Bartlett Regional | House Calls | Winter 2019

Here for our patients Like all health care workers, lab clinicians make patient care their top priority. And they develop a unique connection. “The patients may never see us, but we’re here, making sure that the doctors and nurses have the test results they need to treat their patients,” Kelsey says. “They don’t know us, but we know them.” Histology Over in the histology section, a tray is brought out with slides of specimens ready for viewing cell biology under the microscope. They look like block-cut stamps for an art project. They are really fine needle excisions of tissue from lumps or other abnormalities embedded in paraffin, cut into small slices as thin as tissue paper and then stained. The stain highlights diseases such as cancer on the cell. Separate specimens are from a gallbladder, a placenta, a small bowel and a stomach. Diagnosis “takes a very fine and precise technique,” John says. Analiza Lopez demonstrates proper “having your blood drawn” technique with co-worker John Fortin. do now, and I don't want to walk away from it.” She likens the advancing situation to catching up with Star Trek . One example is molecular testing. Say a person is having flu symptoms. They can now be tested with a nasal swab placed in a small cartridge in a simple-looking machine. “It’s like a miracle in a box,” she says. A PCR, or polymerase chain reaction, is performed. The PCR involves multiplying DNA many times over. A diagnostic test result will be revealed in 30 minutes. Another exciting development is participation on the Antibiotic Stewardship Committee. Leanne says she’s been waiting 30 years for a more effective process to guide the use of antibiotics, which, when overused, can lead to antibiotic-resistant bacteria. Doctors, pharmacists and microbiologists collaborate to ensure that patients are treated with antibiotics appropriately. Then there’s the change in her physical environment. Much has changed since Leanne began her career at Bartlett. One example was the tiny emergency department. The ED had one treatment room with two beds and an office the size of a closet. “And don’t get me started about how tiny the waiting room was!” she says. More complex health issues A major shift in patient diagnoses over the years involves substance abuse. In the early 1980s, GI bleeding was a common condition associated with alcohol abuse. “Jump ahead to the past five years, and we see a lot more IV drug users,” Leanne notes. “It is now common to have patients with wounds or abscesses associated with injection sites, or with the impaired self-care that comes from drug use. We also see a lot of endocarditis now, a diagnosis that was fairly uncommon here in Juneau when I first started in 1980. “The microorganisms associated with these infections may be the standard pathogens, like Staphylococcus aureus and hemolytic Streptococcus species, but they also include a lot of microorganisms that used to rarely be associated with disease. My job has become much more complicated, as we have seen an increasing number of these fragile patients with complex health issues.” Passing on her passion One of Leanne’s favorite parts of her long- standing job is giving tours of the lab to high school career education classes. “I tell every student that comes here, know yourself, know what drives you, where you get your satisfaction, and go for whatever you want to do. There's a place anywhere in medicine for you.” www.bartletthospital.org 9