly respectful from start to finish and we cherish and take care of our donor gifts as if they were old friends. We strive to honour the individual who, when they no longer needed their body, gave it to people who could best learn from that gift.
Many people are coming to the dissection process with a keen desire to understand the body in a more three dimensional way, in order to fully engage and relate what see in the lab to what they are doing day to day in clinics.
It’s hard to fully appreciate the impact that this process has on hands on work, but hopefully some of the videos on this site from people who have attended the class, will go some way to explain it. You can also see Gil Hedley’s Integral Anatomy series, free of charge at his website, the link to which is here.
Finally, even if you never come to a dissection class, please consider donating your body after your death to your nearest medical school or university. These days the whole process is strictly regulated under the Human Tissue act of 2004 and regulated by the Human Tissue Authority, the HTA
You can find a list of universities who accept donations at the HTA website. Your gift will allow those working to help others to study the human form in a way that a book can never do..