Path. Res. Pract. 164, 117-120 (1979)Practical Notes

Department of Pathology, University of Basel, Basel, Switzerland

Technical Assistance

SUSIHABER

In every division of the Institute the services of the department ofpathology to the hospital are carried out with the help of technical assi­stants. I should like to examine the work of the technical assistants fromfour sides: Why? How? When? Who?

I. Why?When we understand the "why" of an order, we take pleasure in our

work. Our laboratories are not located in the same building as thepatients; so one might think that in the Institute we are comfortably doingour research. But actually we are constantly running. Why? Neither theprompt handing over of the body of a deceased person to his relatives northe diagnosis of the specimens entrusted to us for analysis can be delayed.

Our services extend to these two main areas, and from them to the spe­cial departments:

Every week we take care of an average of 35 deceased persons. Thebody must be given to the bereaved family, that is, to the public, in ac­ceptable condition.

An internist once said, with reference to laboratory results, that thediagnosis is established by the department of pathology in a third of thecases. We know that biopsies are precious specimens, since we cannot ob­tain another as we could of blood or urine. Liver and kidney biopsies areparticularly delicate and yet they even will be examined electron micro­scopically and immunohistologically. Together with the tissue samplesfrom autopsies, approximately 1,500 histological sections on which thepathologists base their findings and their diagnoses are prepared daily inthe Institute. Based on these analyses about 200 reports, protocols andopinions leave the Institute every day.

I 18 • S. Haber

"Why" therefore means for us that we contribute in the laboratories andin the secretariat to serving the public and to assuring that patients can bequickly and correctly treated and then released.

2. How?

The task given to us is to work:correctlyquicklyeconomicallyhygienically

An autopsy begins with the receiving of the body by our technical staffunderground and continues through many steps to the giving over of thebody to the undertaker. The morgue assistant makes the preparations forthis. His work is the technic which conserves the external part of the body.He also washes it, combs the hair, then clothes it in a reverent manner,stores the coffin, arranges the personal effects and jewelry of the deceasedand gives them to the bereaved. Only perfectly hygienic work keeps theInstitute from becoming the object of criticism in the public press.

The task of the histological examination of the specimens from theoperating theaters, out-patient clinics and doctors offices begins with thearrival of the biopsies and ends with the delivery of the diagnostic reports.In between there are many steps. Histological technique demands dexte­rity. It is handicraft combined with intellectual work and hurrying feet.The specimens are received by the medical laboratory technicians. Basedon the macroscopic examination of the specimen by the pathologist wereceive directives about which lesions we must pay attention to in pre­paring the sections. If a biopsy covered with epithelium is imbedded in­correctly, a diagnosis is impossible. We are most careful to avoid mix-upswhich are so feared in the field of pathology. The various special coloringsare performed with solutions we have prepared ourselves. The quality ofsection and coloring is checked through a microscope before we send theassembled items, along with any earlier reports from the laboratory, tothe doctors for diagnosis. The reports are carried by hand to the hospitalby technical aids.

3. When?

The technical preparations begin in the examination station at 6 o'clockin the morning. The quick sections arrive from 7:30 on as long as oper­ations are being done. After 9 a.m. the biopsies delivered by mail or inperson arrive. The total effort of the staff is then concentrated on thecompletion of reports for the hospitaly by 3 p.m.

Technical Assistance . I 19

In the morgue the disposition of time is also similar. The first deliveringup of bodies begins about I I a.m. and continues until early afternoon.

Though the technical staff is organized around a definite time schedule,the doctors are burdened with many other obligations. It is possible thatthey are detained unexpectedly by conferences with colleagues, lectures orexperiments.

The coordination of the schedule for all services and concerns of such alarge institute becomes a problem. Just in the hospital stations theschedules of the doctors and their collaborators often do not mesh, evenwith the best of planning. The institution doesn't run very smoothly whenthe normal tempo or work cannot be adhered to.

4. Who?Technicians must be chosen very carefully. Besides adequate professio­

nal education we look for the capacity to undertake difficult and un­pleasant tasks. It is not just anyone who could spend his days with deadpeople. The fact that mistakes in preparing examination materials, oncemade, are often so difficult to detect and also the pressure of time underwhich we must work can be very taxing.

We, are members of diverse nonacademic occupational groups, and weare assisting a unified professional group, the doctors. Our work is basicto their services. From this fact flow certain administrative problems.

The art of administration has as its objective the rational organizationof work. A division which must often work overtime in spite of the de­sperate efforts of the head laboratory technologist is not well run. It suf­fers from disturbances which result when agreements are not respected.Working toward a definite deadline necessitates strict planning of the de­ployment of the available personnel. Every disturbance interferes with thisplan and causes senseless loss of energy which could lead to our not beinghappy in our work. Disturbances can be reduced to a minimum through thegood management of our superiors. We are grateful for this good manage­ment. It insures our being treated as persons. We experience understandingfor our needs:

for security in our work and area of competence,for education to self-criticism of our efforts,for physical well-being.

An institute needs a good staff of technicians. Loyalty to the Instituteis fostered by the Director and the doctors. Their personal influence ra­diates out to encompass every worker in the Institute.

120 • S. Haber

In conclusion I'd like to say:We are happy working in our institute; and we feel comfortable there

because we are well-informed, and we enjoy human understanding, supportand esteem.

Received and Accepted July jI , 1978

Susi Haber , Institut fiir Pathologic, Schonbeinst r. 40, Postfach 113, CH-4056 Basel,Switzerlan d