News

*This interview has been edited for clarity and length.  

My first literal and figurative steps towards a life in pathology were one and the same as I traded the blazing south Florida sun for the cool corridors of the University of Miami Pathology department for my final medical school interview. What I expected to be just another interview in a long and tiring cycle became the most memorable of the process when at its conclusion my interviewer noted “writing is clearly what makes you special, no matter what you do or where you choose to go to medical school never give that up.” Following closely on the wings of this moment of unexpected warmth and support was the assertion to “seriously consider pathology; it will really give you the time to write.” In the near decade since, the seed planted by that single conversation has germinated and flourished. 

Pathology for me has been the rare tropical transplant that first blossoms in the depth of a mid-western winter. In January of my M1 year I took the step of reaching outside the medical school curriculum to take a graduate student pathology elective. Not only did this class teach me an enormous amount academically, but it also demonstrated for the first time the unique joy I still find in pathology and opened the door to the opportunities that defined my pre-clinical medical school experience. Until I experienced it, I never anticipated being confronted so strongly and emotionally with the gravity of the case for which we were analyzing samples. Each morning, I found myself an eager participant in calls between my attending the team at the bedside and watching with equal enthusiasm change in the analyte values during sign-out at the end of the day.  

Pathology is a field where I find my skills and values prominently represented. The diagnostic challenges of identifying pathogens, interpreting antimicrobial susceptibility patterns, and guiding empiric therapy require the same analytical thinking that defines pathology practice.  

Pathology allows me to contribute directly to patient care through accurate diagnosis while engaging with the evolving landscape of molecular diagnostics, precision medicine, and laboratory innovation.   

What is your favorite test to perform and why? 

Surprising as it may be to those who have spoken with me after a night of heavy malaria call, malaria smear preparation and microscopic review stands out as my favorite pathology procedure. This preference reflects not only the technical challenge and immediate clinical impact of the test, but also my personal commitment to developing expertise through deliberate practice. 

Learning to create quality thin and thick smears—each serving distinct diagnostic purposes—demanded careful attention to blood drop size, spreading angle, and drying time. I spent considerable time reviewing my own practice slides, identifying imperfections in cell distribution, assessing whether erythrocytes in thin smears were adequately monolayered for morphologic evaluation, and ensuring thick smears achieved proper hemoglobin lysis while preserving parasite integrity. This iterative process of creation, critical review, and refinement taught me the value of technical diligence that extends beyond pattern recognition to the foundational quality of the specimen itself. 

What makes malaria smear work particularly meaningful is its immediate clinical impact. A positive malaria smear can prompt life-saving antimalarial therapy within hours, while accurate speciation guides appropriate drug selection and helps predict disease severity. The test directly connects technical laboratory skill with patient outcomes in a way that few other procedures demonstrate so clearly. 

While much of clinical pathology has moved toward automated platforms and molecular diagnostics, malaria smears preserve the tradition of morphologic diagnosis that has defined pathology since its inception. The ability to sit at the microscope, methodically scan fields, recognize subtle morphologic clues, and render a definitive diagnosis keeps me connected to the observational foundations of our specialty.  

Can you share a specific experience or moment that solidified your decision to choose a career in the laboratory?   

One of the most pivotal episodes on my journey to laboratory medicine occurred during my second year of medical school, at the very hospital where I now serve as microbiology director. I was rotating through the HIV clinic when I encountered a patient who had just received a new HIV diagnosis. The encounter fundamentally changed how I understood the weight and power of laboratory testing.  

The patient was experiencing understandable and profound distress. Not only were they facing a grave diagnosis but their partner, the person partially responsible for it due to introducing intravenous drug use into their life, had abruptly abandoned them just hours before. In that examination room, I witnessed the full emotional impact of a positive HIV test—the fear, uncertainty about the future, the immediate questions about mortality. This was not an abstract laboratory value or a checkbox on a requisition form. This was a diagnosis that, in the patient's mind, carried the specter of death and fundamentally altered their sense of identity and future. 

What struck me most powerfully, however, was not just the weight of the diagnosis, but the hope that an accurate and timely diagnosis could provide. As the clinical team explained the meaning of the test results, discussed antiretroviral therapy, and outlined the patient's prognosis with treatment, I watched the conversation shift from despair toward cautious optimism. The diagnosis that had initially seemed like a death sentence became, through careful counseling and education, the first step toward effective management of a chronic condition. The same laboratory test that had caused such distress was simultaneously the gateway to life-saving treatment. 

This duality—the gravity of diagnosis and the hope it enables—revealed to me the profound clinical impact of laboratory medicine. The HIV test was not merely a technical procedure; it was the critical inflection point that allowed this patient to access highly active antiretroviral therapy, achieve viral suppression, preserve immune function, and ultimately live a near-normal lifespan. Without accurate laboratory diagnosis, none of this would be possible. The test transformed an unknown infection silently destroying the immune system into a known, treatable condition. 

That experience taught me that laboratory medicine is not removed from patient care—it is central to it. Every specimen we process, every result we report, every quality control measure we implement has the potential to profoundly affect someone's life trajectory. The laboratory provides the objective data that transforms clinical suspicion into definitive diagnosis, guides therapeutic decisions, and monitors treatment response. In the case of HIV, laboratory testing enables not only individual patient care but also public health interventions, as viral suppression prevents transmission to others. 

Now, as microbiology director at that same institution, I carry the memory of that patient with me. It reminds me why precision, accuracy, and timeliness in laboratory testing matter so deeply. I understand viscerally what these results mean to the people whose lives depend on them. That moment in the HIV clinic showed me that laboratory medicine is not about tests and numbers—it is about providing answers, enabling treatment, and offering hope to patients facing their most difficult diagnoses.  

How do you personally see the impact of your work on patients, even though you may not interact with them directly?  

My background as a historian taught me that behind every data point lies a human story. Historical research requires looking beyond statistics and dates to understand the lived experiences of individuals navigating their circumstances. This same perspective informs how I view laboratory specimens. Each blood culture is not merely a tube of media requiring incubation and interpretation—it represents a person experiencing fever, rigors, and the fear that comes with serious infection. Each HIV viral load is not just a quantitative PCR result—it reflects someone's adherence to therapy, their hopes for undetectable status, and their ability to live without transmitting infection to loved ones. When I review a peripheral blood smear showing blast cells, I am not simply identifying morphology; I am providing the diagnostic information that will fundamentally alter someone's life trajectory. 

My bioethics training reinforces this patient-centered approach by grounding my laboratory practice in fundamental ethical principles. The principle of beneficence compels me to ensure that every test I perform or interpret is done with maximal accuracy and care, because the patient's wellbeing depends on the quality of my work. Non-maleficence requires that I consider the downstream consequences of laboratory results—understanding that false positives can lead to unnecessary treatment and psychological harm, while false negatives can delay life-saving interventions. Justice demands that I advocate for equitable access to high-quality laboratory testing and resist shortcuts that might compromise results for underserved populations. Perhaps most important is patient autonomy—the recognition that laboratory results enable informed decision-making. When I ensure the accuracy and timeliness of diagnostic testing, I am protecting the patient's ability to make autonomous choices about their care based on reliable information. 

Bioethics also taught me to grapple with the moral weight of uncertainty. Laboratory medicine is not infallible—tests have sensitivity and specificity limitations, pre-analytical variables affect results, and rare conditions may produce atypical findings. My ethics training helps me communicate this uncertainty appropriately to clinicians, ensuring they understand the probabilistic nature of diagnostic testing and can counsel patients accordingly. It prevents me from overstating the certainty of results or dismissing unexpected findings that might represent true pathology rather than laboratory error. 

Ultimately, my background in history and bioethics ensures that I practice laboratory medicine not as a purely technical discipline, but as a fundamentally humanistic one. Though I may not see patients directly, I serve them with every culture I read, every result I verify, and every quality improvement initiative I champion.