Friday, August 12, 2016

Tumor Board

I walked in 5 minutes late. The Nightingale patted a seat beside her at the front of the room, beckoning me to join.

I sat down after getting breakfast (greek yogurt, almonds, blueberries, water, coffee) amidst the din of cases being presented. Feeling guilty for being late.

As I settled in I noticed Cid Vicious. Decided to text him.

"I woke up at 6:50." My alarm originally went off at 5:30, but I fell back asleep. When I woke up I startled and got ready in 10 minutes. Skirt. Blouse. Wash face. Drive to CARTI.

He texted back. "I woke up at 4 - I have seen 11 ICU patients, put in 3 central lines, intubated and bronched so far this AM. I am going to Chicago at noon and have to get outta here."

"Are you calling me a slacker? What's in Chicago?"

"Nothing in particular. Just going up there for baseball, eating, drinking, etc."

"At least I'll get EBUS relief." Amid more talk of patients.

"You call non diluted cases with the peacock relief?"

He had a poker face. I could not. Kept silently laughing from the front of the room. I was jealous.

"Aren't you taking her with you?"

"Yeah, we usually travel together, my wife thinks it's weird but we really enjoy each other's company."

I've met his wife, in the Kroger parking lot. Super sweet and adorable.

"Traveling with the peacock would make a really good SNL skit."

Then I presented. It went over pretty well. I even had the hard nosed thoracic surgeon engaged. Can't wait to present next week.

I was trying all day to think of texts that might have broken Cid's poker face.

"It's a good thing my leg hair is blond because I've got two days growth going on."

"My ponytailed look is not styled by product. It's grease from lack of showering."

I'll have to try harder next time. Good to have goals.

My partner at work who missed tumor board was incredulous that I didn't have time to shower. "It looks like you took an hour to get ready."

This is a granular cell tumor. It was in the arytenoid cartilage. 30 ish year old. Very subtle on frozen section, but I called it. Looks like macrophages. Never seen it in the larynx. Has a 3 (or .3?) percent malignant rate - most are B9. The clinicians were fascinated, gave lots of good advice. I've only seen it malignant once, in Conway, in the soft tissues of the buttocks. I think this one is B9, but local recurrence is a concern. The hard nosed surgeon wants a full laryngeal resection. None of the radiation oncologists had any idea of what it's response to radiation therapy might be, it's so rare. I'm not so sure I agree with resection, but it's not my granular cell tumor.

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