The Long Look
Notes from a CEO, senior pathologist and physician-scientist — by John-Paul Bogers
Why a pathologist starts a Substack at 61
I have spent 28 years looking at slides under a microscope. Most of what I have learned does not make it into papers. Papers reward findings that can be replicated. The things that actually matter for a working clinician often resist replication. The case where an algorithm flagged the wrong cell and a senior eye caught it or like the Kenyan PhD student who steered her project into territory I could not have seen from Antwerp.
This Substack is for those things.
A short introduction. I am John-Paul Bogers, full professor of histopathology at the University of Antwerp, pathologist at AML in Antwerp, and CEO of ElmediX, a Belgian MedTech company running a pivotal trial of whole-body hyperthermia in metastatic pancreatic cancer. From 2016 to 2020 I directed the Belgian National Reference Centre for HPV; cervical-cancer screening in sub-Saharan Africa has been my second research line for two decades. Outside work I read history and espionage thrillers, listen to classical music on more equipment than I should admit, and play the piano at a level that keeps me honest.
What I will write about
Four recurring threads.
1. Pathology, for colleagues and for patients. Notes from 28 years at the microscope. Gynaecological cytology and histology, HPV biology and cervical screening, occasional dermatopathology. Most posts in this thread are written for working pathologists and the clinicians who refer to us. Once a month a different post is written for patients and their families: a constructed biopsy or smear report, translated line by line. No real patient data, no individual medical advice.
2. AI tools as a working researcher uses them. I am not an expert on AI in pathology. I am a senior researcher who pays for Claude Cowork, Consensus, Elicit, NotebookLM, and others, and who uses them daily for writing, mentoring, literature work, and running a company. What works in real workflow, what wastes time, what surprised me. Amateur enthusiasm under a senior-researcher’s eye.
3. Operating a MedTech startup as an academic. Concrete observations from running MATTERS-2: family-office fundraising, investigator recruitment, the parts of a pivotal trial nobody writes about until they have lived through them.
4. Mentoring, and research from the global south. I supervise PhD students in Belgium, Kenya, and South Africa. Three of my African mentees are now mentors themselves with their own students. I will write about how that happened, and why most North–South research collaborations still get this wrong. Cervical-screening implementation in the Lake Victoria basin, what the data actually show against what the WHO targets imply, sits in this thread.
Around these four threads I will sometimes write about books that earned their pages, music I have analyzed, or a piece of nineteenth- or twentieth-century history that has stayed with me. Roughly 70% of posts sit in the professional threads above; 30% do not. If you are subscribing for one and not the other, I will not be hurt if you mute the rest.
What I will not do
I will not pretend to be impartial about things I have an opinion on. When I write about hyperthermia, I will state where my financial interest lies and what I think anyway.
I will not write hype. I have spent a career around medical claims that did not survive replication. I am tired of the language that surrounds them.
I will not fabricate citations. If I cite a paper, the paper exists and says what I claim it says.
I will not write to fill space. Some weeks I will have something worth saying. Some weeks I will not. I would rather post less than post worse.
Practical
Two posts a month for the first six months. If the project sticks, I will move to weekly. Everything is free for the first six months. After that, roughly half the posts stay free; the other half move behind a paid tier.
If you read scientific papers professionally, you will recognise the citation style. If you do not, the prose is meant to be plain enough that it does not matter.
One last thing
I am writing this because the things I find most worth saying do not fit anywhere else. Not in the manuscripts I write with my students. Not in the investor decks I write with my co-founder. Not in the reports I sign at AML. They sit in between, and they have for years. This is where they go now.
Thank you for being here.
— John-Paul