Friday, December 23, 2011

Microbiology rotation done!

This is the first day in over a month where I’ve felt relaxed.

It’s been the best month clinical-rotation-wise, but it’s also been the most stressful. This is the end of my microbiology rotation, and microbiology is my favorite discipline. My dream day job would be in a micro lab.

So of course I put pressure on myself to do well, to learn fast and to know as much as possible. I did learn a great deal - there was a lot of new information on bacteriology, antibiotics, mycology (the study of fungi) and so on – and the technologists asked a lot of questions to make sure I knew what was going on. The end result was that I did enjoy the rotation, but I also felt as though I was under a microscope myself. I can only hope I made a good enough impression.

On top of that were my two part-time jobs and the need to study for a qualifying exam that’s less than two months away. So I came home exhausted every day – my apartment looks as though it’s been burglarized, with stuff lying everywhere – and I was way too tired to blog.

They let us have today off, which is a great relief. I’ll still be going to the hospital, of course, but that’s for one of my part-time jobs rather than lab work, so it should only be a few hours.

So, what goes on behind the scenes at a microbiology lab?

The lab processes hundreds of specimens on a daily basis. As well as receiving samples from people who are sick, the lab tests screening swabs (to make sure in-patients aren’t bringing any superbugs into the hospital), water samples, and even medications from the pharmacy department. Everything is sent through the front end, where it’s entered into the system and given an accession number.

The people in the front end work like maniacs as a result.

After that the specimen, like a piece of luggage in the airport, goes on to its final destination. Depending on what the specimen is or what the doctor has asked for, it could be sent to the blood bench, the virology department, the screeners, etc. The bottles of blood are incubated and rotated in a large analyzer that looks like an enclosed wine rack. Technologists at the different benches put the specimens on various agar plates to see what grows.

It is always good when nothing does, not only for the patient but for the technologist. If something does grow, that’s when the train of thought speeds up. Is the bacterium a pathogen (disease-causing agent) or just a contaminant which sneaked in somehow? If it’s a pathogen, what tests need to be done to confirm its identity? If it’s a pathogen, is it present in sufficient numbers to report?

If technologists reported everything they saw, they’d be either dead from exhaustion or fired for incompetence.

Once the pathogen has been identified, it moves on to the antibiotic testing bench. I moved too, and spent a week learning more about antibiotics than two semesters in college taught me. What antibiotics is the pathogen resistant to? Is it a superbug? What antibiotics can be reported? The analyzer may tell you that the E. coli is susceptible to tetracycline. But if you report that and if the patient is seven years old and if the doctor doesn’t know any better and prescribes tetracycline, the patient will go through life with discolored teeth as a result.

You have to know a whole lot more than the machines and the computer system (and sometimes the doctors), in other words.

I didn’t get a chance to see the virology department, but that was the only disappointing thing about my experience. I even identified a fungal species correctly on my last day, which was all the better because that was the only day we spent on mycology. But it’s great to come home and rest, to have a long relaxed breakfast rather than bolting it with one eye on the clock and to know I’ve got the whole of the Christmas holidays before the chemistry, the next and final rotation.

It’s pretty good to be blogging again too. :)