From my childhood days, I am fond of investigating and solving problems. I am also known for searching and finding lost things. The reputation is such that if any object is not found at home, I am called and fortunately I always end-up finding that. Any change from routine is picked-up by me instantly. In fact, my mom used to enjoy preparing snacks secretly, and observing me pick it up as soon as I was back home from school, by smell. I owe part of this to my dog, “Jackie” who was my partner in crime. Looking back at all this, I feel I have chosen the right branch of medicine.
Being a pathologist is no different from being a detective. Our branch revolves around solving problems. Every slide is a problem, and every case is unique.
Every case has something new to teach us. That’s the beauty of Pathology which can never get boring or monotonous.
Just like nuclear moulding observed in small cell carcinoma, we are moulding ourselves between the patient and clinician to arrive at a proper diagnosis. And that’s the beauty of a Pathologist.
Subtle changes, at the microscopic levels, act as clues that help detectives in investigations. Criteria, reporting systems, if present, we are in a better position. Else there is something or I can say “someone” popularly known as “gut feeling” which is a very loyal friend of any pathologist, I firmly believe. Probably detectives also believe this friend.
A Detective has his team, informers, and students. Similarly, Pathologists have their team too, comprising of peer, postgraduate students, technicians, lab personnel, etc. Each member of the team has an important task to perform in the investigation and arriving at a correct diagnosis. Teamwork can be compared to a “granuloma” with different cell types, all working together for a common cause and that’s “right diagnosis”.
Detectives have their ways of investigating, their methods, and their own tricks in evaluation and finding the criminal. We pathologists, have our approaches, our methods, and our own tricks in evaluating a slide or arriving at diagnosis.
Detectives take help of special forces and special agents as and when required. Pathologists ask for special stains, serial sections, deeper sections, immunos, and the list goes on. Detectives as well as Pathologists refer books and articles, take opinions from peer, while investigating and reporting respectively.
Detectives have no fixed working hours. Similarly, Pathologists too have no fixed working hours. Though we may not take slides or microscope home, we do refer for cases when at home, and keep thinking about it until it is reported. If reporting a cytology case, sometimes, we even keep thinking about the case till histopathology is available and found correlating.
With small piece of information, detectives must go about investigations. This is comparable to Pathologists reporting on small biopsies and cytology smears. This exercise requires lot of additional information for both.
Detectives face challenges by criminal disguises and look-alikes. Pathologists face challenges with variants of tumours and masquerades. A notable and notorious masquerader is malignant melanoma and we put it under the differential diagnoses for any malignant tumour.
Detectives investigate the crime scene for clues. We Pathologists do a gross examination and document all the findings for clues and diagnostic information. Our diagnosis is never complete without a proper gross examination in histopathology or clinical examination and characteristics of the aspirate in cytology.
Pathology revolves around solving problems. Every slide is a problem, and every case is unique. Every case has something new to teach us. That’s the beauty of Pathology which can never get boring or monotonous.
Another mystery is awaiting you. On your mark, get set, go!!!
Kudos to Path-detectives!
Dr Archana Bhat
Assistant Professor
Dept of Pathology
Father Muller Medical College
Mangalore
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