Thursday, January 12, 2017

Cold Moon

Bronch #1 - hilar nodes.

Me: Blood. Still blood. More blood.

Cyd Vicious: Fuck. I thought I could get it.

Me: This slide is still blood.

Cyd: I'm done.

Me: She seemed like a tough patient. Coughing, talking.

Cyd: That shouldn't have affected anything.

Bronch #2 - hilar nodes.

Me: Metastatic poorly diff adenocarcinoma. Doesn't look like colon, unless it is poorly diff. When colon goes to the lung, it usually retains it's architecture. Picket fence nuclei. Dirty necrosis. This is ugly and clean as a whistle.

Cyd: He doesn't just have colon cancer. There's lung too.

Me: Oh! I didn't know that. Could be ugly lung. Get a good cell block so I can stain it up.

Cyd to nurses: I need to get to the contralateral node and see what's going on.

My tech (not hearing about the contralateral node): Are you done with us?

Cyd: Sure, I'll just put the rest in cell block.

Me: Are you sure? I can stick around. It's 15 minutes until my lunch (garner guffaws from the nurses and respiratory therapists).

Cyd looks up from the procedure into my eyes.

Me: I'll stay. No problem. That's what I'm here for.

Cyd: Ok, sure. Sure.

Me: Lots of lymphs, heterogeneous, and no cancer. This is a great sample. I think the contralateral side is clean.

Cyd: Ok. That's what I thought. Makes a big difference. Thank you.

I walked out of the bronch lab, mind on Boulevard Soup. Vietnamese Hot Pot today, I discovered when I got there. It felt good, having my time valued by an esteemed colleague. Many lesser clinicians take three times as much of our time for granted. It made me feel light and ever willing to stay in the fight.

The Cold Moon is also called the Wolf Moon. It is one of the longest Full Moons, as nights in January are long and dark. It is both painful and transformative.

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