The late Guido Majno, one of the greatest pathologists of the 20th century (1, 2, 3), was certainly one of the great pathologists of any age. Apart from his considerable scientific accomplishments, one of Majno’s greatest gifts to us is his pathology textbook,. Not only is it one of best textbooks I’ve ever read, it’s one of the best books I’ve ever read, period.
Here from that textbook are Majno and his co-author’s, his wife Isabelle Joris, own words for why pathology is important for the optimal practice of medicine. His answer is more about how doctors and biomedical scientists benefit from training in Pathology. However, it also ends up emphasizing the extent to which pathology and medicine are intertwined.
‘FIGURE P.2 The Tree of Medicine: the trunk is General Pathology, which draws from all the basic sciences, and divides into the many branches of Special Pathology; each one of these supports a specialized field of Medicine, the crown of the tree. (Courtesy of Dr.George Th. Diamandopoulos, Harvard Medical School, Boston, MA.). To sum up, we are suggesting that experimenters in the field of biology would have a lot to gain if they had some basic, introductory training in General Pathology. We wrote this book, in part, to address this need. How long does it take to learn enough general pathology to make a difference? In our medical school, the students learn it in 25 hours of lectures and about 50 hours of laboratory, mainly with microscopes. The time investment is not prohibitive. We recognize an obstacle: not all Schools of Biomedical Sciences offer General Pathology courses for graduate students. One way to obtain some practical experience might be to coax a friendly pathologist into offering some time on a two-headed microscope as a tutor. The tutor might learn something too. What is lost if this exchange does not occur? The loss comes in several forms. We do not want to sound presumptuous (surely there is no lack of errors in the pages of this book), but here is an example. Sometimes, in disease, one kind of tissue is replaced by another; this event is called metaplasia, a well-chosen term that is about 150 years old and as alive as ever. A few years ago, the monster-word transdifferentiation appeared in the literature, ostensibly to mean the same as metaplasia, although the word was not clearly defined. We contacted some of the authors of papers on “transdifferentiation” and asked why they had chosen that new term. Some of the answers: (a) metaplasia was not a familiar term; (b) metaplasia is used by pathologists (!): (c) the two terms mean the same thing; and (d) the two terms mean different things. Now this has created real confusion in the field. Who will take the time to clean it up?‘
In short, pathology and medicine are mutually dependent and mutually beneficial. This figure from their textbook illustrates the central place for pathology in the art of practicing medicine.
- Damjanov, Ivan. “Guido Majno, MD, 1922–2010.” The American journal of pathology 177.5 (2010): 2150-2151.
- Fraire, Armando E., and Bruce A. Woda. “Guido Majno, MD 1922-2010 In Memoriam.” (2010): 1733-1735.