Wednesday, July 25, 2012

Evisceration and adventures in histology

This morning we had a conference with some of the autopsy staff where we had a presentation on evisceration. One of the PAs made us cinnamon rolls. As we all sat around munching on breakfast and watching slides on how to properly remove the chest plate (and hearing about how to deal with a heart that is adhesed to it if the patient has had bypass surgery), I realized that the level of squeamishness of the people in the room was ridiculously low. This is probably a good thing given the profession we are training for.

The autopsy staff PAs are also pretty accommodating about student guided learning. If we want to practice a given skill, then we can (I want to see if I can get the brain out by myself, for instance. I feel like I can do that so I'd like to try it and see how it goes). If we want to focus on a particular organ block then we can or if we need someone to walk us through removing the bowel one more time, then they're there. Not that I've removed a bowel yet. That was more of a resident thing since they were getting ready to be on their own for weekend call. But the next time I'm there I should be able to do the evisceration with assistance (for the summer rotations I started out in the middle of the two weeks of autopsy, so I'll have my second week after I go through the VA and Duke surg path).

Random internet picture of a cryostat
Moving on to today's rotation, I practiced frozen sections which I haven't done in ages and didn't feel very secure about. However, using the microtome on Monday made it easier to use the cryostat. The tissue was also well frozen and not very fatty, which I'm sure helped immensely. The histology lab manager mounted one block for me and showed me how to use the machine. Then he left and I practiced a bit before mounting a second specimen on my own and making my slides. They turned out much better than I thought they would, so that is a relief!

Also I went through my now stained and cover-slipped slides from Monday to pick out the ones for grading and see which ones needed recuts. I had a couple that I redid and will stain in the morning after conference. The histology manager looked over my special stains and said they were all just fine so that's good! I just have to finish up the written portion of the rotation (which is not going as quickly as I would like) and I should be all set to turn everything in on Friday.

So far, so good with regards to rotation. Next week is the VA though, which is more surg path and a grab bag of specimens so we will see how that goes!

6 comments:

  1. Nothing goes together quite like cinnamon rolls and evisceration...

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  2. I'm from Columbia, SC and interested in becoming a PA. I just now signed up on here so I could see about asking you a few questions if you had the time. Not sure if there's an option to PM you or not (i didn't see that as an option though.) Anyways, I'd be very interested in chatting with you in one way or another whether it be by email or on here somehow and getting some info about the profession. Please let me know if that's possible. I just recently found your blog and even more recently realized that you're from Columbia (awesome!) and couldn't pass up the chance.

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    1. You can email me at tre3@duke.edu :)

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