Monday, July 30, 2012

The Pathological Personality

In medicine we know the basic personality of specialists.  Pediatricians, warm and fuzzy.  Orthopedists, “strong as an ox, and twice as smart!”  Surgeons, cut it out and ask questions later.  And pathologists, just a little removed.

So here’s the story.  My stepdaughter Sara has a cat, Blinky, also known as The Blinkster, now up to 14 years of age.  An indoor cat, and never one to turn down a meal, so, rotund.  But lovable.

Unfortunately, ironically given his name, Sara noticed a couple of months ago that Blinky couldn’t blink his left eye.  We took him in to a cat ophthalmologist who diagnosed a condition called Feline Restrictive Orbital Myelofibroblastic Sarcoma (FROMS).  The tissues behind the eye get invaded and the eye can’t move and the lid can’t close, which leads to erosion of the cornea, pain, and then blindness.  Poor Blinky had to have that eye removed.  It was sent off for examination to the cat pathologist who is the best expert on this condition, in Minnesota.  That’s what he does for a living, examine cat eye specimens. 

Sara took it well.  She knew that the other eye would likely become involved and Blinky had been with her a long time, but she did what people do in this situation, take it one day at a time and appreciate the time you have.  Still, thinking ahead, she thought that when the other eye did become involved, rather than have a blind old cat in failing health, she thought that euthanasia would be the best course.

Then, two weeks ago, Sara thought Blinky was having trouble moving his right eye, just as had happened with the left.  So she took him into the vet.  Maybe so, said the vet.  But not too bad yet.

So, being a medical professional herself, Sara figured she would call the pathologist in Minnesota, since he is the expert.  She got him on the phone, and he said that it sounded like progression, and actually he was surprised it hadn’t happened a little faster.  It was sad.  Sara, who had been holding it together pretty well, teared up as she discussed with him whether to euthanize or not.

The pathologist heard her tearing up.  His voice softened a little, and Sara could tell he was affected.  She listened attentively then, as he talked to her.  He said slowly, “Well, if you do decide to go and euthanize him, could you send me the head?”

Budd Shenkin

1 comment:

  1. Pathologists can be a strange breed. I once cared for a patient with an unusual neurological condition similar to Pick's disease. When he died 1/2 of his brain was to be frozen and sent to Dr. X and the other half preserved in formalin and sent to Dr. Y. Well somewhere along the line the specimens got mixed up and went to the wrong labs. Our chief of pathology got fed up with the back and forth bickering over mixed up brain specimens and gave each lab the others address and told them to sort the brains out amongst themselves.