| Spring
Tutorial at Guy's Hospital on 7th April 2000
I live in Reading
near a railway station so I thought this is the way to travel. Although
I left home at 7.15 I arrived just after the opening remarks as
the train stopped at tevery station between Earley and Waterloo.
Dr Smith
was just starting his talk on borderline changes, which is a grey
area to be absolute about. He managed it. The main thought I had
after hearing him talk of the review they did on a sequance of 150
code 8 smears from a hospital with a high reporting rate at that
level with the subsequent regrading as negative of 50% was 'Could
this be a useful QA method?'. This sharing of borderline smears
could hone the minds of us all. The figure of 30% repeat smears
having significant abnormalities was higher than I expected.
The next lecture
on 'Atrophic Changes' I found very enlightening. I was raised in
the pre HRT era and atrophic changes were quite straightforward.
There is red and blue atrophic smears, air drying, stripped nuclei,
degenerate or dyskaryotic and a combination of all these. The bottom
line is if there is any doubt then a repeat after oestrogen treatment
is called for. News to me was that both anorexia nervosa and depression
could cause atrophic smears.
Dr Gray
then gave a talk on Invasive Carcinoma from the comforting start
that this is becoming a rare finding and we should be reminded of
it. The screening programme is working well and is very effective
at making this a rare disease for the women of this country.
After lunch
the workshops started. my first was the 'atrophic' smear to underline
the morning lecture. We looked at 53 slides. They were well speaced
so that as I reached the 'I can do this' stage, I couldn't. By the
end I was more sure about the negative side of things and Dr
Turnbull had walked up and down the lab 53 times. She got up
at 4am to do all this exercise.
After that it
was onto Invasive Carcinoma for the reason Dr Gray gave in her introduction.
The biggest shock was a smear from a 23 year old, maybe the lowering
of the screening age should not be too long coming.
My advice if
you get the opportunity to go to one of the days is go and select
one workshop and the case studies. My criticisms - mobile phones
in lecture theatres, the lunch (not enough buffet and too much frozen
dessert) and looking at 98 slides in less than ideal ergonomic situation
- are more than outweighed by the total mental exhaustion of a good
day concentrating on a subject that I love.
On a personal
note I have not been to Guy's since I took my micro practical there
in 1971 and it has changed beyond recognition, also I met my old
senior from 1967 who was the person who started me on the cytological
path. I thought she was ever so old then (she retires this year)
and it made me wonder what the recently successful trainee from
our lab thinks of me!!
Thankyou for
the opportunity of a great day out.
|