Thank you so much for doing this with us! What is your “backstory”? In college, I double-majored in Bio-Psychology and Studio Arts, worked in neuroscience research at the University of Rome, La Sapienza and then decided to go to medical school. After attending medical school at the Keck School of Medicine at the University of Southern California (USC), I began my residency training in Internal Medicine at the West Los Angeles VA — UCLA program, however this field was not quite right for me. Thereafter, I was in a research fellowship at USC for wound healing. During my academic journey, I realized that I really liked pathology, especially anatomic pathology, because looking at tissue under a microscope is all about pattern recognition: it is all visual, very much like art. I completed my residency in anatomic and clinical pathology at UCLA and went on to complete a cytopathology fellowship there. It was early in my residency that a doctor came to speak to us about his unique practice: a stand-alone (that is, not hospital or large laboratory associated) pathologist-run FNA clinic. Being a pathologist who studies slides in a lab all day wasn’t enough for me. As I like working with my hands, performing procedures, as well as figuring out the outcome — that is, being at the beginning, middle and end — of the diagnostic process, I realized that becoming an FNA specialist was exactly what I wanted to do.
Can you share the funniest or most interesting story that happened to you since you began leading your company? A 73-year-old woman comes to see me with her husband, who happens to be a retired physician. She is in my office because she has a lump behind her left ear, discovered during a dental exam. She is terrified, as she is a recent breast cancer survivor. So much so, that she wouldn’t even let her husband touch the area. As part of the work up, subsequent imaging of the lesion reported “right level — a pathological lymphadenopathy with necrosis, consistent with metastatic disease”. This meant a death sentence to her. As indicated in the report, she likely had breast cancer that metastasized to the left head and neck lymph nodes. Reflecting on this, I found this odd, as this would mean the tumor would have to cross the midline, which is quite unlikely. However, her own primary care doctors, oncologists and radiologists were convinced that she had metastatic breast cancer. As I was preparing the patient for the biopsy, by viewing the lesion under ultrasound (hypoechoic lobulated right neck nodule) and by cleansing the skin, I noticed she had a scar behind the ear…Not wanting to be rude (as many of my patients undergo plastic surgery) but also needing to be thorough, I asked her what the scar was from. She responded that it was from surgical removal of a benign salivary gland tumor years ago. At that moment, from the ultrasound image together with her pertinent past medical history, I had a suspicion that what she likely had was a recurrence of that benign tumor. After performing the ultrasound-guided FNA, I immediately stained the slide and looked under the microscope. And low and behold, my hunch was correct: the nodule was a recurrent pleomorphic adenoma, a benign tumor of the salivary gland and NOT breast cancer. I told the patient right then and there. The relief on her and her husband’s faces were indescribable. She told me she hadn’t slept in weeks and now she could rest easy.
What do you think makes your company stand out? Can you share a story? For most people who need a biopsy, their doctor performs the FNA or they go to a clinic to have the biopsy done, and then the material gets sent to a pathology lab to be analyzed. I am one of very few doctors in the U.S. who operate a combined FNA clinic and in-office laboratory, where I perform biopsies and also analyze them. I have performed and interpreted thousands of FNAs of palpable and non-palpable (ultrasound guided) masses and have one of the highest rates of obtaining diagnosable samples on the first effort, virtually eliminating the need for repeat biopsies. I perform onsite evaluations and provide diagnostic results to doctors usually within 24 hours, therefore alleviating patient anxiety.
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