One day a week, I am an honorary member of the surgical pathology
department. I help with what are called “frozen section” specimens, the
kind that require a rapid, intra-operative diagnosis so the surgeons
know how to proceed with the operation. The bulk of these are cancer
cases, in which the surgeons are looking for margins - basically trying
to find out how close they are to the edge of your cancer without
taking out anything you could still use. We do a lot of biopsies to see
if anything is cancerous in the first place - lymph nodes, chunks of
curious growths and so on, in order to make sure that as long as
they’re in there, the surgeons get what they need to get the first time.

I got to carry a couple of prostates today. Not my most interesting
specimens though, but that’s how Lindz’s post about… um, male parts…
came into play and made me think about those, and the fact that
sometimes it’s a little weird that I might be walking out of the OR
suite with something in my hand that you didn’t quite expect to lose.

Most people know when they go in for a procedure that the surgeon is
going to remove lymph nodes, a liver lesion, an ovary, a ureter. I got
all of those today. When i take the specimens out of the OR to the lab,
I sign off on the Tissue Exam Request and check out what the procedure
is. Today those prostatectomies were both expected (one was even being
televised; more on that in a bit) but there have been times when the
patient’s record indicates that she is just having an ovarian tumor
removed and I end up walking out of the room with an entire ovary and a
uterus because there were a few surprises in there.

I get called several times in succession for some cases, depending
on whether the patient had a good margin and the operation can end, or
if they had a poor margin and more tissue has to go up for tests. And
sometimes the docs just open a patient up and say “Well. Holy shit.
THAT didn’t show up on the film we took two weeks ago,” and hand me
half a kidney, five lymph nodes, and a left ureter...

Read on at My Red Stapler.