I'd just settled down to my lunch today - Kimberley has been bringing in Boulevard's Kale salad for the girls in transcription and I was formerly addicted but hadn't had it in years was dying to try it again. So many pine nuts. Kimberly adds chopped up boiled egg whites; I excitedly got two boiled eggs from the Dr lounge this morning in anticipation. Then I got paged for frozens.
Two different frozens on two different patients, Jessica told me, and the first one was a Scott Stern. We were reading the history on Epic. Jessica said Wow! He's had a sore throat for 1014 days. I looked and sure enough that was in the H&P. That's pretty specific, I said, do you think it's a typo? She said maybe not, that's a little over three years. We all belly laughed so hard and I wondered why it took so long for him to address it. I told her I needed the laugh after a funeral, my second one in a month. Jay Clark did a wonderful service. I texted him this evening, and he thanked me for my kind words.
The patient had a history of squamous cell carcinoma, it was a tongue lesion, and I was relieved when I looked in the scope that it was normal lymphoid tissue. Waldeyer's ring, I gathered. When I called the OR to tell him he was so flabbergasted - I guess he thought it was recurrent cancer - that I physically recoiled in paranoia. Was there a specimen mix-up? Did someone give me the wrong slide? But no, it all checked out. Meanwhile Laurie announced from her grossing table that she's had a bad attitude for 48,579 days. We all laughed. Then she said I think there is a blues song in this sore throat thing, and started singing about a guy with a sore throat for 1014 days. We all joined in, except Savannah, who was on break watching boxing matches on her phone. But she was smiling.
The other one was a 20 something year old with endometrial cancer - luckily it was superficial so she will probably do ok. I learned from an ob on the way home that she had a BMI of 88. If you are storing that much estrogen in your fat you will inevitably grow an endometrial cancer. So she's a victim of the food industry, I said. We were problem solving another case of a 30 something year old with mucinous carcinoma of the ovary. His wife is an oncologist and wants to know how to treat - this was all over the abdomen. I assured him I was confident of my diagnosis, but since there is a clinical question that will make a difference I will pull everything tomorrow and re-evaluate and stain and give him feedback ASAP.
I had another gyn/onc Bandy frozen later in the afternoon. Gross only. I cringed calling the OR. I told Melody earlier in the day can we just replace that OR tech that answers the phone? He is often in some robotic equipment so he depends on her to take the frozen diagnosis. I told her very superficial cancer on the frozen at the most inner one half of the myometrium. This helps him make a decision to take pelvic lymph nodes or not. She said let me write it down, speaking slowly and asking me to repeat every word. She said in or one half? I said no inner one half. She said inner or one half? I said no, there is no or, only inner. Melody said she asked her to wait on hold so she could relay the information to Bandy in case he had any questions. I said hell no, she's done that to me before, I learned to hang up the phone as soon as I get her to write it down. If there are questions they know how to find me. Luckily the tech in the late afternoon was a competent guy he said thanks and I was done.
Jessica said she had entertained Joe with the story about the guy with the sore throat - he works in cytology in the mornings and in the gross room in the afternoons. Apparently after I left she and Laurie made a parody of it to Red House. She couldn't remember all the lyrics, but relayed a few, and it was genius.
In the Guardian over lunch I read the title to some review of the Friends reunion and their stint on James Cordon's Car Karaoke - neither of which I have seen - and knew it was Stuart Heritage. Another good laugh, and good replacement for any latent desire to watch either. Happy Friday Eve. Much love, Elizabeth
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