Things to Come

     After 6 months of my medical technology program, I think I have figured out which departments I would rather work in.  By far, my first choice is the tissue typing or HLA lab.  I spent a day there during symposium week at Strong Hospital, and it was fascinating.  In the HLA lab, specialist medical technologists work to identify the human leukocyte antigens (HLA) present in a patient.  These antigens are what determines what tissue type they have, which is they type they can receive for an organ transplant.  The other end of their work involves typing possible donors, usually near death, to determine who can receive their organs.  As specialists, they have much more autonomy and can interpret results to surgeons, the organ procurement teams, and other individuals.  The lab is staffed during the day 5 days a week and on an on-call basis, with one tech being on call at any given time.  Many donors are individuals who are on life support and whose families have decided to take them off.  The next steps are to type the individual and to work out a time for the organs to be removed from the donor.  This is decided by the surgeons and organ procurement team and is usually done at night as that is when operating rooms are available.  Organs must be transplanted shortly after removal, so this means that when a tech is called in, it is usually at night and they must work quickly and efficiently.  I feel that this work would be massively rewarding as what you do would have a massive impact on the lives of many, many people; it would also be very intellectually stimulating.  The only stumbling block is the lack of open positions; it is unlikely that one will be available when I am looking to apply for jobs since not many hospitals have this department; strong is the only local one with it.  Nevertheless, I hope to be able to work in an HLA lab in the future.
     I think my next choice for where to work would be blood bank, again at Strong.  In blood bank, techs type patients and then test units of blood products to ensure that the patient can receive that unit safely.  There is a lot of immunology and complex interactions that go into this, which makes the work interesting and investigative in nature.  The work is far more involved than it appears on the surface and, like the HLA lab, the work has an immediate impact on many people.  The issue with blood bank is the fact that new techs start out on the night shift, and then move to the evening shift, and finally the day shift, meaning that it would be at least several years till I was working at a "normal" time.
      Roughly in order of preference, the other sections of the lab that I might end up working in in the Rochester area (at either Rochester General or Strong) are microbiology, advanced coagulation, hematology,
histology, and chemistry.  To be honest, I probably would not enjoy the last two very much, but it is highly unlikely that I would have to work there.
     Another option that I am considering is working as a generalist at a smaller community hospital, like Clifton Springs.  The variety of the work would be interesting and there certainly is appeal to working in a small hospital where you get to know everyone, but there are drawbacks as well.  One is that there aren't specialty areas; the only sections at smaller hospitals are usually chemistry, hematology, microbiology, and blood bank.  The other - and possibly more important - one is financial concerns, both in terms of pay and the long-term stability of the hospital as many small hospitals are facing very uncertain futures.
     If I could pick any department to work in, it would be the HLA lab, but I would enjoy working in many of the other departments as well.  Only time will tell what is available and what will happen, but I'm hoping to be able to get into an HLA lab as soon as I can.

Histology: More Art than Science

      Histology is an interesting department; it is certainly part of the lab, but it is very different from the more normally thought of sections such as chemistry and hematology.  Histology is concerned with the pathology of tissues, and the bulk of the work involves the preparation, sectioning, and staining of specimens for examination by the pathologist.  Medical technologists, histotechnologists (who have gone through histotechnology school) and pathologist's assistants work under the supervision of pathologists (or a pathologist in smaller hospitals).  Examples of specimens that would be processed by histology include biopsies, removed organs such as appendixes and tonsils, and tumors that have been surgically removed.  Autopsy specimens are also handled by histology.  The main goal is to preserve the specimen as a whole and then to remove small sections from the specimen for staining and subsequent examination by a pathologist to see if there are any ongoing pathological processes.  While it sounds and is very scientific, much of it - especially when it comes to microtomy, which will be discussed more later - is also an art form, including the final product.  Below are a few images of stained tissues and after those I will discuss histology in more detail.

Thyroid gland stained with a Hematoxylin and Eosin stain at 100X magnification

Skin, also stained with Hematoxylin and Eosin at 100X.  The purple layer is the epidermis.

Lung, yet again with Hematoxylin and Eosin at 100X.  Open spaces are the alveoli or air sacs.

Colon, Alcian Blue PAS at pH 2.5 and at 400x magnification. The flower-like shapes are various carbohydrates and other macromolecules found in the cells of the lining of the colon that are involved in absorption.

Awesome Nerdy Comic

     Here's a quick post with an awesome comic for all us science nerds out there. Mouse over the comic for bonus fun!!

Starting Back Up Again

      I'm gonna try and start posting again some, depending on my work load.  My internship has been going well, the introductory 10 weeks were busy and now I am finishing up my 10-week microbiology rotation.  We have rotation 4 days a week and on Wednesdays we have lectures on the full spectrum of lab topics, as well as a test most weeks on a single topic, most recently, antibiotics.  In micro, each week is dedicated to one type of culture, such as urine, stool, and respiratory.  This last week we covered blood cultures, a very important type of culture as it is used to detect bacteremia and septicemia.  Bacteremia is the presence of bacteria in the blood that does not cause a disease and is usually not a threat to a patient's health.  Traditionally, the bacteria are present but not actively dividing.  The main risk is that, in those with heart valve defects, bacteremia can lead to the seeding of the heart valves, particularly the mitral valve, with bacteria and lead to endocarditis, a serious and potentially fatal condition.  Septicemia is the presence of bacteria in the bloodstream that causes disease and is a potential issue for the patient.  In this case, the bacteria are usually dividing and thriving in the blood.  Septicemia can be caused by a wide variety of conditions, including abscesses, untreated UTIs, and, ironically, endocarditis.  The complications of septicemia are numerous and many are potentially fatal.

One Semester Left!

      Today was the last day of classes for the semester, and even though I'm excited, the semester is far from over - finals are lurking around the corner.  Adding to my excitement is the promise of a spring semester with many classes that I'm looking forward to taking, as well as a Christmas break full of work and a family trip to Florida!!  Many of the classes that I will be taking are directly related to my schooling as a medical technologist; they are microbiology (with lab), biochemistry II, immunochemistry (with lab), two med tech seminars, cancer biology, and biomedical ethics.  The other class that I am taking is called Age of Cicero, I choose it in part to complete my core requirements.  Canisius is not offering micro, so I will be taking it at Medaille College, a smaller private school that shares a border with the Canisius campus.  Below, I detail the way in which the various classes I am taking will prepare me for my clinical year.