I am well used to the pace of a Gil Hedley six day dissection and the frustrations that come with having to blast through a layer that you want to hang out with and study for longer. It’s something I tried to address last year when I ran an eight day dissection course over four weekends and it worked very well, apart from the disappointing attendance.
Three weeks however is another ball game entirely. If I was concerned about the level of concentration required to spend so long on skin and superficial fascia, I needn’t have worried, as come the end of day five, the fascination and intrigue still being demonstrated by all involved was evidence enough that there is plenty to hold the attention for this long.
The week has presented its challenges for different reasons. Gil wants to document these layers and write about them, drawing comparisons and noting differences. In order to do this though, measurements need to be taken and two issues arise from this. As far as I know, no-one has ever really tried to document the thickness of superficial fascia in cadavers. We are well used to fat measurements in humans, used to tell people how inadequate they are, yet the true depth of the tissue as well as the lobular lengths in certain areas, remains unchartered territory. Similarly the patterns of circles on the underside of the skin.
Do these relate to areas of function or strain? How do they change around the body and is this consistent across all the forms? What is their purpose? How do they respond to scarring or wear? Because no-one has really asked these questions there isn’t really any system to follow, requiring a whole new method of study.
There is no doubt that Gil has thought long and hard about this, but faced with the reality of needing to get this information down, with 50 people in the room doing the measuring, the best laid plans will always need to be re-considered and in this case simplified. If we were to get any data at all, it had to be done in a way which was going to be at least consistent throughout the room.
Robyn, a graphic artist, leapt to the rescue and created a series of line drawings which we photographed and imported to a word document and to which tasks and questions were then added. Observation is an essential element of any measure and Gil has encouraged everyone to write down what they see, from skin onwards.
It’s a useful skill to apply to any practice. You only get one chance to observe so make it good. If you see something, anything on the surface, you have no idea how this will relate to layers further in to the body, so it’s vital that whatever you see first is noted.
The discussion of the circles was ironically enough an extended element of circle time midweek. It’s sometimes hard to be part of a debate that is clearly never going to be anything except speculative and this was one of those times. The ‘meaning of the circles isn’t something that is clear just yet, but the important thing here is to know that they have been studied and measured. At some stage someone will define them more clearly and these measurements will be the basis of the next step. Whatever the case I have no doubt that it’s going to change the way we look at and understand the body and thereby the way we treat it.
Similarly, understanding the variability of the adipose/superficial fascia/panicular layer, is going to be more relevant when referred to other studies or way of understanding how this tissue is distributed. For the body worker, the main thing is to fully appreciate that the skin and superficial layer is the workbench for manual therapy. We have no real interface with muscles or viscera except through this layer. The tricky thing is that it’s not as obvious as we might think.
One cadaver in the room is a big guy. 18 stone with a huge belly, yet with a superficial covering of less than half an inch at the front. Another table had a man with a similar build, maybe smaller, but with a superficial fascia layer of well over two inches. Being fat means man different things.
Saturday and it’s a voluntary day to ‘discharge’ as Gil so neatly puts it. Get out and blow the cobwebs away. About half the group have come in to tidy up and follow up on what was left over from the end of the week. Weighing and measuring samples, trimming up under the axilla to develop a clear space for the week to come.
For me my partner Jane had arrived the night before, so it was the tourist trail for us, jumping on and off trams and trolley buses and taking in the sights of SF. A big week ahead with muscles!