Dear everyone,
It has not been the usual whirl of activity around
here. The Bears won their last
pre-season game (against the Titans). I
only saw the last half of the last quarter, because I mistakenly thought they
were playing at noon. They looked
competent in the bit I saw, but we’ll halve to see. The Cubs split a two game series with the
White Sox (the “cross-town classic”); both games had an abundance of
scores. I was able to purchase a quarter
season (eleven games) of the Blackhawks; I’m splitting the tickets with Jami
Walloch and Andy (Andy is getting three games only). They are down near the rink, which is nice
because you are close, but you actually miss a little of the play when the
players are skating close to the boards on your side. Very exciting though!
Vivian was in Chicago for a few days before going on to
Pittsburgh (Jasper went with her to help her move in - - she hasn’t been back
on CMU campus since March 2020). She helped
Jasper move into a single bedroom apartment on Harper Ave. - - this is Jasper’s
third move in less than 18 months. I
think he would have stayed in the one he had at the Algonquin on 50th,
but he had trouble finding an acceptable roommate. We didn’t help them move this time, and it
took a lot of time and effort. We did
see them the day after at Bon Chon in Chinatown. I don’t know how they get the fried chicken
skin so crispy; it’s almost like candy.
We went to the new apartment to unload a few odds and ends Jasper had
claimed from 1261. Guido, the cat, was
so traumatized by the move that she was hiding in one of the kitchen
cupboards. Apparently, she had meowed so
much during the move (she was in a cat carrier) that she lost her voice.
Bob Garza, the head of my dojo, came down with a
breakthrough case of Covid. He got it
from his unvaccinated 20 year old stepson, who lives at home with him. Bob’s wife, a high school teacher, also got a
breakthrough case. So, I have been
teaching a few extra classes. Illinois has
now issued an indoor mask mandate in all public spaces, and trying to do
anything aerobic with a mask on is no fun (we’ve been masking at the dojo for
the last two weeks). I have put my
athletic club membership on suspension for the next three months, since I
usually start my workouts there with 20-35 minutes of rowing or running. Jami’s basement gym is still open though!
Work is about the same as always. I guess one of the bigger problems there is
our lack of ability to generate the type of reports we need for accreditation.
As bad as Copath (the old system) was (and Epic is a big improvement in most
ways), it came off the shelf with built in reporting modules that fulfilled all
the requirements. For instance, every
time we make a diagnosis of breast cancer, we run a suite of additional studies
looking to see if there is expression of estrogen and progesterone receptors (ER
and PR), and another protein called Her2-neu (H2N). Therapy is tailored to the patient on whether
these proteins are present. We use
immunoperoxidase markers to do this, which is sufficient for ER and PR, and
usually good enough for H2N, but the latter can be scored as negative (0-1),
maybe (2) or positive (3). If it is
tagged as ‘maybe’, we run another test on it called fluorescent in situ
hybridization (FISH), which is much more sensitive to the treatable absence or
presence of H2N. All of this is preamble
to see that we need to be able to generate the number of cases that we test for
H2N, the number that we scored as ‘2’, and of these, the number that turned up
positive on additional FISH testing. It’s
basically a check to make sure we are doing everything correctly. About15-20% of all of the breast cases should
be scored either 2 or 3, and of the ones we scored 2, about half should be
positive by FISH.
You might want to ask why we don’t go directly to the FISH
test all the time - - it’s considered the ‘gold standard’. The easy answer is that the immunoperoxidase
test is very accurate for the negatives and positives, it’s faster, and
cheaper. I must admit some hospitals don’t
use it though. Still, hospitals across
the country do the exact same testing, and answer to the same masters, so you
would think that Epic would have some pre-written program to allow us to search
for this information. At the moment this
doesn’t seem to be the case - - and this is just one example. Anyway, I’m trying to set up a meeting with
some of the pathologists and some of the Epic informatists to see if we can
figure out a way to do this.
Not much is new entertainment wise. Cindy and I started watching The
Chair with Sandra Oh, and I have been watching Kim’s Convenience. These both seem moderately interesting/funny.
I just finished Gamechanger
and Dealbreaker (its sequel). The first
novel took a while to get moving, but the second half was a lot of fun, and I
enjoyed the sequel (maybe it was even better than the first novel, which is often not the case). Of course, you know the plucky heroine(s) will
win in the end, but it was fun to see them in action. The reviews suggest this book
for Neal Stephenson fans, but I thought it was more of a mash-up of William
Gibson and Iain Banks
Love, H
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