November 15, 2012

On Virchow’s Eightieth Birthday Party and the Mainstreaming of Digital Pathology – Kim Solez, M.D.

BY Dr. Keith J. Kaplan

Technology is the easy part to change. The difficult aspects are social, organizational, and cultural.

Donald Norman, The Invisible Computer, Cambridge, 1988. 

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Digital pathology, whole slide imaging, has been promoted well within the pathology community but adoption is limited. What is needed now for it to become ubiquitous is broader promotion in the world at large using social media. If you would like to do your part in this promotion you should
“like” this blog posting on Facebook, 1+ it on Google+, perhaps even pin it on Pinterest, add it to del.icio.us, Digg it, discuss it on Newsvine, stumble it on StumbledUpon, add it to Mixx, reblog it, retweet it, and if you don’t know how to do some of those things, consider learning how to do them. Social media channels are becoming mainstream. More and more hospitals and large companies are giving up blocking social media as a security threats and embracing Facebook and other social media in the workplace.

The advantages of digital pathology are easy for the general public to understand.  In fact members of the general public may assume that digital pathology is much more widely adopted in medicine already than it actually is. When one is attempting to promote a new concept reaching the general public can have enormous advantages, as you can enlist the whole rank and file of humanity to join your cause.


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No one knew this better than the most famous pathologist who has even lived, Rudolf Virchow, who was amazingly successful promoting personal causes during his lifetime.  In his outstanding lecture in the University of Alberta’s Technology and Future of Medicine course, surgeon Jonathan White mentions (in minutes 40.42-41:26) three people he would like to see brought back to life: physicist   Richard Feynman, science fiction writer Philip K. Dick, and his own grandmother. I would propose adding Rudolf Virchow to that list. In a sense he is already very much living among us as can be seen below.

It would not make sense to write just another article about Rudolf Virchow. There are already too many such articles.  Born in 1821, Virchow, the father of cellular pathology, is not only the most famous pathologist, but also one of the most famous physicians who every lived. His life was so rich and storied that it is likely that every health care professional knows something about him.  The author of over 2,000 papers and books, he never imagined that one day medical students would each have a personal microscope. When he lectured, he sent his microscope and slides from student to student around the room on a specially-built model train. It is not just his work in pathology that keeps his memory alive, he also helped found the discipline of medical anthropology, and his writings about the social responsibility of medicine still are highly influential and include such memorable quotes as:

It is the curse of humanity that it learns to tolerate even the most horrible situations by habituation. Physicians are the natural attorneys of the poor, and the social problems should largely be solved by them. 1848 Report on the Typhus Epidemic in Upper Silesia, Archiv für pathologische Anatomie und Physiologie und für klinische Medicin. Vol 2. Berlin, Germany: George Reimer; 1848;143–332.

Another Virchow quote from the same source is featured prominently in cardiologist Bibiana Cujec’s lecture in the Technology and Future of Medicine course (start of video) about social determinants of health and the new medical school devoted to rural health we are creating in Nepal:

If medicine is to fulfill her greatest task, then she must enter the political and social life.  Do we not always find the diseases of the populace trace to defects in society?

Virchow was twenty-seven when he wrote the words in these two quotes. In this blog piece I will concentrate on an event which occurred much later in his life, his eightieth birthday party in 1901, which became the occasion for an unprecedented worldwide celebration. A torchlight parade in Berlin and numerous receptions in the leading scientific centers,  as far away as Japan and Russia, gave testimony to his unparalleled international reputation. A three page article in the British Medical Journal described the elaborate party and celebration that took place in Berlin.


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So what can we conclude from this?  Virchow was a true medical celebrity who was able to fully enjoy during his lifetime the high regard in which he was held in the eyes of his peers and the public at large. His notoriety allowed his ideas and beliefs to be promulgated far and wide.

For the maximum dissemination of digital pathology we need to think well beyond the strict confines of pathology and laboratory medicine
and traditional professional publication and promotion methods.  Using the general and medical celebrities of today and social media to get the message out to the general public is particularly useful as the arguments in favor of digital pathology should make good sense to many intelligent lay people, while the arguments against the technical and lose much in translation.

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Why is digital pathology not part of Daniel Kraft’s description of the medical future in the FutureMed program at Singularity University? It could be if one pushed hard enough for its inclusion. Why is it
not part of Peter Diamandis’s description of the Qualcom Tricorder XPrize?  It could be. We just need to push for it.

Beyond medical celebrities like Daniel Kraft and Peter Diamandis one could go after musical celebrities like iconic Canadian poet singer/songwriter Leonard Cohen. Surprisingly when I visited
him over a three day weekend
in November 2005 he was quite curious about my work as a pathologist and we talked at length about standard setting in medicine. Shortly after that, when he accepted the Canadian Songwriters’ Hall of Fame award in 2006 he talked (at minutes 2:09-2:25) about writing “with a microscopic precision” and said “the appetite for precision is ferocious”. One could use those quotes to promote digital pathology to the general  public.


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There are many dimensions that might be employed for promotion of
digital pathology in the world beyond pathology. To reach the giant swath of humanity influenced by science celebrities like Neil deGrasse Tyson one could also conceive of somehow engineering coverage of digital pathology on the television show Nova on PBS which reaches an audience of one
hundred million viewers.

With your help clicking those Facebook “like” and Google+ buttons and making other promotional uses of social media we can make 2012 the year when we began to solve the matrix of promotional possibilities to make digital pathology mainstream. So go out there and start clicking!
out there and 
start clicking! 

My original blog posting in this space has had 30 Facebook likes so far. Let’s see what you can bring the number up to for this one!

 

 

 

 

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