Monday, August 4, 2014

OMG Brainfreeze!

I was thinking of the name of Cecelia's ice cream company for our contest in Boston while I was freezing a brain biopsy tonight on call. I just got home about an hour ago.

It takes me a lot longer than it did in residency - I only do it every few months. Late frozens are usually performed when the on call path assistant is there until 7. This one didn't go until after 8. She offered to stay or come back - I told her I might make a phone call to help her talk me through the freeze process so I didn't screw up the tiny biopsy but once I loaded the chuck on the machine to cut it I would be fine.

While I was cutting I was having problems getting a nice thin three micron sheet of ice and tissue - I got a little frustrated but figured I just needed to cut deeper into the block. My hand was getting cold. Then I realized that the lesion looked dark - it must be hypervascular and so it wasn't cold enough (thank you residency experience doing lots of frozens). I got the cryostat - sprayed a blast on the surface of the tissue, and voila. Three fantastic sections later, each carefully applied to the slide with a pointed probe, I was ready to stain with the slides in alcohol. I ran them down the stain line, applied the glue (I forget what it is called just now love the smell so much) and slide cover, and looked at my handiwork proudly under the microscope. Called the OR with the diagnosis. Cleaned up, melted the block and put the tissue into a biopsy bag then a casette, and poured formalin into the container before closing the lid.

I remember we used to sing this in residency while we were cutting autopsy brains.

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