Updated: Mar 10, 2019
It takes a lot to impress a cynical med student, but that's what the pathologist did.
I heard from her at the end of an 'M&M' conference (Morbidity and Mortality). These are large lectures, attended by multiple medical specialty departments in a teaching hospital where a recent patient with complex medical care is presented. We had heard from radiology, oncology, infectious disease and surgery. But after all the presentations, the false starts and dead ends, the pathologist provided the answer. All the hypotheses about the patient's condition and the tests to prove them were evaluated by the pathologist. She had seen the cells and made the call; she ended the guessing. Now the treatment team knew the cause of the patient’s problem and could explain it. That, I decided right then and there, is what I wanted to do. The power of the pathologist’s interpretation was exciting and highly motivating. She was the definitive expert.
I'm a pathologist now. Pathologists go to medical school yet we don’t interact with patients. We are called by some the ‘Doctor’s Doctor', because we talk to your doctor - not you. Consider this blog a direct connection. As a master observer, I want to share my perspective and my knowledge - greasy, granular and fascinating - directly with you.
My stories start from the opposite end of most medical tales. But what may appear backwards is actually the true understanding of disease. If you've had a biopsy, an aspiration, or a scraping it's been seen by a pathologist. All day we diagnose disease, making decisions that affect you and your loved ones. We see your cells, and make the call – do you have cancer or not? And when it’s not cancer, we diagnose that too. Dermatitis, hepatitis, appendicitis… we’re trained to diagnose any condition that arises in the body. Your biopsy is the start of my story and I usually just share the ending.
This blog is not here to teach you pathology. There are many sites and textbooks for that. Nor am I able to interpret your pathology results, although hopefully by sharing my approach and terminology you can better interpret the information you receive from your doctor.
What I want to share is deeper even than the disease process. How I became the expert involved not just learning medical information, but also learning how to evaluate visual information. I have been immersed in learning a visual language and acting upon it. The same skills I have learned can be shared with those who are not pathologists.
In world less reliant on text and words, most of us are not trained to evaluate images. But I have been. How I have been trained to see our bodies has equipped me with observational skills I use in my life. I think that you can use these same skills.
You're the expert in your own life. Whether you're an oncologist or an art student, my observations will provide you with new perspectives. You can learn how to avoid cognitive pitfalls, improve your visual literacy and approach decisions with a mindful mindset -- all while learning more about biology, disease and diagnosis.