Why Pathology?

'Why Pathology' was written on March 17th, 2020 when I was a second-year Pathology resident. This post was originally published on ilovepathology.com, a blog hosted by a wonderful teacher and Pathologist, Dr. Vijay Shankar.

Why Pathology?

Well, why not?

If you are a curious med-student considering a life in Pathology or just someone wondering about what it is and what role does a Pathologist plays in patient care, then you, my friend, have stumbled upon the right place. First, let’s talk about what exactly is Pathology? The word in itself translates to the ‘study of diseases’ but essentially, it is a branch of medicine that deals with the cause, the diagnosis, and the effects of the disease, to be precise. Often regarded as the bridge between basic and clinical science, Pathology is a unique amalgamation of life in research, academics, and diagnostics.

Pathologists are rightfully called ‘the detectives’ in the field of medicine because they do much more than just blood tests, which unfortunately is a common misconception among the general population. We diagnose cancer, we grade cancer, and that in turn decides the treatment plan for our patients. We diagnose infections, autoimmune conditions, various allergies, and the list can go on.

There are various sub-specialties within Pathology like hematology, cytology, histopathology, and a Pathologist can choose to specialize in either one of them or can practice as a General Pathologist, a trend we see very often in our country. As a resident, we are required to rotate through each of these sub-specialties, learning how to interpret each and every cell under the microscope, to pick up the essential clues pointing towards specific diagnosis and not to forget, develop procedural skills like doing an FNAC or biopsy when required.

A usual day in a life of a resident specializing in Pathology consists of screening through various biopsy slides, researching about the clinical background, coming up with the differential diagnosis, correlating and substantiating the same. We see Pap smears, study the CSF or look for malignant cells in body fluids. In addition, we examine a tonne of hematology slides, that essentially forms the significant burden of any laboratory for suspected blood-related disorders.

We also get to teach medical students, paramedics, those in nursing, and other allied health science students. We ‘gross’ various specimens that are received in histopathology ranging from a small biopsy to large amputated limbs. We learn how to sample the area that represents the pathology, process these tissues, and monitor their staining in order to finally be able to see them under the microscope.

Like any other specialty, most of the learning happens while at work. Unlike medical school, there is no conventional teaching in residency. You learn by doing, by observing, and by assisting diligently. However, we do have academic programs to assess our learning from time to time, like journal clubs where we learn about current trends, new research, or developments happening in the field of Pathology. We also have biopsy review sessions and slide seminars to keep our progress in check.

It is rather unfortunate that many a time, even medical professionals are unaware of what we do and how we do it. A lot of unappreciation towards our specialty stems from the lack of awareness and more importantly, the lack of communication. Having an open conversation with a Pathologist about the differentials in your mind and what specific tests to order can indeed improve the quality of patient care.

Another beautiful aspect of Pathology is the fact that ‘it’s a very specific science’. There is no shooting in the blind. You see the tissue exactly for what it is. To be able to give some answers to our patients and tell them exactly what’s wrong can be extremely satisfying in my opinion. Even though we never get to meet our patients personally, we know the valuable role we get to play in their lives on a daily day-to-day basis. We despair an unfavorable outcome just as much if not more before signing out something as malignant. We have sleepless nights too when we cannot find a way to reach a conclusion.

It is a common notion that Pathologists lead a very balanced lifestyle and hey, I am not denying that, it’s all about the balance but all that glitters is not gold kind of holds true here. While we do work in a very controlled environment, there is still pressure, a pressure to be accurate, a pressure to be precise, a pressure to know things, all of it, all the time, and don’t get me wrong, we love knowing things. If there’s one trait that the Pathologists worldwide would share, it would be their zest to ‘know things’.

Pathology is truly an amalgamation of it all. It’s interesting but demands hard work, it’s diverse, so much that you never really know what to expect under the microscope but offers a great work-life balance. It’s intellectually stimulating but also serves as a potential medium for modern medicine to integrate with the cutting-edge technology of tomorrow.

So, the bottom line is – • Choose Pathology only if you cannot see yourself doing anything else. Not because you imagine a certain lifestyle for the future. • Do not shy away from having an open conversation with your Pathologist, tell them what are you thinking and why? The goal for both of us is the same, to be able to find an answer for our patients. • Next time, you get a test done, ask who is reporting your sample. Make sure to meet your pathologist and understand your results. • Precision medicine is the key to the future. Integrating the branches like Pathology and Radiology with clinical medicine can help us deliver more personalized care to our patients. • Even though we work from behind the microscope, the assumption that we don’t like to socialize is far from reality. In fact, the majority of Pathologists I have met carry an extremely dynamic personality and are great conversationalists.

Let us not forget what a privilege it is to be able to do what we do and what a pleasure it is to share that with the world! -From the wandering mind of the ‘Pathology resident’

The weather of nostalgia!

The weather of nostalgia was written on 17th September 2017 when I was a PG aspirant. This holds a special place in my heart as it speaks of my struggle and the fire that kept me going. I hope it reminds you too of how capable you are!

Long cold wintery nights, the sound of the fireworks in the background, reminds me of someone I was not,

the painful bearer of my forever lurching dreams, the solo traveler of the deep dark roads leading the way of my nights,

I have not forgotten where I started or how far I have come, and I am forever grateful for these nights which brings a shiver down my spine,

reminding me of just how real it is to live through your dreams, for your dreams, and I wouldn’t have it any other way!

Why am I here?

Rain is pouring down my windowpane as I write this, enjoying my hot cup of tea on this rainy Sunday afternoon. The plan was to launch this website as soon as I am done with my decade long journey in to medicine. When I will finally have some time to breathe, to catch up with life. When I will start building my practice, around the things I am passionate about, things that bring me joy and hopefully be able to add some value and meaning to the life of others in the process.

But what do you know? We are amidst the Pandemic of the millennium. The exams are being postponed. The healthcare system is breaking down. The world has literally stopped turning and so I thought why wait? This is something I have been meaning to do a long time, to be able to connect with more like-minded individuals, to build a supportive community and to gravitate personal growth. More than anything else I know it will help me to just keep GOING.

So here I am. Sharing with you, the purpose of this blog, what am I looking to achieve through this? Why am I here? And of course, feel free to join me along if any of our interests match! I would love for us to connect, have long conversations over coffee, become friends, and more importantly, be able to enrich each other's life. Here are some of my 'whys':

• I love writing. I do. I truly and wholeheartedly love it. I used to journal my entire high school. I have then since written many articles, stories, blog posts, and so on. But all of my work is segregated and it's everywhere. I just want to compile everything and document important ones here. So you may find my dear diary moments, my everyday musings, travel stories, recipes, and the midnight writer's extraordinaire here and there.

• As a soon-to-be Pathologist, I feel like it's my responsibility to share more about my profession. There is so much medical misinformation online and instead of just adding on to the noise, I want to be able to engage my audience in a safe space that allows for asking questions and have healthy discussions.

• I want to be able to break myths around Pathology. Do you know what we do? What is Pathology? If not, then stay tuned. It is a fascinating world of medicine. Much like detective work.

• I believe in education. To advocate for my patients. To advocate for me. I believe in education to empower those around me. And what better way to do that than this? This is my way of bringing everything I have learned over the years into digestible bits so as to empower you with knowledge and hopefully, help you make an informed decision, around your own health.

• Last but not the least, I want to be able to showcase a side of me that not just a doctor. I am a daughter, a wife, a friend, someone who is constantly striving to do better, to become better, and is definitely, a work in progress.

If any of the things I said interests you, come and say hi. Until next time!