- Many patients are still unaware of what a pathologist is, much less the vital role they play in patient care
- Inspired by an artist and sarcoma patient, a book of art by pathologists and patients, hopes to bring the two groups together
- “The Healing Art of Pathology” features paintings, sculptures, drawings, essays and more by people on both sides of the microscope
- The editors hope the collection will contribute to pathology awareness, and give patients and pathologists some common ground for communication
There’s no one better placed than a pathologist to understand the connection between art and medicine. From those who find the hidden humor in histopathology to those who see the beauty in bacteria, it’s clear that the people behind the microscope have an eye for the unusual and the visually fascinating. But it’s not just the professionals who see it – the patients do, too. And when Ray Paul, an artist and sarcoma patient at Moffitt Cancer Center, wanted to see what his tumor actually looked like – to “stare his devil in the eye” – it was his pathologist, Marilyn Bui, who viewed it with him and later sent him digital images to enlarge and use as a canvas for his art. This unusual collaboration led to a better understanding of his disease for Paul, a better understanding of her patient for Bui, and a deeper connection between pathologist and patient. Now, along with College of American Pathologists publications committee chair Katherine Galagan, Bui has turned that experience and others into a book. “The Healing Art of Pathology” features artwork and essays about pathology from the perspectives of both doctors and patients – something both editors hope will give each side insight into the other, igniting communication and collaboration. Bui and Galagan discussed the project and its potential with The Pathologist...
Should pathologists interact more with patients?
KG: Definitely! Not only do we have a lot to offer patients – a unique perspective on their disease without the heavy overlays of treatment options, symptoms, and so on – but we also have a lot to learn from them. If we are insulated from their concerns and misunderstandings, we can’t ensure that their questions are answered from the pathology point of view. Although in many cases the primary care physician serves as the intermediary, the depth of that doctor’s understanding of the pathologic process is necessarily more limited than that of the pathologist who’s actually studying the tumor or disease. For some patients, like Ray Paul (see Sidebar, “More Than a Cluster of Cells”) visualizing their disease can be an important step in understanding and fighting it. In addition, their questions may create new insights and suggest new avenues of study for us. MB: Absolutely yes! I’m a cytopathologist. Performing fine needle aspiration biopsies at my patients’ bedsides has always been a rewarding experience. By directly communicating with patients and the clinicians while examining fresh tissue samples in real time, cytopathologists play a critical role in patient care. Many patients are wowed by the microscope, my portable “lab,” which reminds them of their high school science classes; others are impressed by the immediate diagnoses we render. Most of us became physicians because we like to help people – and once you meet the patient, you’re no longer just “signing out a case,” but helping a real person. You’re more willing to go the extra mile, so the patient gets our best efforts.
The CAP (College of American Pathologists) Foundation has a signature program called See, Test & Treat (http://foundation.cap.org/get-involved/see-test-treat-program/). Created and led by pathologists, the program directly benefits underserved patients by providing them with breast and cervical cancer screening, education, and a connection to health care. My home institution, the Moffitt Cancer Center, has a Mole Patrol program (https://moffitt.org/molepatrol) that promotes sun safety and provides free skin cancer screening to the public. Its medical director for the past two decades has been a fellow pathologist, who has led the program to great success – screening over 15,000 people. Quite a few pathologists I know volunteer at local and national patient education events on topics like cancer, heart health, or infectious disease. Most of us agree that interacting with patients reinforces why we became doctors and gives us the opportunity to learn from and be inspired by them.
How my pathologist helped me regain my confidence and self-worth, and confront my cancer By Ray Paul
I am a 53-year-old artist, musician and science enthusiast with a Bachelor’s degree in biology and a Master’s in painting. I am also a sarcoma survivor. I first noticed a rapidly enlarging lump protruding from my left flank in the spring of 2011. A urologist friend of mine agreed to remove it in his office, believing it to be a lipoma, but he quickly realized it was something more sinister. Marilyn Bui at Moffitt Cancer Center confirmed a diagnosis of high-grade myxofibrosarcoma, for which my primary oncologist gave me a prognosis of “better than a coin flip.” Since then, I’ve had metastases and recurrences, repeated resections, chemotherapy, and several rounds of radiation therapy including participation in a clinical trial for high-risk soft tissue sarcomas (1) – and follow-up is still ongoing. Before my experience, I had been aware of the pathologist’s vital role in diagnosis and was able to read pathology reports, but I’d had no direct interactions with my own pathologists. In 2013, when my cancer returned for the third time, I was at my lowest point – physically, emotionally and spiritually. I had abandoned my art and was simply going through the motions of life. A concerned friend suggested I find a way to combine my artwork and cancer. Together, he and I came up with the idea of having images of my cancer cells printed onto canvas, serving as a substrate for my painterly expression. Marilyn graciously invited me to her lab to view my pathology slides and provided me with digital images of the tumor histology. The resulting paintings were exhibited in The Healing Arts Gallery at Moffitt Cancer Center in 2014 and also appear in “The Healing Art of Pathology.” Why did this matter so much to me? I envision my art to be a persistent, visual manifestation of the battle raging within, and a powerful testament to the beauty and healing powers of hope. It was cathartic and inspirational for me to be able to attack my cancer directly, through the act of frenetically and meticulously painting over the printed images of my cancer cells. The importance of this interaction with my pathologist can’t be overstated. Marilyn stepped out of the shadows of the lab, put a face to pathology’s mysterious workings, and made me realize that pathologists are an integral part of the patient care team. My interaction with her helped me regain my confidence and self-worth by directly confronting my cancer through art and collaboration. It helped me, a devastated cancer patient, return to life as a productive artist. And it gave me a major boost of confidence to know that such brilliant and dedicated professionals cared about me as a person – that I was more than just a cluster of cells gone haywire. Healthcare services should never discourage contact between pathologists and patients. That would deny the patient the emotional, psychological and spiritual benefits of direct interaction – and for me, at least, that relationship has been invaluable. To other patients, I would say: educate yourselves on the vital role of pathology and pathologists. Know that they are an integral part of the team fighting for you. Go to the lab, view the histological slides, and get to know your own pathologists. You will find, as I have, that they are caring human beings, dedicated to helping the patient win the battle and hopefully, one day, finding a cure.
Reference 1. ClinicalTrials.gov, “Radiation therapy and intratumoral autologous dendritic cells in soft tissue sarcomas (STS)”, (2016). Available at: http://bit.ly/2dBfyWi. Accessed October 2, 2016.
Marilyn Bui is a Senior Member of the Department of Anatomic Pathology & Sarcoma, Section Head of Bone and Soft Tissue Pathology, and Scientific Director of the Analytic Microscopy Core at Moffitt Cancer Center. She is also a Professor and Director of the Cytopathology Fellowship Program at the University of South Florida Morsani College of Medicine Tampa, USA. Katherine Galagan is an Anatomic and Clinical Pathologist, with subspecialty boards in Cytopathology. Prior to retirement, she was Chief of Pathology and Director of Clinical Laboratories at Virginia Mason Medical Center in Seattle, USA, and has volunteered in various roles for the College of American Pathologists. “The Healing Art of Pathology” can be ordered at www.cap.org or by calling the College of American Pathologists at +1 800-323-4040 (option 1, request PUB315). Purchasing this book will support pathologists and royalties from the book will be donated to the CAP Foundation, to support their patient advocacy efforts, such as See, Test and Treat.
Newsletters
Receive the latest pathology news, personalities, education, and career development – weekly to your inbox.
