Kumarasen CooperDirector of Anatomic Pathology and Professor of Pathology, University of Vermont/Fletcher Allen Health Care, Burlington, Vermont, USA

Interview location: Hotel room in Boston, USA
Interview date: 21st November 2007

Key Themes: International Perspective, Legislation and Regulation, Life, death and the hereafter


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Section 1

  • Describes in detail growing up in South Africa under apartheid.  “You were taught to think of yourself as an inferior being, and [you were] treated as such... You had no political representation.”
  • Seeing how vital education was to surviving under an oppressive regime, his parents started their own school, but he says, “We had to follow the restricted curriculum [for Indian pupils].”
  • His brother Saths was a political activist, starting the Black People’s Convention with Steve Biko.  Describes how Saths’ activities, arrest, trial and imprisonment had a powerful impact on the entire family.  Cooper’s university and medical school studies were also affected by the wider political turmoil. “I think we spent about 25-30% of our time marching and demonstrating...”  But he was determined to succeed academically.  “It was just by a sheer act of will that we managed to write our exams and get through.  It was extremely difficult.”
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Section 2

  • Comments that science was always his favourite subject at school, and he took to medicine immediately:  “Loved it.  Just the science of medicine – the knowledge and understanding of disease processes, and translating that into clinical signs and symptoms.  And seeing patients, learning about all the diseases we saw in patients -- it was just fantastic, just phenomenal.”
  • Describes the place of pathology in the curriculum and some of the inspirational teaching he received.  “We attended three autopsies a week -- full autopsies, from the moment of dissection to correlating with the clinical notes, to producing a clinical-pathological profile of the entire case.  It was superb... I believe that nowhere compares to the training I or the people of my time received.”
  • His original ambition had been to become a science teacher, “so the opportunity to marry both the love of teaching and the love of biology attracted me to pathology.  You saw patients as well, and then later on you realised that you’d had the opportunity to interact with all the physicians in a variety of disciplines...”
  • Expresses regret that some of that interaction has been lost in the practise of pathology, especially in the USA where he now lives. “These days I think there’s more isolation... pathology is practised behind ‘the paraffin curtain’.”
  • Muses on the difference between models of pathology training in South Africa and the USA.
  • Describes the pathology he saw in South Africa, and says it was an amazing environment in which to train.  “The range of [pathology], the depth of it, was just surreal.” Comments that  “I would probably take about a year to see [that variety of pathology] in Vermont, but I saw it in a week in Durban.”
  • Discusses briefly the impact of HIV and AIDS in Southern Africa.
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Section 3

  • Describes a life-changing three years in  Oxford under a Nuffield Fellowship: “I wish that every South African colleague of mine could have had the opportunity to spend three years in Oxford.”
  • Focus of his DPhil was the role of the human papillomavirus in cervical cancer, which was a major problem in Durban: “There were five gynaecological wards, and every time I’d go into one I’d find 20 to 25 beds with patients with cervical cancer.”
  • Talks about his good fortune in being able to do this research in Oxford.  “The technology was just phenomenally superior; way ahead of anything I’d known...[and] you had to read and learn a lot more.”
  • However, despite his appreciation of being able to work in “a first world laboratory, which really was science at its best”, he describes the continuing personal turmoil that was the legacy of apartheid.  “Remember, this was coming after a period back home when I was getting used to the idea of having whites as colleagues.”  In Britain, where his colleagues were “predominantly Caucasian” he had to keep reminding himself, “these are not the people who voted in the apartheid system....”  He says, “The cultural, social, geographical change was an enormously stimulating, exhilarating experience.”
  • Relates the poignant story of how he felt being alone in Oxford when Mandela was released in 1990. “The fact was that history was being made back home, and I wasn’t there.” Soon after, his wife and baby join him in Oxford.
  • Describes the deteriorating political situation back home and how it led them to question their intention to return.  However, he was recruited to run the department of pathology at the University of the Witwatersrand (‘Wits’).  “I was to be the first medical professor of colour in the medical college.  Talk about the anxieties of going to Oxford, this was twice that anxiety!”
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Section 4

  • His decision to return in late 1992 was not without misgivings.  “The political component made me anxious.”
  • Describes the post-apartheid situation at Wits, a period of transformation, and how his work was divided between the university and the South African Institute of Medical Research (SAIMR).  He “took advantage” of the changing times “to create a similar system” to that at Oxford, which he had found so effective.  “[We allowed] consultants and registrars to do research as well as their service work, and to engage in molecular research that I’d learnt in Oxford...”
  • There was a practical value to this system:  “It enabled us to translate a thought or a question based on observation of some morphological changes [in patients] into an experiment that you could then perform in a research laboratory.” It worked well:  “We became one of the most successful pathology departments in the country.”
  • Describes briefly the origins of SAIMR to provide a service for the gold mines.
  • Relates an anecdote about his inaugural lecture in which he took the opportunity to “defuse” some of the tensions involved in taking up this post – not least the fact that Wits had twice refused him a place in medical school.
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Section 5

  • Describes one of the highlights of his return – South Africa’s first all-race election in 1994.
  • At the next election, in 1999, he was in the process of moving to his current post in Vermont, USA and missed the vote.  Describes his feelings at discovering, in 2004, that the rules had changed for expatriate South Africans and he was not eligible to vote.  “It caused me so much heartache to realise that the country of my birth had literally rejected me, because I was not allowed to vote anymore.”
  • This sense of alienation from his country was deepened when the family of his successor at Wits was brutally attacked within their own home, which left him “drained of feeling a sense of belonging”.  He now regards himself as a “citizen of the world”.
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Section 6

  • Describes his friendship with Harvard Professor Christopher Fletcher , renowned for his work on soft-tissue tumours, and the role he played in Cooper’s appointment to the University of Vermont.
  • One of the challenges in Vermont was to immerse himself in “pure first world pathology.  It was more diseases that pertain to lifestyle – the ‘cost of living’ as we call it – rather than diseases due to starvation and hunger and infection.”  The other challenge is his involvement in the “regulatory bodies” of the USA, which undoubtedly have their uses, but which he also finds “enormously time-consuming” and at times “over-bureaucratic”. 
  • He now finds himself in a position “to contribute to the way pathology is moving into the new century” through his membership of various national bodies, including the College of American Pathology.  One of his concerns is the move towards increasing specialisation. “What we are leaving behind is classical pathology... Instead of being general surgical pathologists, they become super-specialised...and lose the big picture.”
  • Talks briefly about a public health education campaign for young women about cervical cancer.

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Section 7

  • Talks about his religious beliefs and how he sees no contradiction between faith and science.
  • Closes with a reminder that we still live in a divided world. “In Africa they’re having difficulty getting basic stains; in the United States it’s whether you should do the super-stain or not.  You cannot say that these disparities don’t affect all of us.”