In Memoriam: Dr. Christopher David Marsden Fletcher, MD, FRCPath

It is with profound sadness that we announce the passing of Dr. Christopher Fletcher, one of the world's foremost surgical pathologists, who passed away peacefully, surrounded by family, on July 28, 2024, at the age of 66.

Born on March 13, 1958 in Huddersfield, England, the son of a surgeon, Dr. Fletcher gravitated to the medical sciences from an early age. He earned his Bachelor in Medicine and Bachelor in Surgery from St. Thomas's Hospital Medical School in London in 1981. He completed residency training in Histopathology at St. Thomas's Hospital and a research fellowship which earned him a Doctorate in Medicine by research thesis from the University of London in 1991. His diagnostic brilliance and preternatural talent for surgical pathology were evident at an early stage, and his subsequent career, which spanned more than three decades, was unmatched in its contributions to the field of oncologic pathology. His groundbreaking research and clinical innovations set new standards and radically advanced tumor classification, thereby allowing more effective treatment of patients with cancer. Yet his most enduring contribution is undoubtedly the generations of pathologists and other clinicians who benefited from his teaching, mentorship, and seemingly limitless generosity.

During the course of his career, Dr. Fletcher often boldly challenged the status quo, as demonstrated by his paradigm-shifting article "Pleomorphic malignant fibrous histiocytoma: fact or fiction?" published in the American Journal of Surgical Pathology in 1992. With characteristic candor, this single article forever altered the world's approach to classification of soft tissue tumors, a mere three years after completion of his residency training. In 1995, Dr. Fletcher was recruited from the University of London to Brigham and Women's Hospital and Harvard Medical School in Boston, MA, by Dr. Ramzi Cotran, then Chair of the Brigham and Women’s Hospital Department of Pathology. In addition to his appointment as Professor of Pathology at Harvard Medical School, Dr. Fletcher served successively as the Director of Surgical Pathology and Vice-Chair for Anatomic Pathology at Brigham and Women's Hospital, and during most of that time served concurrently as Chief of Onco-Pathology at Dana-Farber Cancer Institute. His extensive body of work includes nearly 600 original journal articles and over 150 books, book chapters and review articles. His seminal, award-winning textbook, Diagnostic Histopathology of Tumours, first published in 1995, is now in its fifth edition and is the definitive resource for tumor pathology. He chaired the World Health Organization Working Group for the Classification of Tumours of Soft Tissue and Bone, served on the editorial boards of 15 journals, and held numerous leadership roles within national and international pathology societies, including presidential terms at the Association of Directors of Anatomic and Surgical Pathology, the International Academy of Pathology, the Arthur Purdy Stout Society, the International Society of Bone and Soft Tissue Pathology, and the United States and Canadian Academy of Pathology (USCAP). He delivered invited lectures worldwide, captivating audiences with his frank and insightful discourse, whether speaking to a vast lecture hall or providing diagnostic guidance at a multiheaded microscope. In 2023, after three decades of unparalleled personal commitment to pathology and medicine, he retired to the position of Professor Emeritus in order to devote more time and energy to his family.

Dr. Fletcher received numerous prestigious accolades recognizing his clinical excellence, research contributions, and commitment to education, including the USCAP Young Investigator Award (1997), the Fred W. Stewart Award from Memorial Sloan-Kettering Cancer Center (2005), the USCAP Board's Distinguished Pathologist Award (2017), and the American Association for Cancer Research James S. Ewing-Thelma B. Dunn Award for Outstanding Achievement in Pathology in Cancer Research (2024). He was also an honorary fellow and member at institutions throughout the world. Beyond these achievements, Dr. Fletcher is remembered as a generous mentor, providing wisdom, guidance, and encouragement for all manners of professional or personal challenges. His extraordinary empathy was comforting to many who sought his advice. His advocacy, born from years of listening to others' concerns, reached beyond the walls of his department. He did not hesitate, and, indeed, relished the chance to ruffle a few feathers in his staunch commitment to physician autonomy and wellbeing. He also recognized the vital role of pathologists-in-training and support staff in the shared mission of exceptional patient care. Within his department, Dr. Fletcher was cherished by administrative assistants and laboratory technicians and was deeply admired by residents and fellows for his invaluable career planning assistance as well as his highly entertaining bi-annual "Director's Rounds". Outside of the world of medicine, his generosity extended to significant support of the arts, culture and education in the local Boston area and beyond.

Dr. Fletcher's legacy extends to the countless patients whose care was transformed by his extraordinary diagnostic skills. He diagnosed approximately 5000 consultation cases annually, received from all corners of the globe, many of which he reviewed without charge for those in need. Every afternoon, surrounded by junior and senior pathology trainees, faculty, and visitors from around the world, he examined stacks of challenging cases. These “sign-outs” were a unique educational experience animated by Dr. Fletcher’s diagnostic prowess and sharp wit. His expert diagnoses were accompanied by personalized and detailed explanations of his findings, which he would readily discuss with submitting pathologists or the patients themselves. The privilege of reviewing these cases, which included many rare or previously undiscovered and unreported entities, inspired a remarkable body of research including pioneering discoveries in the classification and molecular underpinnings of soft tissue tumors. His generous inclusion of junior colleagues in these investigations launched many successful academic careers, a continuing tribute to his brilliance and talent.

Dr. Fletcher is survived by his beloved partner Dr. Janina Longtine, and by his three daughters, Amy, Alexandra and Fenella, his son-in-law Joshua, his step-children Amelia and Jared, and his five grandchildren, who were a source of immense pride and joy.

In remembering Dr. Fletcher, we reflect on those personal traits that conferred his astonishing diagnostic skills and inspired generations of pathologists, oncologists, and surgeons to bring excellence, humility, and compassion to their practice. His legacy will continue to guide future generations of physicians and improve the wellbeing of patients for many years to come.

In lieu of flowers, the family requests that donations be made to the USCAP in Dr. Fletcher’s memory.

A memorial service celebrating Dr. Fletcher’s life and unparalleled contributions to our field will be held on Thursday, October 24^th, at 10am, at Trinity Church Boston, located at 206 Clarendon Street in Boston, MA. All are welcome. For those unable to attend in-person, please use this link for the livestream service.

The family requests privacy at this time. Messages of condolences for the family may be sent to Diana Matta (dmatta@bwh.harvard.edu).