Everything I know about anatomy before coming to medical school, I learn in an acting class. The class focuses on speaking on stage by using our whole bodies as vocal apparatuses. Our professor, a professional voice coach, can tell by the way we speak and carry ourselves where each of us physically holds tension. We learn to locate this tension in ourselves and learn to relieve it. We discover how to make the sounds of our voices resonate across our rib cages, sinuses, hard palates, teeth, and skulls. If I send my voice to my teeth, you would be able to feel them vibrate with your fingers.
I hold most of my tension in my psoas; when I let my leg swing while I speak, my voice instantly changes to become more full, more honest. This does not come easily to me. On the other hand, my voice resonates across my hard palate with a sharp strength that does come easily to me. This ease is why, when my professor suggests to the class that we break things when angry rather than hold rage in our bodies, he looks at me and says, “I’m not worried about you. I know you already do this.”
In this acting class, we learn how to inhale into each part of our ribcage. It becomes a habit of mine to press my thumb into each intercostal space until I can feel it expand with air. I know where my rib cage ends.
In anatomy class, when I palpate the ribcage of the cadaver for the first time, it only takes me a few seconds to find out where hers does. When I cut through her ribcage, droplets of formaldehyde and adipose flying into my face, I wonder how often she thought about where her ribcage ends. How often she thought about us finding out where her ribcage ends. I wonder if the thought ever amused her. I wonder where she held her tension and where her words moved through her body most naturally. I wonder whether all of this changed when she got her cancer diagnosis and her mastectomy, or when she first considered donating her dead body to the anatomy lab. When she first considered her dead body. I wonder why nobody in this room is calling the cadavers “dead bodies,” but I think I already know.
While I am sheathed in microscopic particles of her bones, I wonder how her voice vibrated across them.
Aside from her body, the only fragments of her narrative I have are her age, occupation, “cause of death,” and the fact that she chose to let us dissect her body. I do not know where in her body her voice lived, but I can see many of the places that it might have. I have peeled the pleura off of them and felt them succumb to blades under my pressure. With every layer removed, I unveil more empty space where stories once lived, where remnants of stories still live. All of this unveiling of empty space, potential pleural space, potential narrative and experiential space, happens within the empty space that her death has left in this context of life – an empty space that I and my medical student companions have now been asked to work within.
This, I think, describes much of the physician’s task as I understand it: inhabiting and working through empty space within a human narrative. Considering the empty space inherent to any narrative, including my own, is somewhat daunting. Some gaps cannot be filled and some spaces are not meant to be more than potential spaces. If, as a medical student, I can continue to work on embracing gaps and potential gaps – to work, not on filling them, but allowing them to be generative outside of themselves – I will feel fulfilled.
Sound needs empty space to resonate within. I hope that, as I am faced with bodily cavities, I do not forget the narratives that bounced within their walls. I hope that, as I encounter various narratives, I do not forget the empty spaces from which they grew. I hope that, instead of denying empty space and carrying tension in my psoas, I continue to break things when I am angry.
Fadwa Ahmed is a first year medical student (MD’22) who loves words but especially loves the empty spaces between them.