It was the most perfect hysterectomy specimen that I had ever seen. Quite literally in the pink of health. A perfect cervix, myometrium, endometrium, fallopian tubes and ovaries. It could have been the poster child for a teaching class on the female reproductive system. There was a problem. The patient was a 16-year-old. The entire history was summed up in two words scrawled across the form that read 바카라irregular periods바카라. I grossed the specimen taking extra sections or 바카라bits바카라.
The next specimens were gallbladders, core biopsies and prostatic chips. I saw the second showstopper. The form read 18-year-old male-preputial biopsy performed for 바카라Itchy prepuce바카라. The handwriting on the uterus and preputial biopsy forms were identical. On pouring the bulky contents into the dish I saw skin, and multiple large chunks of tissue. I hadn바카라t seen so much soft tissue removed along with preputial skin before. I processed multiple sections.
Two days later I received the slides of the cases. The hysterectomy was completely normal. There was no specific lesion in all the multiple sections taken including the deeper cuts. The preputial skin had skin removed with no ulcer, significant inflammation, infective lesions or malignancy. What was distressing was the presence of mutilated seminal vesicles, a portion of the urethra and penile musculature. What kind of botched-up surgery, was this?
As there was no way to decipher the doctor바카라s illegible handwriting, I called the patient to ask for his phone number. This was strongly discouraged by the Lab Manager who said that patients and their relatives tend to get suspicious when contacted. An alien concept to me, where my medical training had always stressed the importance of doctor-patient-pathologist interaction to provide the best clinically meaningful report to the patient.
Almost simultaneously there was a call from security to inform me that the relatives of the boy who had the preputial biopsy done had come to the lab. Three large burly men entered flanked by two armed security personnel. This was standard procedure in the city that had witnessed an increased number of doctors being violently assaulted by relatives of patients who either contested the diagnoses received, or were upset when a patient had died in the hospital.
The man in front bellowed, 바카라So, is there a tumour or not? We have given some of the specimen to another lab also, just so you know바카라. 바카라Sir there is no tumour,바카라 I said, 바카라I will speak to the referring doctor.바카라 I was cut off mid-sentence when he said, 바카라I hope my son바카라s discharge clears up. He has severe problems when he tries to pee, after the surgery.바카라
I sat down, sweating profusely as I called up the nursing home where I hoped to contact the surgeon. I was informed by his attendant that he was operating and to call at 2 PM. When I called again, he was sleeping. 바카라He is such a senior doctor, and at 72 years of age we should respect that,바카라 said the attendant.
By this time, the little red flags on my computer screen were blinking that indicated these reports were both past due. 바카라The currency of any successful corporate lab is the Turn Around Time (TAT), Dr. Samuel, or do we need to remind you of this?바카라 said the Director of the Lab, who monitored every case like a hawk.
I explained sternly, the absolute need for me to speak to the doctor as both cases were troubling with no visible lesion. The next phone call was from the Chief Executive Officer (CEO) and Chief Financial Officer (CFO) who spoke on a conference video call to sound more assertive and not-so-gently-threatening my position in their esteemed organization, if I delayed releasing the report any further. When the phone rang again I asked the Lab Manager, 바카라Who is it now, a UFO?바카라 It was a poor joke meant to alleviate the tension that everyone felt, as we positioned our relatives, friends or loved ones who might have had such medical procedures performed on them.
Finally, the septuagenarian surgeon came on the line. I described the specimens to him, mentioning the time that we had received it in the lab. He finally remembered the cases. 바카라Ah, yes, the 16-year-old had irregular periods바카라. 바카라Was there any previous biopsy, Sir,바카라 I asked. 바카라No바카라, he said, 바카라the gynaecologist did an examination and thought the uterus was bulky. Better to remove it in such a situation, what if there was a tumour and it spreads rapidly? No sense in taking such a risk!바카라
I then asked about the 18-year-old and why the biopsy was done when there was no ulcer grossly or microscopically. 바카라Ah, that바카라s why I removed a lot of tissue to be sure and maybe it is in the sample that has gone to the other lab X바카라. At this point the lab director who was listening in on the phone conversation piped in, 바카라Thank you Doctor for your continued patronage of the lab. We will release the report by this evening바카라. She had done the necessary damage control.
I checked with a colleague at the competing lab what the preputial biopsy showed with the specimen that they had received. The findings were identical to mine, and they had released the report on the day the slides were received, with no additional sections, no conversation with the doctor and certainly no angst.
As I was typing in the reports for both as no significant pathology, the Lab Director called me again. 바카라Can바카라t we say mild non-specific inflammation? Something like that바카라. 바카라No, I cannot,바카라 I said, tired, and frustrated. It had been a long day and with hypoglycemia kicking in I had no filters.
Before heading home, I heard two junior doctors in conversation.
Doctor #1 - 바카라This is the same doctor who had that legal case filed against him. He removed the fallopian tube instead of the appendix in the 12-year-old. She developed sepsis and died. It바카라s no wonder patients beat up doctors, can you blame them바카라.
Doctor #2 - 바카라Violence is never the answer, no matter what! They could have waited for the case to have gone to trial바카라.
Doctor #1 - 바카라And how many years would that take? He would have gotten off on a technicality.
Doctor # 2 - 바카라Can you imagine the implications of the surgeries as these young patients have had their reproductive organs removed or mutilated바카라.
Doctor # 1 - 바카라Yeah, it바카라s cruel to say, but these two should hook up as they no one could understand their situation better than themselves바카라.
There was a phone call for me. It was the mother of the 16-year-old asking me if there was any tumour in the uterus. I could detect relief when I told her there was no tumour. 바카라Thank you for this good news doctor! We were afraid that the diagnosis of a cancer could affect her marriage prospects and what if her children got cancer as well? That would have been catastrophic.바카라
I turned off my microscope, switched off the lights and made my way through the dark.
