The Mythical Land of the Lab

So, working at a medical laboratory, I see a lot of stuff to do that people generally don't think about. They know tissue goes there and that results come back, but not a whole lot else. So, I thought that it might be fun to do a full chronicle of the journey from hospital to result. There's a lot of steps that I'm guessing you never would have thought about. Maybe some of you will find it informative, maybe it'll be boring. Either way, I think it's pretty cool, so I'm going to write about it. Obviously, there is going to be a lot of variation from specimen to specimen, lab to lab, but here's what I have experienced.

1. The courier picks up a bunch of specimens and their paperwork from the hospital. Sometimes these are designed medical couriers, sometimes specimens are literally sent through FedEx. It depends on the specimen, what tests are ordered, and who ends up giving the final diagnosis.

2. When the specimen arrives at the lab, it is accessioned. This was what I did at my old job. Patient data is entered into the computer and verified to match the paperwork and it's given a case number.the case number follows everything associated with that patient's specimen through the lab. Tissue block are printed with the case number. These things are impossible to describe, so here's a picture:

3. The specimen is grossed. This means a Pathologist's Assistant (PA) cuts a bit of the tissue of interest whole describing the specimen into a recording that will later be transcribed and sent with the final report. The bit of tissue is placed into the blocks and loaded onto the processor.

4. The specimen is processed. Processing is basically cooking. In fact, early processing was done in a microwave. Not kidding. Processing removes the formalin and water while preserving the cell structure. Processing can take anywhere from a couple hours to half a day or more, depending on the tissue.

5. Once processing is complete, the blocks are given to an embedder, a person who arranges the tissue and embeds it in paraffin, like this:

The tissue is in that little button that sticks out. On the right is the mold they put it in the make them all uniform

5. Slides are printed for all of the stains that the tissue requires. All specimens that I see at Inform get Hematoxylin and Eosin (H&E) and some get special stains on top of that.

6. The tissue is given to a microtomist for cutting. Microtomy is the ultimate deli slicing. The tissue is cut to a width of 5 microns and laid on the slides, like this:

This part takes special training, obviously. I avoid walking past the microtomists because I walk fast and the gust of wind can mess them up. That is how sensitive these things are. Pity the microtomist with hay fever.

7. Slides are loaded onto various stainers depending on what stain is ordered. A stainer has a mechanical arm that moves the slides through a series of buckets of reagents and dyes. All of the stains are pre-programmed, so we just load them, start them, and wait. Some stains take only 45 minutes, some take 3 hours, it depends on which one. Slides are then given a coverslip to protect the tissue.

8. When the stains come off the stainer, they are then matched up in the computer by case number with their tissue locks to ensure that we have everything that was ordered and that it was done correctly. This is called Matchmaker at Inform, I don't know what other labs do.

9. Blocks are archived, put into storage on case the doctor asks for more slides, and the slides are imaged. Imaging is where the slides are looked at and any areas of interest are highlighted and put into a description that will also go on the final report.


10. Slides are given to distribution and sent to the appropriate pathologist with the report to be read and give a result. That result is sent to the doctor and the doctor gives it to the patient.


And all of this happens in less than two days. Labs generally run all hours of the day, and they are busy places. There are a lot of gaps of waiting for things to finish like the processing and staining, but there's always something going on. There are a lot of people who influence the result of every specimen, and we have to do it with a less than 1% error rate.

So yeah, that's the life of a skin biopsy, or a colon polyp, or whatever you get sent to the lab. I hope you found this interesting and informative. I like my job, so I enjoy talking about it like this. There, you can say you learned something today!

I'm a Bat

Okay, big fat life update because time to blog has not been a thing the past....couple of months. But with good reason!

Work: So I have a new job! I am working as a lab aide at Inform Diagnostics. It's not as gross as my previous job, but still a lot of fun. There's a lot more variation in my day-to-day tasks, and I feel like I'm learning a lot more about lab work in general.

I'm currently working overnight shifts. It's awful. Mad respect for anyone who can handle it. The problem for me is not staying awake at work, it's being able to get adequate sleep on weekends to be able to do social things. I'm exhausted all day and can't sleep at night. Nope. As soon as a day position opens up, I'm out. I have dubbed people who work graveyard shift "bats" and I have joined their ranks. I'm a bat.

What does a lab aide do? A little bit of everything. Print slides, load staining machines and stain the slides, maintain the machines, get cases together to be scanned into the computer before being read, anything else that needs doing. We're the worker bees that do all of the in-between of the big steps that happen between the tissue arriving at the lab and ending up on the pathologist's microscope. Maybe I'll do a blog post on the life of a sample, it's pretty interesting (at least to a nerd like me), and I feel like it's a good thing to be informed what's happening rather than the lab just being that mysterious place that gives results.

Living Situation: I LOVE MY NEW APARTMENT. So, my former roommate, Katherine, is getting married, and I wish her and her fiance all the best. However, that means I no longer have a roommate. If you've followed me for a while, you would know that my apartment has....displeased me in many ways. From the bugs to the lack of decent parking to the fact that I lost heat three times and air conditioning twice, I have HAD IT. So, because I can afford it now that I have a steady income, I looked for an apartment by myself. And boy, did I luck out on this one. I love the floor plan, it's within my budget, and the amenities are reasonable. I'm not near a busy street, so it's nice and quiet, and I'm on the ground floor, which I have never had before.

So, how does one girl with one small car get her stuff moved? She calls friends. I signed my lease on Wednesday, then unloaded my packed car into my new place. Repeat with another carload on Thursday, and another on Friday. Then came the big day.

Let me give you the numbers. Four wonderful friends showed up. We loaded three cars and two trucks to the gills. And we got it all. In. One. Trip. The moving of my stuff could not have gone better. I took everyone who showed up for gourmet pizza afterwards, as is correct. You guys deserve it and I'm so grateful to have people who are willing to help me. Seriously, you guys are great.

My cat, on the other hand, made some trouble. She was crying, so I let her explore a bit and went to go get her food/litter from the car. I came back and she was gone. I looked in every nook and cranny of tgAt small apartment, walked around the outside multiple times, and called for her. The problem with finding Puff is that there is nothing that will tempt her out aside from me. She has no interest in treats or toys, she just wants me. She will come for cuddles and nothing else.

We had looked behind the fridge. Several times. The fridge is black, and Puff is mostly black. We had looked right at her and not seen her! The little twerp nearly gave me a heart attack. But I have her, and she seems to be settling in quite nicely.

All of that stuff is why I haven't had the proper combination of time and energy to blog, but as I get settled, I should stabilize a bit more and be able to update again. Until then, here's pictures of my new place!

I was entirely too excited that my new apartment has a bar. It's small, but I love it

My living room. I haven't gotten a TV yet, and it needs some nice wall art. It's getting there

My glorious kitchen. I have it laid out to maximize the small space and be easily accessible to my short self.

Not the best shot of my bedroom, but that closet is amazing. It's huge, and it holds everything. Including my cosplay.

When I lost my job just a few months ago, I was straight up not having a good time, bit now it's looking up. I may be a bat for now, bout you know what? I'm a happy bat.