Twenty (forward looking) questions

The old proverb about the sudden appearance of the teacher when the student is ready to learn has been a good guide for our roles as both learners and teachers. Select business schools have long recognized this truth about motivated learners and hence have given admissions preference to students with enough “real-life” experience in the business world to know the “questions” that they don’t know the answers for. For pathologists it is not uncommon to come away from a course with a few “ahha!” moments of recognition regarding that puzzling case they had last week or last month. The day-to-day problem solving nature of our work brings us an unending supply of stumper cases and problems to motivate lifelong learning. But sometimes, one needs a wake-up call of sorts to see if there are more questions and answers that might be worth thinking about. This kind of intense dosing of challenging questions to further motivate learners with new questions is also a valid learning technique. The recent Molecular Medicine Tri-Conference (Tri-Con) held in San Francisco, February 10-13, like its two decades worth of precursors, provided a snapshot of many new and exciting technologies being used at the research level internationally, and offered a stimulating environment with respect to both kinds of questions, those generated from our own experience and those offered as futuristic challenges. These are the “imagine if” kind of glimpses into the potential landscape of medicine generally and perhaps pathology specifically, that may not be too far off. This yearly meeting provides a base from which technology and research beyond that currently encountered in clinical laboratories can be explored and influenced. As such, it has some exciting and frightening implications for the profession of pathology and the operation of clinical laboratories. From our experiences in several of the sessions and different tracks at the conference, we started a list of questions that we might want to have answered in the coming years pertinent to the readers of the journal. Twenty possible questions that occurred to us are provided in Table 1, with apologies in advance to any of the presentations and presenters that did not prompt a question on this list. Table 1 Twenty questions from the molecular medicine tri-conference meeting If we were playing 20 questions with an average focus group of practicing pathologists, these would likely seem to be unanswerable to the average contestant, and may not have even crossed the threshold of consideration. However for someone coming home from the 2014 edition of Tri-Con in February, these are questions that forced their way into consciousness, and some of the answers were quite startling. Granted that some are more important than others, yet they all have the potential to impact what people like us are going to do with our time in the next year to some degree, as well as to a much greater degree in the coming 5-10 years. We have selected two representative questions for each time interval, near future, intermediate future, and longer term and offer a brief discussion of the implications of these questions. There is value in surveying the landscape ahead to see whatever hints on the horizon allow us to adjust our course today. Join us in thinking through some of the questions where the answers seem most intriguing based on the presentations offered at the sessions we attended.