Hello, Wracks says the Frenchman.
I am a doctor now says Dr. Wracks
What do you get says the Greek.
I have a leg we amputated due to deep venous thrombosis. I saw some clots in the femoral artery says Dr. Wracks.
Put it on the accession table and stand behind me. I will tell you when you can go says the Frenchman.
There sits a huge vat of liquid nitrogen next to the accession table, the opaque milky liquid seethes and boils and vapor lingers at the base like a real Halloween movie and Dr. Wracks is the captive.
The Greek throws a tumor into the liquid nitrogen and it sinks bubbles come up and the liquid boils.
I am waiting for the tissue to rise to the surface when it is done, then I will microtome it and do thin sections.
When a pathologist does thin sections, this is what happens
Wrights Giemsa stain identifies cellular organelles for detail
Gram Stain primarily demarcates intracellular, gram-positive bacteria
Warthin’s argentaffin silver stain makes spirochetes and parasite occlusions stain black
Calcofluor white stain identifies fungal elements that fluoresce under ultraviolet light
Nigrosine stain absorbs fat and Golgi apparatus identifying lipid-associated disease conditions
Carbolfuchsin Acid-fast stain makes tuberculosis germs appear like magic.
PAS reveals glycogen inclusions
A five-thousand-dollar microscope in two, one for the Greek, one for the Frenchman sits on a different bench in front of comfortable television chairs. These monstrous apparatuses have silicon lenses carved and polished out of crystal and multiple magnifications and they finally use the oil immersion lens for fine detail. After the microtome cuts the tissue into extremely thin sections that anyone can practically see through, they are stained, set on slides and a coverslip in balsam keeps the oil off the tissue. The slides are labeled with a wax pen with a number so they cannot be changed and set in a box, one for each case.
I will get to the leg later says the Frenchman, the surgeon is waiting for the results on several of the specimens. He moves to an electric typewriter, conveys his findings for a case, types the document, signs the paper, inserts the letter into an envelope, seals the envelope, and hands it to Dr. Wracks. Bring the letter to OR 3 after you scrub in, they are doing a bilateral mastectomy and waiting for the results.
It’s a lot of work, You can go.
All English hospitals look the same, like bastions or forts with heavy security. Pathology here is in the basement and the lower floor is painted white on white with red arrows and large signs with names degrees and designations. No matter what people do, it is cold and clammy and quiet down here and the silence is deafening. There is such purity in white on white down below where no one goes.
Dr. Wracks hurries back to surgery and OR 3. He scrubs in like they taught him at the Autonoma and walks in backward so his hands don’t touch anything but he holds a letter. He hands the letter to Dr. Gold the surgeon, he opens it and reads the results. “There is metastasis in the draining lymphatics,” Radical procedure he says, you can go.
In the late afternoon, on the East Coast, in the spring, everything is green, growing, verdant, and beautiful and Dr. Wracks is here. At least I have a window to look outside at God’s given world thinks Dr. Wracks. The pathology results are always positive, it seems a waste to make a patient wait under anesthesia for the results. As a certified anesthesiologist, Dr. Wracks knows that the longer the procedure, the greater the chance of morbidity, mortality, and adverse reactions to the anesthesia. The longer the procedure, the greater the chance of an idiosyncratic happening occurring.
It is the rite of passing says another of his resident brethren.
Dr. Wracks does not cross his hands in prayer anymore because they say he is a nut. Look for good counseling when choosing a profession and hope that you find someone to love you on the way. Then you have won the game of life. Time for another spin. Like anything good in life, it is a lot of work.