Frozen section in Surgery 12.  Those are familiar words to anyone in the laboratory at one of the local hospitals. Behind those five words lie one of the many services offered to the patients While there. They very seldom if ever hear of it; yet on this may depend the extent of their surgery or their very lives

Rippy, Betty

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The FishermanELIZABETH BRANThe calmness of the lake was shatteredby the put-put of an outboard as it round-ed the bit of land at the edge of the bayand came in toward the boathouse.The stocky figure at the end of theboat waved as he cut the motor andbrought the boat in. He lifted the catchon high and then started about the busi-ness of gathering box, tackle, and the restof the gear together. Having assembledall this, he lifted himself laboriously to hisfeet to start the long slow trudge uphill tothe house. A heavy iron brace tugged andpulled at his leg as he began to climb.He was a gray-haired veteran of nearlyseventy years, and the iron had unsuccess-fully tried to retard his march through lifefor something like sixty years of that slowbut diligent progress. He had been school-teacher and postmaster in the little townwhich was his home, and his driving spirithad touched many lives whose braces wereweighing minds and wills instead of with-ered legs. No one who knew him couldfeel without shame the feeble handicapsof life, for he had surmounted them all.His huge head and shoulders lifted abov,e.those iron-clad limbs proved, without adoubt, the mastery of "will to do."He was kind, generous, and almostgay. We who knew him best always feltiJ.S if we should hail his approach with wav-ing banners.This summer "he slipped his anchorand sailed away" into the great unknown.I am sure that when he reached that far-away shore, he waved and called oncemore. "Ahoy on shore! A good day-afine catch!"A Five Minute DecisionBETTY RIPPY"Frozen section in Surgery 12." Thoseare familiar words to anyone in the labora-tory at one of the local hospitals. Behindthose five words lie one of the many ser-vices offered to the patients While there.They very seldom if ever hear of it; yeton this may depend the extent of theirsurgery or their very lives.What does it mean? It means thatwhile operating, the surgeon's keen eyehas noticed something unusual. It maymean that during his preoperative exam-ination, he has discovered an enlargedlymph node or a suspicious area. He im-mediately asks for a frozen section.Perhaps that simple little mole on theneck will not look so innocent when cutinto. Perhaps that node under the arm isa metastasis. Where did it come from, andwhat story does it tell? Is that little Ulceron a patient's lip just a cold sore, or is itdreaded skin cancer? Is that mass in the-20-...right breast malignant? If so, what gradeis it, will X-ray help, will extended sur-gery help, or will the surgeon mark thechart "case inoperable?" The frozen sec-tion in just a few minutes will tell theanswer.When she hears those words, the tissuetechnician immediately stops whatever sheis doing and goes to surgery. There in thesmall green lab off main surgery she willfmd the pathologist awaiting her and ex-.amining grossly the piece of tissue thenurse has brought. He will hand her asmall piece of the suspicious tissue measur-ing approximately one-half inch in dia-meter and one-eighth inch in depth. Thisshe will lay in a dial about the size of aquarter. To this has been attached a tankof carbon dixoide, the same gas you findat the nearby drugstore. By turning a littlelever she releases the gas, and in a fewseconds the tissue is thoroughly frozen.Then taking a medicine dropper, she dropsa few drops of clear water on the tissueand also on the keen edged blade which ishinged immediately above the tissue. Thenshe will adjust the blade so that it willcome to the edge of the tissue. She willslide the blade across the tissue repeatedlyuntil she has cut into the block and has agood cross section of tissue. It will beabout fifteen microns thick, depending onthe type of tissue. If it shreads and goesto pieces, she will make thicker ones.Upon obtaining a satisfactory section, shewill moisten her finger in water and witha sweeping motion pick up the tissue fromthe blade and with a similar motion de-posit it in a petri dish of tap water. Bythe aid of a glass rod she will begin thetedious task of straightening out thewrinkles. Again with the aid of a glassrod, she will transfer the flimsy tissue toa dish of methyl blue stain. Upon beingleft in the blue stain about twenty seconds,all the nuclear structure will become stain-ed a dark blue. By this the pathologistcan read the slide and give an acquratediagnosis. Then it is washed carefully intwo dishes of normal salt solution. Thiswill remove the excess stain and the re-maining wrinkles. It is transferred care-fully to a dish of glucose and by carefulmanipulation with a needle is placed on aclear, clean slide. Then a drop of extraglucose is dropped on the tissue. This willfurther smooth it out and also make theglucose slip, which is to be placed on thetissue, stay in place. Then she wipes offthe excess glucose and hands the finishedslide to the pathologist. The technician'sjob is finished and all await the findingof the pathologist.All of this can be done in about fiveminutes. In the meantime the patient ison the operating table still under theanesthesia and the surgeon is waiting thereport so he can continue his course ofoperation.You 'are no doubt wondering if sucha diagnosis can be accurate. Yes, it is.The fmal report will be given out afterpermanent sections are made, but thisfrozen section is of untold value to thesurgeon and to the patient. It will answermany questions for the surgeon, sometirnessave the patient another operation, and iftime is a determining factor, it will savethe patient's life.- 21-

A Five Minute Decision

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A Five Minute Decision

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