At the multiheaded microscope, the working dynamics of the academic dermatopathology sign-out demonstrate that much more occurs than the provision of a diagnosis. There are concurrent clinical correlation, teaching, debate, consultation, research, troubleshooting, and social interaction. With this light-hearted analysis of these dynamics, I applaud those who offer the opportunity to participate in the process.
As someone from a farming community, I have always likened the multiheaded microscope to the udder of a cow, both physically and symbolically. The heads of the microscope project like teats, while there is a jostle of parasitic younglings gathering for their scholarly feed. A clear hierarchy forms, with a dominant figure making all the noise and a new entrance runt who just cannot quite manage to get things into focus. In this medical hierarchy, a stereotypical pattern emerges.