Life stories from Paul Farmer, Drew Faust, Howard Gardner, Annette Gordon-Reed, Martin Karplus, Toshiko Mori, Steven Pinker, E.O. Wilson, and many more, in the Experience series.
The University’s longest-serving current dean, Harvard School of Dental Medicine’s Bruce Donoff, will step down in January after 28 years in the post and return to the School’s faculty. Donoff, the Walter C. Guralnick Distinguished Professor of Oral and Maxillofacial Surgery, guided the School through various changes, championed reforms to dental education, and advocated a closer relationship between dentistry and primary medical care — he earned both his D.M.D. in 1967 and M.D. in 1973 at Harvard. Donoff, an oral and maxillofacial surgeon who has conducted research on wound healing, bone grafts, oral cancer, and nerve repair, sat down with the Gazette recently to share his experiences in leadership and his hopes for dentistry’s future. A symposium and reception at the School will honor his service on Dec. 10.
Q: Why don’t we start at the beginning. You grew up in New York?
A: I grew up in Brooklyn. I’m an only child. My mother was a schoolteacher, and my father was a manager at a printing company in Manhattan. He did not go to college, but he was very well-read. He could carry on a conversation with anybody. I grew up on the third floor of an apartment building and had my mother’s sister and two cousins, including my cousin Harvey — whom I went to school with — on the second floor. Brooklyn was a great place to grow up, because you interacted with all different kinds of people.
Q: What were the neighborhoods like? Did they welcome each other or was there a “stay on your own side of the street” aspect?
A: They were welcoming. I lived at Troy and Lenox, and went to Erasmus Hall High School — Barbra Streisand and Bobby Fischer were in my homeroom for four years. But if I lived on the other side of Lenox Road, I would have gone to Wingate High School. And if I lived one block away, I would have gone to Tilden High School.
Q: Barbra Streisand was in your homeroom?
A: She was.
Q: How well did you know her?
A: I knew her to say hello. One time she was up here at the Kennedy School for something. I wanted to see her but had to go through about six secretaries to reach her.
Q: How did dentistry come into the picture?
A: I was always interested in science. I went to Brooklyn College, where I paid $28.50 a semester for tuition and had a state scholarship every semester. Brooklyn College was a great experience. That’s where I met my wife. I lived at home and joined a fraternity, Alpha Epsilon Pi, which provided a social outlet. I was a chemistry major, although I loved history. I started doing research with one of my biochem professors on active sites of enzymes, and I was thrilled to do history term papers that took me to the main branch of the New York Public Library. I loved going to the main library, but the other reason for going is the last automat in New York was down the street. Do you know what an automat was.
Q: I don’t.
A: Horn & Hardart automats were a kind of cafeteria where you put nickels into slots and you got your food out. It was a great concept, though it faded and never got resurrected.
Q: What’s your wife’s name?
A: My wife’s name is Mady. She was a speech and theater major and did a lot of costume design. I used to tutor her in physics and chemistry, that’s how we met. She’s a great lady. We got married in December of my second year here in Dental School. I always joke she taught so she could keep me in the style to which I was accustomed. She wound up getting a job in Malden, and we lived right up here by Brigham Circle. She took two trains to get to Malden and made some good friends. She is an extraordinary person. She gives her time to everyone.
Q: How important has your marriage been to your career and your life?
A: Fabulous. She’s a common-sense person and a great adviser and always supportive. And there were a few times when there were serious decisions to be made. Whether to go back to Medical School after Dental School was one. Taking this deanship was another. She was a guidance counselor in the Brookline schools for about 30 years, retired 10 years ago, served on more boards than humanly possible. And now is president of our temple, a big one — 1,360 families — including the president of our University.
Q: How did you go from studying chemistry in college to coming up here for dental school?
a: That’s a great question. I was also considering medical school, but I wanted to combine teaching, research, and practice. I met the dean of students here at the Dental School, Howard Oaks, and he convinced me that I could do all of this easier through Harvard School of Dental Medicine. I believed him. He was a very persuasive fellow. We came up here — there were two of us from Brooklyn College who went to Dental School and three who went to the Medical School that year.
Q: Tell me about your dental education. How different was it from what a student gets here now?
a: Well, the Harvard Dental School was the first dental school associated with a university and its medical school. In fact, the whole profession might be different if it had been the very first dental school — I’m very passionate about medical/dental integration. My education at that time was quite different, though philosophically the same. We took every single Medical School course. I took tropical medicine and even took medical boards at the end of my second year, before we came to the Dental School. Now, it’s 14 months together [with the medical students] and, of course, the learning pedagogy is different. But it was a great education. David Weisberger chaired oral surgery and oral medicine at Mass. General and was the chairman of the department here. Weisberger was a very talented teacher. His class was a highlight of Dental School for many. He’d ask one member of the class to go to a cabinet where he had stored all these lantern slides, and he say, “Pick a set.” These were slides of patients he’d seen — and they were unbelievable cases. We’d spend the next hour, hour and a half discussing the case. Amazing experience. In those days, drug companies could give you black bags — I still have my black bag in my closet — and there was a little red book, “How to Take a History and Do a Physical Exam.” I was assigned and went off to see my first patient at the Brigham. Now, there’s a lot of preparation. In 1986, I instituted — along with the Medical School — “Introduction to Medicine,” in which first-year students learn to take a history and do a physical exam. Now it’s entirely different.
Q: So, you took courses at the Medical School for your dental degree and later looped back to HMS for your M.D. Why?
a: When I was a senior, my wife and I discussed whether I should go get my M.D. before pursuing oral and maxillofacial surgery, but Harvard didn’t allow transfers anymore. The Medical School was very strict about closing any back doors in. But Walter Guralnick, the head of the Department of Oral and Maxillofacial Surgery, along with the Medical School and Gerry Austen at Mass. General Hospital, devised a program that would allow dental graduates from Harvard to return to the Medical School as part of the program at the MGH in oral and maxillofacial surgery. The reason for that is, with the M.D., you could do general surgery at a more appropriate level of experience. At that time, the specialty was expanding and you did just a three- or four-month rotation in general surgery. The M.D. program was at least one year, sometimes two. We had great success with that program and, in 1986, with the help of Dan Federman, we extended it to graduates of dental schools other than Harvard. What started as one program here in 1971 is now about 50 around the country. I think it’s really changed the specialty, because it’s practiced by dual-degree people elected to the American College of Surgeons. It really has enhanced the whole specialty.
Q: Do you think that becoming an oral and maxillofacial surgeon enhanced your view that medicine and dentistry are more than just sister disciplines?
a: I think partly that’s it, but the other thing that’s important is having residency training. Almost all of our students do some kind of residency or graduate work, which is something that I believe in.
Q: You were saying earlier that you always wanted a career that combined practice, research, and teaching. How did that come about?
A: I was a resident, and then I worked as a research fellow — Walter Guralnick said I needed to get some good research, and I did. I worked with Hermes Grillo, who was a thoracic surgeon, and Jack Burke, who was a physician. And I studied wound healing for about 20 years. I had a laboratory at the Shriners Burn Institute at the MGH.
Q: Was burn repair connected to dentistry?
A: No, it was just wound healing. We did a lot of wound healing with artificial skins and things of that nature.
Q: Then your research moved to bone graft repair or bone graft survival?
A: I cared for a lot of head and neck cancer patients and in those days, the radiation methods were not kind to bone. There were conditions that led to loss of bone and bone grafts. I did the first of what’s called a microvascular bone graft, where we’d hook up the blood vessels from the bone graft to the patient so that it could survive radiation. Since I was doing microsurgery, I began repairing injured nerves, trigeminal nerves in particular, that were damaged either by trauma or by surgery, unfortunately. And I still see some of those patients.
Q: How has your thinking evolved about dental education and is that reflected in the curriculum here?
A: A lot of dental schools are very heavy on procedures. This School was always different because of its alignment with the Medical School. When I was still a student, I remember people coming to observe the educational system here. The University of Connecticut School of Dental Medicine was modeled after this School in terms of spending the first two years with the medical students and then moving to the Dental School. Reidar Sognnaes, who was a faculty member here in the ’60s, started the dental school at UCLA in Los Angeles, same kind of thing. Physicians learn very little about the mouth. It’s hard to believe, because there are specialties for the eye, for dermatology. But here, we’ve always emphasized the science and we benefited from being together with the basic scientists, the teachers at the Medical School. There was a report in 1926, called the Gies Report, that said dentistry needs to stay integrated with medicine — separate, but integrated. I’m a great believer in that kind of education.
Q: That’s been your message for decades, right? Are you being heard?
A: I think so. I’ve been invited to the Harkin Institute in Iowa to speak on integration of oral health into primary care. And I’ve written on it, so I think I’m being heard.