It Was Where?

A block was found instead of lost this week. This is 2017. It was a block from 2013. That means the lab report was delayed four years. I’ve heard labs are slow.

The block was found because we have a person in the lab that likes to clean. For some reason they decided to clean out a file cabinet, the bottom drawer, which is used to store rarely used lab tools. That file cabinet is between an embedding station and block storage trays.

A couple of things about this. One, some parts of the lab are obviously not cleaned very often. I mean, its been four years. Good lord.

Two, when they searched for that block, wasn’t that sort of an obvious place to look? A drawer right next to the place it was embedded?

Three, I wonder if the patient will be told their specimen has been found?

I saw the block. It was a skin biopsy and it was never cut. It ended up in the bottom of the file cabinet right after a tech embedded it. That means the patient and their doctor were either told the block was ‘lost in processing’ (guarded truth) or the ‘specimen was lost’ (the truth) or the ‘specimen was inadequate’ (cover-the-ass lie).

Regardless of what they tell the patient, the block will now be cut and a pathologist will look at it for disease.

Probably there is nothing in it to change the patient’s treatment. They probably received the exact treatment they should have because clinical doctors usually have a pretty good idea of what the skin condition is when the specimen is sent to us. They want the pathologist to verify they are right and or tell them which of a few possible diagnoses are correct.

Does the fact the patient received the correct treatment make everything good? No harm done? Would the patient having sure knowledge that they received the right diagnosis due to their specimen being seen, help them recover? Does the lack of that knowledge hinder their recovery? I think I would have fretted more not knowing if the treatment I received was the right treatment, at least until I got better.

What if the patient didn’t get better? What if the block showed they didn’t receive the treatment they should have? What if they had too much treatment, maybe a large chunk of skin was removed ‘to be safe’? Then the patient is mutilated for no reason.

What if the patient didn’t get any treatment, but their doctor decided to ‘wait and see if anything develops’ and the block now shows cancer? Then that cancer might have been growing for four years undetected.

It is also possible the cancer was immediately detected because the patient was brought back repeatedly to guard against any disease being missed. And they were brought back for free. Again, no harm done except the patient must keep returning.

All of these are possibilities, and in each of these scenarios the patient may never be told the block was found.

Given pathologists and doctors tend to not share information with patients, I’m guessing the only way that patient will ever know their block was found is if it does change the diagnosis for the worse. Then the patient will have to come in for more treatment and they will have to be told why.

I know one thing is certain, the hospital will use its many resources to mitigate the damage if that happens. They might try being upfront and declaring, in happy exuberance, that they have righted a wrong and found the block. Or they might quietly wait. After all, they might have already paid damages and if the patient is dead, there is no reason to dig up that grave, is there?

 

 

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