Your Biopsy Lives On-What Happens After the Diagnosis is Made

blocks-in-storage — Biopsy blocks are stored for 10 years. Current regulations also require additional identifying information such as patient name.

So we have made your diagnosis. Hopefully, your biopsy was benign, but what if it was malignant? What happens next? What does a lab do with any leftover bits of your tissue? What happens to the glass slides we looked at under the microscope to make the diagnosis? While I will use the prostate biopsies that we see in our lab as an example, much of this can be extrapolated to other biopsies, such as those from the breast, lung or colon.

Let’s talk about the “left-over” tissue first. With prostate biopsies, all the tissue is processed; that is to say that all of the biopsy material has been dehydrated, rehydrated and embedded in paraffin wax. The diagnostic slides were made from these paraffin blocks, but not all the tissue in the blocks is used up. What happens to the remainder? Sometimes nothing, but sometimes a lot. And more and more is being done with each passing year.

In cancer cases, we use that extra tissue to verify that the specimen we just made the diagnosis on is from the right patient. That’s a no-brainer you say, but we want to do everything we can to ensure that the Mr. Bowl’s cancer didn’t inadvertently get transferred to Mr. Plate’s specimens. So we work with a company that does a DNA double check. The company compares the DNA in Mr. Bowl’s biopsy core to the DNA in cells on a cotton swab that was rubbed against the inside of Mr. Bowl’s cheek when he was in the doctor’s office for the biopsy. The DNA results should be the same. It’s a high tech version of “The Match Game,” and creates a sense of confidence for patient, urologist, and pathologist.

The tissue in the paraffin block has other valuable uses. An increasing number of analyses can be done to determine the aggressiveness of the cancer, usually by using DNA testing to evaluate what genes have been altered in the tumor. There are even tests that look at benign biopsies and “predict” the likelihood of cancer being diagnosed in the next two years.

The glass slides have use as well. We can send them to another pathologist for a second opinion. They can be run through a device which creates a totally digital replica of the slide that can be viewed anywhere around the world. And they can be reevaluated as part of research studies.

How long do we retain the blocks and slides? We follow our accreditation regulations and local/federal laws and dispose of this material after 10 years. Space requirements make maintaining the material for longer than a decade prohibitive. While it would seem valuable to use this older material in research rather than dispose of it, investigation with some of our research partners has indicated the 10-year-old material has degenerated and is not suitable for the studies currently being done on newer material.

One more thing; most pathologists would be glad, and often eager, to show you your slides under the microscope. Usually a phone call is all it takes to make the arrangements. Don’t be shy, it is YOUR health!

And on a closing note–HAPPY LAB WEEK TO ALL MY LAB PARTNERS. Your pride and dedication in your work makes us an outstanding laboratory.

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The above is the opinion of the author and not of UroPartners, LLC.

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Carsons Department Stores are Closing for Good, and I Care. Do you?

Because Bon-Ton, the bankrupt owner of Carson’s cannot find a buyer, all Carson’s stores will be closed. Except for Carson’s employees, this is probably a pretty ho-hum announcement for most Chicagoans. After all, Chicago is the city that was Marshall Fields.

Fields had the iconic State Street Clock. It had Frango Mints and it had The Walnut Room, scene of holiday celebrations “under the Tree” for many generations.

And Fields was my family too. My mother worked at Fields, and so did my sister, my wife, and my daughter. They sold Christmas lights and fabric and candy at stores stretching from the Loop, through Old Orchard and out to Vernon Hills. For many years I would have brunch in the Walnut Room with my aunt and uncle; my initiation to doughnut holes. But Carsons was always there too, the Second Store for the Second City.

Fields had the clock, but Carsons had the fabulous Louis Sullivan designed State Street main store. It was part of Chicago’s rich architectural history, though it didn’t feel quite the same once the building housed a Target store. But I can’t say it was the architecture of the building that has the most memories for me. Rather, it is the many Saturdays that I spent as a young boy, holding my mother’s hand as we wandered through the merchandise. Even though she worked at various times for The Fair (a long-vanished Chicago department store,) as well as Fields, my mother’s favorite store to shop at was Carson’s.

We would take the EL downtown, boarding at Morse or Loyola, staring out the window, past Wrigley, and past Fullerton until the tracks angled down and we were in the bowels of the subway. We would get off somewhere along State Street and pop in and out of Fields and Wieboldt’s. We rarely made it to Sears or Montgomery Wards. But the day would always wind up at Carson’s. When Mom was done with her purchases there, laden with shopping bags, we would head to the basement and The Tartan Tray Cafeteria. It was here that we would get our nourishment before the Subway-EL ride home. Sliding our trays along, we would pick out a sweet treat, a glass beaker of coffee for Mom and some tea for me, before searching out a table in the crowded seating area. Since then, I have had many meals in department store restaurants such as Nordstrom’s Cafe and the Zodiac Room at Nieman’s, but they don’t hold a candle to those almost forgotten department store restaurant memories.

And remember the Carsons at Edens Plaza in Wilmette? If you got your ears pierced there in 1981 or 1982, and the right side doesn’t quite match the left, you may have me to blame. Yes, I was Carson’s ear-piercer back in the days when the state required a licensed physician to do the piercing. But I have to admit that as a pathology resident, I didn’t have quite the aesthetic eye of say, a plastic surgery resident. So if you have felt slightly lopsided for the last 35 years, I apologize. To make up for it, I’ll run your next blood test or read your next biopsy for free.

Goodbye Carson, Pirie, Scott and Company! I will miss you.
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Fleetwood Mac Says “Go your Own Way” to Lindsey Buckingham

rumours — Fleetwood Mac and Rumours. Lindsey Buckingham will be gone.

Have a favorite song? I’ve been reading the book “Why You Love Music: From Mozart to Metallica, the Emotional Power of Beautiful Sounds.” It had me wondering what songs would make my Top Ten list.

Of course, in my list, there would be some U2, some Steely Dan, a flicker of Pink Floyd. But sitting way up at the top would be the most perfect rock-pop song ever recorded, Fleetwood Mac’s “Go Your Own Way.” A relentless drumbeat, a wailing guitar, and the Lindsey Buckingham lead vocals make a relentless, infectious, pop wall of sound. But things are about to change…

A little history. Way back in the sixties, Mick Fleetwood and John McVie, two bluesy sorts of guys helped form a group with the inspired name of Fleetwood Mac. The band got some radio airplay here in the states and had a minor hit or two, but was best known for its constantly changing lineup and for a fight with a manager over whether the band, or the manager, owned the name “Fleetwood Mac.” A phony tour and the ensuing lawsuits gave the group some publicity but didn’t sell many albums or concert tickets.

And then, in the mid-70’s, the California couple Stevie Nicks and Lindsey Buckingham joined the band and the blues guys began to rock and roll. They called their first album together “Fleetwood Mac.” The lead single in the US, “Over My Head,” was written and sung by Christine McVie, John’s ex. I heard it and I was hooked. Hearing the song still reminds me of my first med school crush. The album was a hit, but Fleetwood Mac was about to unleash a monster.

Late in 1976, the band released the single “Go Your Own Way,” followed in early 1977 by the album “Rumours.” Fueled by drugs and disintegrating relationships, the song and the album were the band’s pinnacle of success, selling millions and spending months at #1.

The band has rolled on ever since. Barb and I caught them in Rosemont three years ago. Mick, John, Christine, Stevie, and Lindsey had all aged, there were rumours of a shadow band playing behind the curtain, but the show was still fun and still brought back all the memories.

And now the band has announced it is going on tour again–but without Lindsey Buckingham. While the reasons why are known only to insiders, the man behind my top tune has been fired, replaced by two other musicians. But I will always have his sound, safe in my iTunes, as he goes his own way.

And how about you? What is your favorite song?
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Was This Timeshare a Scam? No, but the Follow-up Sure Seems Like One.

royal-scam — The Royal Scam, Steely Dan. 1976

Barb and I bought a timeshare at The Beautiful Beach Resort in Mexico two years ago. No, that’s not the scam. Sleazy as the process was, we paid our money, got a contract, and have even returned to the facility for a very nice week with friends. Sure, Mr. Unctious, the salesman, and Mr. Slimy, his boss, made personal promises of special arrangements and deluxe villa availability, but did we really believe Unctious and Slimy would be around a year or two later to give us those perks? No, we did not believe them then, and yes, a quick phone call last week confirmed neither is any longer associated with the resort. But I still don’t consider our purchase a scam–just a mistake on our part.

The scam has just come recently and not from BRR. A few weeks ago I sent an email to the resort booking office, looking to arrange a family gathering next February. A day later I received a phone call on a very bad, echoey, phone line. “Mr. Raff, I am Donald Jones. I represent a developer that is working with the owners of The Beautiful Beach Resort. BBR is in the process of converting from timeshare to condominiums. We would like to purchase your timeshare, and we guarantee you 125% of your purchase price. But this offer is only good for the owners of another 4% of the outstanding timeshare units, so you will need to act fast!”

Now, Barb and I both have buyer’s remorse over the timeshare purchase. We would gladly unload it for what we paid for it, and a 25% bonus sounded too good to be true. And that, of course, is when the alarm bells should always start to go off.

Despite my skepticism, I had already given Mr. Jones my email address. Within minutes I received an email from him. It listed a company name, which proved unverifiable on the Web, along with a request for all the details of our timeshare contract–if he was working with the resort shouldn’t he have known things like my contract number and how much I had paid? A phone call to BBR confirmed that the resort owners had no plans to convert the property Ito condominiums. I trashed the email and forgot about Mr. Jones.

This week, Mr. Jones has reappeared. He has made repeated calls to our home. I decided to call him back and chat him up. Over another creaky phone connection, I told him BBR denied they were converting to condos. He gave a lengthy answer explaining this was all hush-hush so the staff would still give good service. He also provided me with a link to the Arizona State Corporate Registration office. The company he claimed to represent was listed, but of course, that didn’t make them legitimate. It did not even prove he was working with them. He repeated his pitch, and reminded me of the urgency. I said I would “explore.”

So what kind of scam is being run here? Following some Google digging, I presume that if I agree to Mr. Jones’s terms, I will be told I need to send a check, or more likely wire some cash, to pay for “fees” before he mails me my check. And when will I get that check? The year the Cubs and Sox both win the pennant, or President Trump receives a Nobel Peace Prize? I think we will pass on this opportunity of a lifetime. One bad timeshare decision is enough for us!

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Yes, I Watched Jesus Christ Superstar. And Here Is Why.

As I have said before, I’m a big musical theater guy. Lots of “Broadway in Chicago,” lots of Marriott Theatre productions, and lots, but not enough, trips to New York City–Evan Hansen, you are next. But I have skipped the live TV broadcasts of the last few years of “The Sound of Music,” “Grease,” Hairspray,” and the like. They didn’t fit into my interest or my schedule.

So why was I glued to my set last night to watch the live concert version of “Jesus Christ Superstar”? It wasn’t the thrill of seeing John Legend flogged (and worse) or Alice Cooper with more subtle makeup than usual. No, the thing that got me following Saturday night’s Seder with Sunday night’s Superstar was nothing but nostalgia, nostalgia for a time long ago in a neighborhood far away.

I was in my mid-teens when the Andrew Lloyd Webber-Tim Rice double album hit the States.A few songs made radio playlists, but it wasn’t until the Easter following its release that one radio station took the bold step of playing the album in its entirety. Ian Gillian, Murray Head, Yvonne Elliman. Names that I didn’t know, but that I would never forget. I was hooked.

I didn’t buy many record albums, but For Superstar, I plunked down the few bucks at the Morse Avenue record store. After a week of non-stop listening on our old mono record player I had memorized the lyrics and got my somewhat belated introduction to the birth of Christianity. Not a very accurate view, but at least it filled a yawning gap in my knowledge base.

I was not the only one in my crowd with a Superstar habit. A road trip to Champaign-Urbana turned into a 140-mile long Acappella concert, with 4 male Jewish voices singing every note, every word. One of my travelling companions from that night died way too young, and I always think of him when I hear the opening notes of the JCS overture. Hosanna, Hosanna.

After the album, Superstar evolved into a concert version; minimal staging, just singers walking to a microphone at center stage. I saw it from the back row of the Auditorium Theatre with a high school sweetheart, my enthusiasm mirrored by her boredom. It just wasn’t a show for everyone! Then came the Broadway musical, the movies, the local theater productions. I can’t recall if I saw any of them. As I grew older my infatuation clearly waned or was buried beneath my studies, my family and my career.

But last night my enthusiasm was back. I watched every minute, and sang along with almost every word. Barb was surprised I remembered it all so well, I was more surprised that there were a few lyrics I had forgotten.

When Barb asked if I wanted to see the production coming to the Lyric Opera. I turned down the offer–I’d rather savor a single glass of a fine old Scotch than drown in an entire bottle.
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