Where has the time gone? I literally feel like I just began my Ruby Memorial surgical pathology rotation yesterday and now I'm about to start my last week. It has been a very busy fives weeks, but I have welcomed it with open arms because I have had the opportunity to gross so many complex and interesting specimens that I had never had the chance to do before. For example, I finally was able to gross a laryngectomy, which other than a Whipple (which is still on my "to do" list), is one of the most daunting and complex specimens that will probably come across my bench. It's not that the overall process is complicated, you just need to have a thorough understanding of the anatomy before tackling the specimen because it is important for tumor description, sectioning, and staging. I made sure to review the anatomy before I started and had Lester close by just in case I needed a reference or confirmation on anything along the way. Overall, I thought it went well for my first laryngectomy, so I am confident in my knowledge and abilities to take on another one in the future.
Another specimen I had the opportunity to do was a 21 week old fetus with Trisomy 18, also known as Edwards Syndrome. This condition can be characterized externally by a small head (microcephaly), small jaw (micrognathia), low set ears, and clubbed feet to name a few. Internally, you can see things such as kidney abnormalities, congenital heart defects such as a VSD, and esophageal atresia. Since I received the fetus at 21 weeks, I was able to appreciate some of these characteristics. These particular cases are a little more difficult to do than other's, but I do find genetic cases like these very interesting. It's fascinating to see how one additional chromosome can create so much "chaos" within the body. When you receive a case like this, you essentially do a very thorough external examine, taking all measurements of the body and describing any features that could be abnormal, such as webbed fingers, clubbed feet, fused nares, etc. This was the most demanding aspect of the process. Then, a "mini" autopsy is performed to make sure all the organs are there and in their respective positions as well as to make sure they have been developing normally. As for sections, we submitted the gonads to definitively determine the gender, and put through representatives of the lung, kidney, liver, heart, and brain.
Other than these particular cases, I also had the opportunity to do a gastrectomy, multiple lumpectomies and mastectomies, colon specimens, and melanoma skin excisions to name a few. Even though this has been a busy rotation, I think it has been my favorite so far just because of the vast majority of specimens I've had the opportunity to do. Other than the routine biopsies and small cases, every day brings something different and that is one thing I've really enjoyed about it.
I can't believe I'm already over halfway and in the home stretch of my graduate career at WVU, but I'm ready to see what the future holds with my up and coming career as a Pathologists' Assistant. I have applied to a couple of jobs and am just waiting to see what those opportunities may have in store for me!
