Those unacquainted with the dissecting room are often struck by its instrumentation. A standard kit is modest enough—scalpels, forceps, and various probes—but one notices that a kit’s volume tends to expand in direct proportion to the time one spends in these environments. While some individuals possess a talent for losing tools, others, like myself, seem to attract them. I hasten to clarify that this is not a matter of larceny; I have never deliberately stolen an instrument, yet I invariably possess more than I began with.
Most of these tools would not be out of place in a modern operating theatre. However, the dissecting room frequently employs an implement seldom seen in surgery: the tenon saw. While orthopedic surgeons certainly use saws for amputations or osteotomies, theirs are specialized instruments—designed to be entirely sterilisable, with smooth surfaces that offer no refuge for organic debris. In the dissecting room, such clinical necessities are absent. Here, the saws are identical to those one would find in a carpenter’s workshop; they are, in every sense, tools for woodwork.
I recall passing a group of students, one afternoon, who were attempting to saw through the left femur of a male cadaver. The cut was positioned just above the mid-thigh, roughly a third of the way down from the hip. Despite their exertions, they were making no progress. When I was called over, the students were visibly baffled; they reported that they had been sawing with such vigor that smoke had begun to rise from the site of the cut.
Taking up the saw myself, it was not the sensation of a blade against bone that I felt. It was that of saw blade against surgical steel. We soon discovered that the individual had undergone a total hip replacement. Upon eventually removing the distal portion of the limb, we exposed the lower extremity of the prosthetic femoral stem.
Two details were particularly striking. First, the metal remained as pristine and reflective as the day it was implanted. Second, despite the formidable density of the alloy, the students’ persistence had left a mark: the tenon saw—a tool designed for timber—had cut a groove some three or four millimeters into the metal.
The students had indeed been trying very hard. One cannot wonder at the smoke.
