Letters: Why I chose pathology

Why I chose pathology

November 2025—Starting medical school marked a shift in my life. As an osteopathic student, I was immersed in patient care from day one—taking histories, performing physical exams, and practicing osteopathic manipulative medicine. It stood in contrast to my previous life as a medical laboratory scientist, where I spent long days at the bench, close to disease yet far from the people it affected.

Most expected me to return to the laboratory, but I entered school with curiosity wide open. That openness was tested the summer after my first year. While traveling abroad, I was struck by sudden chest pain and relentless palpitations. Though the symptoms passed, they haunted me. When we began our cardiology block that fall, each lecture felt personal. Every slide seemed to reflect the fear I couldn’t shake. Eventually, I sought care. The initial diagnosis of acid reflux brought temporary relief, but symptoms persisted.

A turning point came after an esophagogastroduodenoscopy procedure. As I drifted awake in recovery, the steady hum of monitors and the voices of the clinical team surrounded me—sounds I was more accustomed to hearing from the other side. Still groggy, I overheard the physician remark, “Areas of duodenal inflammation.” Without thinking, I mumbled, “Villous blunting and intraepithelial lymphocytes?”

The room erupted in laughter. Even in a sedated fog, I had unconsciously recited the histopathologic features of celiac disease. Later that week, I learned biopsies had been taken to confirm the suspicion. In that moment, suspended between sedation and awareness, I saw clearly: Pathology wasn’t just something I knew. It was part of how I made sense of the world. The diagnosis was celiac disease. But what stayed with me wasn’t just the answer—it was how that answer came. Pathology gave shape to what I was feeling.

That experience reframed how I see illness. Behind every biopsy is a person holding their breath. And behind every microscope is someone who can offer understanding. Pathology, though invisible to patients, bridges the unknown with the known. That quiet act of naming disease became, for me, an act of healing.

Though I’m grateful for the patient-facing training of osteopathic medicine, I now know my hands belong behind the microscope. It’s where I feel most human, most useful, and most at peace. Pathology is not just a specialty I admire; it’s where I found purpose, clarity, and a place to build a life.

Nicholas Barron, OMS-III, MLS(ASCP)
Michigan State University
College of Osteopathic Medicine

Defining PAs and grossing technicians

I write in response to the letter on the recommended definitions of the American Association of Pathologists’ Assistants for both pathologists’ assistants and grossing technicians (CAP TODAY, September 2025). I agree with all points made in the letter.

I wrote in 2015 an editorial on grossing histotechnologist training, and in 2020 a review article on grossing technology, in which I concluded that the emerging grossing technologist subspecialty requires that a special training program with eventual certification be developed (Dimenstein IB. J Histotechnol. 2015;​38[2]:33–38; Dimenstein IB. Lab Med. 2020;51[4]:337–344). Under the AAPA’s auspices and with the organization’s resources, such a training program could be carried out optimally. The AAPA has the necessary materials on the specific methods of grossing technology. Licensure or additional regulations to define the PA profession would work to formalize the distinction between PAs and grossing technicians and provide quality assurance for the surgical pathology diagnosis.

Izak B. Dimenstein, MD, PhD, HT(ASCP)
Loyola University Medical Center (Ret.), Chicago
Grand Rapids, Mich.