I recently had an interesting discussion with a new colleague at the University who is an anatomist and paleontologist. Her passion for the field reminded me just how important anatomy is to anyone practicing any form of medicine today.

Incidentally, I have to mention just how lucky I am to have colleagues close by who are paleontologists. I happened to “meet” one of them, Dr Matt Wedel, via television a couple of years before I met him in person. When my son was 5-years-old, he had a passion for dinosaurs. He and I were geeking out to an interesting documentary about dinosaurs when we saw Dr Wedel being interviewed about sauropods (the dinos with the long necks). He’s an amazing speaker, so his interview was easily recalled a few years later when I happened to start working at the same University as him. Low and behold, he was actually teaching anatomy to my podiatry students!

It seems many paleontologists pay the bills by teaching human anatomy as their day jobs at various universities and then spend a portion of the year doing their paleontological research. What a benefit for me to have an expert nearby in a topic in which I happen to have a strong amateur interest. Dr Wedel is responsible for naming and describing three different extinct species, including Sauroposeidon and Brontomerus, two of those long-necked dinosaurs. How cool is that!

But I digress. Let’s return to our anatomy discussion.

For all medical professionals, anatomy is the lynch pin of almost everything we do. Without a strong understanding of the body’s parts, we are working in the dark. For example, take phlebotomy. If we didn’t know the basic anatomy of the antecubital fossa of the arm (or any superficial venous component), we would have difficulty drawing blood for analysis. Similarly, if a podiatrist doesn’t know the anatomy of the foot, they would never successfully complete a surgical procedure.

It’s interesting to consider that many years in the past, doctors were not only restricted from studying anatomy - it was looked down upon. That was the purview of barber surgeons, the precursors to modern day surgeons. You might also find it interesting that barber surgeons, those “non-doctors” who pulled teeth and amputated limbs, were the same people that would also cut your hair. Imagine that. “Shave, a haircut, and a limb amputation – 2 bits!”

For more than 1300 years, Galen’s concept of humoral medicine (imbalances of the humors - black bile, yellow bile, blood and phlegm leading to disease) reigned supreme as the paradigm in which to treat patients. Can you imagine a podiatrist in the year 1000 treating gout? “You have an imbalance of the humors, my good man, so we’re going to bleed you.”

This type of thing was the case until Andreas Vesalius published his De Humani Corporis Fabrica (On the Fabric of the Human Body) in 1543, an anatomical tour de force that revolutionized the study of the human body. Eventually, it became legal to dissect humans (with quite a number of giant hiccups along the way, such as the resurrectionists, who stole corpses for medical school dissectors) and is now the first, and perhaps most significant, educational experience in medical school today. I still remember, with mixed feelings of fondness and revulsion, the cadaver I dissected during medical school. Fondness because it’s such a special gift to give your body to education; revulsion because the patient had an inordinate amount of liquidy adipose tissue, making our dissections challenging.

For the modern day podiatrist, anatomy is also necessary for the diagnosis of disease. For me, this is the first step in diagnosis of just about every problem that affects the lower extremity. After obtaining a history, where we obtain the initial diagnosis most of the time, I begin palpating and thinking about the anatomical structure that is injured or under stress. One can then determine the cause of injury (biomechanical dysfunction, trauma, etc) and focus treatment on that cause.

A similar example for the practicing podiatrist is non-mechanical heel pain. Understanding the neurological anatomy pertaining to the lower extremity allows us to determine, via history and physical examination, that a prolapsed intervertebral disk or spinal stenosis is compressing the L5 nerve root. Knowing the anatomy allows us to understand the clinical manifestations of this problem via a dermatomal nerve loss and muscular weakness in a very specific pattern. The power of knowing anatomy is clear every time we examine a patient.

These are the reasons why the growing movement of discontinuing medical school cadaver dissections is such a poor idea. One may argue that high tech computer model systems and virtual reality provide sufficient accuracy to allow medical school students to learn anatomy. However, this is false. After graduation, doctors of all stripes will work on actual human beings with real life bodies, not simulated ones. As such, dissecting actual human cadavers provides doctors with the essential understanding of not only the various anatomical structures and relationships but also a feel for the variability of the many organs in our bodies. You can’t replace actual reality with simulated virtual reality, no matter how hard you try.

To that end, I say “hooray” for anatomy and the incredible power of understanding it brings to us in the medical professions. Without it, we are adrift, cursed to see the human body as an unknown shell of humors, and disease as a miasma with uncertain vague cures. I vote for knowledge every time.

Best wishes.