One of the reasons I came back to Saudi Arabia was to get away from an 
almost smothering regulatory environment. However, I never intended to get 
quite as far away as I did.

Safety is not even a secondary concern here. We are required to wear white 
lab coats at all times in the lab and gloves are to be worn when handling 
specimens and chemicals. Our lab coats are cloth  and will only keep out the 
air-conditioning. I think we have a pair of goggles somewhere, but I'm sure 
there are no safety glasses.

Our pathologists don't accept the germ theory. We get fresh lymph nodes 
occasionally from patients known to have TB. Rather than divide the specimen 
in surgery for histo and microbiology, or send it to microbiology first so 
they can take their part and we can immediately fix our part, the 
pathologists insist they want to see it first. So when we get one of these 
fresh nodes, they plop it out on a paper towel on an open bench in an open 
room, slice through it, make touch preps from the cut surface, then WAVE THE 
SLIDES AROUND IN THE AIR (excuse me for shouting)to dry them off! And these 
are supposed to be pathologists. Needless to say, I refuse to go into the 
room when one of these things comes in; I didn't come here to commit 
suicide. One day I walked by and saw one of the residents cutting a node 
while another resident stood by watching and drinking coffee! I followed up 
that particular node and discovered microbiology later got a positive TB 
culture from it.

The ladies who work in the TB culture room in microbiology wear lab coats, 
gloves, and VEILS rather than masks, then they wear the lab coats and veils 
everywhere they go, including home.

Last year we got a spleen from a TB patient. It was filled with large, white 
caseous lesions. The following day, the surgeon came and wanted to see the 
spleen. Outside the pathologists' offices is a 10-head microscope where they 
just happened to be having a little "tea party". While one of the 
pathologists moved the food aside, another one got the spleen out of 
formalin, spread the slices on a tray, brought it out like a plate of spare 
ribs and set it down on the same table where they were having the party. 
They all stood around and oohed and aahed over it, then took it back to the 
gross room, moved the food back over and continued on with their party.

A friend said "You have to make your own personal safety zone around 
yourself and not worry about anyone else."

Some days I miss those overbearing inspectors.

David Anderson
Riyadh Armed Forces Hospital
Saudi Arabia
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