CLL here. CML here. A melanoma. Colon cancer discovered on screening colonoscopy. Breast cancer following screening mammography. The slides are arranged with the others. You glance at the name. You do a double take. You remember they may have mentioned going for a colonoscopy or mammogram. The next day is much like the last. You read your cases. Solve problems in the clinical laboratory. Then you see the name of a colleague attached with that accession number. That “case”.
My first frozen section at Mayo Clinic in the unique practice there of frozen sections was on a pathology colleague, not much older than I, undergoing breast lumpectomy with margin assessments on frozen. It doesn’t change what you do or how you do it, but knowing the person beyond the name and case number does make it different.
They will ask you. What did my biopsy show? Did my disease recur? What did the margins and lymph nodes look like? Most patients we do not see as colleagues, colleagues who are patients we do see. Some have taken their own slides to their own microscopes. Clinical colleagues look for reassurance and perhaps curiosity about what their disease looks like beyond their clinical symptoms, radiology and how the surgeons and oncologists explain their disease.
Sometimes it is the spouse or a child or a significant other and you are forewarned their slides are coming. Surgery is next week. They may do a frozen section. They want to be called when you see what it is. Sometimes they call before the specimen(s) arrive.
I gather many pathologists have seen colleagues diagnosed with cancer or other major illnesses, perhaps rendering their diagnoses. Many of us have also seen colleagues die, aware of their illnesses, their struggles and ultimately their demise. One tries to take some solace in knowing they helped care for them.
Being a pathologist does not confer immunity from separating the personal from the professional.
When a colleague becomes a patient, it’s personal.