Dr Anita Borges: The doyenne of Pathology education
The strains of music wafted in through the open windows. We were reporting in the Histopathology OPD of the Golden Jubilee Block in Tata Memorial Hospital. “What’s the name of that tune?” she asked. “It is so familiar.” Over the buzz of histopathology reporting, her sharp ears and keen observation had made her pause. I know nothing about Western classical music. Had it been Hindi film music, I could have made some suggestions. And so the moment passed quietly. But when she returned the next morning, dressed impeccably in one of her starched crisp cotton sarees, she told me, “I found the name of the tune. It is Lara’s theme from the film Dr Zhivago.”
That was Dr Anita Borges for you. A connoisseur of the best things in life: music, books, films, food, fun, anything. She could have a deep conversation with you on any topic under the sun, and you would be mesmerized. And since the last two days, I have been playing Lara’s theme on the loop, not willing to believe that she is gone.
Dr Anita Borges was an oncopathologist who was teaching at the Tata Memorial Hospital, when I got an opportunity to train briefly under her. I had first met her as a naive first-year postgraduate student when she visited the Department of Pathology at the Government Medical College in Nagpur. And I was awestruck by the way she held her audience spell-bound, as she drilled the basics of interpreting a biopsy to us students. Everything she did seemed magical. The way she pronounced “Giemsa”. The way she coaxed you to speak aloud about what you were viewing under the microscope. It was like being in the presence of a movie star. And it was not for nothing that people whispered “AB”- with fear, with respect, with awe. She was more than Amitabh Bachchan when she strode the world of Pathology teaching like a colossus.
“When you speak aloud, you will realize that something you are seeing doesn’t fit into that jigsaw puzzle”. “Let the slides speak to you.” “Never forget that you are a clinician. You have done your MBBS. You cannot be a pathologist until you know the clinical findings.” So many valuable lessons. So many stories of how in Sherlock Holmes style she saw things under the microscope which we all missed. It wasn’t magic. It was sheer diligence and hard work. Focus on the right things. Keeping the patient always at the forefront. Never for once hesitating to pick up the phone and ask the clinician for more details. As more often than not, they never understood that histopathology was not about sticking a slide under the microscope and conjuring up a diagnosis. It meant completing every bit of that jigsaw puzzle for the sake of the patient. And without relevant information, the woefully incomplete requisition forms would add up to nothing.
We all have our special stories about being reprimanded by AB. Things which still make us remember never to slip up the next time. And each time we walked into her presence, we realized how lucky we were to be taught by her. I spent six months as a Fellow at Tata Memorial Hospital, craving to be posted with her. But you always knew that this opportunity would go to the local students, and not to some outsider. Somewhere during my last two months, an angel (thank you Mufi!) decided to reward me for the long hours I spent at work, and I got posted to the OPD in GJ block. There I got to see the best of cases which came from all over the country for second opinions with the best of the teachers. AB was of course the guru we craved to be taught by. But even if I stayed there daily until 8 pm working hard to write my provisional reports, some local student would push me away from the multi-headed microscope when the faculty arrived. No one noticed. Except AB.
She picked up a form and said, “Whose handwriting is this?” My beautiful cursive writing had caught her attention. “Whoever has written these reports last evening should have the first chance to report with me”, she said. And I stopped breathing. It is a moment I remember so vividly. As she navigated my way through each nucleus in a laryngeal biopsy, showing me the abnormal polarity of cells, which I had earlier called normal. The next few weeks were like floating in heaven. She would pick up a random slide which another faculty had reported as cervicitis. And tell us to call the patient. “I bet she doesn’t have a cervix,” she said. And we would gape in horror. And true to her word, the patient said she had undergone a hysterectomy two years ago. It wasn’t magic. It was sheer observation. It was knowledge of what was normal and what was not. Nothing was routine to her. Every slide told her a story. Her questions made us think, the slides she tossed over to us to report, were challenging. And best of all, behind all this genius, was compassion, curiosity and humility. She behaved respectfully and gently with everyone. Whether it was a patient, a ward boy, a technical person or a student. But she had no tolerance for shortcuts or slackness at work. My colleague was hauled up on her birthday for grossing a specimen incorrectly. After she received an earful and was taught how to correctly gross the specimen, she was told, “I know it is your birthday. But it is also why you will remember never to make this mistake again!”
My moment of shame was to come years later. She had come to a neighbouring college, and I was unaware that one of my students was presenting a case there. I just happened to attend the teaching session, when my student went to present the case. It wasn’t my case, and I wasn’t even posted in Histopathology then. “How many sections did you take of the 10 cm tumour?” she asked. “Two,” mumbled my terrified student. Before I knew the cannon had shifted to me. “How is it that a student from an institute which has a teacher trained from TMH makes this rookie mistake?” I wished the earth would part and swallow me in that moment. My face and ears burnt red with embarrassment. But that was AB. Blunt, brutal, with no space for error. Yet, magnetic, magical, and leaving a mark with every statement.
She is the only pathologist I know who had the guts to say “I don’t know”. I wish I had taken a picture of that report. It was a testicular mass. She struggled with it for around four days, trying all kinds of possibilities. Then she wrote the report. She talked about five lesions she had definitely ruled out using immunohistochemistry. She wrote about all the references she had consulted. And then she wrote, after all these attempts, I still don’t know what this tumour is. She was a role model to place on a pedestal. It didn’t take her a moment to tell a patient, “This is not my area of specialization. Go to Dr XYZ, he has more expertise and experience in brain tumours than I do.” I have heard disgruntled people grumble that she was not special. That she was only well-read and up-to-date. But then we all have access to the same literature. Why haven’t we all reached the same heights that she did? It was a mystical medley of in-depth reading, questioning what she read, not taking things for granted, and being able to correctly connect the dots. There was no compromise on quality: whether it was in the laboratory, or whether it was about her own hard work or ethics. She stood by her beliefs. And that is what made her so special to everybody.
When the pandemic happened, you could see the teacher in her panic. She worried that a whole generation of pathology students would lose out on learning during the lockdown. And she could not sit doing nothing. Along with her trusted colleague and friend, Dr Sumeet Gujral, she started the Online Teaching Programme for Postgraduates in Pathology with the help of Tata Trust. It is a programme which conducts online teaching sessions twice a week free of charge. It is now into its fourth iteration and covers the entire gamut of pathology education, including sessions on career counselling. They have students not just from India, but from countries like Russia, Myanmar, Tanzania etc attending these sessions. The best faculty across the country were handpicked by her to teach the whole syllabus.
I looked forward to her sessions, which were as uniquely named as her personality. So we had discussions on Tweedledum and Tweedledee, The Garden of Eden, and Cinderella. Her first talk in the series would be on “Why should you be a Pathologist”, and that would invariably end with a slide saying “Why not!” I absolutely adored her passion for teaching and have always aspired to be like her. I am amazed at how her slide teaching sessions online could actually replicate face-to-face sessions, giving equal opportunity to pathology students from Srinagar, Chitradurga, Dhaka, and Dar-es-salaam to learn step-by-step. With the virtual space, she groomed a thousand more Eklavyas like me. I wish she could have been with us forever. Instead, she has left behind a foolproof mechanism and a trusted ally to carry forward her legacy in the best way possible.
I remember her once saying, “Do you know why I accept all offers to go to remote towns all across the country? Because the quality of Pathology has to improve.” And so the knowledge that she (like President Kalam) went doing what she loved most, teaching, comes like a warm hug.
I am grateful for the little time that I was able to share with her. I will cling on to her lessons, her warm emails, and her memories forever. But most of all, I will celebrate her joie de vivre. Honest, frank, forthright, unafraid to question everything, passionate. She was the woman I always wanted to be.
