Dr. Ryan Cole, Head of Medical and Scientific Affairs at the Independent Medical Alliance, marks medicine’s 250th year by putting his own field under the microscope. Pathology, he says, is the search for truth beneath the surface, and in that sense it shares something with the Founding Fathers: a refusal to defer to unexamined authority. He traces the field from the theory of the humors through van Leeuwenhoek’s lens and Virchow’s cellular pathology to American innovators like Osler and the Mayo Clinic’s frozen section.

But naming a disease, Cole argues, is only the beginning of the work. The harder questions are why it developed and what supports healing, and a diagnosis should open a conversation with your doctor rather than end one. He worries that a nation with the best diagnostics in the world has drifted from the habits that kept earlier generations well, and makes the case that Western medicine and natural health were never meant to be enemies. The next era, he says, must be advanced enough to read disease at the molecular level yet humble enough to pair rigor with biological humility.

Check out these related resources from IMA below, followed by the full video transcript.

Transcript

Dr. Ryan Cole: I’m Dr. Ryan Cole, Head of Medical and Scientific Affairs for the Independent Medical Alliance. As we celebrate 250 years of history, it’s interesting to look back on each profession and subspecialty and how things have evolved here in America.

Pathology. I’m one of those nerdy pathologists, but it’s the story beneath the surface. Pathology is basically looking for truth in medicine. And to compare it to what the Founding Fathers did, pathology is basically a rebellion against unexamined authority.

For so long, we believed in the theories of the ancient Greeks, or Galen: the humors, the bile, the phlegm, and so on. As we made scientific advances, with van Leeuwenhoek discovering the lens and the invention of the microscope, we found that there was a completely different world. It was through discovery, through curiosity, that medicine advanced generation to generation.

Going from the original anatomists back in the time of Vesalius or Morgagni, who were basically the fathers of anatomy and anatomic pathology, it was once we had that microscope that we could really look deeper. And that was Virchow, the father of cellular pathology.

So why does all this matter? Those were the European greats. Here in America, at first we followed what Europe did, but it was the innovative thinking that came along and changed the field altogether.

I like to joke that the pathologist is the most important doctor you never meet, the one you always hope is right. And that’s true. We have this special calling in medicine to be behind the scenes, a support doctor to the doctor. As we make a diagnosis, we’re consulting with your physician, your clinician, helping them understand what the findings mean.

Here in America, after adopting some of the basics of the original discoverers in Europe, we advanced the field. It was Osler at Johns Hopkins who taught his students the value of the autopsy, and autopsy actually means “looking for oneself.” He had all of his students perform autopsies so they could understand and see inside. He was the father of what we call clinical pathologic correlation.

Why does this matter? It matters because they would look at what the patient had gone through in life, and then have the postmortem teach them about those symptoms. So when you go to your doctor now and say this is hurting or that is hurting, they have the opportunity to do radiology, but back then they didn’t. They would look into the symptoms and, going forward, apply that to their future patients. That innovation in medicine was really put forward and advanced here in the last couple of centuries.

Then we developed incredible diagnostic tools. We became, for better or worse, the first country to really have a big public health system, which used to be a good thing. And we can get back to that being a good thing.

Take the intraoperative. So many people will say, “Oh, I’m having a surgery.” When you’re having surgery to, say, have a tumor removed or some tissue identified, now we can freeze that tissue, stain it right away, and look under the microscope before the patient even wakes up, so they can have a diagnosis. That was pioneered by Dr. Wilson at the Mayo Clinic, and now it’s become standardized all around the world.

Okay, so that’s a lot of nerdiness. I told you it would be a little nerdy at first. We didn’t used to have the ability to look inside the body. Now we do. Pathology, microscopy, medical diagnostics, laboratory medicine, it all changed. A lot of those changes came here, and we’ve spread them to the world. This is the great part of modern medicine: we can give you an answer.

But we can’t forget that, with all the answers in the world, does it matter? I don’t think so. What’s more important is whether those answers serve the patient. Diagnostics are wonderful tools, and you hope there’s somebody with a heart of humanity behind them. But diagnostics can’t replace judgment. We can name diseases, and we’ve named many over the years, but we must ask more important and deeper questions. Why did the disease develop? The best science looks both at pathology and physiology: what’s wrong, and what supports healing.

I’ve said this many times. As many diagnoses as there are, as many cancers as there are, as many of this, that, and the other as there are, there are the same number of humans. Each person is going to experience disease differently.

So what are some of the things we can do to go back to the basics of life? It’s a technical field, with wonderful advances, a wonderful history, and some pretty revered individuals. But I think back to someone like Dr. Wilson, developing that frozen-section, intraoperative diagnostic technique. These people were kind of like the Founding Fathers. They were rebels. They were pragmatists. We have all this knowledge, but we don’t defer to authority. We’re going to be innovative and do things differently.

So how about health and wellness in general? With all the technology in the world, are we a healthier nation at the moment? I would question that. Not to be judgmental, but we can look around us and say that, as a nation, we definitely aren’t headed in the right direction in terms of overall health.

Part of the challenge that has come with advances in science and medicine is that we’ve stepped away from nature. We’ve stepped away from the pathways of life. What was a habit the Founding Fathers had? What was a habit many generations had? Your grandma, your grandpa, most likely they would meet the sunlight in the morning. They didn’t have these obnoxious alarm clocks, and now phones with 20 different sounds. They would get up in the morning, and most of them were agrarian. Most of the Founding Fathers had farms. Many of the Founding Fathers were even physicians. They would get up in the morning and move their body.

And did they have ultra-processed foods? Of course they didn’t. Their food came from the earth, without chemicals, without all the different inputs we have in this day and age. They arose with the clock, and they went to bed with the clock. Why? The clock was the sun, and in the evening they had dim candlelight. They lived a circadian life, the circle of life.

They were probably more healthy mentally, and you think of the great thinking of that era, because they didn’t live under artificial light at night. They lived the rhythms of life. They lived in more laborious times, for sure, but they lived with rich, healthy, regenerative soil. They lived with stresses like we all do now, but it’s interesting how many of these Founding Fathers lived long lives. We think that all these advances in modern medicine give us longevity, yet many of them lived long, abundant lives.

Now, did they have risks of bacterial diseases and things we can diagnose now? Sure they did. But really, Western medicine and natural health should not be enemies. Think of all the advances we believe we’ve made in science and diagnostics and medicine, and then think of all the generations that made it here without the advances we now have. We’re here today because people were resilient, they lived in harmony with nature, and they found things from nature that helped heal. Absolutely, medicine is miraculous in many ways. But so is the medicine of nature herself. And the best of medicine uses both responsibly and in harmony.

So here we are in a new era. Patients want answers. They don’t want just a label. My profession, lab-test pathology, can certainly clarify what’s happening in the human body. But that should lead to care of an individual. A diagnosis should be the beginning of a deeper conversation with your healthcare provider. It should not be the end.

We’re in a wonderful transition period, having gone through another hiccup in history these last couple of years, and we’re still fighting that battle in certain ways. We need scientific rigor, but we also need biological humility. We need to look back and say, “Huh, they figured it out long before we had all these tools.” It’s exciting to say, “Here’s a new innovation.” We can celebrate the things we can do, but do they do the things we need them to do in the context of real health?

We need to remember that the body is an amazing machine that can repair itself when given the right conditions. All the diagnostic tools in the world can be present, but if we aren’t cognizant of our own health, being our own best doctor, being part of a caring community, then where are we? That rural family doctor with the black bag is the picture in everybody’s mind, visiting the mother in the home and attending to her. We have the opportunity to really find balance and say that all the science in the world is great, but if we disconnect it from the basic cycles of life, then I think we’re heading in the wrong direction.

I’m blessed to have so many of these aspects of modern science in my life. I’m also blessed to keep bees on the farm, to live with the soil, and to live an organic, regenerative life in my little circle of day-to-day activities, on top of all the other responsibilities. If you think of the Founding Fathers, and if you think of the amazing, rebellious citizens of this nation, they were in tune with nature. That’s an example for us in this next era of medicine. With 250 years behind us, and hopefully a good 250 years to go, this next era of medicine must be advanced enough to see disease at the cellular and molecular level. But medicine needs to remain humble enough to remember that healing still depends on the entire, whole human being.

May the next 250 years be a blessing, not just for us, but for our children and our grandchildren’s grandchildren. Thank you.

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