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The Story of
Last revised 3 June 2021

By: Nat Pernick, M.D.

I started in August 2001 while at Camp Michigania, a family camp. As a pathology resident and surgical pathology fellow at Wayne State University in Detroit, Michigan, from July 1995 to June 2000, we had weekly unknown conferences hosted by Drs. John Crissman, David Grignon and Wael Sakr. We would be given a glass slide and had to determine the diagnosis and then talk about its important features. At the time, the residents used a great reference book, "Outlines in Pathology" by Dr. John Sinard. However, it had no references, no images and since it was not updated, quickly became out of date. We used to tape updates into the book and use it during the unknown conferences. Later, I decided to put the important information on my laptop, including the updates, images and references. Over the 5 year period, many of the cases repeated themselves so the laptop notes were very useful.

Towards the end of my residency and fellowship, I thought that perhaps this material should be put on the web and it would be useful to me when I was in practice and perhaps others would use it. Most physicians are somewhat obsessive-compulsive, including me, and I wanted to combine all the material I had compiled from my unknown conference notes, textbooks, atlases, journal articles, conference articles (the USCAP used to distribute extensive handouts at its conferences) and other sources into one online source that would be readily available. I had a friend who designed websites and he got me started. While my family was doing art projects or horseback riding, I was writing what became's free online textbook. I started with the Thyroid chapter, compiling notes from all these sources, and creating one big Word file, which was then saved as an HTML file and uploaded to the web. Next was the Parathyroid chapter; I added chapters as quickly as I could.

It is important to note that this was done as a "cause". I strongly believed, then and now, that this information should be easily accessible to physicians for no charge. It's hard to apply medical knowledge and exercise judgment but getting the information we need to make decisions should not be difficult. Although I love PubMed (and as a medical student toured the National Library of Medicine where it originated), I strongly disliked having to pay for some journal articles on PubMed and elsewhere and so was determined that our website would be free. Also, I believed in the Golden Rule, with my interpretation being, "what is obnoxious to you, do not do to others." For this reason, I decided there would be no popup ads, no registration, no intentionally difficult web design or other features that I disliked.

I did wonder if anyone would use the website other than me. My "dream goal" was to attain 200 visits per day, which was reached after one year, in July 2002. I was quite surprised. Since then, traffic has grown dramatically. Click here for current statistics. Click here and scroll down to History for more information.

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