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Enjoying Pathology Is It?

Why did I chose Pathology department to work other than other department. My attitude is more on the clinical side. Perhaps nobody know about it but I really like medicine. I enjoyed diagnosing a disease.

When I choose Pathology, most of my friends thought that I want to run away from the busy life of being a clinician. Pathology is a hot seats here in Sabah state. Everyone applying for pathology even after finishing housemenship which I don't think is right because you need to go out and get some experience first before entering this field. Most of the people who apply for a medical officer position in Pathology are doing it for the sake that they can relax and chill out in this department..

I don't think we are chilling out here in this department. Now I am still junior in training here in this department, so as my two other colleagues. Three of us in Histopathology unit and we have to gross ( cutting all the specimen you all sent) almost everyday. They were only 2 table to do grossing meaning that only 2 people will do that work for all specimen sent from all over Sabah. How big is Sabah? That's like doing all the grossing for all specimen all over peninsular malaysia.

Before this I always thought that when we send a lump and bump or maybe uterus, colon, and any other tumour, they just went straight to lab enter a machine and processed into a slide to be read under microscope. At that same time, I also thought, how can a big uterus, for example, can be put inside a small microscopy slide. Always have that kind of thought since I was in medical school.

Now I know how they do it. I will explain here. First surgeon cut the tumor with all the adjacent organ and feel satisfy about it. The specimen then sent to Histopathology department. The specimen then received, the package open by a medical officer and the specimen will be cut like a bread loaf or something like that. Then fix for a day or two. Fix means the specimen is all 'cook' up by formalin to that point where all the blood and other soft tissue will become a firmer tissue just like specimen that we used to see during our medical school time.

After it was fix, then we will cut it and try to describe the anatomy of it. That's why when surgeon go all mad and cut whatever they want, it will become a pain in our head when the specimen arrived. Now I know, a good surgeon are not just simply cutting thing up. Are they a good surgeon will be determine when we received the sample. Haha.

After describing, measuring and everything, we will then need to sample the specimen. Cutting a smaller section just enough to be put inside a small microscope slide. Thus the representative segment from that specimen must be correct. If we sample 0.5 cm away from the pathological side then when you read the slide everything will look normal. We are not using any machine or instrument to do this but our own eyes and hands. See, feel, palpate, sometime by smell. Same like how a clinician examining a patient.

After sampling, then the sample will be processed into becoming a slide for microscope. I will not explain that process here. It will take  a few more paragraph to explain that.

So the other job of us the medical officer is to read that slide that already prepared. We did not read that difficult slide as cancer or lymphoma or something, pathologist did that. We at medical officer level, what we read is all that simple specimen like appendicitis, fallopian tube, molar pregnancy, tonsilitis, gallbladder..etc.

You know how frequent they did this kind of operation right? Meaning we still need to read about a hundred slides or more.

They are almost 6000 slides per month in our department. Divide that to only 6-7 pathologist and 3 medical officer. Just assume if the pathologist read 5000 slides and we read 1000 slides, we still read 300+ slides per month and do 6000 grossing.

I don't think I am chilling out in pathology. Always work extra hours up to 8 PM, even during weekend, I can work up until 4PM.

Do I enjoy this? I am not into histopathology kind of stuff. But I don't hate it. Actually I enjoy working in pathology. I am not sure why. I guess it's because of all the new thing I learn everyday.

To expect the relax part in Pathology is totally wrong, but to enjoy medicine in this department is a yes..


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