Skin

Where body meets air we are all cadavers

The Body: A guide for Occupants by Bill Bryson

Epidermis

Epidermis

I walked into the gross anatomy lab at a medical school, wearing a brand-new white lab coat, and stood at one of the dissection tables. The steady hum of  the air purifier filled the room. Under the gleaming florescent lights, the lab appeared sterile and lifeless. It held multiple tables, each with a cadaver lying upon it. It was my first human dissection class, and I was nervous. Unless you are a medical student, funeral director, coroner, forensic examiner, or some kind of specialist, you rarely have the chance to see naked dead bodies quietly resting on stainless steel tables. The cadavers were embalmed for preservation, giving their skin somewhat foreign texture.

In my old country, we don’t have the custom of embalming. When my grandmother passed away, she was laid on a futon in her home, as if she were sleeping, and family members took turns staying beside her body through the night. It is an old tradition for family members to spend the last night with a loved one—a way to familiarize the living with death. I stayed with her body for several hours, keeping incense burning. Her skin was yellowish, wrinkled, and dry but otherwise intact. The cold air from the dry ice, used to slow the body’s decomposition, seeped through the futon, carrying with a faint, distinct whiff of death.

In the lab, the cadavers’ skin was unnaturally moist due to the embalming fluid saturating their tissue. We carefully observed the artifacts of death and embalming process to distinguish them from the inherent characteristics of the deceased. The outer layer of skin was peeling in patches, similar to sunburned skin but slightly deeper. This is a decomposition process where the bond between dermis and epidermis begins to break down. One of the cadavers was a dark-skinned man, and we were startled to see the pale skin layer beneath. We realized the skin color is only epidermis deep. Beneath the epidermis layer, we are all same color: pale and fair.

The epidermis, the outermost layer of skin, is only 0.05mm (on the eyelids) to 1.5mm (on the palm and sole) in thickness. It defines our social identity, being the first aspect others notice. It is a social organ. As a person of east Asian origin, my skin has an olive tint.  When I was a child, I spent most of my time outdoors and became tanned in the areas exposed to the sun.  Naturally I was darker than adults who spent most of their time indoors. My father used to tell me I was too dark to be considered pretty. In my old country, at least at that time, fair skin was idealized as a standard of beauty for women; the lighter, the better.  My skin is still tanned, though not as much as when I was younger. In fact, the parts of my body that rarely see sunlight are as fair as those of my friends with natural light skin. I simply don’t burn as easily as they do. Being labeled as an “Asian girl too dark to be pretty” haunted my self-image, even though it was just an epidermis-deep judgement, easily shed like a snake’s slough when it no longer fits. Today, I am a proud woman of a certain advanced age with beautifully tanned skin, less sun-damaged than that of some fair-skinned friends.

Melanocytes, located in the bottom layer of epidermis, produce melanin, which determines skin color. Without the epidermis, you would be pale. Defining people by skin color is absurd. Melanin protects the skin from UV damages caused by sunlight. A darker skin color simply means your skin is more tolerant to UV exposure. 

In the living body, the deepest layer of the epidermis, where melanocytes reside, is firmly attached to the dermis and does not peel away easily. Since the epidermis lacks sensory nerve endings — except for vibration-sensing Merkel cells, which are found in the bottom layer— touching the epidermis itself does not produce sensations. However, there is a rare genetic disorder in which the bond between the dermis and epidermis is very weak, causing the epidermis to peel away with the slightest contact, exposing nerve endings. Individual with this condition are vulnerable to UV damage, infections, and other external threats. Imagine being without an epidermis. Every slightest touch would cause excruciating pain, and your existence would become a constant agony. When I studied psychology in a post-graduate psycho-spiritual counseling program, the instructor described a person with borderline personality disorder as “being without skin.”  The analogy might be more accurately described as a condition of being without an epidermis.

The epidermis forms the boundary between what is me and what is not me, serving as the first line of defense by protecting what is inside from the external environment. Despite its crucial role, it is less than 1mm thick. Our physical existence is remarkably vulnerable in this way.

When I get a temporary henna tattoo, the “tattoo” fades away in a week or two because the pigment only penetrates the epidermis.  The outermost layer of the epidermis, the stratum corneum, consists of dead cells that are constantly flaking away. The cells in the outer layer of epidermis are replaced every thirty to forty days. Part of us is constantly dying from birth. Our physical existence is not as separate as we might believe. When I step into a subway car, I sometimes encounter a distinct smell associated with a particular human state. Even if the source is no longer present, the oder lingers as if the ghost of its presence remains. Occasionally, we find ourselves in someone else’s personal space, and as I inadvertently breathe in tiny molecules of oder, I also realize I am inhaling minuscule flakes of dead epidermis. 

As a manual therapist, when I touch a client, I make contact with their epidermis. I would never touch their dermis, the true skin, directly. Between “them” and “me,” the epidermis stands guard, keeping “not me” out.  Every caress of lovers passes through the layer of dead cells. Flaked-off dead cells mingle with other minute substances, floating away in the air or settling on the floor. This thin, evanescent boundary keeps us safe from one another.

The first difference between a living person and a cadaver lies in the skin. In the dissection lab, we stood around a table with a cadaver. No one touched it until the instructor encouraged us to do so. Initially, most of us hesitated, but soon we began to touch the cadaver quite aggressively. The cadaver allowed us to explore in whatever way necessary for study. A person has boundaries; a cadaver does not. When somebody violates your boundaries through inappropriate touching, they are treating you as if you were a cadaver.

Imagine yourself as a corpse lying on the ground. Focus on the outermost layer of your skin. Peeling away in patches, this interface with society falls off. It becomes desiccated and papery—light and fragile. Part of your identity sheds away, your boundary dissipating with a mere whiff.

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