New Jersey College of Medicine - Journal Yearbook (Jersey City, NJ)

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n ZIGMUND KAMINSKI, Ph.D :fue-faasfgll : ,jji 9'-'- Lu 'L www,

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,--f' A F . 4. 4 5 4 . X 1 The primary purpose of a physician is the care ofthe sick. A pathologist is a physician and, in the last analysis, everything he does is directed to that end. The understanding of the na- ture of illness is in reality the obiective of pathology whether it be approached as an investigative or diagnostic problem or a combination of both. In practice a pathologist is closest to the immediate problem of a sick individual when he is concerned with the evaluation of a biopsy. Until recent years biopsies were usually thought of only as a means of determining the presence of and type of neoplastic, or possibly pre-neoplastic process. This is still a maior part of a pathologist's work and one that is very ob- viously critical forthe patient in terms of life or quality of life. Twenty or twenty-five years ago when the evaluation and significance of cervical carcinoma in situ became a maior problem, a large number of young women were subiected to total hysterectomy because of atypical cytologic changes in the cervical epithelium. lt may well be true that an unknown number were thereby spared the later development of a disas- trous disease, but it is equally true that a large number were condemned to barreness with all the distressing personal problems that may change the quality of life. It has required careful study by a large number of pathologists to refine diagnostic criteria to the point where more accurate evaluation may lead to the best possible treatment for non- treatmentj of the individual. The increasing utilization of biopsy methods, particularly electron microscopy, in an understanding of many renal diseases has allowed the clinician to estimate prognosis with a high degree of accuracy and, in some instances, to select therapeutic approaches guided by the fine structural altera- tions observed by the pathologist. There still exists a curious misapprehension that a pathologist arrives at interpretive decisions by some sort of semiautomatic process. Many biopsies, it is true, can be in- terpreted without any information about the patient. But many cannot be made meaningful without full information of the clinical manifestations of the problem. All of this demands of the pathologist that he have a sound basis of clinical medicine and that he be thoroughly imbued with the hallmarks of the conscientious physician-a deep personal concern tor the in- dividual human being who is the reason for our professional existence. Hugh G. Grady, lVl.D, Professor of Pathology 29