Chapter 02: The Young Scientist and the Pathologist's

Chapter 02: The Young Scientist and the Pathologist's "Eye"

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Description

In the next chapter, Dr. Bruner sketches her love of science and her educational path. She notes her love of mysteries as a young person, and draws an analogy to pathologist as a detective solving the mystery of tissue. She traces her path to a pharmacy degree and then to medical school (as opposed to graduate school), explaining how she discovered pathology in her second year of medical training at the Medical College of Ohio, Toledo. She gives a very complete definition/description of a pathologist's "eye," on which good diagnostic capabilities rely. Dr. Bruner observes that today she sees fellows struggling to develop this "eye" "some are able to develop it, others are not.

Identifier

BrunerJM_01_20120604_C02

Publication Date

6-4-2012

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Educational Path; Personal Background; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; Overview; Definitions, Explanations, Translations; Professional Practice; The Professional at Work

Transcript

Tacey Ann Rosolowski, PhD:

Well, thank you for that. That’s really useful. Would you mind now if we turn to some of your own background and journey into this field?

Janet M. Bruner, MD:

That would be great.

Tacey Ann Rosolowski, PhD:

Okay. Well, let’s just start with some real basics. Where were you born and when? Where did you grow up, and how did you get into the sciences?

Janet M. Bruner, MD:

I was actually born in East Liverpool, Ohio, which is a little town on the Ohio River right by West Virginia, and I don’t remember that, of course. Then we moved to Cleveland, which I also don’t remember, and the first place I remember living is Detroit, Michigan. We lived there until I was about five. My father was a Woolworth’s store manager, and my mother was just a homemaker, so really no background in the sciences at all. But I do remember growing up that I was very interested in Sherlock Holmes and detective work and I think people—I’ve told that story before, but when I was about twelve, I saved my money for six months to buy this giant tome of Sherlock Holmes stories. It was the complete works of Arthur Conan Doyle, and I still have it. It was great! I read that book—I can’t tell you how many times I read that book, and I compare that a lot to pathology because with pathology you’ve got a piece of tissue, and you have to use your intuition, your observation skills, and you are the detective trying to solve the mystery of that tissue and bring all of its—reveal all of its secrets and make a diagnosis. I think that’s really a very good analogy for what pathologists do.

Tacey Ann Rosolowski, PhD:

Do you still read mysteries?

Janet M. Bruner, MD:

Not so much. I still love Sherlock Holmes, though. You know the new series—that new series on PBS that I’m watching, too. But I think growing up I was just good at biology and good at science. I really seemed to enjoy those and I think because they were very—the answer was there, if you will. It was not like literature where there may be several answers. It was—in the sciences and in math, it’s like there was one answer, so that was something that I liked. I went to pharmacy school. That’s my undergraduate degree, and the reason I did that was I was looking for something in the sciences. I was the oldest of three children, so my dad told me, “Okay, you’re going to go to college, but when you graduate you’ve got to have something you can do to make money, because I can’t support you after that.” He said, “You’ve got to have a trade.” I thought pharmacy school really fit that bill, and I was very happy with pharmacy school, but during pharmacy school I met my husband. He’s also a pharmacist. We got married, and I had decided that I wanted to go to graduate school. I talked to some people about going to graduate school, and also my husband had a hand in it because they all advised me that if I wanted to go to graduate school and be a scientist that I probably would want to do research that involved people. You know? They said, “You know, it’s all well and good to go to graduate school and do research, but if you want to get involved with people and medical research, you might as well go and get an MD because that way you would have access to the people you need to do the research, and you wouldn’t have to be asking a doctor, ‘I want to get your patients to do this research.’”

Tacey Ann Rosolowski, PhD:

So you were convinced very early in that process that you did want to work with people—that you—

Janet M. Bruner, MD:

Yes, I was convinced that I wanted to do research that involved human—the human condition and not just rats, or not just chemistry research in the lab. I wanted to do something that could help people more directly. So that’s what made me decide then to go to medical school rather than graduate school. At the time I thought I was going to go to medical school and get some—get a graduate degree in pharmacology, do something combining my pharmacy and medicine—I didn’t know what—and then about two years into medical school—during the second year of medical school I discovered pathology, and I just loved it. It was just—all of a sudden it was like, “Wow! This is really, really neat!”

Tacey Ann Rosolowski, PhD:

What was it that so captivated you?

Janet M. Bruner, MD:

I think it was the visual specimens and just the visual part of the body—the parts of the body that were really particularly interesting to me. Again, that was sort of hard science, and I realize that the people part of it is sort of softer science. I liked the hard science, if you will, a little bit better.

Tacey Ann Rosolowski, PhD:

Doctor, when I was interviewing Dr. Frederick Becker [Oral History Interview] he talked about discovering at one point that he had what he called “the eye.”

Janet M. Bruner, MD:

Right.

Tacey Ann Rosolowski, PhD:

So you know what that is.

Janet M. Bruner, MD:

Right.

Tacey Ann Rosolowski, PhD:

Maybe you could give me your take on that and when you discovered that?

Janet M. Bruner, MD:

Well, I’m not sure that I knew, but I do think that it’s something that people have, and I think you can train yourself. It’s sort of a power of observation, if you will, but I notice it today, and it’s very strange. A pathologist who’s got the eye or somebody who’s been doing pathology for a long time has these powers of observation that seem to be more acute than other people. I always thought everybody was like this, but when I’m driving down the street or when I’m in a car—I’m going somewhere with somebody—if a car goes by, somebody will say, “What kind of car was that,” and I know what it was just by—if I’ve just seen a corner of it or the back of it. I never knew that that was any different than anybody else until—my husband will do that, and he’ll say, “I don’t know how you can tell what those cars are. It just went by so fast. You hardly saw it.” But it’s just like I can see the part of it that tells me what it is, and I think that is part of a pathologist’s eye. I think there are pathologists also who are photographers and maybe have the same kind of eye. I’ve known quite a few pathologists who are birdwatchers, and I think it’s a similar type of thing. You see the flash of a bird, and they can recognize it because they have this observation. They work on it every day.

Tacey Ann Rosolowski, PhD:

So you said that you can train your—you feel like—

Janet M. Bruner, MD:

I think people can train themselves.

Tacey Ann Rosolowski, PhD:

Did you work in consciously obtaining—?

Janet M. Bruner, MD:

Not consciously. Not consciously, but I just think that you sort of develop that. Now, I’ve also known pathologists, sadly, that didn’t have the eye, and I just felt so sorry for them. We’ll get sometimes coming through our program—we have fellows in our program—clinical fellows. Once in a while you run into a clinical fellow that you know they’re trying and trying as hard as they can. They read a lot, they look at slides, they look at cases. They try to do the best they can to do the analysis and make the diagnosis, but you realize that they just don’t get it. They don’t have it, and there have been some that have been so bad that you just say—I feel like saying, “How did you ever get into pathology? You just need to get out of it, because you’re never going to be very good at it.” I’ve never said that to any of them, but there’s a couple of them that I’ve wanted to say that to. I don’t know what it is, but I think it’s this power of observation or a way of looking at something visually and mentally analyzing what you see.

Tacey Ann Rosolowski, PhD:

Yeah. And from what you’re saying, the speed at which you can do it is quite extraordinary.

Janet M. Bruner, MD:

Yes, and I think the speed develops as you have more experience. We notice that in young pathologists. Young pathologists will look at a slide, and it will take them much longer to finish a case their first year or so that they’re in practice, and again, I feel sorry for them. We had a person start recently that—he was having such a hard time! He said, “Oh, this is much harder than I thought. I don’t know if I can make it. I just don’t know if I can make it here. We have so many cases. It’s so burdensome.” And then I talked to him about a year, a year and a half later, and he felt much better about it. He said, “You know, I’m learning about the cases. I’m getting through them faster,” and that’s what happens. I think that’s what happens with all pathologists that we send out. We send these fellows out into the world, they’ll call back, and they’ll say, “Oh, I’m having such trouble here in practice! I’ve got so many cases. I’m here until eight-o’clock at night. I don’t know what to do!” Then you talk to them a few years later, and they go, “Oh, you know, it’s no problem now.” So I think people do—you get faster, and it’s not carelessness. It’s just that you look faster. You observe more quickly.

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