Learn more about our Member Spotlight of the month, Dr. George Birdsong from his conversation with Membership Committee member Dr. Uma Krishnamurti
Member Spotlight Interview
1. How did you first find out about cytology?
I was first introduced to cytology when I was a second year pathology resident at Emory University. Dr. Zuher Naib, attending cytopathologist who had started cytology services at Grady Memorial Hospital, played a very important role in stimulating my interest in cytology. I was in awe that “cytology was a very important screening tool for early detection of cervical cancer.” Beginning in the 1960s under the leadership of Dr. Naib and some very committed gynecologists, incidents of cervical cancer at Grady Health System decreased markedly. During my fellowship and the years immediately following, Dr. Naib (and Dr. Chester Herman, who was Director of AP at the time) were very supportive mentors and they directed me toward resources and connections, which allowed me to pursue my interests.
2. What drew you to this profession
I was greatly attracted to Fine Needle Aspiration biopsy (FNA). The patient contact FNA provided, and the fact that one can provide an accurate diagnosis by a low cost, minimally invasive procedure were reasons that I was drawn to this profession.
3. Tell us about an interesting case or situation that you’ve encountered in your practice.
There are several interesting cases and situations in my clinical practice that have been of great educational value. A couple of situations that comes to mind that I would like to share are as follows: Around the year 2000 when the accuracy of the Pap test was being questioned, I had a cervical biopsy with invasive squamous cell carcinoma. The patient had an abnormal Pap test in the past with negative biopsies. Retrospective review of the prior negative biopsies revealed one endocervical curetting with rare high-grade dysplastic cells admixed with mucus. This case drives home the importance of the Pap test in cervical cancer screening and also reiterates the importance of diligent screening of the endocervical biopsy specimen. Another case was a patient with a prior history of lobular carcinoma of the breast who presented with an enlarged axillary lymph node which was interpreted as positive for carcinoma on FNA. Upon excision of the lymph node, the diagnosis was dermatopathic lymphadenopathy. Subsequently, it was confirmed that the patient was an avid gardener who had scratched her ipsilateral forearm on some thorns three weeks before developing axillary lymphadenopathy. This was a lesson learned; to be wary of pitfalls particularly in the context of lobular carcinoma of the breast.
4. What do you like best about being a cytotechnologist?
The FNA service is what I like best about being a cytopathologist. It promotes patient contact and greater interaction with clinical colleagues, which I really like. In my first year as an attending pathologist I was very active in doing FNA’s on both outpatients and inpatients. Although I was the most junior faculty member of the Department, I was one of the most visible pathologists to my clinical colleagues, to the extent that I was once mistaken to be the Chief of Service.
5. What is the most rewarding thing that has happened to you in cytology?
Serving as President and on the Executive Board of ASC have been very rewarding. In addition, serving on FDA panels for approval of cytology devices has been very valuable.
6. What do you value most about your membership in the ASC?
Being part of a society dedicated to education and advocacy of cytology is very important in delivering clinical care in a rapid, minimally invasive, cost effective manner is one of the things I value most about my membership in the ASC. The other is the many friends and colleagues I have had the pleasure of interacting with over the years.
7. Do you have a memory from the ASC that you would like to share?
In 1989, I presented my first poster at an ASC Annual Scientific Meeting and was right across from Dr. Daniel Kurtycz. We started talking and this encounter resulted in a friendship that continues today.
8. What advice would you give to students coming into the profession?
The advice I would like to give incoming students is to learn to integrate several skills. Students should integrate cytomorphology with molecular pathology and also learn information technology so that clinical care can be provided not just on an individual basis but also on a population basis. Integrating cytology with IT will allow for better cyto-histo correlation and error prevention. Residents should develop a “10,000 foot big picture” understanding of population based health care delivery.