Digital Pathology Blog

My maternal grandfather was a glazier. He was orphaned at a young age and raised in an orphanage on the West side of Chicago with 2 brothers. One of those brothers died during adolescence. My grandfather and his oldest brother fought in World War II and became part of America’s Greatest Generation. He and his brother started Chicago Glass which became the largest glazier company in the city. For over 30 years, my grandfather hung glass on some of the tallest buildings in the world at the time. Sears Tower, John Hancock, Lake Point Tower, Standard Oil, you name it, he worked on it. Buildings downtown had to be “glassed in” by November 15 if the electricians, plumbers, elevator, drywall and carpet guys were to have a chance to work through the winter for spring occupancy on a residential or commercial high rise. In the winters, my grandfather drove a cab between “indoor” jobs such as hanging mirrors, repairing windows or building storm windows. He would drive me around in his large Checker cab and point out what buildings he worked on and what he did, what worked and what didn’t, if he got injured, or one of his men did, and when they “glassed” it in.

There is a joke among surgeons and oncologists -- the pathologist at a tumor board is like the guy whose funeral that you are attending; you can't do it without him, but you don't want him saying too much. 

Nearly 2 years ago, our tumor boards went "virtual". Like billions around the world, we scrambled to get Zoom, GoToMeeting, WebEx and other applications up and running to hear each other’s voices and share screens to show radiology and pathology images. We anticipated that by the Summer or Fall we would be back to "normal".

Recently I received a call from an oncologist. After giving me the patient’s name, she asked “What does the gene panel show?”

I responded we didn’t have the patient’s biopsy yet, that he was scheduled to undergo a CT-guided needle core biopsy, and we would process it overnight and review tomorrow as we normally do.

The oncologist acknowledged the patient was undergoing the biopsy in the afternoon, and we hadn’t even yet done an immediate fine needle aspiration rapid on-site assessment prior to the core biopsy.

Late last month, the CEOs of Amazon, Buffett and JPMorgan Chase announced they were teaming up to form an independent healthcare company for their employees.

The details were scant and vague but mentioned the new corporation would be “free from profit-making incentives and constraints”. Mr. Buffett is quoted as saying, “The ballooning costs of health care act as a hungry tapeworm on the American economy… Our group does not come to this problem with answers. But we also do not accept it as inevitable.”

Probably not the best analogy considering tapeworms are easily treated with oral generic medications that are very low cost.

I’ve spent a lot of time in Starbucks, and over the years, it seems little has really changed with the basic operations. The line to the register is flanked by food options and souvenirs leading to someone who takes your order and your money (The Register). Your order moves to someone standing at the espresso machine (On Bar). Other Starbucks associates are simultaneously working the Drive-Thru customers (On Drive-Thru).

Another associate is grinding beans, ensuring the coffee urns are full, teas are brewed, cups, lids and cup protectors are in place, and coolers are well stocked with sandwiches, croissants and breakfast sandwiches (Customer Support).

So, who has the most important job at Starbucks? The Register? On Bar? On Drive-Thru? Customer Support?