Ending Dental School under COVID-19: Bending with the Wind
Earlier today, I entered the COHCR one final time as a student for my last clinic check-out. After turning in my things, cleaning out my bay, and saying my goodbyes, I had to stop by UT Police to turn in my UT Health San Antonio I.D. badge. I couldn’t help but be a little wistful as I did so. If you saw me on campus at any point over the last four years, I was wearing that I.D. badge around my neck on a blue silk lanyard.
I was asked to write about the dental student experience under new social distancing protocols regarding COVID-19. When pondering how to jump into this article, I reflected upon that lanyard. The lanyard that I wore every day of dental school is a branded product for Vandoren, a French music company that makes reeds for wind instruments, such as the clarinet and the saxophone (the latter of which I play and studied formally in my undergraduate program as a music major). I was given this lanyard at a lecture I went to prior to dental school, where representatives from Vandoren talked about the process by which they make their cane instrument reeds. The level of microscopic detail involved in reed-making is commensurate with the nitty gritty precision we employ when prepping an esthetic fixed dental prosthesis, or when arranging semi-anatomic denture teeth I learned that the cane that makes these reeds – Arundo donax perennial wild cane—grows easily in several parts of the world, but the most prominent reed-makers source their cane from the Var region in the Southeast of France. The reason, as the music company explained to me, is that in most places in the world, the cane is far too stiff; however, in Var the cane stalks are buffeted by incredibly strong winds. These winds are heavily traumatic to the growing plant, making the tall stalks bend almost fully to the ground, and yet the mature cane becomes pliant instead of rigid, resilient instead of brittle, ultimately superior to similar crops around the rest of the world.
I think most dental students and faculty can pretty quickly make the same cognitive leap here that I made earlier today. Life in dental school is, as we all know, a constant challenge of surviving gale-force winds. For graduating seniors such as myself, complete clinic closure, and cancellation of a commencement ceremony, alongside cancellation of other school milestones are yet another gust following a year-long sequence of challenging exams, pre-clinical competency woes, patient cancellations, delayed laboratory turnarounds, and more. Those of us who have reached the end of dental school have not only learned to stomach these frustrations but have also had to learn what many generations of dentists before us learned as well: in every crisis, there is a lesson to be learned. In that spirit, there are five central lessons that I have learned since the arrival of COVID-19 and I’d like to share them.
1. Negative feelings must be acknowledged in times of duress. Dental students are a positive, high-achieving group and these traits are not only what got us into dental school but also allowed us to build and maintain relationships with our peers, our faculty, and our patients. The forward-minded positivity of dental students is, in my opinion, a trait to be admired, and yet it certainly contains a small degree of self-delusion. In such overwhelmingly new circumstances, such as the sudden removal of the final two months of the dental school experience, failure to express negative feelings helps nobody. In the Class of 2020’s shared Facebook page, we recently all partook in a “venting thread” meant to allow members to air out all of their negative feelings without having to filter themselves or paint on a thin layer of silver linings. Reading what everyone shared, I was surprised to see that almost all of my classmates were struggling with the same feelings of anger, frustration, helplessness, and loss that I myself was dealing with. We all present as stoic and unflappable to the public, but openly engaging with those uglier feelings showed us all that we weren’t facing this challenge alone, but rather were sharing the load with our 100-or-so colleagues. There is a time for unwavering positivity, there is a time for vulnerability and it is incumbent on us to work towards both.
2. Our patients do not see dentistry as “non-essential”. The last day that I treated patients in our clinic was the Friday before Spring Break, March 13th. Since then, I have been inundated with phone calls and text messages from patients eager to know when they can return to the clinic and continue or complete their dental treatment. For some, this is a source of excitement, such as patients eagerly awaiting porcelain veneers on anterior teeth. For others this is a source of desperation, and I can’t help but feel sad for my edentulous patients who were just one appointment away from finally receiving a prosthesis that would allow them to eat more comfortably, re-establish a proper and maintainable relationship between their maxilla and mandible, and let them feel comfortable being seen in public. As I transition for the first time in my life out of student life and into full-time employment, I am grateful to be reminded that what we do changes people’s lives. During a period of such economic anxiety, it is also reassuring to see that even when patients may be facing social and financial limitations that impact their decisions, there are still plenty of folks eager to get back into their dentist’s chair.
3. Dental students are a financially vulnerable group. The now-unavoidable delay in licensure and employment will have a very real impact on our living situations. Many of us live solely off of student loans and most of us budgeted these loans for a few months past graduation in anticipation of being employed shortly thereafter. With our licensing exam delayed by around two months, our first income will probably be delayed by the same period of time. Many of us do not have wealthy families or earning spouses on whom we can fall back and the reality is that most of us have not yet had the ability or experience to create a short-term emergency savings account that an earning individual might have prioritized. In truth, some of us may be in a position that we will have to seek hourly part-time employment to tide us over in those months or may have to borrow at high interest rates, even this close to the end of our long years of study. This delay in earning ability also means less time that we will be able to earn before our loans come out of deferment, further limiting our ability to develop short-term monetary padding against future emergencies. Younger students may benefit from being aware that they too might see some unexpected change in circumstance leaving them financially struggling after graduation and may choose to prepare accordingly. Alumni and faculty, likewise, might not be aware of how the dental student experience has evolved financially since their own dental education and may be surprised to learn of the level of financial insecurity that current graduating students are facing.
4. In this day and age, connection is the greatest weapon that we have in the face against adversity. As mentioned above, connection with our patients is what puts them at ease when they face mid-treatment delays such as a clinic closure and it is what will get these patients excited to return and continue their treatment plans when they are able to. Electronic connection with guest lecturers and our own graduate program residents is what has transformed “wasted” weeks into the opportunity to participate in remote lectures over special topics such as immediate implants and resin infiltration from the comfort of our own homes. Notably, connection with our faculty and mentors is what has allowed us to be reassured and find guidance, rather than feeling bereft and forgotten. I have learned in these past few weeks that students and faculty members truly do care for each other and want the best for each other. We do not find the time to express that often enough throughout dental school. Personally, I know that I owe immeasurable thanks to my clinical faculty mentors in GPG 8, Drs. David Cox, Daniel Lavin, Richard Seals, and Jeffrey Thompson, and to faculty members who guided me through the Academy of General Dentistry, Drs. Kevin Gureckis and Jon Dossett. Not only would I not have made it to the end of dental school without their guidance, but I will also owe the fruits of my whole dental career to their wisdom and their support. I believe that if the time is set aside to encourage communication between students and faculty, both parties would be happy to see how much the other respects them, appreciates them, and cares for their success and happiness. This brings me to my final point:
5. The UT Health San Antonio School of Dentistry Class of 2020 is a family. I can’t speak for other dental school graduate classes, since I was not a part of them, but for my over-100-person-strong motley crew, I can say with conviction that our bonds have been forged over the past four years through a real gamut of tribulation and shared struggle. We have learned together, laughed together, cried together, and above all else have shared terabytes of dumb internet memes together. We truly have seen each other at our worst, and by virtue of sharing those low moments, have a greater appreciation for the moments of growth, victory, and celebration. The relationships that we have formed amongst us will persist beyond dental school. I am bolstered by the knowledge that I am entering the profession of dentistry alongside such a body of sharp minds and kind spirits that I can continue to rely on in the future.
Ultimately, while the experience of dental students at our school has been significantly disrupted by the necessary precautions and accommodations for a historic global pandemic, I am grateful that our dental school family has remained largely healthy and safe. Indian poet and Nobel Prize winner Rabindranath Tagore wrote in his Sadhana treatises: “everything comes to us that belongs to us, if we create the capacity to receive it.” I hope to be able to look back on this some number of years from now and view it as just another strong breeze that made me and my peers stronger than we were before. As dental school ends and life as a dentist begins, my colleagues and I await years of new challenges and trials that will come; we look forward to seeking the lessons contained within.
