ISN, Louis, July 2021
To my colleague members of the International Society of Neuropathology,
In mid-July, I received an e-mail from my friend and colleague, Seth Love, the President of the ISN, to inform me that I would be the next ISN President. As he put it, I would be “captain of the ship.” The metaphor made me smile—not because I am a committed boatsman, but because it reminded me of some fond neuropathology-boat connections that I have had over the years.
The first was that one of my teachers, Dr. E.P. Richardson, Jr., the long-time neuropathologist at Massachusetts General Hospital and an early member of the International Society of Neuropathology, was an avid sailor, spending his many summers sailing on the coast of Maine… one of my favorite places. “EPR” had pictures of sailboats in his office and was always doodling sailboats on his daily notecards. Sometimes, when preparing to call a frozen section diagnosis into the operating room, he would say, “Let’s run that up the flagpole and see what happens” (an allusion to the use of semaphore flags to communicate between ships at sea).
The second was one of my fondest days of the past decade, spent on a boat with Pieter Wesseling and his family in the canals of the Netherlands and on the IJsselmeer (formerly the Zuiderzee). It was a wonderful day, with perfect weather and perfect companionship. Notably, the day arose out of my friendship with Pieter, which itself was directly attributable to our participation in the international neuropathology community. The day was capped off by Pieter’s family allowing me to “captain” the boat for little while (Figure 1). Fortunately, all on board lived to tell the tale.
They say that things generally come in groups of three, so the ISN-captain connection must be my third. As such, I am honored to steer the ship for a while. As a result of the many ISN officers and members who have contributed so much to ISN over the years, the Society has been remarkable effective in a number of key initiatives: the international congresses of neuropathology, the book series, the flagship journal Brain Pathology, and the educational offerings, including educational bursaries and courses in less resourced countries. In my own area of brain tumor classification, the ISN has been tremendously helpful in its influential sponsorship of two key initiatives over the past decade: for what became the “Haarlem-ISN” guidelines and for the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW). I hope that I can contribute further to these multiple ISN missions, and I look forward to working with the ISN Executive to plot a course.
Pathology and laboratory medicine have reached a state in which they are transforming from technology-centric disciplines to data-centric disciplines. This pertains to neuropathology as much as it does to all other areas of pathology. Coupled with the connectivity enabled by the internet, data-centricity may enable a relative democratization of laboratory interpretation capabilities around the world. To some extent, we have already seen this with the generous www.molecularneuropathology.org site run by the Heidelberg group, into which methylome data can be sent for central analysis. But, from a different vantage, we have also seen that advanced molecular technologies are not widespread in the world, despite the substantial insights into disease classification being brought about by such advances. In this context, ISN guidance could be useful in adapting cutting-edge diagnostic criteria to countries with fewer healthcare resources.
It would be exciting to see if ISN can take a role in leading such changes for the field of neuropathology, and I welcome ideas from ISN members on how to move in those directions. Please feel free to email me if you have proposals to consider (firstname.lastname@example.org).
With best regards and with hopes that you and your families remain safe in these trying times,
David N. Louis President ISN