Friday, February 26, 2010

Acute Inflammation

At 2:00 I got a call in my office from the transcriptionists.

"They're ready in CT4."

I headed down the long hallway, toward radiology. I quickly scuttled through the CT room, protecting the ovaries I probably didn't really need anymore, to the scope. The cytotech had some slides ready, fresh from staining. I grabbed a paper towel to clean the slide, so the water on the slide wouldn't hinder the slides movement on the scope. I started looking. Benign lung elements. A little acute inflammation. "I'm not seeing much. Better get cultures."

The radiologist was looking in the computer.

"It's a mystery. They say she has a history of non-small cell lung cancer, but she's never had a biopsy. We can't figure out where the diagnosis came from."

The radiology assistant, a beautiful brunette with sky-blue eyes, echoed the conundrum. All the guys, the radiologist, the radiology P.A., and the cytotech, headed back into the CT room to get more sample. I heard the radiologist questioning the patient, who was on the CT table. I engaged in chit-chat with the assistant.

"I'm sure glad it's Friday. I've been working for two weeks straight."

She replied, "I wish I had been working that long. I just got back from a conference in Vegas. It was amazing."

I said, "I've never been to Vegas. Only the airport. Did you see any shows?"

The crew came back into the control room, with a new sample. The cytotech began to stain the touch preparations, for my review. While I waited, the radiologist solved the mystery from earlier.

"She had a lobectomy. On the other side."

I said, "No wonder. That's where they got the diagnosis. Not a biopsy, but surgery." I noticed the board was conspicuously clean. I remarked on it.

The radiologist said, "Yup! 2:00 on a Friday. No more needles in sight. Normally, I'd be stacking them up, on Friday afternoon. But I'm on call tonight, so I'm keeping it minimal. Part of my new plan. Like transparency in Washington."

I started laughing. The radiology P.A. said, "more like plausible deniability." I laughed harder.

The radiologist said, "Them's big words, Randy! I don't understand what you're talkin' about." He turned to me. "You say you saw poly- mofo (really he said morpho, but I think mofo is funnier) - nucleo- sites? So we should get cultures, right?"

I had stopped laughing, and answered tersely while I was looking in the scope. "If you guys would just stop making me laugh, I might be able to concentrate and help you out." It was the only way to give them a compliment, in hopes that it wouldn't go to their heads. The radiology assistant laughed. "Now you know what it's like to live around here."

They got cultures. I was happy for the patient that I didn't see cancer. I jotted down my preliminary diagnosis on the requisition sheet, and stood up to leave. "So long. Have a great weekend."

The radiologist bowed, with a flourish. "You too, doc-tuh."

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