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Tuesday, October 19, 2010

biting the hand that feeds

I was struck this weekend at just how under appreciated pathologists are. They’re the ones who look at peripheral blood smears. Biopsies. Removed organs and tumours. They try and find out after your death why you’re there on the autopsy table. Their work is the basis of what your doctor will use for treatment when you’re really sick. They have the nerve wracking role of being expert – the one who will declare the dreaded “C word”. The one who can tell you you have 6 months to live.

Sometimes the doctors I work with frustrate me. They are busy. They are over-intelligent and tend to order underlings around. They expect from us what they give to us and others and will not put up with bullshit and can be very curt. And yet, I must admit, I am in awe of the pathologists I work with. Yes, admittedly some of them are pathologists because their people skills are totally lacking and will freely admit it. They are suited to look at the specimen - to see only the disease and not have to deal with people - and I get why. Having to diagnose a fatal condition in a small child…a mother of 4…nailing the coffin closed on yet another regular life - that is hard enough day in and day out. To have to put faces to the cases and tell the patients and their families day after day? THAT takes a special kind of person.

And things are changing. Slowly they, even at their level of expertise, are just another cog in the wheel. They are pushed for x numbers of cases per month to prove their worth. I mean, I am a “lowly tech”…what I do could be done by others -I’m not vain enough to think otherwise. Sure I’m good, and my skills are great and I benefit the ones I work for, but in the end, while I can see some things now after 10 years in pathology- like whether someone has a ER, PR or HER2 positive breast tumour, or some common GI conditions or bloodwork results, I cannot know, simply at a glance in the microscope, what organ the tissue is from. I cannot give my expert opinion on whether a tumor is benign…determine stage 1 from stage 4. I cannot recommend therapy. They can. And they do - often 16 hours a day 6-7 days a week. These are doctors who often have no lives because they are the only ones who can do this and cannot bring themselves to leave a patient wating…often, unless they are married to other doctors, their families and spouses simply cannot understand why they do it - why they would work like this and neglect them. They don't get why after nearly no sleep they’d get up and do it all over again…and sometimes their family life is sacrificed for the care of others. Their work becomes their life.
In all this they are becoming under appreciated for the amazing work they do. And it is a true shame…

I did a lot of thinking this weekend, after seeing and working with pathologists in a huge health and research centre work and hear them complain and thrive like any other job. I repeatedly thought of the cardiologist who attended my mother. How he took the time to speak candidly and compassionately with my mum, my dad and with us. How he made sure my mum was well cared for, and how her last days were full of as much comfort and compassion as he and the girls on the ward could offer. How the people I work for gave him the information he had to tell us.

I simply do not know how exhausted, under appreciated doctors get out of bed and do it day after day…I don’t think I am enough of a person to do that. To me, no amount of money is worth the sacrifice they put in…I do not have their inner spark and drive that fuels them exhausting week after exhausting week. My home life is more important to me than what I do...but I do not do what they do...

But I do know this – I am glad that I can call some of them my friends.

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