 Specialist Registrar at University College Hospital, London
Interview location: Wellcome Trust Building, Euston Road, London.
Interview date: 24th April 2009
Key Themes:Mentors and Influences, Motivation, New Technologies, Research versus Clinical Work
Section 1
- Talks about her family’s origins in Sri Lanka and how the family came
to Britain when she was three years old. Both her parents were
dentists.
- Talks about her own experience of racism, particularly at one
school. “I do remember those early days as very hard.” But she made
good friends, did well, and with a change of school and the
encouragement of her parents, she got to Cambridge, where she read
natural sciences.
- It was at Cambridge that she realised “I was actually quite keen on the
research, but I wanted to do it with humans rather than looking at
biological systems.” Moved to Barts and the London to study medicine.
Section 2 - She had some very inspiring teachers, including Paola Domizio. “Paola
used to get the audience involved... she also made it very real... I
think that really made me think pathology...I really wanted to do it.”
- However she had misgivings about loss of patient contact, and went
initially into paediatrics. But realised she didn’t have the same
passion for this specialty as for pathology, and returned to Barts and
the London and pathology. “It was wonderful, I just never looked back.”
Section 3- Describes the changes being introduced into pathology training,
including the establishment of SHO schools, and the emphasis on
workplace-based assessment.
- Talks about the “amazing advantages” of new technology, which allows
them to scan microscope images for viewing on computers. This is a
massive leap forward in terms of accessibility. Sharing of images and
information, she believes, is “the way the world is going, actually –
all health care”.
- Discusses the importance of visual appreciation and memory for a
pathologist, and her own passion for art and “design in all its
aspects”. But says that when she first looked down a microscope “it
was quite terrifying actually, because you’re there to diagnose disease
correctly... You don’t see the beauty of it until you’re more relaxed.”
- Talks about her early experience of postmortems and relates how one of
her tutors read a poem written by a relative of one of the cadavers.
“The theme was just about respecting that person as someone who really
wanted to teach us...that we would be able to learn from the body and
do good in the world as a consequence. It was really quite wonderful
and moving.”
- Sums up her attitude to autopsy work as having respect for the
individual while maintaining professional distance. “My parents are
Buddhist, and that has sort of informed my philosophy throughout my
life... It’s really about living your life in a good way, not harming
other people by your actions... I think medicine, having respect for
people, fits into that philosophy very well.”
Section 4- Describes how she became fascinated by the pancreas and the role played
by another inspiring teacher, Marco Novelli at UCL. “Pancreatic cancer
is one of the most challenging cancers you can look into because the
survival rates are so poor.”
- Another influence was Nicholas Wright, who encouraged her to do
research into aspects of familial adenomatous polyposis coli (FAP),
which became the focus of her PhD.
Section 5- Another great “passion” is educating and enthusing the younger
generation about pathology. Describes various projects at the Natural
History Museum and other centres, including schools. One project
involves students in a fictional scenario of the Black Death
reappearing in London. Creating this “was just amazing, one of the
best experiences of my life!”
- Part of her motivation is to increase understanding of the reality of
pathology and how “pathologists are integral to health care in many
different ways”. Her intention also, in visiting schools, is to be a
role model for children who lack encouragement to go on to further
education. “It’s so important for them to have someone tangible so
that they can think, ‘Actually that person looks really normal and
they’ve done it, so I can do it’.”
- Also talks about the ‘disease detectives’ project for the 2008 RCPath National Pathology Week.
Section 6- Discusses the difficulty of finding a balance between her different
interests in pathology – research, clinical work and ‘public
engagement’ with science. Has worked out a happy compromise which
involves collaborating in research but not taking a primary role.
- Talks more about the wider issue of the split between research and
clinical practice in pathology. Points out that “nowadays in order to
publish in anything, you really have to commit yourself to a research
career or you’re not going to be able to do the volume of work or get
the funding.” What it boils down to, she says, is that “if you want to
keep a lab in a very prominent institute you need to be able to
demonstrate those sorts of publications, and you can’t do that when
you’ve got 50 patients waiting in clinic for their results.”
- She has accepted for herself that she is “never going to be a
ground-breaking scientist”. Nevertheless her collaborative research can
“have a huge impact on patient care”, and she gives “a perfect example”
of work which has changed the way autoimmune pancreatitis is diagnosed.
Section 7- Touches upon the stereotypes of pathologists, the extent to which they
are true, and the impact these have on the status of pathology.
Discusses how medicine is “just the most hierarchical thing you could
go into... And even within medicine there are the sorts of golden
specialties.” Her decision to leave paediatrics for pathology gave her
first hand experience of such attitudes. “Overnight I became the sort
of black sheep. It was very hard.”
- Mentions that recruitment into pathology is rising, but questions how
much of this is simply due to the family-friendly hours: “I’d just love
it if people said, ‘Actually, I really love pathology’.”
- Continues the discussion about misperceptions of pathologists, not just
in general public but also within the medical profession. Believes
part of the problem is that medical students no longer have so much
direct contact with inspiring teachers like Domizio. Concludes
“there’s a lot of work to be done out there to change perceptions.”
Section 8- Talks about how she has benefited from strong and supportive women,
professionally and personally, and how this has helped her negotiate
the ‘glass ceilings’ within medicine.
- Touches upon the influence of cultural expectations in the career choices some women make.
- Ends by reiterating how incredibly fortunate she has been in terms of opportunities and contacts.
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