A day in the life of a pathologist (COVID era)

Published March 15, 2022, 12:05 AM

by Raymundo W. Lo, MD, FPSP


Dr. Raymund W. Lo

Most people don’t know what a pathologist is. They probably don’t even know we’re MDs. Pathologists work behind the scenes, diagnosing diseases like cancers on tissue biopsies, analyzing blood samples for even more diseases and supervising operations of the clinical laboratory to ensure quality results. Lately, pathologists have been more involved with direct patient care with analysis of tissues for targeted therapies for certain cancers.

In my case, I also perform DNA testing for paternity cases, necessitating direct contact with the parties involved. Work is mostly office hours with few instances requiring us to be present in the hospital during unholy hours, like being requested to diagnose tissues during frozen sections at 6 a.m. and in some cases, at 2 a.m.

Enter the pandemic and everything changed in our lives. There was a mad scramble to set up molecular laboratories for SARS-CoV-2 testing. This alone was an exercise in patience and perseverance. We have had to contend with regulatory issues that were deemed very burdensome and not responsive to the call of the times. It involved months of planning, rudely interrupted by more required revisions by inspectors.

A rush ensued to train med techs in PCR testing as well as biosafety with limited slots available. Once set up, we were required to pass a proficiency test to ensure we will put out accurate results.

We pat ourselves on the back for a job well done after being issued our license to operate. But there is time to rest and recuperate. The pandemic had not only dragged us kicking and screaming into the molecular age of pathology, it upended our generally peaceful lives. Gone were the restful nights of yore. We have to stay up at night to validate testing results of COVID-19  RT-PCR tests. Thankfully, we have colleagues to alternate with each other to somehow catch some much needed rest and sleep. But if you’re involved with multiple labs, and most pathologists are, we have night duties most of the week.

My own experience is probably similar to most pathologists. I have COVID sign out duties practically 24/7. My phone is constantly alerting me to new batches of COVID tests to sign out. I’m glued most times to my laptop running the raw files through computer programs to make my calls. This case is positive for the virus, the next one is not. It goes on endlessly.

The surges are the most difficult with me being up all night signing out many more positive cases wondering when this will end. We are probably experiencing some degree of burnout after more than two years of such experiences. But we’ve never felt more needed now than in the past.

So, when a close friend asks, “How do you think this pandemic will end and when?” I had to rouse myself from the morass of COVID tests I’m currently involved in to think about it. Being in the midst of the battle gives you a certain view of what’s going on. Reading about others’ experiences and viewpoints also helps shape one’s perspective. Let’s do some crystal ball gazing as an exercise to see our way out of the pandemic.

 When daily cases were at an all-time-high during surges, I felt very pessimistic. From a pathologist’s standpoint, we’re not testing enough, in fact, we’re testing too few people to even know what’s really happening. The virus is insidious. It infects but may not show signs, then that infected person, like a zombie in a B movie, infects more and more. Multiply that scenario thousands or hundreds of thousand times and the scenario pretty much looks like World War Z. In this case, it’s World War C for COVID-19.

But now that we’re at an all-time low for positive cases, and almost all (except anti-vaxxers) in the NCR fully vaccinated and boostered, the atmosphere is less doomsday and more of the dawn of a new day. We will hopefully see less and less cases and begin living the “New Normal” as in my previous column, Livin’ La Vida Pandemica (Oct. 19, 2021). We will coexist with the virus, and it will have to live with us since it needs hosts to survive.