What advice would you give to your younger self, at the beginning of your pathology career?
Probably not saying yes to absolutely everything – which is exactly what I did early in my career. When you’re starting out, being invited to give a lecture or visit an institution feels like a big deal. It’s flattering, and I said yes to all of it.
That meant a lot of travel – often to places that were difficult to get to – and then rushing back home. I had young children at the time and, in hindsight, I regret how much I traveled and what I took on. It may have been good for my career, but I’m not sure that it was worth the personal cost.
I think I could have been more selective. And that applies more broadly, not just to travel. You have to be thoughtful about what you agree to do and weigh the cost–benefit of each opportunity.
What other things might you have said "no" to, on reflection?
Anytime a collaborator at the Cleveland Clinic approached me about a research project, I said yes. In many cases, I had a sense that some of those projects probably wouldn’t go anywhere, but I agreed anyway. Looking back, I likely spent time on things that didn’t yield much, simply because I found it difficult to say no.
In retrospect, it would have been helpful to run those opportunities by someone more senior – to ask, “Is this worth my time?” – and get some guidance. That kind of perspective could have saved me from pursuing projects that weren’t likely to be productive. But I didn’t really have that person.
I was one of the first new hires in the department in many years, so I was surrounded by very senior colleagues. While they were excellent physicians and colleagues, there wasn’t a strong culture of mentorship or career guidance. As a result, I largely had to navigate those decisions on my own and figure things out as I went along.
How did you approach work–life balance early in your career, and how has that shaped your perspective as a leader?
My father was a physician and a workaholic – he was excellent at what he did, but he was always working. I knew I wanted to find a different way to operate.
When I started my first job, I made a conscious decision that I wasn’t going to be the kind of person who stayed at work until nine o’clock every night and never saw my kids. That meant I had to become very efficient and learn how to multitask. I worked extremely hard during the day so I could leave by five o’clock – which I did then, and still do now. I don’t have any regrets about that.
At the time, though, it wasn’t exactly encouraged. The culture I was in – working with a group of more senior physicians – was very much about being physically present all the time. In fact, during my first annual review, I was criticized for leaving “early.” I pushed back and asked, “Am I doing my work? Am I publishing, lecturing, meeting expectations?” And the answer was yes.
That experience shaped how I lead now. I have a large department with many early-career pathologists who are in the same stage of life I was in, with young families. I tell them very directly: you cannot become a slave to your job. If you do, you’ll burn out, become frustrated, and eventually leave. It’s not sustainable.
Maintaining that balance does come with trade-offs. I was very task-oriented – moving from one responsibility to the next, often without taking time to socialize. I missed out on things like lunches or coffee with colleagues, even though I’m naturally a social person. But it was a deliberate choice, and it worked for me.
Which technology advancement made the biggest difference to your work?
I practice both gastrointestinal (GI) and soft tissue pathology, and the impact of molecular testing has been very different between the two. In soft tissue pathology, the field has changed dramatically over the past decade. Ten years ago, we didn’t really have access to molecular testing; now it’s central to what we do. It plays a critical role in diagnosis, prognosis, and guiding therapy.
The challenge is that it’s evolving incredibly quickly – honestly, faster than I can keep up with, even when I’m paying close attention. But there’s no question that if you’re practicing soft tissue pathology in a setting without access to molecular testing, you’re at a real disadvantage.
By contrast, GI pathology hasn’t changed nearly as much over the course of my career. For the most part, the fundamentals have remained the same. But in soft tissue pathology especially, molecular diagnostics have truly transformed the field.
Is there a particular project or publication that has had a defining impact on your career?
You’re not really supposed to pick a favorite child – but if I had to, the publication that had the biggest impact on my career was Enzinger and Weiss’s Soft Tissue Tumors. My mentor, Sharon Weiss, approached me about it when I was only about four years out of fellowship.
I still remember the moment clearly. She tracked me down at a conference and kept saying she wanted to talk to me. I was convinced I had done something wrong. Instead, she told me that Dr. Enzinger no longer wanted to continue with the book and asked if I would take it on with her. I was honestly surprised – I thought, “I’m still pretty junior, why would you want me to do this?” But she said she trusted me and believed I would do a good job.
My instinct was that I should probably say no – it felt like far too big an undertaking at that stage of my career. But I said yes. It ended up taking three or four years of very intense work, and it was a huge commitment, especially since it was my first experience with something of that scale. At times, it really felt all-consuming.
But in the end, it was absolutely worth it. When the book was published, it was an enormous source of pride for me, and it had a major impact on my career. So if I had to choose, that would be the one.
What role has your involvement with professional organizations, such as the United States and Canadian Academy of Pathology (USCAP), played in your career?
My involvement with USCAP has been incredibly important for my career. But the most meaningful aspect hasn’t been any single course or educational experience – it’s been the people. The interpersonal connections you make through the organization are extraordinary. Even just attending the annual meeting, you meet remarkable individuals, but getting involved at the committee level takes that to another level. Many of those colleagues have become close friends over the years.
In fact, when I eventually think about retiring, that’s what I’ll remember most. Not the lectures I gave or the specific things I learned, but the relationships I built with people who are truly exceptional.
From a career development standpoint, USCAP also opened up a tremendous number of opportunities for me. It’s a phenomenal organization. I spent 14 years on the Education Committee, which is essentially responsible for planning the annual meeting – longer than anyone else had served. I also chaired the committee for eight years during a period of transition within the organization, when there was a need for continuity and stability.
I loved every minute of that work. USCAP is extremely well run, and it aligns closely with the values that matter most to me – education, mentorship, and collaboration. That’s what the organization fosters, and that’s what has made it such a rewarding part of my career.
What is your biggest motivator in your work today?
I still enjoy practicing surgical pathology, but what really keeps me engaged is the people I work with. I’ve hired every member of my team, and I’ve always been intentional about bringing in individuals I genuinely enjoy interacting with – people I’d want to talk to, collaborate with, and spend time with.
That makes a huge difference. I have a lot of fun with my colleagues, and that’s not an exaggeration. They’re what make the work environment so rewarding.
At the same time, I’m responsible for managing a large group – about 110 people – so there’s always something going on. It’s never boring. There are inevitably challenges that come with leading a group of that size, but that’s part of what keeps the job interesting. It’s still very much a challenge, and I enjoy that.
Would you say you enjoy management as much as you do science?
I do – but I’m not sure I always felt that way. It’s something I had to grow into. I took on this leadership role relatively early, about 8 years into my career, and at the time I didn’t really know what I was doing. Over the years, though, I’ve come to understand how important the role is. You may not always get overt recognition for it, but the work is essential – and that realization has made it much more rewarding.
You spend a significant portion of your day with your colleagues – they really do become a second family. So it matters that you like and respect the people you work with.
What would you be if you weren't a pathologist?
I think I would have ended up in film in some capacity. I’ve always had a real interest in movies and television – my family jokes that we’re all movie nerds. We’re constantly quizzing each other on actors, directors, who wrote what. That’s something my kids definitely picked up from me. In fact, two of them have gone into film – one is in Los Angeles working in the industry, and another studied documentary filmmaking and may eventually head there as well.
The other path I’ve thought about – especially looking ahead to retirement – is teaching. When I was younger, I did a lot of teaching and coaching, and I’ve wondered whether I might go back to that, maybe even at the elementary school level. It would be a very different pace, but it’s something I find appealing. I think I’d enjoy it. Whether I actually do it... well, that will depend on how I feel when the time comes.
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