"I really became interested in pathology during my second year at medical school... Looking through the microscope, I kind of saw medicine come alive.  I realised that by looking at tissues, you could really understand what was happening to the patient"
Elaine Jaffe (USA)

  More quotes on Motivation

The most commonly cited motivation for entering pathology is curiosity about the mechanisms of disease and the ‘thrill’ of unravelling medical mysteries.  As Sue Black says, “It's the detective in all of us, isn't it?” 

It's the detective in all of us, isn't it?As a medical student Sebastian Lucas wondered “is there a bit of medicine which is problem-solving, and where you can solve one case and move on to a new one?”  The answer was pathology.  “It's like doing crossword puzzles -- solving one and then having a new one to do.  And actually, 35 years later, that's what I still like about pathology: it's problem solving.” 

Contrary to the popular perception, fanned by the media during the Alder Hey controversy, preoccupation with death was not a factor in anybody’s decision to enter the profession.  “We're in the business of investigating the dead in order to assist the living – there's no other reason for doing it,” says Derrick Pounder. 

Although they are not on the frontline of medical care, the fact that their work is helping patients and their families is a powerful motivation for many of the interviewees.  “I am always very conscious there’s a patient at the end of [the diagnosis],” says David Levison.

We're in the business of investigating the dead in order to assist the livingSome recognised they could serve the interests of patients better at one remove because they were not temperamentally suited to dealing with the sick.  Elaine Jaffe explains, “I was just very squeamish: I didn't like hurting people, so [for example] when I had to go draw blood I was terrible at it!”

A couple of people said that one of the things they appreciated about pathology was that there is often time to think through a diagnosis and consult with colleagues. “The pressure is not as great as for the surgeon who has to make an instant decision… and the wrong decision may have disastrous consequences.” (Francisco González-Crussí).  And Waney Squier says, “This is part of the reason I’m a pathologist – because I’m not good at dealing with dying people and clinical situations where you have to make decisions immediately: do you give this drug or that drug?  No, I’d rather go away and think about things quietly.”

I was interested more in understanding the mechanisms of disease than curing patientsFor some the overriding attraction of pathology is the science.  “I think it was because of the research angle,” says Julia Polak.  “I was interested more in understanding the mechanisms of disease than curing patients -- the mechanisms and the science.” 

For others, notably Derrick Pounder, Irene Scheimberg and Miguel Reyes-Múgica, underlying their work is the desire to serve the wider community.  “I always wanted to do something that could help other people.  It was a family in which you didn't do things just for yourself, you had a bigger vision.  Being part of society was very important in that family, and you had to do something for society,” recalls Scheimberg. 

“Serving the community in a very direct sense is very much part of what we do,” says Pounder. For him ‘the community’ ranges from the local to the international.  He co-founded  Physicians for Human Rights.

Key intervieweesDerrick Pounder, Sebastian Lucas, Miguel Reyes-Múgica, Francisco González-Crussí

See also: Mentors and Influences, Research versus Clinical Work

 

QUOTES

James IronsideI've always felt that one of the challenges, and in many ways one of the joys, of diagnostic pathology is that every month, certainly, you see something you've never seen before... Not [necessarily] a new disease, but a different manifestation of something, or some appearance you've read about in the books but you've never actually seen. And there it is! I think that's really what keeps the interest going, or one of the things that keeps the interest going. I think the day I get tired of doing this is the day to go off and do something else. I've not lost that over the years, and I hope I never do.
 - James Ironside (UK)

Miguel Reyes-MúgicaI never forget that behind everything that we do there is a patient, or group of patients.
 - Miguel Reyes-Múgica (Mexico and USA)



 

Irene ScheimbergNot every [postmortem] is the same, and some are more intellectually stimulating than others. But each baby is somebody's child, and it is always emotionally engaging, if you know what I mean. You know you are doing something that's going to help somebody through their grief, even if it might be very [straightforward]. 
 - Irene Scheimberg (UK)

 

Chris FletcherI get a lot of pleasure from running this part of the department, and I like seeing the trainees do well. And I don’t mind doing all this admin. But the fun bit is seeing lumps and working out what they are. And feeling as though you’re helping patients -- I mean, I think I’m probably a doctor at heart.
Christopher Fletcher (UK and USA)

Bill Bass[My motivation?] The challenge to see if I have the knowledge to figure out who this individual is and what happened to them. And the satisfaction of knowing that I've helped a family or I have helped society put away somebody that probably should be put away. And students... I have two families. I have three biological sons, and then I have all of my masters and doctoral students and we're very close.
 - Bill Bass (USA)

Derrick PounderI was always interested in human rights. I've always been sympathetic to the underdog, it comes from my cultural and social background. And it happened that, in the mid 80s, a few forensic practitioners who were interested in human rights found that...we could bring together our professional interest and our social interest, and we began to form an informal international network. 
We liaised with the various human rights organisations, and we started to consult for them in the same way that we would consult for lawyers nationally.
 - Derrick Pounder (UK)  

Elaine JaffeI really became interested in pathology during my second year at medical school... Looking through the microscope, I kind of saw medicine come alive. I realised that by looking at tissues, you could really understand what was happening to the patient. Seeing patho-physiology unveiled beneath the microscope really made medicine exciting to me -- I wanted to understand disease and what caused disease, and how these changes occurred in the patient... I never had this Florence Nightingale fantasy of healing the sick... I didn't go into medicine because I could help humanity; I went into it because I thought it was interesting to study...
 - Elaine Jaffe (USA) 

Juan Rosai[My motivation is] the fact that I help patients by making the right diagnosis, teach young people to become good pathologists, and at least think about mechanisms of diseases...I have always liked the idea of contacting patients directly whenever it was indicated. Not only do they appreciate it but sometimes you get information from them that you have not received from the clinician and that may influence your diagnosis a great deal.
 - Juan Rosai (Argentina, USA and Italy)

Derrick PounderI belong to that generation of the working class that was the first generation to go to university. I got to university because of the socialist movement and the trade union movement and all their support for education. In fact the government and the tax payer paid for my entire education... I feel very much that I wouldn't be a doctor had it not been for the efforts of previous generations.  And I can't repay a previous generation; I can only repay this generation.
 - Derrick Pounder (UK)

Nicholas WrightI entered medicine with the express wish to become a pathologist, which is very unusual... I read, as a 15 year old, a book called Men Against Death by Paul de Kruif. This was really the history of the early bacteriologists, like Robert Koch who became my hero... You had these conditions – like Rocky Mountain Spotted Fever, tuberculosis, leprosy, typhoid, cholera – which just seemed like black magic for the practitioners of those days... Then along came Louis Pasteur and Robert Koch and the early bacteriologists and isolated these organisms and put medicine on the first scientific basis it's had... It's a real saga, and I think any young person reading that sort of thing now, it would really turn them on. It's extremely exciting.
 - Nicholas Wright (UK)

Sue BlackIt's the detective in all of us, isn't it? You know, we all like Morse and Taggart and those things because there's a mystery and it's got to be solved. Our mystery [as forensic specialists] is: who was this person? And when you get that solved, it's a huge adrenalin rush. You think, ‘Yup, someone's got their husband back.  Someone's got their wife, their daughter (whatever it is)… I've made a difference.’ Even if it's not going to make a difference to the courts, it'll make a difference to families, it'll make a difference to somebody. And that's grand.
Sue Black (UK)

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