One of the Great Things About Pathology I Don’t Usually Do
The second in a series of brief snippets from our interview with pathologist Dr. Eve Crane. Here, Dr. Crane talks about the low profile of the profession and how that’s not always the case.
The WorkNotWork Show 0:23:17 Pathology is often characterized as a ‘behind-the-scenes’ speciality within medicine, but you’ve been involved in some cases that were anything but that.
Dr. Eve Crane 0:23:32 Yes, I think that’s true and that’s something that we’re working to change as a field in pathology to be more accessible to patients who have questions about their diagnosis and to be more readily involved with the clinical teams.
I can’t think what the original case was. I did have a more recent incident where the patient had a very aggressive looking lesion that was seen on an imaging study. And it certainly, for all the world, looked like very bad cancer. They were suspecting it was a lymphoma.
But it was the sort of thing where she was okay we need to get a diagnosis…then maybe she needed to put her affairs in order. But we got the slides and I was, like, “what is this?” There’s all these weird little clear dots. “That’s not…what is that?” It was – my gosh – Cryptococcus.
WNW 0:24:25 For our listeners, what is that exactly?
EC 0:24:27 It is just a fungus. The patient had been treated with a course of steroids and sometimes that will suppress your immune system – that’s part of it. This had allowed an infection you can get sometimes cleaning out barns or just being outdoors, it’s kind of a soil fungus. Sometimes it lives in your lungs and sometimes it can get into the bloodstream. Usually it’s not an issue unless you have patients who have HIV or other immunosuppressants or a patient on steroids or something.
But no one was suspecting any of that because she was a healthy patient. No history of any of these type of disorders and the only thing that had shown up on the imaging was this weird, really aggressive looking bone lesion. But it turned out that it was actually this fungus that had seeded that area and then had gotten out of control on the steroids.
Potentially, she had an injury in that area or something that had led to that. But she was very concerned. I think it was the weekend or something. I realized that her clinical team wasn’t going to be able to check the pathology report and I couldn’t get a hold of them in the clinic. I was, like, “you know what? I’m just gonna call the patient and tell her what this is.” Because this poor person, she’s been told how bad this looks and who knows what we can do to treat this. [But instead we’re] going to be treating with an antifungal agent or something. But it shouldn’t be a life threatening issue.
So to call her up and be able to reach out, I thought was one of the great things about pathology I don’t usually do.
Listen to this excerpt by clicking any of the timecodes above, or listen to the entire interview. We welcome your comments below as well as a clap or two if you feel so inclined. Also, ratings and reviews on Apple Podcasts are invaluable and very much appreciated. Thank you so much for listening!
