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Award-winning anatomist inspires learning

June 26, 2008

“What do hippopotami and medical students have in common?”

Rebecca Fisher makes you want to ask questions. Not just about why there is the huge hippo skull on her desk or what the stuffed raccoon-like creature above her keyboard is, but deeper queries about species evolution and how one short career can span the study of large semi-aquatic animals closely related to whales (yes, whales) to empowering future physicians.

Fisher is an assistant professor in Arizona State University’s School of Life Sciences and the department of Basic Medical Sciences at the University of Arizona College of Medicine-Phoenix in partnership with Arizona State University.

It is Fisher’s out-of-the box scholarship, as well as her creative course development and teaching of anatomy, which garnered her the coveted Basmajian Award from the American Association of Anatomists; an award that recognizes exceptional health science faculty who are in the formative stages of their career.

Fisher teaches two anatomy courses at the College of Medicine-Phoenix. According to her, most medical school anatomy courses are fairly encyclopedic, presenting “a lot of detail without necessarily a lot of clinical correlations.” In addition, the hours dedicated to anatomy courses have declined dramatically in recent years. So when offered the challenge of developing her own anatomy course for first-year medical students, Fisher took a fresh approach. She rooted her class entirely in clinical practice, rejected the traditional stand-alone lectures, and decided to hold all sessions in the lab.

“When I was designing this course I asked, ‘is this relevant to the practice of medicine or laying the foundation for the practice of medicine?’ Fisher also considered where she had learned best and what she had enjoyed most when she took anatomy classes as a graduate student at Yale.

“Anatomy lectures are good for learning terminology, but the light bulb never really goes on until you go into the lab,” she says.

So Fisher’s course is entirely based in the lab, with plasma screens next to the cadaver tables: “The idea was when they were learning about the anatomy, they could look at the cadaver, real time. There wasn’t that delay between the lecture and the lab setting.”

Fisher describes her mixed modality lab-based teaching as “a guided tour in the lab.”

“We often had little exercises, where I would ask, ‘if your patient has X- clinical condition, which procedure would you recommend? Simulate that on the cadaver.’ They’d argue amongst themselves, give me an explanation, a foundation for a procedure and doing it a certain way,” says Fisher. “They could see; this is why I’m learning anatomy and basic science and why it is relevant.”

It was this hands-on, clinically oriented, entirely lab-based study that grabbed the attention of the Basmajian Award committee, along with her incorporation of active and retired clinicians in the labs. Fisher invited specialists who were tied to whatever body region she and her students were studying, so students could then ask an experienced practitioner questions pertinent to that body region.

Fisher’s colleague, Kenro Kusumi, who co-teaches a musculo-skeletal class with her, believes that "true to the spirit of creating a new medical campus in Phoenix, Rebecca has created a dynamic and interactive clinical anatomy course lauded by the inaugural class of medical students and faculty who had the pleasure of participating or observing the class."

Agreeing is Stuart Flynn, associate dean of academic affairs and professor at the UA College of Medicine-Phoenix in partnership with ASU.

“Fisher’s work is truly pioneering and sets an example for others to follow,” says Flynn.

Fisher’s research has also captured attention in other ways. Some of the special delivery packages Fisher receives border on the macabre; gory, but highly instructive remnants of carnivores and artiodactyls (even-toed ungulates, like deer) that died of natural causes in zoos. She dissects out, literally, answers to evolutionary puzzles haunting their history and relationships within the mammalian family tree.

Fisher examines modern mammals’ muscles and constructs maps that document their attachments to bones. She then compares these modern muscle maps to correlates in fossil species. She has worked up muscle maps for common and pygmy hippos, sun bears, red pandas (a carnivore that is an herbivore, with a pseudo-thumb, but unrelated to giant pandas), and binturongs (a carnivore with a prehensile tail).

What seems like a strange assortment of unrelated mammalian species with enigmatic evolutionary histories do in fact have connectivity for Fisher:

“Not many people work on such disparate groups of mammals, but to me they seem very similar, in terms of the hypothesis and the theoretical framework of the question. I like working on animals with unresolved phylogenies,” Fisher notes. “I also enjoy working on functional anatomy, particularly adaptations to different behaviors as reflected in the musculoskeletal system. That is the common thread.”

Hippos have been a passion since she was a graduate student studying primate anatomy. She worked with Andrew P. Hill, a professor of anthropology at Yale, and curator of anthropology in the Peabody Museum. On their first field trip to Kenya, she discovered not only a passion to do field work, but was also unexpectedly drawn to hippos and the questions that surround their prehistory.

“I still remember my first night at camp and seeing my first hippopotamus. Common hippos are huge, fascinating looking creatures, like a sausage with legs. We’d camp by a lake and in the evening, they’d come up onto the land and feed at dusk and on into the night.

“I started picking up hippo fossils when we’d go out, prospecting for them while everyone else looked for primates,” Fisher muses. “I guess what struck me most was how understudied hippos are. Sure, they are in zoos and popular with the public. However, in terms of their anatomy and their evolution, there wasn’t a lot of research going on.”

She adds, “That was a very exciting thought as a graduate student.” Fisher makes hippos seem convincingly attractive. Semi-aquatic sausages with legs they might be, but by some accounts they also kill more people than any other mammal in Africa, are related to ancient whales, and lack sweat glands, Hippos also are a keystone species, which means that while they are fascinating and peculiar creatures, they are also crucial to the sustainability of their environments.

“Hippos create their own little ecosystems,” she notes. “And they poop a lot.”

What National Geographic correspondent and scientist Brady Barr termed their “explosive fecal discharge” provides a food source for a plethora of species. There are also different types of birds and fish that feed off the parasites of hippos and clean their wounds. “Without hippos, lakes become stagnant. The food source is gone,” Fisher notes.

Hippos are also instrumental in the physical movement of lake and riverbed sediments and establishing healthy aquatic water systems, according to Fisher. “I had never thought about how these large mammals affected their environments in these fundamental ways.”

It was her move to the College of Medicine-Phoenix in 2006 that allowed Fisher to bring all of her passions together and maximize her own footprint, from hippos and basic research in evolution, to mentoring ASU undergraduates, to teaching anatomy to medical students.

“I realized early on in graduate school that I really wanted to teach med students; that I wanted to make a contribution that was palpable, not esoteric. Training people to save lives is very rewarding to me. But it can be hard to fit in at most biomedical institutions with my other interests in mammals.”

Being associated with a new college is “really exciting,” Fisher says.

Some 31 faculty members form the backbone of the College of Medicine-Phoenix. Fisher is one of 10 from ASU’s College of Liberal Arts and Sciences; seven of whom have appointments in ASU’s School of Life Sciences. Fisher is also a research associate in the Division of Mammals at the National Museum of Natural History, Smithsonian Institution.

As an anthropology undergraduate, turned paleoanthropology doctoral student, turned functional anatomy post-doctoral fellow and finally, assistant professor of anatomy, Fisher offers this advice to students who are trying to find their path: “The number one thing is discovering what gets you excited. Be a sponge and try as many different disciplines as possible.”