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October 2010
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The Hidden Wholeness

St. Catherine's new human anatomy lab brings 'silent teachers' to campus.


From the womb to the tomb: It's a phrase Catholics know well, encompassing the total sweep of human life and reflecting the Church's central social teaching that every stage of life has inherent dignity.

But what happens when burial or cremation is delayed by a person's decision to give her life to science, allowing medical students to dissect her body? Does the scalpel undercut the Church's call to honor human life? How can reverence be fostered and maintained during hours of exacting dissection? Are there Catholic ethics that apply to an anatomy lab?

St. Catherine University President Andrea Lee, IHM, considered such ethical and religious ramifications last year as the University prepared for its own human anatomy lab, which opened this past September in Mendel Hall on the St. Paul campus.

As the second largest collegiate anatomy lab in the state, trailing only the University of Minnesota, the facility is a boon for St. Catherine's thriving Henrietta Schmoll School of Health. It provides another level of education for departments that have never worked with cadavers, another avenue of scholarship for faculty and an impetus to partner with outside medical professionals.

The lab also will attract prospective students for new academic programs, such as orthoptics and physician assistant, and serve as a welcome anchor for venerable ones, such as the doctor of physical therapy (DPT).
Most important, by raising thought-provoking, soul-searching ethical questions, the lab offers a reason to revisit and renew the University's cherished Catholic identity.

Bodies of evidence

St. Kate's physical therapy graduate students have trekked over to the University of Minnesota to dissect cadavers since the program began in 1991. Although the arrangement at the U of M worked well, the prospect of having an anatomy lab at St. Kate's became a topic of conversation early on, conjuring up a host of benefits.

Our students can see what arthritis looks like. They can look at the joint and see the breakdown of the cartilage. - Jaynie Bjornaraa, Professor of Physical Therapy

Imagine the possibilities for research, the potential to attract students, the collaboration among various academic disciplines, says Cort Cieminski, associate professor of the DPT program and director of the anatomy lab.

Then in August 2010, the University of Minnesota announced that its anatomy lab could accommodate St. Kate's students for only another year. Penelope Moyers, the newly hired dean of the Henrietta Schmoll School of Health, immediately created a task force to examine options and tour labs.

Human dissection is an indispensible exercise for certain fields of study, a rite of passage that for decades has informed and advanced the medical professions. Some universities in recent times have opted for virtual dissections, using software St. Kate's possesses. But however sophisticated the equipment, technology can't compare with an actual human body made available for firsthand study.

"You can see what arthritis looks like," says Jaynie Bjornaraa, an assistant professor in the DPT program. "Our students are actually looking at the joint and seeing the breakdown of the cartilage. There are divots in the bones. It's like, 'No wonder that hurts!'"

Meanwhile, students in the orthoptics program — now in its second year — are able to identify the origin of a vision disorder. "Eye movements are controlled by an intricate neurological process," says Assistant Professor and Program Director Lisa Rovick. "To try to learn all that by looking at pictures and reading paragraphs is a challenge. It's really helpful to be able to put it in almost geographical perspective: Where does it all lie in your brain?"

Like Rovick, Program Director Heather Bidinger welcomes the recruiting boost the lab will provide as she builds the master of physician assistant studies program that will launch in fall 2012, pending state approval and successful accreditation.

Ultimately, the compelling case for a lab prompted a $1.1 million remodel of Mendel Hall's fourth floor. The renovation includes a mathematics suite and some classroom remodels, plus a sparkling 3,600-square-foot anatomy space that includes two labs — each one large enough to accommodate nine bodies — plus showers, lockers, storage units and a cleaning room.

Eight different academic programs are using the human anatomy lab this year, only three of which have worked with cadavers in the past. Most are studying the tissue their peers have dissected, which sets up students to teach one another, Moyers says.

"It's a great resource for everybody," says Dan Frush, a second-year doctor of physical therapy student. "Having it as our own adds a little pride."

The Catholic response

Without question, the human anatomy lab will benefit healthcare students and the healthcare disciplines. How the lab will add dimension to the Catholic principles that fortify St. Kate's is less obvious — and suggests more complex questions.

"It became clear that we really needed our own [lab], and then we started thinking, 'Oh!'" Sister Andrea says, tilting her head. "'Are there Catholic implications in taking this step?'"

The president is no stranger to applying faith-based ethics to healthcare, having served for seven years on the board of Catholic Health Initiatives in Denver. She set out to explore this unique situation: how to apply the Church's teachings on respect for human life to the bodies of deceased persons in an anatomy lab.

The president called her counterparts at Loyola University in Chicago and Creighton University in Omaha, Nebraska, both Catholic universities with medical schools. She then spoke with staff members who operate those institutions' anatomy labs.

The Church has no explicit guidelines on anatomy lab dissection, Sister Andrea says, but its directives on healthcare apply. Those include the well-known "Ethical & Religious Directives for Catholic Health Care Services" (ERDs) developed by the Committee on Doctrine of the National Conference of Catholic Bishops, which are part of the learning experience of every St. Catherine healthcare student.

"Catholic healthcare institutes should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death," the directives assert.

Medical and religious ethicists point to one key element in considering human body donation: informed consent, a voluntary decision by the person to contribute her or his body to science once deceased. There should be no pressure from outside sources or economic inducement. (Although it's illegal to pay for a body, anatomy labs typically cover expenses such as transportation of the body, embalmment and cremation.)

Provisions must be clearly spelled out to ensure the person understands exactly how her or his body may be used, says Aana Marie Vigen, an associate professor of Christian social ethics at Loyola University who specializes in medical ethics.

Dave Lee has been directing the University of Minnesota's Anatomy Bequest Program since 1974 — and often provides counsel to bequest programs in other states. The program procures bodies of those who have given informed consent and carefully transports them to participating colleges throughout Minnesota.

Lee (no relation to St. Kate's President Lee) manages the process with respect and anonymity. Schools and students do not learn a person's full name or religion. Every November the U of M hosts a service for anatomy students and the families and friends of those they dissected. This year's event, at the Minneapolis Convention Center, is expected to draw 2,500 people. (Learn more at bequest.umn.edu.)

Ultimately, a Catholic university's approach to an anatomy lab may look a lot like the approach of a public university or one rooted in a different faith tradition. But Bill McDonough, an associate professor of theology at St. Kate's, identifies the distinguishing characteristic. "We would need to keep in mind the meaning of katholikos, a Greek word from which we get Catholic, meaning 'moving to wholeness,'" he says.

That calls for a certain humility and breadth, McDonough explains. "A Catholic school is always looking for the bigger wholeness, beyond what we see, and never presuming to have the full truth. To be Catholic means to admit there's a wholeness that's hidden, that we don't know."

Weaving in ritual

Catholic universities acknowledge this hidden wholeness in lovely and meaningful ways. The efforts are intended to keep a deceased person from becoming simply a cadaver, honoring the belief that each was created in God's image and therefore "is not just something, but someone," as the Catechism of the Catholic Church puts it.

You see the beauty of the Catholic faith and it application in this kind of situation. - President Andrea Lee, IHM

Such gentle guidance helps medical students grapple with questions of meaning and value, says Vigen, the Loyola ethics professor. "It leads to a better sense of, 'Wow! What do I want to do with my life? What really matters?'"

Creighton University hosts a memorial service each spring for donors' families. They're given wildflower seeds and a booklet with hymns and thank-you notes from medical students. "We were told that Gerard was a firefighter," wrote six first-year med students who dissected his body. "Just as he graciously served the community in life, he continues to serve through his gift to us. His legacy will forever live through our knowledge."

Loyola bookends an anatomy semester with prayer services — first, a dedication, when a student reads from the Book of Ecclesiastes ("for everything its season … a time to be born and a time to die") and then a thanksgiving service. The man who leads these services, Father Jack O'Callaghan, met recently with Laurie Svatek, director of campus ministry at St. Kate's, to share ideas.

St. Catherine had the honor of having its human anatomy lab blessed in September by the Most Reverend John C. Nienstedt, Archbishop of Saint Paul and Minneapolis, during a service and reception for donors who supported the lab's construction. The service, in concert with the Church's ritual of blessings, had the sacred, artistic flavor that characterizes all of St. Kate's ceremonies and celebrations.

Moving forward, the University plans to begin each semester with a religious service that will help students express gratitude for the generosity of their "silent teachers."

Taking time for such ritual is important, Svatek says. "At the center of our Catholic identity is the deep respect for human dignity. We engage in activities that help us as human persons have visible signs of God's presence among us."

Amata Miller, IHM, an economics professor who directs St. Catherine's Myser Initiative on Catholic Identity, believes this integrated approach will strengthen the University's Catholic roots. It underscores a philosophy inherent to St. Kate's, she says: "Professional study is enhanced by the spiritual dimension."

The human anatomy lab may be new territory for St. Kate's, but the delicate marriage of science and St. Catherine's Catholic beliefs is familiar ground. "You see the beauty of the Catholic faith and its application in this kind of situation," Sister Andrea explains. "Because of St. Catherine's deep engagement with healthcare, we look at complex issues like this from the perspective of science and medicine and from the perspective of our faith. Both are facets of the bigger reality."

Freelance writer Christina Capecchi has been covering the Catholic Church since 2003 and met Pope Benedict XVI in 2006.