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What gets me up in the morning – Suzy Lishman, pathologist

I first saw Dr Suzy Lishman in action at the Cheltenham Science Festival where she was chairing a panel discussion. A few twitter connections later and I am delighted to say that she has found time in her very busy schedule to write this guest post. To be frank, I wasn’t entirely sure what a pathologist does so this is not only really interesting but her enthusiasm and commitment are leaping off the page. Enjoy!

What do I do?

When I tell people that I’m a pathologist, the usual response is ‘Oh, like in CSI?’ or ‘Is it really like it’s shown on Silent Witness?’ The short answer is ‘No, nothing like it’, but there’s more to it than that.

Very few of the scientists on CSI are pathologists – doctors who have undergone years of specialist training to enable them to diagnose disease. Silent Witness does feature medically qualified pathologists, but their lives bear little relation to what I do. I am one of around six thousand pathologists working in NHS and private laboratories in the UK. Fewer than 1% of these work in forensic pathology, the investigation of unnatural deaths – the specialty most often portrayed on television.

I work in cellular pathology, the specialty involved in diagnosing disease by examining human cells and tissues under the microscope. All my patients are alive and I work in an office and state-of-the art laboratory, miles away from the seedy crime scenes which seem to be home to television pathologists. There are eighteen other pathology specialties including biochemistry, haematology, microbiology, genetics, immunology and toxicology. Every time you have a blood test, a urine test, a cervical smear, a biopsy or a lump removed, it is a pathologist who tells your doctor what the diagnosis is and enables them to offer you the most appropriate treatment.

It has been estimated that pathology is involved in over 70% of all diagnoses for patients yet it accounts for only 4% of the NHS budget. When politicians talk about protecting the NHS, they often refer to safeguarding frontline services, perhaps forgetting that pathology may be ‘behind the scenes’ but the frontline services can’t function without it. Because many pathologists don’t see their patients face to face, their importance in the prevention, diagnosis, monitoring and treatment of disease is often unrecognised.

I have been a consultant cellular pathologist for fourteen years. I currently specialise in intestinal pathology, particularly cancers of the colon (large bowel). I examine approximately six thousand specimens each year, and work closely with multidisciplinary teams of surgeons, physicians, nurses and other health professionals to ensure that each individual patient is offered the treatment of most benefit to them. I work in Peterborough City Hospital and am fortunate that my employer values the contribution that doctors make to the wider NHS, as I also have a national role.

For the last eight years I have worked on behalf of the Royal College of Pathologists, the organisation that sets and maintains standards in pathology. One of my roles at the College is to lead the public engagement programme, encouraging pathologists to open the doors of their labs to the public and to take their work out to local schools, museums and shopping centres. I have done this through initiatives such as National Pathology Week and National Pathology Year, with over 2000 events being held around the country. I developed resources such as event templates, presentations, booklets and posters that pathologists could customise to take pathology to the public. I have also developed and delivered hundreds of events myself including the popular ‘virtual autopsy’, which I have performed in venues including the Royal Institution, Harrogate Crime Writers’ Festival, the Old Operating Theatre Museum, Cheltenham Science Festival, the Royal College of Surgeons and Latitude festival.

Some people assume that public engagement is merely about going to schools to encourage students to study science or consider a career in pathology. But it’s much more than that; audiences include people of all ages and backgrounds, from families and the general public to politicians and hospital directors. I hope that by raising the profile of pathology I can help people understand what a central role it has in healthcare.

What gets me up in the morning

What gets me up in the morning is helping individuals make informed lifestyle choices, empowering patients to feel able to be involved in decisions about their care and encouraging politicians to consider the need for first class pathology services when planning and re-configuring the way in which healthcare is delivered. It is too easy for those commissioning health services to think only about front-line specialties such as general practice and emergency medicine and forget that neither can function without pathologists performing the tests that enable them to make decisions about their patients.

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Suzy Lishman (pictured above at a virtual autopsy at the Old Operating Theatre!) is a consultant cellular pathologist at Peterborough City Hospital and Vice-President of the Royal College of Pathologists. She has received several awards for science communication, including the Royal Society Kohn Award in 2012. In 2013 Suzy was named one of the fifty most inspirational women in healthcare by the Health Services Journal. Suzy holds pathology-related events for the public throughout they year – follow her @ilovepathology and www.ilovepathology.org.

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