Third-year pathology resident Dr. Rachael Gruenwald examines a microscopic slide in the pathology residents' office.
Sept. 22, 2022
Story and photos by Jens Odegaard
For as long as there’s been life, there’s been disease. The ancient Greeks were the first to try to study and understand it, bringing life to the discipline of pathology with dissections of deceased people by the physicians Herophilus and Erasistratus.
In the 1850s, Rudolph Virchow, a German physician and professor of pathology, pioneered translating this scientific discipline to the animal kingdom.
Today, there’s an entire branch of veterinary medicine known as veterinary pathology focused on diagnosing and researching animal disease. Some of these veterinary pathologists work here at Oregon State University passing that knowledge down to the next generation of disease detectives.
“Pathology is inevitable,” said Dr. Elena Gorman, a clinical pathologist at the Oregon State University Carlson College of Veterinary Medicine’s Oregon Veterinary Diagnostic Laboratory and co-director of the college’s pathology residency program. “Diseases will always be a part of life, and it’s important that we have mechanisms to detect and, hopefully, treat and prevent them.”
Gorman and her fellow pathologists at the diagnostic lab use their specialty veterinary skills to help provide insight and answers to their colleagues about why an animal is ill or has died while also training resident pathologists to carry on the work.
“Pathologists are scientists, detectives and medicine specialists who also want to know why patients are ailing or what that tumor or other lesion might be,” Gorman said. “Most veterinary pathologists have experience as general practitioners and even specialists. Thus, we very much appreciate the opportunity to communicate with other doctors and animal owners. We work closely with them to find answers for the illness of their patients and pets. Our passion is in identifying and understanding the disease process and assisting the clinicians who can (hopefully) fix or cure it.”
There are two main branches of pathology: Clinical pathologists like Gorman primarily diagnose disease in living patients through analyzing tissues, including their products (e.g. blood, chemistry and fluids), at the cell level. Anatomic pathologists meanwhile diagnose disease through examination of whole organs, tissues and posthumous dissection of bodies (autopsy in humans or necropsy as it’s known in veterinary medicine). “An anatomic pathologist focuses on the forest, while a clinical pathologist focuses on the individual trees” said Dr. Beth Ihms, an anatomic pathologist at the lab and co-director of the pathology residency program. “Both perspectives are valuable, and highly complementary, because each is seeing a different aspect of the problem.”
The college’s three-year pathology resident program was launched in 2008 and trains both anatomic and clinical pathologists. “The program trains residents primarily through intensive, hands-on diagnostic service” Ihms said. “Residents learn through working up cases that come through the diagnostic lab.”
Many cases come to the lab from the college’s Lois Bates Acheson Teaching Hospital, where small and large animals of all kinds are treated, but they also arrive from private-practice veterinarians, zoos and sanctuaries and from wildlife agencies. “Our resident might look at samples from a goat, a rabbit, a dog, a bearded dragon, a bighorn sheep and a chicken in one morning,” said Dr. Jennifer Johns, a clinical pathologist at the lab.
For each case, residents are paired with board-certified pathologists like Johns, who oversee and advise the diagnostic work-up. “Initially they are working alongside the pathologist on duty 100% of the time. This oversight continues throughout much of their first year. As they become proficient, we start to allow more and more autonomy,” Gorman said. “By their third (final) year, we essentially are there for support with unusual or more ambiguous cases before final releases of their reports.”
Dr. Samantha Polk, a first-year pathology resident, prepares for a necropsy on a small animal to help determine cause of death.
Currently, the program has four residents. Dr. Samantha Polk (first year), Dr. Tamsen Polley (second year) and Dr. Rachael Gruenwald (third year) are anatomic pathology residents while Dr. Shannon Phelps (third year) is in the clinical pathology program.
They all have their own individual caseloads, research and studies, but as a cohort, the residents work collaboratively with faculty pathologists to solve whatever micro- or macroscopic mystery comes through the door. “Every day is different! You get to see tissues functioning at their highest and lowest levels, and it is impressive what animals can live with,” Polk said. “Not only is seeing the pathology exciting, but the challenge of putting the puzzle together with all the data you have collected and being able to provide an answer to the owner or doctor – it is incredibly rewarding!”
“I love looking at cells under a microscope!” Phelps adds. “I think it is so fascinating that we can provide a diagnosis, after looking at a slide, that can help the patient.”
In addition to polishing their own pathological skills, the residents help teach and train the college’s veterinary students, some of whom will go on to their own careers in pathology. “During the school year we have senior veterinary students on the necropsy floor with us as part of their clinical year, where they learn how to perform a necropsy, present their cases and develop analytic skills to approaching a case,” Polley said.
Polley and her peers also deliver lectures, serve as teaching assistants in pathology courses, assist in labs and help run the college’s student Pathology Club. “Veterinary students seem to especially enjoy learning from residents, as they are often closer in age and experience and are able to offer unique perspectives that students don’t always get when engaging with faculty,” Ihms said.
Veterinary students and faculty discuss a case during cytology rounds hosted by the pathology residents. Cytology is examining cells to diagnose disease.
Passionate for pathology
Since its inception, 14 residents have completed the residency program and are now working in both private and academic pathology careers. Two former residents working in academia have even received national teaching awards for their expertise in passing their knowledge of pathology on to future pathologists.
The current crop of residents are still plotting their futures, assessing each option and opportunity, but they are all looking forward to careers full of “finding answers” as Phelps put it.
“They’re all phenomenal,” Gorman said, in speaking of both former and current residents. “These are my people! They have become pathologists because they are excited about the diagnostic process and digging deeper into the ‘hows’ and ‘whys’ of a disorder. Because they are studying and reviewing nearly every case they encounter, they are far more on top of the recent literature and keep me up to date on new information and even treatment strategies … This has been the most rewarding experience of my academic career as it creates an environment of constant education and has helped to make me a better resident advisor. They teach me as much as I (hopefully) teach them.”