Still truckin'

I finally got some time at one of the plate benches today. It was really cool. I got to look at a bunch of culture plates and see what was or wasn't growing. I saw some alpha and beta hemolysis, some gold Staph colonies, and some nasty-looking mucoid Klebsiella growth. I also watched a latex agglutination test for Staph and an oxidation test for Pseudomonas. Later that day, I saw a yeast plate with an amazing growth pattern -- it looked like bunched-up black velvet. I really wish I'd had my camera with me.

We also learned a simple but valuable lesson during rounds. We had a sample from one patient with a liver abscess that showed Gram-positive organisms on the stain but no culture growth. From another patient, there was a plate with no growth in area 1 (the most dense), but as the sample was diluted, growth appeared. Lesson: take the sample BEFORE starting the patient on antibiotics.

I also discovered that people will send just about anything down to the lab for sampling. There was a patient with suspected infection of the spinal cord. He had an apparatus implanted in him that delivered pain medication to his spine. The doctors took the entire device out and sent it to the lab in a huge bucket. This is, of course, massive overkill (you can usually just send the tip that's most inside the patient), but the lab director remarked that he'd rather get the whole device than not get anything at all.

I still feel like an imposter, walking around the hospital in my long white coat (which doesn't even have my name embroidered on it). I think it'll be a long time before I feel confident and competent enough to walk around in it and not feel like I'm being deceptive.