Landing the Lead Role... in Pathology

How did you first get into pathology?

I didn’t know that pathology existed until I went to medical school. I wanted to be an actress, but my parents said that my choice was not realistic (too short? glasses too thick? use too many swear words?). Instead, I went to university and studied chemistry! Medical school followed naturally; my plan was to study obstetrics and gynecology – but then we reached the pathology course and it was love at first slide. Even though I considered the first-year normal histology course to be the stupidest thing I had ever encountered, I couldn’t stay away. Steve Silverberg, one of the faculty members at my medical school, made pathology look cool and fun… (I had to go back and figure out histology. Oops.)

Steve was a real inspiration to me in medical school. Because I joined the military to pay for my education, my residency was in uniform at Walter Reed Army Medical Center in Bethesda. At the time, the Armed Forces Institute of Pathology (AFIP) was still in its glory days and right next to Walter Reed, so I had the great honor of learning from wonderful morphologists, including Tanya Tavassoli, Dennis Heffner, Glauco Frizzera, and many others.

What led you to gastrointestinal and soft tissue pathology?

As a resident, I loved soft tissue pathology very much. I had the privilege of working with Sharon Weiss for a little while as she transitioned to the University of Michigan. I also loved the time I spent working with the orthopedic surgeons at Walter Reed. Upon graduating from my residency, and after being sent to an Army community hospital for a time, I was ultimately assigned to the AFIP soft tissue branch and had the opportunity to work alongside Jeanne Meis and Franz Enzinger, who were both spectacular morphologists. It was a fantastic experience.

When I left the Army, I took a job at Georgetown University. They wanted a gastrointestinal pathologist, so I began educating myself. Although I had done some projects on Campylobacter pylori (now termed Helicobacter pylori) as a Walter Reed resident, in collaboration with my gastroenterology colleagues, there was still a lot to learn! It was a bit of a challenging process, but I eventually caught on. Because of that experience, I ended up moving to Johns Hopkins in 1999, where I have remained ever since.

What are you most proud of in your career?

I am not a “hot stuff” scientist, but I do feel proud of the fact that I have been able to help with the success of many former fellows – some of whom are “hot stuff” scientists! I am also very proud of having written the original descriptions of a few entities in surgical pathology, and of a small body of textbooks that I hope are of value to my colleagues.

Of the 15 textbooks I have authored, my favorites are the biopsy interpretation books in the Wolters Kluwer Biopsy Interpretation Series. The gastrointestinal pathology one was updated to its third edition not long ago – a big effort, because each textbook not only has images in its main text, but also includes a large cache of online images and quizzes. I was also recently appointed Editor in Chief for the fifth edition of the renowned AFIP Atlases of the American Registry of Pathology – the “tumor fascicles” series. My colleagues and I are really excited about the fifth series as we wrap up the fourth (the Intestines fascicle, to which I was a contributor, was released in late 2017). We have been doing a lot of preliminary work to take advantage of new technologies and digital options for the new series, which will have online content, including virtual slide boxes!

In addition to working on pathology texts, I also enjoy giving invited seminars. Over the course of 2017, I had the opportunity to give about 50 individual presentations in 18 different venues. It’s fun to travel around the world and meet colleagues in a variety of different places. One of my favorite organizations to work with is the Sociedad Latinoamericana de Patología; I have been learning Spanish over the past few years, so I enjoy giving lectures in my (still imperfect) Spanish.

My favorite activity of all, though, is looking at my daily consultation cases with our fellows. Colleagues in the trenches share the most amazing lesions and do such a wonderful job that it is a real pleasure to see these “curated” cases.

If you were not a pathologist, what would you have been?

An actress, which probably means a waitress. Maybe I could have found an expensive restaurant with great tips…

With so many challenges and responsibilities, how do you manage everything?

I just twinkle my nose and it all gets done, of course!