Sunday musings. Five things I have learned over the years, cemented by the consult service, that every pathologist should consider when releasing diagnoses into the wilderness. 1. Pathologists are morphologists, yes, but much more importantly, they are consultants. Findings that are beside the point and clinically insignificant need not clutter our microscopic description or diagnosis unless they are relevant to how the diagnosis was made. 2. Because pathologists are consultants, we need to know the clinical implications of our diagnosis. And if both entities on the differential are treated the same way, a differential is perfectly fine as a diagnosis. 3. Pathologists should remember what clinical finding prompted a biopsy. As obvious as this may seem, we sometimes report calcifications and forget that the clinical finding was a mass. If a mass forming lesion is not seen, then the biopsy may be non representative. 4. Immunohistochemistry should be spare and targeted. It should answer a morphologic question instead of serving as a small flash light in a vast and uncharted darkness. 5. Contrary to popular belief, a pathologist’s desire to be definitive is ever present, and always fueled by pressure from clinicians. It is ok not to know, it is ok to seek help, it is ok be inconclusive when facing too little material, as long as we try to provide a plan of action. A tiny bit of ugliness does not a monster make, and one small assumption can wreak irreversible havoc on a patient’s life.