Re: CJD Question

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In a message dated 3/23/00 11:16:34 PM, TimMorken wrote:

<<Regarding performing frozens on hazardous tissue samples, I too have to 
wonder how a lab can justify refusing samples. After all, someone went 
through the trouble to get the sample and faced even more exposure than the 
lab personnel will have. If you don't accept such samples I certainly hope 
you let the physician's know that ahead of time! And, as another pointed 
out, what about all the samples for which you know nothing of the history?>>

This problem of inadequate information is ultimately the pathologist's 
responsibility. Pathologists, along with everybody else in the process, have 
the responsibility to be proactive - to find out in advance what services are 
going to be needed, and be ready to provide them. Unfortunately, most 
pathologists believe that passivity is a virtue, as if their every inquiry 
endangered their job (which perhaps it does). 

Many high-stress frozen section situations can be averted if surgeon and 
pathologist confer in advance. To take an unrelated example - if I'm going to 
be doing frozen sections on a complex skin cancer, I try very hard to see the 
lesion on the patient before the first cut is made, and ask the surgeon where 
the critical margin problems are. - This is particularly important when I 
don't know the surgeon very well, or when my facilities are inadequate (the 
usual case in my travels - no assistant, and a 30 year old cryostat with a 
dull blade).

Bob Richmond
Samurai Pathologist
Knoxville TN

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