First patients as teachers
As a first-year dental student, Erik Hager was apprehensive as his faced his first patient-donor dissection. Compartmentalizing his emotions helped him through the anatomy lab procedure, a requirement for every Texas A&M College of Dentistry student.
“It was when I got home and sat in silence away from it all that I was able to construct in my mind a clear picture. I had been initiated into the ranks of the countless professionals before me,” said Hager, who relayed his experience at a recent remembrance service for the school’s Anatomical Gift Program donors. His introduction into anatomy changed him forever.
“I saw the humanity in each patient donor, and I was humbled by their kindness and dedication to our knowledge,” said Hager, a 2019 Texas A&M University graduate who majored in microbiology. “My heart was full of compassion and I was dedicated to always seeing them as they truly were: generous and selfless human beings.”
About three dozen students, faculty and staff recently gathered virtually for the first service of remembrance to honor 28 patient donors who were a part of this year’s educational experience.
The ceremony was helmed by Dr. Matthew Kesterke, instructional assistant professor in biomedical sciences, who gave an insightful lesson into the evolution of academic anatomy in educating health care professionals, a practice that dates back to the mid-third century B.C.
“The Anatomical Gift Program here at Texas A&M humbles and enlightens me, as I am now continually reminded of altruism, selfless sacrifice and continued dedication to those around us in the betterment of our community that is gifted by a donor when they donate to our school,” he said.
Charlie Fulton, who manages the gross anatomy lab, has been the leading force behind implementing memorial services for the patient donors, though COVID-19 required moving this first event to a virtual format. Fulton intends to make the ceremony an annual campus event because the patient donors and their families deserve a dignified “thank you.”
“These are selfless gifts that these families have given us,” he said. “What a lot of people don’t understand is that it’s not just the donors giving up something. The families are, too. The family doesn’t get to say goodbye in the traditional way. They don’t get to have a full funeral with a viewing and everything.”
And that’s why several dozen students, faculty and staff showed up virtually. They shared just how much that sacrifice has contributed to their own educational journey, as well as scores of others.
“Having a strong teaching anatomy program has enormously benefited our hundreds of students that I’ve taught over the years. Maybe even more importantly, it benefits their patients,” said Dr. Emet Schneiderman, professor in biomedical sciences.
The continued use of dissection as a teaching tool in 2021 is often questioned, Schneiderman said. Even though there are other viable teaching supplements—such as computer simulations, books, videos and models—students quickly learn that each patient is structurally different, he explained. Learning those nuances is instrumental as students perform dental procedures that require administering analgesics that numb pain receptors.
“Understanding the variation in the position of the nerves that supply the jaw and teeth might prevent a dentist from achieving adequate numbness when they use the standard injection locations,” he said. “Having this knowledge of variation gives our graduates the agility to find alternatives versus just being defeated when things don’t work out exactly as expected. There’s no replacement for working with, seeing and feeling actual human tissues and structures in three dimensions.”
Both Hager and third-year student Courtney Favaloro agreed that students’ hands-on anatomical experience gives them necessary expertise and insight as they transition to treating live patients.
“I gained more knowledge of our complex structures from studying an actual human being than I could have in spending twice the time poring over a textbook,” Hager said.
Favaloro said she remembers those first dissections like they were yesterday.
“I’ve seen more and more how this program helps clinicians like us,” she said. “This is truly our first patient we’ll ever get to work on in dental school.”
Students aren’t the only ones who benefit from the program, Kesterke said. Researchers, too, have furthered their knowledge through the patient donors, with recent studies ranging from “the oral manifestations of melanoma, endodontic tool use research, bone biology studies, studies involving bone, tendon, bone-growth interaction, normal and pathological osteogenesis, and hip implant and implant anatomical variation.”
Schneiderman noted that gifted bodies are what have made his 40 years in research possible within anatomy and skull growth and development. Knowledge of the oral cavity and airway anatomy has been indispensable in his current role as director of the school’s Sleep Research Program.
Over the years, he said, as he’s guided students through lessons of anatomy to apply to their clinical skills, he’s also taught them about respect and empathy for patients.
“I ask the students to remember that these individuals were loved ones, loved parents, husbands, wives, and in some sad cases, children. But at the same time, recognize that these donations were made so the students can learn and benefit from what they left behind: their bodies,” he said.
Favaloro expressed her gratitude for patient donors who will never be on the receiving end of the skills the dental students learn from them. Instead, “they’re just doing it for the betterment of society as a whole. So we can really not overstate the selflessness these donors have.”
Fulton, a licensed funeral director and embalmer, hand-delivers ashes to families who want to inter their loved ones’ remains. All other unclaimed ashes are carefully scattered underneath pine trees at an East Texas cemetery where a plot has been donated to the dental school. Plans are in the works for a marker to be placed soon with the college’s name and an acknowledgment of the donors’ contribution to science. A special military remembrance and burial is scheduled for later this year at the Dallas Fort-Worth National Cemetery. This will be the second such event with military honors since Fulton started overseeing the program two years ago.