[Written in the first week of January]
Finally, I have found the chance to sit down and contemplate for the first time today. Prashant and I left our home at 6:30AM and we finally got back at 7:20PM.
In the morning, we awoke to snow covering the cars and icy streets in a layer of powdery white. Just yesterday, we had passed an SUV in our neighborhood that ran right up into a telephone pole and we were hesitant to drive under these conditions. We even considered taking the bus line, but we decided to try our luck with driving. Driving turned out to be a mixed bag of rocks.
Prashant’s GPS (who we jokingly refer to as his girlfriend because of the monotone female voice) led us astray off of our normal path and we took longer than expected to arrive at Shadyside. Fortunately, we had the foresight to leave extra early just in case something like this happened. What should have been a 25 minute drive turned into a 50 minute drive. Let this be a lesson that in some cases foresight/preparation can overcome bad luck.
At Shadyside I met the staff at the tissue bank and the gross room and was given a short tour of the facilities. Soon after, I spoke with the manager of the tissue bank. She explained to me the great breadth of work that goes on regarding the tissue bank and its administration. Although it is her goal to facilitate and encourage surgeons/researchers to make use of the tissue bank, there is a lot of paperwork that needs reviewing, guidelines that must be followed and all sorts of communication is needed between many of the various organizations that are involved. She was very kind and patient with answering my questions, but there was so much information to be absorbed that I fear my brain half turned into porridge.
There were many concepts that we covered, but some of the main ones included the role of the Tissue Bank Institutional Review Board (IRB), the role of the Committee for Oversight of Research and Clinical Training Involving Decedents (CORID), the role of honest brokers and the role of Tissue Utilization Committees (TUC). She also discussed patient consent , which tissues require which protocols and the process that surgeons must undertake in order to use tissues for research. I could probably spend a year or two just here at the tissue bank and still not know half that there is to know.
After lunch I had the opportunity to get some hands on experience with retrieving, filing and storing tissue. As a general rule, tissue needs to be collected as fresh as possible and frozen as quickly as possible. Tissue to be stored for research can come from either
1) Directly from the operating room
2) From the frozen section room
At the beginning of the day, there is a printout that details all of the surgeries with harvestable tissue for the day. This way they can expect when to go and pick up the tissue directly from the operating room. Of course, the diagnosis and grossing of each tissue takes priority over the research, so often a tissue will be sent to the frozen section room first, or a gross needs to be done before a piece of tissue can be stored for research. In many cases though, the surgeon will just provide a piece of tissue that we can pick up directly from them and store for research immediately.
Tissue stored for research usually has three components.
1) The tumor itself
2) Uninvolved ‘normal’ tissue
3) Blood
The main thing that researchers ask for is the tumor, but oftentimes uninvolved tissue and blood is requested as well for their research. For this reason, uninvolved tissue and blood are also taken and stored with each piece of tumor when possible.
With the guidance of a very kind tissue bank worker, I tried my hand at filling out the necessary forms and storing the tissue. It took a couple of tries to remember all of the components needed on each form, but I’m sure that as the week progresses it will become second hand.
The end of the work day came at 4:30PM and Prashant picked me up at 5:00PM. This is when our day really turned to a screeching halt. Today was the first big day of real snow in Pittsburgh and traffic was grinding to a halt all across town. Joggers were passing us by at every block (I could hardly believe they were jogging in this weather) and the roads were so crammed that each green light cycle only allowed one car to cross the street. One measly car! Escaping from Pittsburgh was a nightmare. I have not experienced any worse congested traffic in my life. We tried to take the freeway and when we finally got on it was bumper to bumper for 5 miles. The freeway system is a mess, similar to a spider web except that a spider can spin its web faster than you can get to your destination. If it weren’t for the weather being so cold, I would have gotten out of the car, ran home and had more than an hour to spare. If there is anything that I gained from being stuck in traffic for nearly 2:30 hours, it is that I can understand how people can succumb to road rage.
There are three modules (Conflict of Interest, HIPAA and Research Integrity) that I will need to complete online as soon as possible. After getting home at 7:20PM, eating dinner and taking a shower, I have had no energy to go to the local library to use their internet and complete each module. However, I am thankful that they are giving me some leeway time to complete them.
I could definitely use some more of their foresight.
No comments:
Post a Comment