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In the Lab: Dr. Karen Kaul

Karen Kaul, MD, PhD, Chair of the Department of Pathology and Laboratory Medicine at NorthShore, loves science and the science behind the practice of medicine. She specializes in molecular medicine and has devoted her career to developing the field of molecular pathology. She also leads the Molecular Diagnostics Laboratory within the Mark R. Neaman Center for Personalized Medicine.

While most patients will never meet their pathologist or the many professionals working in laboratory medicine, Dr. Kaul leads a remarkable team that works behind the scenes for their patients every single day. Here, she describes that groundbreaking work and the impact it will have the on the next generation of medicine: 

Pathologists don’t often interact directly with patients but what do they do behind the scenes for their patients? 
Virtually all patients benefit from the work of professionals in pathology and laboratory medicine.  These physicians and lab directors interpret biopsies and complex laboratory tests, as well as oversee the operations and quality of the labs. 

At NorthShore, we perform nearly five million clinical tests each year, as well as 100,000 microscopic examinations of samples removed via biopsy or surgery. The information these tests generate determines much of the clinical treatment for each patient; we serve a critical role in healthcare delivery.  

What does the NorthShore Molecular Diagnostics Laboratory do now? What do you think it will be capable of accomplishing in the future for patients and treatment outcomes?
The lab does testing for cancer, certain genetic diseases and also many infectious diseases for which we can detect the DNA of the microbe more quickly than traditional methods. We can also use DNA-based techniques to identify antimicrobial resistance (or antibiotic resistance) and thus tailor treatment when traditional options might not be as effective.  

The NorthShore Molecular Diagnostics Laboratory also recently implemented Next Generation Sequencing and will soon set up testing for pharmacogenomics, which is the study of how a person’s DNA affects their reaction to certain medications. The goal of pharmacogenomics is to ensure that each patient gets the right dose of the right drug the first time.

Our pathology department also includes the NorthShore Biorepository, which procures research samples of tumors, blood, and also procures the genomic samples for the Genomic Health Initiative; these samples will be critical in the research that will advance our knowledge and the future of medicine.

And part of the future of medicine is personalized, or precision, medicine. What is your role in the Neaman Center for Personalized Medicine?
I have been working in molecular pathology, the lab that performs DNA-based diagnostic testing, since the mid-1980s, and established the first molecular diagnostics lab at NorthShore in 1992.  With the dramatic advances in our knowledge of the genetics of disease, and the technological advances in our ability to more rapidly analyze DNA, the capabilities of molecular diagnostics are the starting point for personalized medicine. 

By helping to determine the best treatment for many types of cancer, our pathology medical staff do remarkable work every day to determine the gene mutations in tumor samples. While I am less involved in the daily operation of the lab, I am deeply involved in the Neman Center for Personalized Medicine here at NorthShore and am pleased to see the ongoing teamwork and progress on the clinical and research aspects of the program, and the use of electronic medical records and our strength in healthcare information technology, that will all be a part of creating novel capabilities to care for our patients.

What impact do you think personalized, or precision, medicine will have on healthcare?  
I expect that in time these novel capabilities will be routine in how we practice medicine, leading to better diagnoses, more effective treatment and better outcomes for patients.  As we learn more, we may be able to more broadly predict disease risk and prevent diseases from developing. 

What led you to medicine? What led you to this field in particular?
I always loved science, and especially enjoyed being able to use science to make people’s lives better.  While a desire to help people leads many of us to medicine, and I enjoyed patient care, I found that the ability to combine science, research, and caring for patients together was what suited me best and that led me to pathology. This field was certainly not on my career list when I began medical school, but I’m very fortunate to have discovered it, particularly during this era of such rapid advances.

What do you find most rewarding about the work that you do?
I love seeing the tremendous advances in medicine.  Pathology and laboratory medicine has a tremendous impact on patients, which is incredibly rewarding even though we generally do not meet the patients directly.  I also enjoy working with the wonderful and dedicated team we have working in the labs.  We also have training programs at NorthShore for both medical technologists and pathology residents—our mission includes training the next generation of laboratory professionals, and I have very much enjoyed my involvement in these programs over the years.

What has been the biggest challenge of your career so far?  
Time! There is a never-ending list of things to be done.

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