A Conversation With a Clinician

This was a phone conversation I had with a clinician many years ago.  There are several like it that every pathologist can relate to. This for some reason sticks out in my head more than most. Healthcare in 2014:

Me: Pathology, Dr. Kaplan

Dr. Opening: Hi Keith, it’s Mike. Mike Opening.

Me: Hi Mike.

Dr. Opening: You or one of the other pathologists called me a few weeks ago about a case and you were concerned there may have been superficial invasion and recommended re-biopsy.

Me: Yes. I remember the case well. I did deeper levels and showed it around and we could not be definitive but we were concerned.

Dr. Opening: Do you remember the case. I think the patient’s name was…

Me: Yes. I remember the case well. The patient’s name was “Smith” [NOT real name for these purposes].

Dr. Opening: Good. I am bringing the patient back in for a biopsy tomorrow and I really need to know what it is [which would have been a Thursday]. When can you call me with results?

Me: I can call you on Friday. It takes us 1 day to get the slides as we usually process tissue overnight unless you need it sooner.

Dr. Opening: No that will be fine. So, if I do the biopsy on Thursday, you can call me Friday?

Me: Yes.

Dr. Opening: Oh, I won’t be in town on Friday. Can you call me Monday?

Me: Sure. I can call you on Monday. I will be out of the hospital but can call you from my cell on Monday to discuss the case. The results will be in the EMR on Friday.

Dr. Opening: That’s OK.  I will wait for your call on Monday unless you call me on Friday.

Me: Sure. I can call you Friday. What number shall I call you at?

Dr. Opening: Give me your cell and I will call you on Friday or Monday.

Me: OK.

Dr. Opening: Or I can check the computer on Monday when I am back and call you with any questions.

Me: Sure.

Dr. Opening: When I biopsied the patient before, the mucosa looked funny.  You said it looked atrophic.

Me: Yes.

Dr. Opening: The mucosa looked funny.

Me: How did the mucosa look funny?

Dr. Opening: You know, funny.

Me: No I don’t know. You said the mucosa looked funny. We don’t have a diagnosis for “funny”.

Dr. Opening: You think this is funny? How is this funny?

Me: No. This is not funny. You said the mucosa looked funny. I was worried about a carcinoma.

Dr. Opening: Yeah, the mucosa looked funny.

Before this went too much farther down a Goodfellas parody I tried to re-direct.

Me: I can rush the biopsies for Friday so they come out in the first batch of tissue processed and call, text or e-mail you with the results.

Dr. Opening: Thanks. I need to know right away but I will be out on Friday.

Me: I understand. You can call me when you can. On Friday or Monday. I will give you my cell.

Dr. Opening: OK. I will bring the patient back in on Thursday and do a bunch of biopsies.

Me: Got it.

Dr. Opening: You can call me on Friday.

Me: Will do.

I called Dr. Opening on Friday without response. He never called me about that particular case again.