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‘Living donor’ uses his medical history to teach students

September 29, 2018
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In this Sept. 20, 2018 photo, Russ Clark has a ultrasound performed by Felicia Toreno, a Associate Professor and Director of Ultrasound Education, and first year medical students Chris Serle, center, and Chris Stocki, right at Eastern Virginia Medical School in Norfolk, Va. Clark is available during some of the medical students classes at Eastern Virginia Medical School, so they can examine him, ask him about his medical history and work through problems. (L. Todd Spencer/The Virginian-Pilot via AP)

NORFOLK, Va. (AP) — Russ Clark’s favorite part of the ultrasound is when the medical students go for his gallbladder.

His heart might not be in precisely the right spot, but it’s there. Same with his liver.

But his gallbladder? It was removed years ago, and the students can get confused searching for it.

So “from a humorous point of view,” that’s his favorite. It teaches them that as you age, organs can shrink, grow or move around a bit.

“Most of them are just young people, and all their body parts are in the right place, and they look wonderful, just like what the text(book) pictures show,” Clark said. “But when they get my age, then they’ve had things happen.”

Clark, 73, has had plenty: a spine injury from jumping out of a plane during the Vietnam War, liver scarring, surgeries on his eyes, heart, lungs and foot. More than a dozen cases, in all.

At first glance, he could be mistaken for a professor at Eastern Virginia Medical School, roaming the halls in a white lab coat and wire-rimmed glasses, greeting students and faculty. But the coat he commissioned himself bears unofficial titles: LC/LD, Living Cadaver/Living Donor.

Clark, a Navy veteran and retired educator, is a full-time volunteer who donates something unconventional: his life story, told through his medical history. He lets students ask him anything about his past — to get a real patient’s perspective — and use him as a test subject in the ultrasound room.

“I love interacting with them and they like having me around,” he said.

Clark was raised on a farm in Maine and moved to Norfolk during his 23 years in the Navy. He married, had four sons — he now has a dozen grandchildren — and spent another many years as a school administration consultant before retiring in the late ’90s due in part to health issues.

Over the course of his many medical ordeals, Clark said he had mostly “excellent care” and started thinking about giving back. He couldn’t be an organ donor “because my organs aren’t good enough for that.”

He was drawn instead to the idea of being a whole-body donor, allowing his body to go to scientific research after death. That brought him three years ago to the office of Craig Goodmurphy, vice chair and professor of anatomy and pathology at EVMS and director of its human anatomy and ultrasound programs.

But Clark didn’t want to wait until he was dead, when he wouldn’t get to experience being a part of the medical education.

His “natural question from that was, what else can I do before the time at which I’m going to lay across this table?” Goodmurphy said.

The idea for a living donor was born, for medical students “to meet a real patient and ask somebody who is not necessarily medically educated himself to answer in a way that a patient would naturally answer.”

Now, Clark’s medical cases are built into the first-year students’ curriculum. They read about each, hear Clark give a short presentation about himself and ask questions they wouldn’t be able to of a cadaver.

“Your donors are revealing a lot to you, but what they can’t do is answer questions,” Clark told students at a recent lecture.

It’s the subtle, personal stuff that he really brings to the table. For instance, Clark talks about the fear he had as a young Navy aircrewman after he had to bail out of a plane in Vietnam and his parachute didn’t fully open, leading to a spine fracture.

“I was bruised up pretty good. I hit the ground rather hard,” he told the class. “I did not want to see a doctor because I was scared of them telling me I was out of the Navy. ... I lived with that and I still live with it today.”

His philosophy is no holds barred. In fact, it’s a rule for the students: Don’t be scared or embarrassed to ask anything. Clark certainly won’t be. (He told about 150 students at a recent lecture that his spine injury still affects certain sexual positions with his wife.)

On a recent Thursday, Clark walked around the school’s anatomy lab as students worked on dissecting cadavers. He moved from table to table, answering questions.

“I think it just makes it much more real,” said 23-year-old Jasmyn Brown, a first-year medical student, “instead of just (studying) a patient that doesn’t have a name.”

They learn “things you wouldn’t have heard before but really do matter to people in their lives.”

Students also practice ultrasound techniques on Clark.

“Hold your breath for a couple seconds, please,” 24-year-old Chris Stocki instructed as he held a linear probe to Clark’s neck, looking to a grainy black and white image on the screen above. “That’s the jugular.”

Carrie Elzie, associate professor of anatomy and pathology, said she’s seen the very nature of students’ questions shift as Clark gets more involved in the curriculum.

“The questions are more centered around feelings — what could your doctors have done differently,” she said. “That’s a huge shift. I was astounded.”

Anatomy is often thought of or portrayed as “being a place where we close off our humanity and we distance ourselves from emotion,” Goodmurphy said.

He hopes to change that, starting with Clark. A couple other people from the community have since expressed interest as well.

Patient stories are “hard for us to get. They’re contrived because of anonymity issues and HIPAA violation issues of sharing that,” Goodmurphy said. “But he’s opened that box up to us. ... Clearly he’s getting something from it, but I always feel like we’re just getting so much more.”

Virginia has a centralized system that sends donor bodies to Richmond to be distributed, but Clark has a special setup and knows he’ll go to EVMS when he dies. Though he’s “not anxious to go too fast.”

Students ask him if spending time in the anatomy lab around cadavers has made him think twice about donating his body, he said.

He tells them, “No, it encourages me more. The alternative is being put in the ground. Here, you’re allowing yourself to be the object of learning. I think that’s a marvelous thing.”

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Information from: The Virginian-Pilot, http://pilotonline.com

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