New Job, New Vision.

I started my new job this week. I am  now working out of a pathology lab based in the KC area. Tissue samples are brought in from surrounding hospitals and placed onto blocks', which the techs can then make slides out of to view under a microscope. Blocks are created when the biopsies are encased in paraffin wax and attached to a plastic backing with a numerical label. I came up with a quick MSPaint image to illustrate what I'm talking about - I didn't want you looking through image searches trying to figure out what I meant. That can be traumatizing. 

Paraffin wax histology biopsy blocks. Or just blocks, for short. 

As you can see, the blocks are quite small, but then so are biopsies, usually. Sometimes there are multiple blocks for a single patient, but I haven't been able to tell yet if that's just because the samples were split into smaller portions or if they are different parts of the body altogether. The paraffin wax embedding process renders the specimen tissue inert, which means there is zero biological hazard to the technician, as well as anyone who handles the blocks after cutting the slides.  

Once the blocks are set, they're put into this super scientific machine that acts like a deli slicer, creating 5 micron wax slices that are still partially connected to one another on top and on bottom via the wax's sticky nature. Typically a histo tech will cut four or five slices at a time, then transfer the connected pieces to a water bath where the wax pieces float on top. They grab a clean slide, decide which slice looks the best, and scoop it up out of the water with the slide itself. This way there doesn't have to be any repositioning of the incredibly thin tissue, and you can get two or three good, clean slides each time. Slides are labeled and either stained in house or stored until requests for outside staining are made. Staining depends completely on what the pathologist wants to see, so I have yet to master what all of them are (from what I can tell there are upwards of a hundred different requests they can make). 

My job has four different parts. 

1. Make sure that any requests made by our in-house pathologists get out to the testing center for analysis.
• Usually a pathologist will request a specific block to be sent out to the testing center and have slides created off-site, or request a set of unstained slides to be stained for a specific test. 
2. Make sure that any requests made by an outside entity get to their respective places. 
• Most commonly this includes doctor or patient requests for a second opinion. Or a doctor will request slides on the behalf of research or for an upcoming conference. Or the patient is being transferred to a more specific treatment site, and the new physician would like to see all of the slides and blocks (including those from five years ago) in order to have a complete picture of the state of the treatment. 
3. Catalog returns from the testing center or outside facilities and store the samples.
• Sometimes an external request will come in for a set of slides that have not yet come back from the testing center, so you have to be on top of what needs to go where and when it comes back. 
4. Faxes and phone calls. 
• Before samples return from the testing center, the results report will come across the fax machine (you know, that robot with the cute dial-up tone). These need to be scanned into our software and passed along to the transcriptionists - they key in what the pathologist has dictated verbally into the final report for a sample. This makes it so that the pathologist can see more reports than if they were typing the final report up themselves. 
• Faxing things out has been a little tricky for me. They don't exactly go over how to use a fax machine in BCIS, now do they? I had a problem with a hospital that had the same area code as our building not going through because wouldn't you know it you don't need to put the area code if it's the same as yours. I'll get the hang of this dino-robot yet. 
• Fielding phone calls is interesting. Either there are a million calls coming in at eight in the morning on Tuesday, or there's radio silence the entire day Wednesday. 

In a perfect world there would be a designated time for items 1 through 4, but it ends up more like being stuck in a money-grab machine where everything is up in the air and you just gotta get done what you can. It's difficult to dedicate any amount of time to, say returns, when you could get a phone call and need to send something asap. I'm not complaining - this makes each day completely different from the previous which is sort of thrilling. As I get more comfortable with how much I can get done before fill in the blank happens, I think I can get the efficiency of this position down to a science. 

If you've noticed I haven't talked about anything except work, that's because all I did this week was work. First one in, last one out, good long hours. Seeing the process from beginning to end gives me the unique position now to determine when I really need to be there and what I can potentially delegate. Poor H - I believe he instigated the No More Work Talk rule at 7PM on Friday. 

In short, I'm super excited to see the other side of the operation, and I can't wait to get back at it tomorrow morning bright and early.