 Director
of Anatomic Pathology and Professor of Pathology, University of
Vermont/Fletcher Allen Health Care, Burlington, Vermont, USA
Interview location: Hotel room in Boston, USA
Interview date: 21st November 2007
Key Themes: International Perspective, Legislation and Regulation, Life, death and the hereafter
Section 1
- Describes in detail growing up in South Africa under apartheid. “You
were taught to think of yourself as an inferior being, and [you were]
treated as such... You had no political representation.”
- Seeing how vital education was to surviving under an oppressive regime,
his parents started their own school, but he says, “We had to follow
the restricted curriculum [for Indian pupils].”
- His brother Saths was a political activist, starting the Black People’s
Convention with Steve Biko. Describes how Saths’ activities, arrest,
trial and imprisonment had a powerful impact on the entire family.
Cooper’s university and medical school studies were also affected by
the wider political turmoil. “I think we spent about 25-30% of our time
marching and demonstrating...” But he was determined to succeed
academically. “It was just by a sheer act of will that we managed to
write our exams and get through. It was extremely difficult.”
Section 2 - Comments that science was always his favourite subject at school, and
he took to medicine immediately: “Loved it. Just the science of
medicine – the knowledge and understanding of disease processes, and
translating that into clinical signs and symptoms. And seeing
patients, learning about all the diseases we saw in patients -- it was
just fantastic, just phenomenal.”
- Describes the place of pathology in the curriculum and some of the
inspirational teaching he received. “We attended three autopsies a
week -- full autopsies, from the moment of dissection to correlating
with the clinical notes, to producing a clinical-pathological profile
of the entire case. It was superb... I believe that nowhere compares
to the training I or the people of my time received.”
- His original ambition had been to become a science teacher, “so
the opportunity to marry both the love of teaching and the love of
biology attracted me to pathology. You saw patients as well, and then
later on you realised that you’d had the opportunity to interact with
all the physicians in a variety of disciplines...”
- Expresses regret that some of that interaction has been lost in the
practise of pathology, especially in the USA where he now lives. “These
days I think there’s more isolation... pathology is practised behind
‘the paraffin curtain’.”
- Muses on the difference between models of pathology training in South Africa and the USA.
- Describes the pathology he saw in South Africa, and says it was an
amazing environment in which to train. “The range of [pathology], the
depth of it, was just surreal.” Comments that “I would probably take
about a year to see [that variety of pathology] in Vermont, but I saw
it in a week in Durban.”
- Discusses briefly the impact of HIV and AIDS in Southern Africa.
Section 3- Describes a life-changing three years in Oxford under a Nuffield
Fellowship: “I wish that every South African colleague of mine could
have had the opportunity to spend three years in Oxford.”
- Focus of his DPhil was the role of the human papillomavirus in cervical
cancer, which was a major problem in Durban: “There were five
gynaecological wards, and every time I’d go into one I’d find 20 to 25
beds with patients with cervical cancer.”
- Talks about his good fortune in being able to do this research in
Oxford. “The technology was just phenomenally superior; way ahead of
anything I’d known...[and] you had to read and learn a lot more.”
- However, despite his appreciation of being able to work in “a first
world laboratory, which really was science at its best”, he describes
the continuing personal turmoil that was the legacy of apartheid.
“Remember, this was coming after a period back home when I was getting
used to the idea of having whites as colleagues.” In Britain, where
his colleagues were “predominantly Caucasian” he had to keep reminding
himself, “these are not the people who voted in the apartheid
system....” He says, “The cultural, social, geographical change was an
enormously stimulating, exhilarating experience.”
- Relates the poignant story of how he felt being alone in Oxford when
Mandela was released in 1990. “The fact was that history was being made
back home, and I wasn’t there.” Soon after, his wife and baby join him
in Oxford.
- Describes the deteriorating political situation back home and how it
led them to question their intention to return. However, he was
recruited to run the department of pathology at the University of the
Witwatersrand (‘Wits’). “I was to be the first medical professor of
colour in the medical college. Talk about the anxieties of going to
Oxford, this was twice that anxiety!”
Section 4- His decision to return in late 1992 was not without misgivings. “The political component made me anxious.”
- Describes the post-apartheid situation at Wits, a period of
transformation, and how his work was divided between the university and
the South African Institute of Medical Research (SAIMR). He “took
advantage” of the changing times “to create a similar system” to that
at Oxford, which he had found so effective. “[We allowed] consultants
and registrars to do research as well as their service work, and to
engage in molecular research that I’d learnt in Oxford...”
- There was a practical value to this system: “It enabled us to
translate a thought or a question based on observation of some
morphological changes [in patients] into an experiment that you could
then perform in a research laboratory.” It worked well: “We became one
of the most successful pathology departments in the country.”
- Describes briefly the origins of SAIMR to provide a service for the gold mines.
- Relates an anecdote about his inaugural lecture in which he took the
opportunity to “defuse” some of the tensions involved in taking up this
post – not least the fact that Wits had twice refused him a place in
medical school.
Section 5- Describes one of the highlights of his return – South Africa’s first all-race election in 1994.
- At the next election, in 1999, he was in the process of moving to his
current post in Vermont, USA and missed the vote. Describes his
feelings at discovering, in 2004, that the rules had changed for
expatriate South Africans and he was not eligible to vote. “It caused
me so much heartache to realise that the country of my birth had
literally rejected me, because I was not allowed to vote anymore.”
- This sense of alienation from his country was deepened when the
family of his successor at Wits was brutally attacked within their own
home, which left him “drained of feeling a sense of belonging”. He now
regards himself as a “citizen of the world”.
Section 6- Describes his friendship with Harvard Professor Christopher Fletcher ,
renowned for his work on soft-tissue tumours, and the role he played in
Cooper’s appointment to the University of Vermont.
- One of the challenges in Vermont was to immerse himself in “pure first
world pathology. It was more diseases that pertain to lifestyle – the
‘cost of living’ as we call it – rather than diseases due to starvation
and hunger and infection.” The other challenge is his involvement in
the “regulatory bodies” of the USA, which undoubtedly have their uses,
but which he also finds “enormously time-consuming” and at times
“over-bureaucratic”.
- He now finds himself in a position “to contribute to the way pathology
is moving into the new century” through his membership of various
national bodies, including the College of American Pathology. One of
his concerns is the move towards increasing specialisation. “What we
are leaving behind is classical pathology... Instead of being general
surgical pathologists, they become super-specialised...and lose the big
picture.”
- Talks briefly about a public health education campaign for young women about cervical cancer.
Section 7- Talks about his religious beliefs and how he sees no contradiction between faith and science.
- Closes with a reminder that we still live in a divided world. “In
Africa they’re having difficulty getting basic stains; in the United
States it’s whether you should do the super-stain or not. You cannot
say that these disparities don’t affect all of us.”
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