I Take it Back!

Good thing I'm not a real doctor ...

A few months ago, I was on call for a Saturday morning. At 10AM, my pager alerted me to an operating room call. It was an add-on, not previously on the schedule which I reviewed the evening before. Fortunately, I was on the road that morning and only 10 minutes from the hospital. When I arrived, the specimen was waiting for me on the cutting table. It was a synovial biopsy from a patient undergoing a knee replacement. The orthopedic surgeon indicated that he was concerned about infectious granulomas. A quick frozen section confirmed his clinical impression: non-caseating granulomas. The surgeon had already taken tissue for mycobacterial, fungal, and bacterial cultures. My job was done!

As I cleaned up the cutting table and placed the frozen tissue into the formalin, the circulating nurse from the operating room came in with additional tissue and paperwork. Grinning, he addressed me with a jocular, "Hey Doc, I take back everything I said about you in the OR!"

Obviously confused, I asked him, "What do you mean?"

"Oh, you know. We were all saying how you pathologists got it so easy, taking call from home, making us all wait here."

"I was here in 10 minutes!"

"I know! That's what I mean! You're like a real doctor."

"I am a real doctor."

"I know...I didn't mean it like that." His smile dissolved as he digested my annoyed tone. "I mean, you guys are great. I don't know how you can do it, looking at the slides all day long."

"No problem...just remember we're all on the same team."

With a nod, he returned to the OR.

The medicine or pathology is never as challenging as dealing with the people who practice it. I would like to think this is an isolated incident but experience has taught me that these types of encounters are common, much to the chagrin of pathologists everywhere. I remember one pathologist stating that even if he isn't on OR call that day, he would dress in surgical scrubs. Surgeons and other physicians would accord him a greater deal of respect, treat him like a real doctor. Another pathologist makes it a point to have breakfast in the surgeon's lounge every morning. Still another makes daily rounds through all of the operating suites touching base with the surgeons, anesthesiologists, and nurses. All of these activities help to magnify the image of the pathologist as a vital link in the care of the patient and diminish the perception of a glass slide pusher huddled behind a paraffin curtain. Yet, when incidents such as the one that I have just illustrated occur, it is a reminder that we still have a painstaking task of educating our partners in healthcare.

What do you think? Please email your comments. I will post them anonymously. If you would like to share your trench stories, please email them to our site. Patient and physician confidentiality will be maintained.

Paul K. Shitabata, M.D.

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Last Updated June 13, 2005