Started surgical pathology...and I thought it was a lot of hype at first when other residents would say it's intense. After two weeks of 12-14 hour days, mixed in with a couple nights of call, and 4:30 am cases...I think the beginning was pretty rough. I thought about other career options...something that would be less hectic...a regular 8-5 job...maybe I could get a job at Starbucks. I honestly think I would enjoy smelling coffee a lot. Now...I feel like my body adjusted to the work load and it's not bad at all. I'm enjoying the material a lot, even though it's such a steep learning curve. One of the most important things I've learned is that: what you know is not the most important thing...even more important is knowing when you don't know...so you don't overcall anything.

What would be worse? Overdiagnosing something as carcinoma invading the muscularis propria which would lead to a cystectomy, when in reality it turned out to be benign. The patient loses their bladder.

OR

Underdiagnosing something as benign when in reality the patient had a cancer that metastasizes everywhere.

My mentor said that anyone can distinguish widespread cancer or normal tissue histologically. However, an excellent pathologist will be able to delineate the very subtle features when a tumor has not undergone full blown transformation. There are many mimickers of cancer which are benign, and vice versa. Only through repeated training and recalibrating ones threshold for calling tough cases which fall on the inbetween line will one be able sharpen their skills. It feels more like an art than science. And I find that to be very ironic. And yes, I realize that I started a sentence with And which is horrible grammar.