Biomedical Engineering Reference
In-Depth Information
So, there seemed to be something else going on simultaneously with
the scientifi c knowledge and the biological mapping of cells in relation to
unclassifi able cells. The prefi x used by my informants: 'slops', can be interpreted
as relating to the clash between the
imperative
and the
impossibility
to classify
all cells. This diagnostic category was sometimes necessary in daily cytology
laboratory practice, which is characterised by a struggle to separate and classify
cells according to normality, cancer and the degrees in between. However,
although unclassifi able cells were kept in some control by being classifi ed
qua
unclassifi able, this group could contain a potentially 'dangerous' mix of both
normal and pathological cells. As such, the group containing unclassifi able
cells disrupts order and threatens the mandate of the cytology laboratory.
However, the daily work with assessing cells also involved cases where the
match between the cells and the classifi cations were perfectly clear.
Exceptional matching of cells and classifi cations
It is half an hour past demm's scheduled start at Cyto lab. The
cytodiagnostician who has demm looks for the cytologist responsible for
the demm today who is late. He arrives and takes a seat at his usual place
by the main ocular in the middle. The cytodiagnostician takes a seat in the
usual place in front of the cytologist slightly to the left by the computer
screen ready to use the mouse. Today two other physicians under training
also participate. One of them sits beside the cytodiagnostician and the
other one sits to the right of the cytologist. First, there are a number of
samples that the cytologist assesses as normal. He informs the physicians
under training about the predetermined 'standard codes' and says they
cover 90 per cent of the cases. During the demm he mostly uses these
standard codes, but in some cases he formulates a diagnosis verbally in
the dictating machine, using his own words. The cytologist has a formal
and slightly
jocular manner and encourages the new physicians to express
their opinion and to argue with him. He asks the physicians several
times 'What is your opinion?' or 'Do you agree?' When the physicians
under training make their suggestions he says 'I trust you …'. Now and
then they ask the cytologist to explain further by saying 'Can you please
…' or 'Excuse me …'. While assessing the samples he tells the physicians
under training about other possible interpretations and about various
forms of cancers. He tells them about some types of cytology that are
particularly diffi cult to assess. Suddenly the three participants protest
loudly, and the cytologist says: 'Excuse me'. He had just taken the same
cytology request form twice by mistake. The cytodiagnostician is asked
several times to display the patients' previous test results on the screen,
and to read them out loud. On one occasion, when the cytologist is about
to assess a sample he considers normal, the cytodiagnostician says loudly
to the cytologist: 'You cannot let this one go!' After some discussion he
agrees and decides to follow her advice. Suddenly, the cytologist calls
