Mother of Ambition

What attracted you to liver pathology?

I’ve always had a great interest in research; I was intrigued by what was happening in tissues and cells, and pathology allows you to see it all. I put my interest in liver pathology down to coincidence. During my first year of training, I was working on a liver biopsy when I came across some unusual cells alongside a liver tumor that had never been published before. They turned out to be neuroendocrine features of bile ductules. Although accidental, this was a very important discovery; I had shown special characteristics of potential stem cells in the human liver. My research was published in the American Journal of Pathology and I decided to start a PhD thereafter.

You then focused on the role of stem cells in liver cancer formation...

Right. I also studied their role in liver regeneration. It was during a period when there was a lot of hype around stem cells, but convincing people that they existed in the human liver was not easy – no one believed it at first. Some years later, I led a consensus panel on a standardized classification of liver stem cells, and later another to develop a standardized classification of pre-malignant lesions with rationalized nomenclature. This was challenging, in particular because tumor classification criteria were quite different between the Far East and the West, and the threshold for tumor resection in the Far East was much lower. Reaching a consensus was a major achievement.

How do you approach management of imaging and pathology under one umbrella?

Close interaction is the key to its success. For example, directly comparing pathology analyses with radiology images of tumors allows us to provide a more accurate diagnosis – and it supports research, too. Furthermore, pathology and radiology are service-driven professions; it’s so important that we speak up and defend our disciplines because we can easily be out-voiced by clinicians who feel their opinions are more important than those who “just look down a microscope.”

I plan to encourage more collaboration in my new role, hopefully by incorporating other imaging departments, including animal imaging. It’s really important for pathologists to recognize that they are at the interface of basic research and clinical application – translational research is a key role for us.

How can pathologists keep up with the many advances?

It’s impossible to follow it all. I see a big role for academic centers that are capable of super-specializing in one organ. In our institute, we have clusters of organ specialist groups and we have an obligation to pathologists and clinicians to attend conferences and educate them in the diagnostic developments in those particular organs. An advantage that we have as pathology educators is that, compared with clinicians, we are less dependent on industry, which I think is important, especially when it comes to the integrity of our research and the interpretation of results.

You are mayor of your hometown, you have a working farm, and you’ve raised three children – how do you do it?

Many women do it – it’s basically down to good time management. Admittedly, pathology is a good career for those women who want to combine it with motherhood, as you can work effectively from home. I’m the type of person who always likes to take on numerous responsibilities. In my tenures on the committees of the European Association for the Study of the Liver, and the European Gastroenterology Federation, I often had to travel in Europe and overseas for meetings. I served on those boards for the maximum term, and when that was over I thought, “I’ve got some spare time now,” so I put myself forward as a candidate for mayor and I was elected. It’s very rewarding to be able to accomplish projects – like building new schools or integrating heritage into housing projects – in your own local environment.

Is gender inequality still an issue for women in science?

Absolutely! It’s a big problem; we have to work much harder than our male colleagues to prove ourselves. You really have to be committed to your job and I don’t think that women who have families want to travel quite as much as I did. But if you like your job, you can do it!

I managed my work/life priorities by taking my children to every overseas meeting that I attended. When I was working in the country, I had home-based childcare initially, and I would coordinate any late night working with my husband. It wasn’t always easy, but having a supportive partner helps.

How can the inequality gap be narrowed?

The more women we have in senior positions, the more likely it is that certain common working practices will change to support a good work/life balance. Women are still in the minority though, especially in academia. I would like to encourage our younger female colleagues to aim high. My top piece of advice is: don’t labor over the consequences of having a good profession and a family. If you think about it too much, you will never push yourself to have both. Just go for it and you’ll find solutions as you go.