My mum and I were perplexed as to what the difference between haemotology and biochemistry was but I was told almost immediately that whilst haemotology was the study of the cells in the blood, biochemistry was focused on the blood plasma itself. I was shown around the biochemistry lab and spent a period of time with each member of the team, each relying on one another to keep the system working effectively and on eachother's knowledge to carry out the task efficiently and to constantly improve. One major lesson I learnt was the importance of considering the sample and the results as individual, even with the data being numerical and seemingly objective, for example, if a patient normally had a marker count of 2 which increases to 4, and another patient with a marker count change from 200 to 1000, it may not necessarily make the second person have worse cancer- one always needs to refer to the patient's history before drawing conclusions. At the end of the morning the consultant talked me through the reasons for why they carried out all of the tests, ranging from kidney function via calcium levels to specific enzymes relating to specific cells (if treatment is successful and the cells are broken down the enzymes will be releases). This linked everything together nicely.
In the afternoon I caught the trust bus to the Fulham road site and managed to make my way to Histology without much trouble. I was shown around by a lovely lady who talked me through the process which a sample goes through whilst in the department. It is a very laborious process involving soaking in fixing agent for several hours and changing between water soluble and fat soluble several times. As the image of the sample varies so greatly from which angle it is viewed from, it is of high importance to follow protocol and place the sample in the wax flat down. Although in every medical environment hygiene is exceptionally important in the histology department it was important not only to protect the reliability of the sample but to protect oneself from the dangerous chemicals used, a constant downdraft was employed to prevent inhalation of the fixing agents. Probably the highlight of the day was being able to see a complete female reproductive system removed, it was different from imagined, much more sturdy and I've always envisioned it as a series of negative spaces rather than the organ it is.
During both the morning and the afternoon validation was continually highlighted as a major issue, incorrect readings or values can result in misdiagnoses and potentially fatal consequences. When dealing with tissue samples and tubes of blood it is easy to forget why the tests are being carried out in the first place, and that they belong to a person and their life may depend on the result. Personally, my eyes kept being drawn towards the names and the dates of births of the people to which the samples belong, remembering the importance of the results.
Despite the obvious mammoth importance of the accuracy and speed of the diagnostic work from the lab aiding treating the patient, Today has made me more sure of my desire to work as a clinician rather than in a laboratory, I'd prefer to access the patient and be able to support and care for them through the illness (when a jaw bone was brought out of the box to be cut up to be made into slides, the only thing in my mind was concern for the poor individual now without a jaw bone!)
I very much look forward to tomorrow and if today is anything to go by, I expect to learn a lot. An early night for me then!
No comments:
Post a Comment