Autopsy, lectures, and dinner for eight

Dr Jane Dahlstrom is inspiring a passion for pathology in new clinicians to better see the cause of disease.

Thanks to TV shows like CSI and Silent Witness, most people are familiar with the concept of autopsy. But there is an older meaning of the word that encompasses much more than metallic slabs and ultraviolet lighting. Taken from its Greek roots, autopsy means ‘to see with one’s own eyes’.

This is the explanation that Anatomical Pathologist Dr Jane Dahlstrom is eager to share with the medically uninitiated. When she is not examining tissues for diseases, such as cancer, or teaching graduate students from the ANU Medical School in her role as Associate Professor, Dahlstrom is called upon to perform post mortems at the Canberra Hospital. She has done this for coronial investigations in the past, but these days she solely examines people who have died in hospital, where permission has been granted by the family.

“If someone had said to me at the start of my career that I’d be performing post mortems, I probably would have laughed at them. I don’t watch CSI, which is where a lot of people get their impression about what a pathologist does.

“I look at it as trying to give answers to families, and I’m very satisfied if I am able to do this. If I can say, ‘There is nothing you could have done to prevent your loved-one from dying’, I think that can be very helpful.”

And there, in the word ‘helpful’, can be found Dahlstrom’s raison d’etre. By performing autopsies, she helps families to find closure. By analysing tissue from living people, she helps fellow clinicians to determine whether or not surgery is required. She helps students understand the relationships between diseases and the body. She helps to expand knowledge on best-practice medicine and clinical education through research. Then, when day is done, she is a mother to six children (three of whom still live at home), where giving help is just an ingrained part of the day-to-day.

For the last 13 years, Dahlstrom has dedicated herself to the vocation of Anatomical Pathology. Unlike haematology, which focuses on blood diseases, and immunology, which is concerned with the immune system, Anatomical Pathology is all about analysing tissue from the body

“Pathology is a very interesting mix of tasks. You do diagnostic work, teaching, and research. The main bulk of my work has me looking down a microscope deciding what is wrong with the tissue I am looking at.”

“In its broader sense, pathology means the study of diseases and this leads to a better understanding of how to treat diseases.

“If a student doesn’t understand disease and the pathological processes that cause it, then it’s very hard for them to treat people. They need to be able to communicate what the disease is about to a patient. So you can see how pathology is at the centre of medicine really.”

While pathology is the centre of Dahlstrom’s professional life, she is also passionate about teaching. The ANU Medical School differs from most other graduate clinical schools by integrating pathology into the entire four-year course, instead of treating it as a discrete subject. Dahlstrom is a great advocate of this across-the-board approach, and says it has been a privilege to be involved in establishing the curriculum for the three-year-old school. She says it is run as a close-knit team where colleagues collaborate to ensure that students are receiving the best education possible.

“When I feel that the students are engaged in the topic, that gives me a real thrill. I feel that they love what I love. The feedback that the students are giving shows that they are enjoying pathology.”

“It’s a privilege to have been trained to do this aspect of medicine. I do have a very high sense of the importance of getting the pathological diagnosis right every time. That’s not always possible, so it’s important to seek consultation with colleagues. It is a job that demands you set very high standards for yourself. There is a patient at the end of every diagnosis you make, and it could have major implications
if you miss a cancer, or call something cancer when it isn’t. You’ve got to be very exacting.”

One senses that Dahlstrom would be most happy if some of her students went on to become pathologists, as she describes it as a field that is often overlooked by those seeking a career in medicine. She relates her own experience of wanting to be a GP, and then happening across pathology while doing a PhD at the John Curtin School of Medical Research.

Through a combination of serendipity and opportunities grasped, Dahlstrom has arrived at a point in her career where she can help students, colleagues and patients to see the cause of disease with their own eyes.

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ANU Reporter
Autumn 2006