Jack's here this week, which is AH-mazing. We've watched two episodes of Merlin in the past two days. We laugh about the cheesiness of it and the ancient special effects. He's downstairs studying right now, but I asked him tonight how many times have you watched this? And what age did you start? I was 11, he said, and this is my third go around. I love that he's sharing something that comforted him at a younger age and ages well and not so well with time.
Learning more about boobs from Christy. She said as long as your boobs aren't bigger than your stomach you can eat as much as you want. Love that, wouldn't work well with size small B but leaves me lots of room for eating at a DD. Another good tip I learned from Monday afternoon from her was a rule of thumb. If your nipples sag below your elbows you don't have enough support and need to seek more to gain higher ground. At my stature I gain that status without any support so I feel like I've achieved something. A gold star.
Work was crazy as hell - I had 5 needles before noon prompting me to convert from kitten heels to flats for the rest of the day. Sarah is the PA who does thyroids. Her first was a bust - a subcentimeter nodule that yielded nothing but blood. She wasn't surprised. It's one of those patients, she said, that is moaning and screaming before you do anything. I'll get a little more for cell block and be done. When I was summoned to her second thyroid, she informed me that if it wasn't adequate she would take it personally. So she was pleasantly surprised when I told her she had plenty of cells and colloid. Is it B9? she asked. I told her I thought so but FLUS's can sneak up on us when we see the cell block and the paps so don't get too reassured.
Pam, the head of cytology, is on needles this week and I told her I was a little enraged. I had a case that was paratracheal mass vs parathyroid vs thyroid. I thought it was thyroid, but the history was so confusing I showed it to Shaver. He pointed out that there was no requisition - we need a req to accept a specimen. He agreed is was a FLUS (follicular lesion of undetermined significance - these go out for Afirma testing - that's a molecular panel - to further guide treatment). Oh! I was so locked up in Epic trying to figure out the location I failed to notice that.
I called Beth and told her to find the req. She called me back and said Tony sent it up with you. I was like hell no there is no req I'm putting it in the cytology box he needs to find it and send it up. I was telling this to Pam and as I finished the thyroid got called to bronch lab by Tony. It was slam dunk malignant and he sheepishly told me that he changed his dx and sent the req to the recycle bin, where he recovered it. I'm so sorry, he said. Tony is a gem. He sees people, and helps out when needed. I'd risk my life before throwing him under the bus. We all make mistakes, I said, no worries.
Speaking of mistakes I threw a huge fit yesterday when Van sent a case to Hal in NLR that needed flow. Pay attention to the damn schedule we are short staffed and we need to not make mistakes that cost us almost a whole day and cost us time problem solving. Poor Melody was so confused - she was taking day call duty bc Maria was acting as an expert molecular pathologist in a court case. She was so stressed I asked Shaver for a ride home instead of her. Luckily she was able to order and find the flow and take care of the patient. Van owned up to the mistake - he's pretty amazing too.
I'm so excited on Monday Shelby from BVD is going to shadow me - she reads Judy Melenik and other pathologists and is so jealous of Kimberly for inhabiting our world. I hope we find a space for her ASAP I've been promising her for months. I want her to meet all the dept heads we may have an opening soon. She had a ganglion cyst removed a few weeks ago and I took pics and sent them to her - her response was so animated you'd have thought I saved her from a fire. She's sunny and wonderful. Hope she joins us.
The new girl at BVD is named Anna and she studied geology at Colorado Springs. She's brown haired and introverted but once I learned she loved rocks I was totally hooked. I showed her my trilobite and my crinoid and my angel's wings and we had an animated discussion of rocks this week - she said I have them all over my windowsills. ME TOO.
Saw some good articles on up and coming horror movies this week so excited about The Maid (Thai) and The Lamb (or maybe just lamb?) and The Manor - love Barbara Hershey. Seems she got the wrong end of the stick twice in her life - first for breastfeeding at 25 on a talk show (in 1973 - the year I was born) and another time for getting lip injections for a role and becoming the butt of ridicule about plastic surgery around the nation. Effing patriarchy. Strengthens her, doesn't diminish her, in my mind. Happy almost Friday. I start a week of call Monday so this weekend will be sweet. Take care, much love, Elizabeth.