[Histonet] The Histology Career was monkeys

rschoon rschoon <@t> email.unc.edu
Wed Mar 2 09:50:22 CST 2005

Here I go on a short rant..... So read no further if easly offended.

It is true that most anyone with normal co-ordination  can be taught to  
"turn a crank" and get sections from the microtome as well as load an 
automatic stainer /processoer,  push various buttons and put labels on 
slides.  Don't know about monkeys but I have trained MD's ( humor is 
intended here but I know, hate mail is on the way) to do manual IHC with 
acceptable results. The old "take them out of housekeeping and let the 
pathologist train them to section" mentality. The point is that most 
"techniques" can be taught but what happens when things go wrong?  The 
stuff nightmares are made of!!!

The following examples were drawn from a short stint as a very partime 
positon I held in a large hospital path lab where I was the only  HTL 
and one of two HT's out of  eight "technicians"  (the supervisor was 
also not registered).

1) The person doing Special Stains (automated) asked me why the acid 
alcohol was not decolorizing his PAS slides.  I asked why he wanted to 
do that and he replied that  the hematoxylin on the stainer had run out 
and he wanted to restian the slides and that the "pink" wouldn't come 
out.  I explained acid/ base dye's but stoped short of trying to explain 
the Shiff's reaction when I realized I wasn't getting through.  Finally 
just told him to put the slides in the hematoxylin  of the H&E stainer 
and that all woud be well.

2) The person doing the microscopic QA on the H&E's before the slides 
were delivered to the pathologist could certainly reccognize folds and 
knife lines in the sections but came to me one evening and asked me to 
look at some slides that didn't have any "blue dots" on them.   Briefly 
explained cells and nuclei , suggested we check the automatic H&E 
stainer and discovered that someone had forgotten to put the "H"  in the 
stainer.......  She had been promoted to "technician"  from accessioning 
clerk several months before......

I could go on  as there were numerous othere incidents, some with legal 
ramifications, that happened on a daily basis that simply would NOT have 
occurred had the laboratory benn staffed with certified HT's.   One must 
be able to understand what one is doing in order to fix what went wrong 
when it does (check Murphy's Laws of Histology, it will).  With the 
increase complexity of the procedures and tests that we now do, IHC, IA 
etc. education is a must.

Robert Schoonhoven, HT, HTL (ASCP)

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