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Dr. William Frable...

Dr. Frable

Profiles in Cytopathology

Andrea Abati, M.D. Bethesda, Maryland

In July of 2001 I sat with Dr. William (Jack) Frable in his office and interviewed him for this column. It is a simple office, but the walls speak volumes about this true Renaissance man. One can not help but marvel at his beautiful and diverse original artwork that hangs alongside various awards, diplomas and plaques. These highlight a career that has culminated in authorship of cutting edge and provocative publications too numerous to count, multiple ground breaking text books, Presidency of the American Society of Cytopathology, Creation and Editorship of Cancer Cytopathology, and most recently, the Educator of the Year Award from the Papanicolaou Society of Cytopathology. In his spare time (?!) he manages to be an avid helicopter skier, golfer and artist.

What is amazing about Dr. Frable is his willingness to just be "Jack". One would think that the man who is very much responsible for popularizing FNA, which revolutionized the field of cytopathology, would like to primarily discuss his professional accomplishments. Refreshingly, however, he was just happy to talk about his life. Jack grew up in Chicago where his father was a manufacturer's representative for a company that made porcelain products and insulators of electrical equipment. He lived in Highland Park, one block from the lake where he liked to go to the beach and fish. He attended Highland Park high school where he was on the golf team that he proudly states made it to the state championship.

Jack has one brother, who is now a retired country surgeon in Indiana. His dad wanted both of his sons to become doctors, but Jack's primary interest was in art. He went to Dartmouth and followed a pre-med curriculum with the intent of possibly becoming a medical illustrator. During his first summer in between college years he functioned as an extern in a community hospital in Pathology. He worked with a doctor named Gerald Dean who was a solo community pathologist and did Medical Examiner work along with autopsies and surgicals. Jack found Dr. Dean and the techs to be wonderful and considers Dr. Dean an early mentor. As time went on Jack found his interests to have more of an inclination towards medicine and less towards art. His brother was in medical school in Northwestern and Jack soon followed. While at Northwestern Jack married another medical student, Mary Ann. (At that time there were only 8 or 9 women in his med school class.) Mary Ann is a practicing ENT surgeon.

Northwestern was also the site of Jack's training in AP/CP, with Opal Hepler, the "queen of C.P". His first job was at Marquette/Milwaukee County Hospital, where he was put in charge of the cytology lab. His interest in cytology was kindled during elective time he spent at Memorial Sloan - Kettering Cancer Center with Drs. Melamed and Koss. Drs. Stewart and Foote at Memorial had begun a tradition of aspiration biopsies, where definitive breast surgery was based on aspiration biopsy diagnoses. He thought this was a fabulous technique and wondered why it was never really popularized.

In 1972 he visited the Karolinska Institute where cytology was utilized as a primary diagnostic technique. He spent time with Drs. Franzen and Zajicek, where they performed FNAs and then immediately viewed the cases. When he returned to the USA he spoke with two Memorial surgeons who were practicing in his hospital about the potential utilization of FNA to preclude the necessity for small biopsies thereby freeing up OR time. The call for breast and head and neck aspirates quickly grew and developed into deep aspirates performed by radiology. Through his experience, his many papers and teaching commitments early on with the ASC and the ASCP, he was instrumental in popularizing FNA in the USA.

At the suggestion of Dr. Robert Hutter, another one of Jack's mentors from Memorial Sloan - Kettering, Jack embarked on a new role - one of Editor of a new journal, Cancer Cytopathology, a section journal of Cancer published by the American Cancer Society. Along with the help of his associate editors (Celeste Powers, Paul Wakely and Peter Vooijs), the journal has become very successful and boasts a high impact factor, cutting edge material, international high quality publications, and a rejection rate of over 50%.

With a career like this what could his future plans be? To keep on working, particularly on his journal, keep at his artwork (which has been shown extensively locally), to keep golfing, and, of course, to keep helicopter skiing.

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