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How do you guys explain what you do?

yaah

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    So, I just returned from reconnecting with lots of family members, close and distant. Of course, it comes up what I am doing with my life, about to finish med school, etc. They keep asking me "What kind of doctor are you going to be?" My sister who was also there is going into radiology. Everyone knows what that is. Then they get to me.

    So, sometimes I say, "Pathology" but quite often I get some autopsy-related quip like, "I guess I wouldn't want to be your patient, huh?" or "You don't have to worry about your patients talking back to you!" or something related to the fact that I must enjoy carving up dead people or hate listening to someone's heart.

    Other times I just say "Lab medicine" which seems to work well, because people equate that with research or pipetting or something like that and don't have as many clever quips.

    What do you folks tell people? A lot of people are not that fond of dead bodies, and since they think that is what a pathologist deals with all day, sometimes people get an odd impression. I once almost alientated this nice girl I liked because she asked me what I did (this was during my PSF and I was on autopsy month). At the same time, trying to explain what pathologists do in one-two sentences is like trying to summarize US history in one-two sentences, especially when you are talking to a 90 year old great uncle. Or a girl you like.

    I often want to jump up in the air and scream, "Pathologists quite often leave the morgue! Ever had a biopsy, dimwit?!?" But I don't want to call a 90 year old great uncle a dimwit while jumping up and down. And it might not get you a second date with a nice girl. Besides, that will just make me look taller (see below).


    Somewhat related tangent: I should note that when I am not having to explain to people that autopsy is only about 5% of what a pathologist does (unless you are in forensics) and that most of my patients will, in fact, be alive (most people have had a biopsy or some kind of fancy lab test, so I can usually explain it this way) I am explaining to people that I DO NOT play basketball. I am somewhat tall, 6-4 or 5 and thus people assume that not only must I play basketball, but I must be astoundingly good because of that extra couple of inches. "Why don't you play, you could probably be so good!" I tell them that most basketball players not only have more athletic talent than I do, but are also even taller! Although even stupid basketball coaches seem to buy into this because even though I can shoot well (I won a shooting contest in high school by finishing with 7 straight 3 pointers) they want me to play on the box and not move more than 5 feet from the hoop because I am tall. (coach: "Nice shot, but next time down get down low and box out, we need your rebounding." Me: "We won't need rebounding if you let me shoot. Besides, I am not going to get a rebound over that kid who is 6-7 and 250 lbs.") So I quit. Take that! I'll play baseball instead like Dave Winfield. Only I am not quite as good as Dave Winfield, but that's another story.

    I'm not quitting pathology though, even though it's easier to be my sister the radiologist on family reunions. Or on dates. Maybe that's why my sister is engaged and I'm not.
     

    Willie B

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      Yaah,

      I'm not even a first year med student yet. But, I figure that explaining what a pathologist does shouldn't be that much harder than explaining what I do for a living now. I'm a medical technologist, so most of the people that I know already have some small idea of what goes on in a hospital lab. Now, explaining the fact that I will probably be a DO and not an MD. That might take some more time and effort.:laugh:

      Also, you said that you did a PSF. Where did you do it at and how did you like it? I know that it is atleast two years until I will be able to apply for one, but I just wanted to get some info and feedback from people that have done them before.

      Thanks,
       

      pathologypete

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        Interesting question, Yaah. I have had similar experiences. I have given up trying to explain it. I want to do forensics, so I used to say ?I?m doing forensic pathology? which evoked 2 responses ?You need to go to medical school for that?? and ?Like Quincy!?. Then I would get berated with a series of questions about murder. I used to try telling them that it was more than murder and that FP is a huge part of preventive medicine public health. Then, becoming tired of discussing the latest Patricia Cornwell novel, I started to say ?I am doing pathology?, to which I received the same responses that you are talking about. I?ve heard ?I wouldn?t want to be your patient!? to which I reply, ?Hey, you ever need an autopsy, I?m your man, you come to me?free of charge!? That usually stops it cold! I think that people just get nervous talking about death and people who spend a lot of time around ?dead people? make them uncomfortable. I dunno. My sister-in-law is a ped resident and when we are all together she gets all the med questions and I get ?that must be very depressing?. Oh well, it?s a never-ending battle, this struggle against the public ignorance of what exactly pathology is and how important it is to their well being! Oh, the best comment I?ve heard: I was at a pub one night with some friends and we were approached by a group of girls. I was talking to one and she asked what I was doing, so I told her. Her response: (With a look of horror and shock on her face) ?Are you some kind of pervert or something?? To which I replied, ?yeah, baby, does that make you horny?!? I may have ruined my friend?s chances, but it didn?t matter to me, I?m married!
         
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        Global Disrobal

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          Damn Yaah, I never could figure out a way to reference Dave Winfield and 3 pointers in a Pathology forum, but damn you pulled it off:D

          As to your question, (in my younger years) when asked about it, I basically said that its the doctor in charge of making the final diagnosis on many diseases. From tumors to blood problems to breast biopsies....thats what I do! It still didn't help with the girls though man. I guess the stinch of formalin eminating from my being after an autopsy on an exhumed 2 year burried body was enough to run them off (which is why I resorted to humor and ETOH instead:love: ) Autopsy always what came up though no matter how much you explain the other 95% of path!

          By the way, isn't this a much more enjoyable, loving thread than the other one? Thanks Yahh for starting it...

          Good luck the rest of the way with the Match!
           

          path19

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            hey yaah, your post reminds me of a guy i knew in high school. this kid was like 6'8" or 6'9" and as uncoordinated as it gets. anyway, as one of his senior quotes he put this.

            "when people ask me if i play basketball, i say 'no, do you play miniature golf?'"
             

            yaah

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              Originally posted by Jeeves
              I tell people I help save lives by learning the nuances inherent in diseased tissue and conveying it to the proper channels for optimal treatment results.

              My 90 year-old great uncle, if I were to say this: "You got whose inheritance?"

              The cute girl: "So, do they pay you for this or are you just a perpetual grad student? Are you ever going to be a real doctor? Do you know any cute surgeons?"

              Seriously though, that is a good answer. I do usually tell people things about how I am learning all about disease, and making the actual diagnosis on the biopsy or test. It just takes awhile to explain and a lot tougher than just saying, "I'm a surgeon" (I guess surgeons might say, "Me surgeon. Cut tumor out.") or "I deliver babies."

              And hey, I'm not that uncoordinated! Remember, I can shoot pretty well. I just don't enjoy basketball enough to be aggressive and rebound well. Apparently I have like the perfect body for crew (aka rowing to those outside new england) because people keep trying to recruit me. I have thought about responding to the basketball quips with "No, I'm a jockey," but that's not very clever.

              And about the PSF - look through the archives or search my previous posts, there is a bunch of stuff from previously - you can PM me if you like, but since you are not yet in med school, I would give yourself a little more time to weigh your options and learn about the great variety you can experience in medicine. It was a great experience though. Not necessary if you are certain you are going into pathology, but very important if you are unsure or want more experience to decide and see what it is like. It helps for any field you go into.
               

              Brian Pavlovitz

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                Yaah, GD, and the rest--

                You all have a wonderful sense of humor...or should I say, "bully" sense of humor??

                I'm ALMOST a third year, pretty much certain of a future in Pathology (previous med tech and cytotech), and people are so shocked that I'm interested in Path. "I guess you don't like interacting with patients!" is a common remark. Actually, I really enjoy talking with patients. Do people really think that a Pathologist is that antisocial? Pathologists can have personalities, too! :p

                Ah, yes, and then there's the "Quincy" comparison. Gotta love Jack Klugman! Unfortunately, most of my fellow students are too young to remember that show (damn them)!

                Cheers!

                Brian
                 

                yaah

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                  Originally posted by Brian Pavlovitz


                  I'm ALMOST a third year,

                  Well, I'm ALMOST a doctor. That and $1.85 will now get me a gallon of gas here in the commonwealth. ;)

                  Actually, I really enjoy talking with patients. Do people really think that a Pathologist is that antisocial? Pathologists can have personalities, too!

                  No kidding! I hate this stereotype. I have had medicine attendings, surgical attendings, OB attendings, pediatric attendings (I think the Psych folks thought I was a patient) tell me during my clinical years, "why would you go into pathology, you are great at talking to people" or "you have a great skill at talking with people" etc. It's important to be a communicator in pathology, especially as many pathologists are also so involved in teaching, whether this is to med students or other physicians. I have seen people with great social skills become great pathologists. Don't listen to hooey from people who are trying to stereotype pathologists as unfeeling, non-communicative beings who speak in grunts and never look up from the microscope. That only describes about half the field!

                  However, pathology makes for difficult cocktail party conversation in this country where everyone is so defined by what they do. I still haven't come up with a good way to explain it to folks quickly, other than interpreting biopsies or lab tests. I guess I'm like John Kerry - can't give a brief answer, feel like I need to explain myself a little more.
                   

                  Global Disrobal

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                    Ah man, I used to get that all the time in IM. Coming off of my PSF and really proud, I mentioned Path once and ever since that they always yapped about me being good with patients. Luckily enough it was never during a Guiac (Hemeoccult) exam which with my fingers allowed me to examine the thyroid at the same time:smuggrin:

                    Stick with it Brian, I think you'll love the field. And I second what Yaah says about the "opinionites." It seems like where ever you go and whomever you talk to (namely surgeons), they always have an opinion and it generally would kill them to talk nicely about a pathologist unless it was while they were on the speaker reading out a frozen dx.

                    As for Yaah's comment, hey man stick with explaining Path. Trust me in that chicks don'd dig the "I deliver babies: comment too much! Their usual reply: "Oh, so you look down there all day?"
                     

                    dr.weiner

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                      I sort of like people having no idea what I do. I also like not doing anything when there are other doctors around and someone's sick/passes out, etc... Sorry guys, I'd help.... but I'm a pathologist.
                       

                      scienceguy19

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                        I can tell you that women won't swoon over you if you tell them you're a pathologist. They'll assume you're some type of morgue attendant.

                        If you tell them you're radiologist you'll be really popular =)


                        So, I just returned from reconnecting with lots of family members, close and distant. Of course, it comes up what I am doing with my life, about to finish med school, etc. They keep asking me "What kind of doctor are you going to be?" My sister who was also there is going into radiology. Everyone knows what that is. Then they get to me.

                        So, sometimes I say, "Pathology" but quite often I get some autopsy-related quip like, "I guess I wouldn't want to be your patient, huh?" or "You don't have to worry about your patients talking back to you!" or something related to the fact that I must enjoy carving up dead people or hate listening to someone's heart.

                        Other times I just say "Lab medicine" which seems to work well, because people equate that with research or pipetting or something like that and don't have as many clever quips.

                        What do you folks tell people? A lot of people are not that fond of dead bodies, and since they think that is what a pathologist deals with all day, sometimes people get an odd impression. I once almost alientated this nice girl I liked because she asked me what I did (this was during my PSF and I was on autopsy month). At the same time, trying to explain what pathologists do in one-two sentences is like trying to summarize US history in one-two sentences, especially when you are talking to a 90 year old great uncle. Or a girl you like.

                        I often want to jump up in the air and scream, "Pathologists quite often leave the morgue! Ever had a biopsy, dimwit?!?" But I don't want to call a 90 year old great uncle a dimwit while jumping up and down. And it might not get you a second date with a nice girl. Besides, that will just make me look taller (see below).


                        Somewhat related tangent: I should note that when I am not having to explain to people that autopsy is only about 5% of what a pathologist does (unless you are in forensics) and that most of my patients will, in fact, be alive (most people have had a biopsy or some kind of fancy lab test, so I can usually explain it this way) I am explaining to people that I DO NOT play basketball. I am somewhat tall, 6-4 or 5 and thus people assume that not only must I play basketball, but I must be astoundingly good because of that extra couple of inches. "Why don't you play, you could probably be so good!" I tell them that most basketball players not only have more athletic talent than I do, but are also even taller! Although even stupid basketball coaches seem to buy into this because even though I can shoot well (I won a shooting contest in high school by finishing with 7 straight 3 pointers) they want me to play on the box and not move more than 5 feet from the hoop because I am tall. (coach: "Nice shot, but next time down get down low and box out, we need your rebounding." Me: "We won't need rebounding if you let me shoot. Besides, I am not going to get a rebound over that kid who is 6-7 and 250 lbs.") So I quit. Take that! I'll play baseball instead like Dave Winfield. Only I am not quite as good as Dave Winfield, but that's another story.

                        I'm not quitting pathology though, even though it's easier to be my sister the radiologist on family reunions. Or on dates. Maybe that's why my sister is engaged and I'm not.
                         

                        WhtsThFrequency

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                          I'm a veterinary pathologist and have similar issues. We have much higher autopsy (in our case, necropsy) load, so the jokes about only working with dead things are slightly less inaccurate...but it's still at least 50-50 split of necropsy and biopsy. I have to remind people all the time that yes, I do work with live animals - just pieces of them. I don't spend my entire day up to my shoulders in dead entrails and cracking horse ribs with tree branch cutters. I'm looking at parts of actual live dogs/cats/horses/cows/pigs/birds/reptiles/whatever comes in that day and consulting with the primary clinicians. Trying to explain my job in the dating world is (well, was) even more complicated :laugh: although thankfully, I didn't scare away the hubs with it.

                          The whole "Oh, you must not do well with people" thing irks me as well. I may not like working with owners but that doesn't mean I have no communication skills. I'm consulting all the time with the internal medicine people, radiologists, surgeons, ambulatory/heard health people, oncologists, etc. at the referral hospital on their cases.

                          Funny, it seems pathologists have a somewhat undeserved rep in both human and veterinary medicine.
                           
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                          scienceguy19

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                            how's the practice of veterinary pathology and lifestyle?
                            can a MD pathologist practice veterinary pathology?
                            might have to quit human pathology the rate things are going now.
                            I imagine the pay for biopsies is better than Medicaid.
                             

                            WhtsThFrequency

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                              how's the practice of veterinary pathology and lifestyle?
                              can a MD pathologist practice veterinary pathology?
                              might have to quit human pathology the rate things are going now.
                              I imagine the pay for biopsies is better than Medicaid.

                              The lifestyle is pretty good. I can't complain (other than the pay). The amount of species variation always keeps things interesting. I really love what I do - there's always something new. In addition to all the domestic species I've done necropsies/histo on reptiles (everything from metabolic bone disease to dilated cardiomyopathy), camels (from fibrous osteodystrophy to systemic pythiosis), a capybara (portosystemic shunt), big cats including lions and snow leopards (usually cancer of some sort), ospreys and eagles (usually heavy metal toxicosis), and a lemur (Toxoplasmosis) to name a few.

                              Nopers, an MD cannot practice veterinary medicine, just as a DVM can't practice human medicine, even in pathology ;). I imagine I could be competent at reading basic human slides (and vice versa for an MD), but I wouldn't ever presume to know, say, all the subtypes of human breast cancer or lymphoma. Just as I wouldn't expect an MD to know all the nuances of, say, avian bone marrow or bovine bunyaviruses. For vet path, it's four years of veterinary school, 3 of residency, pass a pretty brutal set of boards , and then likely some sort of fellowship or research unless you're lucky enough to go straight into diagnostics (our job market is pretty horrible, too). There are comparative pathology/medicine programs for MDs, but you'd still likely need additional training and likely would not be reading out patient biopsies - more research-type stuff. Even then, it irks me at how many researchers don't consult a veterinary pathologist for their lab animal studies - I can't tell you how many shoddy research "diagnoses" I have seen because they don't know the subtleties of lab animal path.

                              I'm pretty sure (but correct me if I'm wrong) you guys get paid a lot more than what we do. Average 140k in debt for vet school, get paid 30k for three years as a resident, maybe 40k as a fellow. In terms of actual jobs, in teaching hospitals the average salary is maybe 80-100k, even with years of experience. State labs, national labs, and industry are better, around 100-150k with experience. Someone making more than 150k would be very lucky.
                               
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                              BU Pathology

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                                Let me echo that your training as a human pathologist will not make you a good, or even competent, veterinary pathologist. I was asked to read some vet path when I was a fellow. When reviewing the slides with a board certified veterinary pathologist it was clear that he was exceptionally knowledgeable and provided a better interpreation.
                                 

                                scienceguy19

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                                  I didn't realize veterinary pathology was so advanced now. Are they doing molecular testing now on animal tumors? That would be interesting if they're already doing FISH cytogenetics on animal tumors. I'm wondering if lung cancers in animals have the same EGFR KRAS ALK mutations. I doubt animal health insurance would cover those things though. Maybe a human molecular pathologist could also make a veterinary molecular pathologist :)
                                   

                                  cmz

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                                    I didn't realize veterinary pathology was so advanced now. Are they doing molecular testing now on animal tumors? That would be interesting if they're already doing FISH cytogenetics on animal tumors. I'm wondering if lung cancers in animals have the same EGFR KRAS ALK mutations. I doubt animal health insurance would cover those things though. Maybe a human molecular pathologist could also make a veterinary molecular pathologist :)

                                    I would hazard a guess and say... there are going to be a lot of similarities between animals and humans (especially at the molecular level) ;) Do a comparative genomic analysis and you'll find what you're looking for.

                                    I'm sure all of the funded NIH/HHMI/etc research laboratories that work with animal models for the basis of studying human disease may give their $0.02 on the matter... In fact, pubmed.com is only a click away.
                                     
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                                    WhtsThFrequency

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                                      I didn't realize veterinary pathology was so advanced now. Are they doing molecular testing now on animal tumors? That would be interesting if they're already doing FISH cytogenetics on animal tumors. I'm wondering if lung cancers in animals have the same EGFR KRAS ALK mutations. I doubt animal health insurance would cover those things though. Maybe a human molecular pathologist could also make a veterinary molecular pathologist :)

                                      In research, absolutely - molecular characterization of tumors in lots of species has exploded in the past couple decades. And many, many abnormalities are similar to man. I was grilled pretty bad on molecular expression patterns in all sorts of species and diseases on boards (augh, brings back "alphabet soup" nightmares! ;) )

                                      However, when it comes to actual patients in the clinic, we usually stick to basic H&E and IHC for our diagnoses. Some vet schools do have FISH labs, though, like Cornell: http://www.vet.cornell.edu/labs/simpson/FISHFAQS.cfm and some do genetic work.

                                      There's definitely room in translational medicine for both! I'm currently working with a (physician) gastroenterologist during my fellowship, collaborating on animals models. I know the animals, he knows the people, and together we make magic happen! Well, papers, at least ;)
                                       
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                                      Johnny Sunshine

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                                        Had to explain my profession to a bunch of relatives this holiday season. It usually went something like this:

                                        They: "Oh right, you're Ed's son, the doctor! What's your specialty?"

                                        Me: "I'm a pathologist. I'm the one who diagnoses all the biopsies, tumors, organs, blood, urine, spinal fluid, and so on. Any time anything is 'sent to the lab', a pathologist will examine it under a microscope, or use various lab tests, possibly molecular or genetic tests, to make a diagnosis so the surgeon or other docs will what to do."

                                        They: "Oh. I thought that was all done by technicians. Don't you do autopsies?"

                                        Me: "A lot of the laboratory work is automated these days (especially blood tests) and the machines are run by technicians, so on that end of things the pathologist mostly acts as a medical director/manager who needs to be able to understand how the tests function - the theories behind them - so that the inevitable confusing result can be explained. But when it comes to biopsies, other tissue samples, and many non-blood fluids the pathologists are very hands-on. That sometimes includes autopsies. But these days, most pathologists don't do any autopsies; I think only 3% or so have it as a major part of their practice."

                                        They: "...Uh huh. ... ... ... So, did you hear about aunt Mildred? Well, there was this cabana boy..."
                                         
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