Pathologist, educator, mentor, Prof K Shanmugaratnam is happiest working quietly in his room at the Department of Pathology. He doesn’t like interviews, but consented to a quick chat with MediCine.
KS: Histopathology is a branch or division of Pathology. It is a medical specialty in which diseases are diagnosed by the microscopic examination of tissue samples.
Fifty years ago histopathology was based on the examination of tissue sections and the use of simple histochemistry. Since then, the introduction of new techniques like electron microscopy, immunohistochemistry and molecular analysis has enabled histopathologists to adopt a combined histomorphologic, immunohidtologic and molecular approach to tissue diagnosis.
What makes a good histopathologist? What attributes should he/she possess?
KS: A histopathologist should have the visual capacity to identify and recognize microscopic tissue abnormalities and, more importantly, he/she should have the knowledge and intellectual capacity to interpret these abnormalities in terms that are clinically relevant.
What do histopathology and pathology have to teach today’s medical students and young doctors?
KS: Pathology, as a subject in the medical school curriculum, is not limited to the study of structural tissue abnormalities. It deals with the causes and mechanisms of diseases, and correlates them with their biochemical and functional effects. Pathology, as studied by medical students, provides a scientific basis for the practice of medicine.
You once told The Straits Times, “There are, however, some basics in medical education that technology has not changed. There are operational skills that have to be learnt through experience and actual practice. And there are lessons on behavior that are most effectively taught by setting an example.” What are these operational skills? What are the behavioural lessons that are best taught by example?
KS: The operational skills to be acquired through practice are the manual skills involved in surgical procedures.
All forms of professional and ethical behavior are best taught by setting an example. A lecture on the harmful effects of smoking would not be effective if it is given by a habitual smoker.
The practice of medicine today incorporates extensive use of technology, from disease prevention to detection and on to treatment. Do you think doctors have become too dependent on technology?
KS: Some doctors may have become overly dependent on technology. There is no question that technology has enormously improved the quality of medical care. But it should be used judiciously and selectively, with a holistic understanding of the natural history of diseases and of the needs and circumstances of individual patients
What do you enjoy more – teaching, or investigating?
KS: It is teaching that gives me greater pleasure.