Thursday, May 29, 2014

Ten Minute Lunch Break

It was really five counting the interruptions from secretaries, radiology to do needles, and clinicians calling for results.

I had a record number of cases today. Over 70. I was home before seven, but it took heroic effort to get there.

I also had a record number of clinicians calling about one of my cases.

Pulmonologist at 8 a.m. yesterday: "The mass looked unbelievable. Fish-flesh color. Crawling around in branches of the bronchial tree like I've never seen before. Can you call me as soon as you get the results?"

Oncologist at 10 a.m. yesterday: "I need to start treatment right away. Can you call me as soon as you get the results?"

Me to Pulmonologist: "I'm just out of a board meeting. It's almost six and the stains aren't out yet. Sometimes that happens when there is a heavy caseload - the machines get overloaded. I've got to go get my kids. I'll call you first thing in the morning. Please tell oncologist."

Me to Pulmonologist at 7:30 a.m. after I screened on a different scope cause my microscope crapped out on me. Took two hours to problem solve and fix.: "I've got stain results I think it's neuroendocrine. I've got it out for consult to a partner it's a tough case. Hopefully that's enough for you to treat."

Oncologist to me at 8:30: "When will you have a definite answer?"

Me to consult partner at 8:35: "He needs a definite answer to treat. No pressure, but pressure."

Partner at 10:00 a.m.: "I agree with you on the diagnosis."

Me to oncologist at 10:05: "Here's your answer. I'll have the report out by noon if you need it for insurance purposes for ordering treatment. There are variables. Secretaries are short staffed. It takes a bit to transcribe. I've got to check the billing to make sure it is kosher. I'll release it ASAP."

Me at 1:20 p.m.: Release case to the ether. Bump into pulmonologist in Dr. lounge as I'm getting afternoon tea. See that she is struggling with EMR, call to her three times before she hears me. She smiles in recognition and listens to my resolution.

Pulmonologist: "I'll call oncologist so you don't have to."

Me: "Don't worry I've already talked to him. Have a great day."

One of 70 cases. They aren't all that tough, but still.

Here's what I watched at lunch:  Hippopodius hippopus. What a fantastic name for a magical sea creature.


4 comments:

Coleen said...

Carcinoid?

Gizabeth Shyder said...

Good guess Coleen! It was small cell. I was worried about large cell neuroendocrine. It's hard to tell the difference morphologically sometimes with a small, crushed sample.

In case you were wondering, lunch was Cheetos dipped in a snack-sized tub of peanut butter with Whoppers for dessert. Comfort food(:

OMDG said...

I love your dramatic pathology stories. You make it sound really cool. Maybe in a different life....

Gizabeth Shyder said...

We get so many diagnostics on cytology it is overwhelming. We field a lot of phone calls. Pleural fluids, peritoneal fluids, radiology cores, etc. Texting is obviously a no no for HIPPA reasons, so you've gotta chat. It's good to talk to the clinicians but hard when it distracts too much from scope work.

It is exciting! This life:)