Published on 12. June 2018

Not in the realm of shadows

Contrary to the stereotype, a pathologist is not busy every day cutting open corpses or solving violent crimes. They devote most of their work to living patients. And that is no less exciting.

The director of the Department of Pathology at Vivantes, Professor Dr. Hermann Herbst, is less interested in crime entertainment on TV and more in sophisticated literature. His work motto corresponds to the title of Carl Zuckmayer's autobiography: "As if it were a piece of me". The reason for this is that Professor Herbst spends around 98 percent of his working time analyzing tissue samples and surgical specimens of living people - just like his approximately 1,400 professional colleagues in Germany. He practices his profession with meticulousness and passion. "To treat every tissue as if it were unique, with great care and appropriate respect. This is sometimes done during an operation, for example in the case of cancer," explains Professor Hermann Herbst. In the so-called frozen sections, tissue removed during an operation is handed over to pathology for review and analysis. Within a very short time, the surgical team receives the findings and can decide on the further course of the operation based on this result, among other things. This is mainly the procedure used in tumor diagnostics to determine whether a tumor is benign or malignant.

Diagnosis at the microscope

Pathologists work precisely at the important interface between diagnosis and therapy. Without direct patient contact, they support their treating colleagues with a well-founded and reliable diagnosis at the microscope in making the decision for the right therapy for the patient. To do this, they use modern technical equipment and apply immunohistological methods. Professor Hermann Herbst's 100-strong team combines expertise from pathology, medical-technical laboratory assistance and section assistance. Astrid Jahn has been group leader of the medical technical laboratory assistants (MTLA) in the pathology department at Vivantes for about ten years. She explains her tasks at the microscope and at the microtome, a cutting device that can be used to make very thin sectional preparations. "We make very thin sectional preparations and mark the tissue with antibodies. This makes it possible to stain specific structures or cells in a tissue and thus distinguish them from others. The pathologist then makes diagnoses on this basis." Molecular pathology is becoming increasingly important in this context: it involves molecular biological examination methods on cell and tissue material selected by the pathologist according to the corresponding microscopic image. As in many other fields, pathology will benefit considerably from digital advancements. Professor Hermann Herbst explains: "Using scanners and image management software, tissue sections are digitized in the computer. By using these virtual and digital slides we can work more efficiently and flexibly, minimize our efforts and save time." The demands on the team in the department are high: careful, precise and fast work, plus continuous training and further education to always be up to date.

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