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AUGUST 2018 | Published by RCPA

Issue #083

Pathology, it’s in the blood

Pathology, it’s in the blood

Doctor Ian Beer is an anatomical pathologist and is Director/Managing Pathologist at Pathlab Waikato, New Zealand. His brother, Doctor Brian Beer is a forensic pathologist, based in NSW, Australia at Newcastle Department of Forensic Medicine, John Hunter Hospital. Growing up in a small provincial town in New Zealand, the brothers both attended high school in Christchurch before going on to study medicine in Auckland, with Ian becoming the first to enter into the profession, and Brian following in his footsteps three years later.

Ian Beer:

“Brian and I both went to Shirley Boys’ High School in Christchurch which was a very good school in terms of encouraging work ethic and training. Following this, I lived in Auckland whilst I was on the general pathology training program and Brian followed along two years after me – he thought it was a good idea too. We both secured jobs in provincial towns, I got a job in Tauranga, and he ended up in Gisborne initially and life changed from then on! I have now become an anatomical pathologist with some coronial pathology which means I do Coroner’s autopsies.

“We don’t come from a professional family; my parents ran a grocery shop before the supermarkets came in and ran them out of business. I think a good dose of sibling rivalry led us into medicine. I was first, but I suspect Brian followed in my footsteps to do something similar.

“My first appointment was to Greenlane Hospital as a Surgical Registrar with the view that a budding surgeon should understand what is required from a pathologist, as surgeons send a lot of pathology to the lab. Effectively, I had about six months there while I realised that becoming a Surgical Pathologist was really what I wanted to be.

“I wouldn’t say that Brian and I have similar personalities but I guess the one thing you need to become a pathologist is to be fixated on detail, which we both are. There are quite a few people that I can think of in whom pathology runs in their family, both siblings and parents and their children. I think it’s probably an example of wanting to do something similar to your sibling/parent, combined with finding that it is intrinsically interesting. I’m 65 now and I’m still enjoying it. Every day there are a new set of challenges, certainly diagnostic challenges that really intrigue me. There’s a lot of routine, of course, but I guess around 5% of the work will be quite challenging and I’m very grateful to have colleagues to show things to.

“Pathology is the hinge on which the diagnostic door turns. You can’t really practise medicine without pathology. Every cancer diagnosis has a pathology test or examination to determine what kind of cancer it is and to assess how it should be managed. More broadly, there are a huge variety of tests performed on a patient to arrive at a diagnosis, which are often based on blood chemistry, immunology, microbiology and haematology, looking at the white cells or red cells and so on.

“And now of course, genomics is becoming a major focus and that applies to almost every discipline because there is a genetic basis to a large number of diseases, especially cancers.”

Brian Beer:

“My earliest memories of Ian are from the town in New Zealand that we grew up in. Our parents owned a dairy (a corner shop) and my earliest memories go back to then and also going to our uncle or granddad’s farms for the holidays, particularly in August which was lambing season. Some of my clearest and vivid memories are of my brother and I helping my uncle or granddad with lambing early in the morning with frost everywhere and lambs running around bleating.

“I was very interested in pathology from medical school and Ian had also made a start in pathology during my latter years in medical school which put the specialty onto my radar as what to do. As part of my last year at The University of Auckland School of Medicine, I did the final year three-month elective in the forensic department. At that particular time the Air New Zealand DC-10 air crash into Mt Erebus in the Antarctica occurred and I was a small part in the forensic team doing the DVI (Disaster Victim Identification) exercise for that. This unique experience whetted my appetite for pathology and into general pathology training.

“Doctors have skill sets/personality traits that suit them to a particular specialty, and in anatomical and autopsy pathology, pattern recognition and attention to detail are critical, which fits with the way my brain operates. This, along with my initial experience of post mortems particularly, drew me to pathology.

“I have practised as a general pathologist for most of my career in regional towns where there is a need for someone who can cover all disciplines in the lab and often as part of that role, I would do the Coronial post-mortems. Later I was able to easily transition to forensic pathology. Training as a general pathologist has allowed me a lot of flexibility in my pathology career over the years.

“Pathology is critical to the current practice of medicine, underpinning many of the advances in medicine, which is something most people don’t appreciate as the discipline is not visible to them. If you didn’t have a good quality laboratory system in healthcare, much of what doctors currently do now wouldn’t be possible.”





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