In the introductory chapter to this superbly edited chronicle of American surgical pathology, Rosai quotes Stout's dictum that "it is impossible to do intelligent surgery without a thorough understanding of the pathology of disease and it is equally impossible to make an intelligent interpretation of pathology without a clear understanding of its clinical implications." These truths today seem self-evident, but they are well worth restating in the current climate of deemphasis on scientific medicine consequent to the usurpation of medical care by political and business interests.
The timing of this book is particularly fortunate because many people who are still in practice witnessed the seminal developments that are described in its eleven chapters, which record the rise of surgical pathology as a discipline. With the collaboration of twelve distinguished surgical pathologists representing seven American academic centers, Rosai has succeeded in providing a multifaceted look at the flow of ideas and the individuals who were involved in the establishment of this subspecialty.
Although surgery-based laboratories of surgical pathology existed in Europe before the turn of the twentieth century, the evolution of surgical pathology as a distinct branch of pathology is primarily a recent American phenomenon. Since 1910, schools of surgical pathology have been established at Johns Hopkins School of Medicine, Columbia University College of Physicians and Surgeons, Memorial Sloan-Kettering Cancer Center, Harvard University School of Medicine, Washington University Medical Center and Barnes Hospital, the Mayo Clinic, and the Armed Forces Institute of Pathology. Each of these institutions was characterized by its own distinctive flavor and personalities. The colorful people who founded these centers, including Ewing, Bloodgood, Stout, Stewart, Ackerman, Mallory, and Castleman, are wonderfully brought to life by the authors, who were closely connected with the signal events being described and who, in many cases, helped to shape them.
Many sections of the book are illustrated with evocative photographs, which recreate the working atmosphere and the cast of characters of a period that influenced the careers of generations of surgeons and pathologists.
As a rare treat, the book ends with poignant autobiographical excerpts by two of the giants of surgical pathology, Stout and Ackerman. Both began their careers as clinicians, and both made enormous contributions to the field. Through the often witty and insightful words of these legendary figures, the reader can experience the flavor of the times and sense the excitement surrounding the flowering of this subspecialty.
This book will help to strengthen the bonds of understanding between surgeons and pathologists—bonds that have resulted in more rational patient care through clinicopathological correlation. It will be fascinating reading for surgeons as well as pathologists who want to know more about how their intimate relationship began and about the factors that led to the current level of constructive interaction. The evolution of our knowledge of the surgical pathology of soft-tissue and bone tumors is documented in a substantial way that will be of particular interest to orthopaedic surgeons.
Howard D. Dorfman, M.D.
Division of Orthopaedic Pathology
Montefiore Medical Center
Bronx, New York