Pathways of Expression: Pathology and Prose

Research and creative writing are not often bedfellows, but the “Humanities in Neurology” section of the journal Neurology has been offering up a platform for scientists to wet their writing whistles.

One such scientist is Kimberly Fiock, whose recent article The Slides I Carry provides an intimately honest look into the trials and tribulations of a pathologist (1). In a world where many in medicine are seeking to explore the emotional baggage associated with the profession, Fiock’s article seems like the beginning of a possible trend in pathology. We caught up with Fiock to chat about the piece, as well as her popularity on Instagram.

Could you introduce yourself?
 

My name is Kimberly Fiock. I graduated with my PhD in April, and I’m now a staff scientist – essentially an independent researcher – working under a principal investigator who helps to oversee my research by providing grant funding. I do all of the independent work; I also direct a resource laboratory called the Iowa Neuropathology Resource Laboratory, which provides investigators with access to donated human brain tissue, histology services, and neuropathology education.

So, I wear a lot of hats. My research interests are in neurodegenerative diseases, specifically those caused by the tau protein. My research tries to understand why one protein causes multiple different diseases with distinct symptoms, distinct presentations, and even different cell types in the brain.

How did you get started in writing?

I've been writing creatively for as long as I can remember. In second grade, my teacher entered something that I had written in class into a contest and I won. But I just wrote pieces as they came to me, entered a couple of contests, took a class in college, things like that.

For a long time I didn’t do anything else with it because I was so focused on science. You’re told that you can’t do anything creative in order to be a good scientist, so that’s what I did.  But after my grandma died last year, it sparked something in me, and the words poured out onto the page.

What was the publishing process like compared to a typical research paper?

Neurology has a “Humanities in Neurology” section, where they focus on publishing creative pieces about the experience of neurology professionals – be they researchers, clinicians, or patients. I submitted a piece to them last year, which didn't get published. In hindsight, I'm actually grateful for that, because I'm much prouder of my article, The Slides I Carry, and feel like it’s a great fit.

The process is basically like any other peer review – you send the paper to an editor, the editor sends it to reviewers who provide feedback, and then you're asked to either submit revisions, or the paper is rejected. I got a great set of revisions, and thankfully, they accepted the piece. It’s very similar to the process on any other scientific publication.

Why is it important that a space for more creative articles exists?
 

It’s easy for people to forget that we – especially pathologists and medical laboratory scientists – are human. We exist and we care deeply. Some people have this idea that if you don't interact with a patient, then you don’t really care about the outcome. But I think it's 100 percent the opposite. I think pathologists and laboratory scientists care too much, because they know how important their job is to the success of a patient's life.

It was really important for me to put this piece out there to show that, while I can do my job and look very detached when working around grief and sorrow, I can also feel those emotions myself. Detachment is critical to our jobs, but it affects us deeply afterwards – particularly in the space of pathology and laboratory medicine.

What has been the reaction to your article?

It's been great! My boss and family were really supportive, and the wider community has shown an outpouring of love for this piece. I've gotten messages, comments, people telling me that it touched them, moved them to tears – which for some people hasn't happened for a long time. I'm really honored that my words and my grandma’s legacy have touched people.

What are your writing plans for the future?

My creative writing process is basically this: I write when it comes to me. Something has to spark in me to write a piece, and I usually do very little editing afterwards. That's how I send it out into the world. So, I'd love to do more pieces, but the inspiration will have to strike. 

Can you talk about your research?

I work a lot in brain donation – see my article and my Instagram account (thepathphd). I'm not just passionate about getting people registered for brain donation, but also for them to understand what the process looks like from the scientific side. Too often we promote this vague concept of scientific donating, but nobody really knows what that means – they just donate and science “happens” at the other end. So, I'm really passionate about telling people: “This is exactly what we do – we take your brain, we weigh it, we cut it, we look inside it, we check for disease.” 

I study a less well-known disease called frontotemporal dementia, or in the pathology world, frontotemporal lobar degeneration with tau. It doesn't get nearly as much attention as Alzheimer's disease, but it's still really important. It affects a lot of people at a much younger age and the symptoms are very different – there are behavioral changes, personality changes, emotional dysregulation. It can be very scary for patients and their families when their entire personalities change because of a disease. I want to bring more awareness to the dementia diseases outside of Alzheimer's that need treatments. Right now, everything on the market is anti-amyloid therapies, which won't work in people who don't have a disease with amyloids.

When did you start your Instagram account? 

Back in 2020, I had just finished my Master's degree and started my PhD, a brand new experimental pathology PhD program, which only had one other person taking it. So, I used it as an opportunity to share my work. Later on I was on a podcast called Dear Grad Student, and the host convinced me to start a Twitter account, even though I was terrified of it. Then I found out about the huge pathology community on Twitter, and I wish I had started earlier!

Do you think people are forging more online connections early in their academic career?
 

Definitely. Instagram is great for talking to people who aren't scientists or aren’t in labs. Of course, there are lots of grad students from various disciplines, but it's great for connecting with people who are not in the field at all. I connect with a lot of dementia caregivers who have impacted my life in so many different, positive ways and I'm so grateful for those connections. 

Then you have Twitter (or X), which I find very much like a professional networking space, with a lot more of the older generation of pathologists using it. That said, residents, fellows, and people who are just getting into pathology are also on Twitter for that very reason – professional networking. 

What kind of opportunities have arisen from your use of social media?
 

I've been really lucky; I've done several invited talks for different organizations about my research and science communication. I’ve also done a lot of in-person outreach events born out of connections from instagram. These in turn have helped me to connect with younger people, which is awesome. I've also been very fortunate to win a couple awards for my Instagram account, which I never ever envisioned when I started it. So many people have told me they're now interested in pathology as a career because of me. It makes me feel that I’ve been able to make a bit of a change in our field.