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High school student diagnosis self with pair of “fresh eyes”

While I do not like the statement “Pathologists also sometimes miss important findings for other diseases, says Dr. Mark Graber, chief of the medical service at the Northport VA Medical Center in New York”, its context can be found in an article with an amazing story I came across on Lab Soft News with some valid comments.

In this particular instance, inflammatory bowel disease can be difficult to diagnose and manage as the biology and causes are still poorly understood.  Histologically, the findings may be non-specific and granulomas are actually rarely present on endoscopic biopsies (less than 30% of cases and perhaps much less than that).  And not all granulomas are Crohn’s disease.  Nonetheless, Jessica became an active participant in her health care and is clearly a bright student who now has some answers to questions long unanswered.

Perhaps Jessica Terry is a future pathologist with a keen eye for detail that is required.  I think the article also points out opportunities for pathologists to engage high school students and educate them about medicine and pathology.  It also points out the power and effectiveness of direct pathologist-patient communication, as in this case, with the power of second consultation with “fresh eyes”.

These mainstream news articles always give me the willies. While it’s nice to see Pathology featured in the news, I can’t but think that the average American reading these types of articles would get the wrong impression of medicine (and Pathology).

That being said, I am very impressed with the exposure these young adults have to histology/pathology in high school. I didn’t really learn any histology, much less histopathology, until college.

I have mixed feelings about this one.

One the one hand it does highlight the need to be an active participant in ones own health care. It also is a wonderful story about a very bright young student with a future in pathology. (Although, I would personally recomend a second opinion by another pathologist rather than getting slides and having a look for yourself.)

One the other hand I get that uneasy ‘I’m glad it wasn’t me’ feeling when I see this. Everyone will make a mistake in their practice. A mistake is, of course, different than different professional opinions on areas of pathology that are muddy, or intrisically open to subjective bias. Most mistakes will not be caught. The ones that are caught usually do not have a large clinical impact. The select few that have large impact tend to make good headlines. It sucks when your mistake makes front page news. I like to think ‘never in my practice’, but I’m sure everyone thinks that…

There can be a small amount of good that comes from the negative PR – (back to the first point) – this type of story encourages people to be more involved in their health care. A well informed patient is alway a plus.