PA programs and Morgue Attendants

I've learned recently that university PA programs are graduating Masters-level Morgue Attendants (MA) (ie. when it comes to autopsy pathology).  Although the graduates are supremely competent in all things 'Morgue Attendant', they have no idea of what it is -- to my way of thinking -- to be a Pathologists' Assistant to the fullest extent of the meaning of the title.
To clarify... the MSc PA graduates are at a point where they are very prepared for a career in surgical pathology.  I'm fine with that but I'm talking about autopsy here.
My vision of a PA's responsibilities at [a medical] autopsy: a PA confirms that a proper consent is in place; does the first draft of the clinical history; reviews the history with the supervising the pathologist and formulates a plan for the autopsy; performs the external examination with the assistance of a Morgue Attendant; eviscerates with the assistance of a Morgue Attendant; dissects, weighs, measures, etc. all of the organs and -- this is the MOST IMPORTANT part -- examines the organs while performing the dissection and interprets all findings, whether normal or abnormal; records all findings; makes judgements while being mindful of the patient's history (and examines the organs for expected findings and, as importantly, for unexpected findings); examines the external brain (removed by the MA); reviews the gross findings with the supervising pathologist after the case; prepares the initial draft of the preliminary report; dictates the gross autopsy report; performs detailed dissection and sampling of heart and brain, as necessary; blocks all routine tissues as well as heart and brain and dictates findings for all routine tissues as well as for both heart and brain, as is appropriate for the case; presents the case history and gross findings at autopsy rounds; blocks all tissues including heart and brain and dictates specific portions of the report related to heart and brain; and lastly, compiles all reports and slides and delivers all to the pathologist in timely fashion.
It is not the MSc PA grads who are to blame (obviously); it is the program.  The program is run primarily (from a curriculum standpoint) by the pathologist(s) at the site(s).  The problem, or so it seems, is that pathologists want PAs to be MAs, not true assistants.  I'd love to see the programs train the PAs to apply the medical and pathological knowledge which they have presumably been taught so that they can competently handle surgical pathology specimens, to autopsy.  In fact, PAs should gain the knowledge gleaned from autopsy BEFORE performing gross descriptions of surgical specimens.  This is the traditional method for training of pathology Residents and it ought to apply to PAs also, for exactly the same reasons.
PAs exist.  Use them.  Don't hold back; train them to their fullest capabilities.

North Korea's successful missile launch

N. Korea saying publically that they've launched a weather satellite is like hearing Japan say that they're killing whales for "scientific" purposes.  What a crock.  I hope I'm mistaken.

PAs way out here in _________

I just thought it was time to declare to all those who bother to listen that we've landed one of the best PAs that I've seen in quite a long time.  There were 6 open positions at the time and we were very fortunate to convince her to try us out.  She's a grad of Western U -- I definitely have a connection there -- and is obviously well trained.  She's smart and a quick learner and, while admitting that there is much yet for her to experience, she has added a new, higher standard to the gross room.  Her level of enthusism is very welcome.  I'm glad that we've finally begun autopsies -- since that's her major penchant -- so that she can get heavily involved in that part of our practice as soon as possible.   I think that she and her colleagues are learning much from each other.  It's a treat to watch as each individual develops and grows.  I am feeling a new level of confidence that the PAs way out here have a secure future, even after I [finally] call it a day.

A great first week

There were two autopsies this week and some really neat findings but the thing that topped off the week was our first autopsy rounds (Friday at noon) which were attended by several pathologists, all of the PAs, one Cardiologist, a few Med Lab students and a big bunch of Medical school students.  There was a great exchange of knowledge and information and a generally high level of enthusiasm amongst all who attended.  I hope the Meds students didn't feel too much 'on the spot' when quizzed; we want them to feel welcome (and to return to future rounds).

We met with the regional Coroner and 2 other Coroners this week; introduced ourselves all around and ironed out a number of details.  We're looking forward to beginning Coroner's cases in the latter part of November.

We've discussed the wording of the job description for the Morgue Attendant and hope to get the posting up soon (my old body can't take the beating much longer!).

NEW autopsy suite!

Although newcomers to this blog have no idea whereabouts I am -- I still want everyone to know how great it is to finally perform the FIRST autopsy in our shiny new autopsy suite in our wonderful new (huge) laboratory building. Our first case was a memorable one -- a young, fit gentleman with amyloidosis (which jammed his heart and spleen with more amyloid protein than anything else; heart weight:  840 gm).  Blessedly, he did not linger long, but faded rapidly within less than 2 weeks.

There are a few lingering minor but irksome shortcomings (plumbing, lighting, minor equipment needs, etc.) to the new autopsy suite all of which are being attended to thanks to our amazing engineering department.  We have instituted weekly autopsy rounds and already have a ton of Meds students interested in attending.  All the PAs will be there and many of the pathologists.  We're off to a great start.

The PAs are super keen to get involved and I'm pumped to help them along.  We're posting a Morgue Attendant position any day now and, combined with at least one more PA position, we'll soon be well positioned to maintain both good turnaround time for surgicals as well as increase our involvement in autopsy pathology.  The future indeed looks bright here in ___________ for the pathology service and for PAs specifically.

Grossing video

I have long thought that a video grossing manual would be a good idea but I never really had a good handle on how to implement it.  A good friend suggested a method and since then I have been thinking about it more and more.  I'm getting closer and closer to buying an HD video camera and beginning with the first chapter of the manual.  I'm sure that the first several versions of the first chapter will be hopelessly flawed but I will hopefully end up with an acceptable  and usable instructional guideline (I don't want to call it a 'manual' just yet).

The latest on Lance

I'm sorry that you have to endure my continuous ramblings regarding Lance Armstrong but I'm an ardent roadie and frankly a large number of my years of cycling have been spent revering Mr. Armstrong and others like him as roll models.  So it pains me greatly that he is being maligned and abandoned.

I am particularly encouraged today by the support that has been provided for Lance by Miguel Indurane, one of the greatest cyclists ever, and Alberto Contador; both of whom feel that Lance is being made the scapegoat for the shortcomings of the UCI.

While I admit that these two individuals have considered the consequences of voicing their support -- perhaps they have no sponsors -- I sincerely hope that this will show the way for others who, like me, feel that Lance, who is admittedly not a saint, is not the pariah that USADA and UCI have made him out to be.

Lance...again

Lance is being treated unfairly.  The USADA, UCI, and the media have yet to publish any of the supposedly overwhelming evidence which apparently shows that Lance cheated.  Lance made a lot of enemies on his way to the top; a lot of cyclists, their teams and their supporters who wished that they were as good...but they weren't...and aren't.  Lance won the 7 Tours and a bunch of other races; that cannot be taken away from him.  Until I hear from Lance or until I hear facts that confirm that he cheated, I'm still siding with Lance and I hope he's doing OK.  Whether or not he defends himself, I'm still in his corner.  I hope that Nike, Anheiser-Busch and the rest of the sponsors who bailed are shown to be shallow and self-serving -- which they are.

Justice? I doubt it.

This week, a woman from Calgary had the audacity to call the employer of a guy from Ontario and, in so doing, succeeded in having him fired.  He had expressed an opinion.  The last time I looked, this was Canada.  In Canada, we are permitted (if not encouraged) to voice our opinion without fear of reprisal.  This is a right which is protected by the Charter or Rights and Freedoms...or is it?

A little background:  the particularly heart-wrenching story relates to the suicide of a BC girl who had been bullied for years and had documented her pain on Facebook.  The Ontario guy apparently (I haven't seen the post) made a statement to the effect that she was better off that way.  When asked, he said that he was trying to open a discussion.  Whether that's true or not if immaterial to this discussion (and for the record, I don't agree).  After learning of his post (on Facebook), his employer fired him and made some grandiose statement concerning their principles, etc. (sound like Nike leaving Lance?  You bet).

• I'm left to wonder who wins and who loses here.
• What right has this woman to contact anyone's employer?
• Why didn't she contact the man directly?
• In what way has she gained by doing what she has done?
• Is the little girl any less dead as a result?
• Who does this woman work for and how do they feel about her intrusion into an innocent (yes, innocent) person's life?
• Has anyone benefited in any way whatsoever?

I'll tell you who has NOT benefited.  The majority of Canadians who previously thought that they had a right to express their opinion without fear of reprisal from anyone, including their employer.

PA opportunity in Australia

Perth Australia is looking for a very experienced PA to assist in the setup of a training program (much like the N. American MSc programs) for that country.  Email me if  you want particulars.

Ivory poachers

This may be WAY out in left field but...
after reading yet another appeal for money to support the anti-poaching people who are frankly losing the battle against those idiots who murder elephants for their ivory (primarily to feed the Asian appetite), it occurred to me that we should spend out money on providing the poachers with tranquilizers guns and enough to chemical to down as many elephants as they could possibly use.  This is somewhat similar to providing safe injection sites for IV drug addicts.  I'm thinking that the elephants are at least as valuable to the world as addicted humans.
ALTERNATIVELY...
Get the genetic wizards to work on creating an elephant that simply does not have tusks!
I'm thinking that the first solution might be easier (certainly easier than trying to shoot the poachers...no matter how much they deserve it).

Diesel engines and catalytic converters

The World Health Organization recently declared diesel exhaust (specifically nano-particles) to be carcinogenic.  Can anyone tell me why it is that diesel engines don't have catalytic converters (or equivalent)?  Are any of our governments pursuing means to protect us from this carcinogen?  Are our governments being lobbied by big-oil and big auto makers?  Trains; trucks; ships; they're all mostly diesel.  Is anyone seriously working to replace them with something else?

Lance Armstrong railroaded

Show me the real evidence!  I want to go on record as supporting Lance Armstrong until I see the real evidence that proves that he doped.  The "overwhelming evidence" is all BS spin from his disgruntled ex-teammates or adversaries.  Don't be duped by Nike or Anheiser-Busch bailing on him; this lends no credence to the claims of the anti-doping dopes whatsoever.

Enbridge & Fighting Cancer

I am an avid cyclist.  I also fancy myself pretty environmentally-minded.  I'm aware that Enbridge has been successfully sued recently (for a paltry token amount of a fine that is far less than the costs related to cleaning up a spill) and I'm aware that they have had up to 600 spills in the LAST YEAR alone!
I'm am sick of the bare-faced propaganda on all of the TV networks; first about how wonderful the trans-BC pipeline will be and second The Ride to Conquer Cancer.  I wouldn't ride in that ride for all of the marbles in China (does China have marbles?!).
I hope you get my simple point:  Enbridge (and anybody who supports them) = BAD.  VERY bad.
Short-sighted, biased decisions by government to fast-track and circumvent environmental rules BAD.
I was so glad to learn that ALL BC First Nations voted against the pipeline and against tankers off the coast of Haida Gwaii.

Update on UBC PA program

I had such high hopes that the UBC MSc PA program would get off the ground this year but my optimism is waning somewhat.  We have reiterated our interest in being [as heavily as possible] involved and have not had a response.
I will do my best to connect with the appropriate individuals at UBC to confirm whether or not the program will, or will not, begin this year.
Note that The University of Calgary is beginning a PA training program this year -- check it out at http://www.pathology.ucalgary.ca/content/pathologists-assistant-pa-msc-program

UBC PA program

There are encouraging rumours that UBC may be able to soon (2012 or 13) offer a 2-year MSc PA program.

puppy

I hope that this isn't too controversial but I just wanted to let everyone know that I have a new girl friend.  Her name is Belle; she's a 5-month old female all-black Newfoundland puppy (42 lb and growing).  She's the cutest, fuzziest, most huggable puppy that ever was and my life revolves around her at present.

PS - I am not expressing any opinion that might be construed as being that of my employer (who will remain nameless).