Unlike Thinprep™, the small white brushes or ‘broom-heads’ associated with Surepath™ preparations just snap right off. They are made to just snap off. Insert the brush into the endocervical canal and rotate it five times in a clockwise direction. Then pull it out and snap it off. Simple. There’s no mystery. It sounds reckless? It isn’t reckless at all. The sole aim is to sample the squamous cells in the transformation zone for it is the cells of the transformation zone that are most in danger of becoming abnormal™. By snapping off the head of the brush inside the vial of ethanol-based preservative fluid there is zero chance of air-drying artefacts and you can be sure that the sample is 100% ‘there’ to be transported to the lab in the same vial.
Vicki Williams knows that the main problem with her job is excessive mucus. The problem has always been excessive mucus and excessive blood and excessive inflammation.
Scanty means there are not enough cells to provide a screenable sample and not enough information to enlarge into the screener’s eyes as they look down through their microscopes. This will result in wasted glass slides, wasted processing time, plus, most importantly, wasted time for the patient. The screener is the one tasked with the job of appraising the state of the cells when looking down a microscope. It’s an important job and it’s a fairly skilled job but screeners don’t tend to get enough respect because historically it’s been seen as a job for women, a good part-time earner for ‘homemakers’. It’s a very important job and many other women would’ve died without screeners acting as an early warning system. Whether the screeners wear headphones and listen to their favourite chart music or to gardening podcasts or to doom metal whilst they do this is really none of your fucking business.
Girl at End aka Vikki Williams thinks: Who knew that things mostly just come down to lab error or luck?
To the outside world, the people who work in the lab are scientific. That’s the idea that labs set out to put across. Vicki Williams wears her white coat like the rest of them. It isn’t completely white. Nobody’s lab coat is completely white. The only wholly white lab coats are seen in classic Hollywood cinema. This, too, is such a funny laboratory joke that you should never tell it to someone who is cutting up something small and delicate like a skin biopsy.
What is scientific though? What constitutes scientific? Corporate visitors to the lab are always dismayed by the jeans and the trainers visible beneath the white coats of the medical laboratory workers because in their world this displays a lack of professionalism but does their idea of professionalism have any validity? They believe it does. They believe that trousers and shoes under lab coats and not trainers and jeans are related to better healthcare but this is bollocks and they are wrong, there is no relation. They’re stuck in Victorian times and they have no ideas. Everyone knows that studying “business-management” at university is basically the study of a Mickey Mouse subject, there is no merit in it. It’s a waste of taxpayer’s money because essentially there is nothing that you can learn about business. Being successful in business means being successful in business already, through already inheriting a lot of money and starting a business with that or through stealing money from poorer people and being allowed to get away with it. Business isn’t rocket science. Business isn’t medical science. There is no mysticism to business. Business isn’t important at all.
Dad and Girl at End are at the Algorave. The Algorave is in Sheffield, it has nothing to do with the Algarve. Dad’s tattoo reads SKF which stands for Smith, Kline & French. These days, 10,318 days after the End of History, Smith, Kline & French is known as GlaxoSmithKline but back in the 1960s it was still called Smith, Kline & French. Dad needs the initials to be covert so as not to invite the suspicion of the authorities and so as to hide, from himself, his addiction to Smith, Kline & French manufactured Purple Hearts (otherwise known as Drinamyl), a vintage stash of which he curates carefully. Girl at End doesn’t care. Sure Girl at End will pop some Seconal sometimes, Judy Garland did it. Dad called them ‘reds’ or, when he was feeling more Liverpudlian, he called them ‘seccies’ and said ‘seccies’ in a regional accent. Girl at End just calls them ‘dolls’ and she will dance all-night when she takes them.
In lieu of being paid a living wage, the National Health Service, some 10,005 days after the End of History, runs on supermarket bought biscuits and cakes brought in by beleaguered senior biomedical scientists who are also tasked with being managers and who complain that they never get any chance to do any science at all these days. Any gap in the flow of cakes and biscuits is filled by a tradition, a childish primary school style tradition, among the staff themselves. The tradition involves bringing in cakes and biscuits for the whole team on their own birthdays. Any other cake or biscuit gaps are covered by a related practice where everyone is to bring something in around periods such as Easter and Christmas. The whole system runs on a mixture of cakes and biscuits combined with diligent, careful scientific practice and, amongst many members of staff, a desire to provide genuinely good healthcare, something that is almost ALWAYS lacking in private healthcare departments.
Vicki Starr aka Girl at End has two hours left before her shift ends. This was earlier and before she goes to the Algorave. That is called ‘plot’. Vicki Starr looks at the clock as she stands next to her centrifuge as it slows down, the digital seconds rolling backwards on the digital display. The first spin wouldn’t have made much of a pellet, it wasn’t meant to. The first spin is just to remove obscurity, to remove non-diagnostic debris and excess inflammatory cells. We call it the enrichment step and it goes like this. Anyone could do the enrichment step.
Everyone do the enrichment step!
Vicki Starr pushes the two buttons necessary to open the centrifuge and it clangs like heavy metal. It’s a large grey armoured tank-like centrifuge, you wouldn’t want to fuck with it. She unclasps the lids from the buckets and aspirates forty-eight test-tubes at once with the custom-made aspirator, the mechanical pump providing avant-garde drone music background noise. Vicki Starr wants to go to the toilet (urine is an acellular liquid product of renal excretory function) and has wanted to go for the past twenty minutes but at this stage of the day she is all alone with no one to watch her preps. The aspirator sucks the supernatant from the liquid and deposits it down the tube into a five-litre waste container that is almost full and which, when you take the lid off, smells like Hubba-Bubba bubble gum.
Five years earlier, Girl at End looked down at the 7-inch as it spun. It was, as ever, ‘The Tears Won’t Stop Falling’ by Vikki Styles, but now, five years later, she listens and tweaks conditional statements with which to produce the music. It doesn’t matter what produces music and only that music is produced. Everybody knows that the earth’s gravitational force is sufficient to separate many types of particles over time. See that tube? See that tube of anti-coagulated blood? Well, leave that standing out on that bench for enough time and it will eventually separate into plasma, into factions of red and white blood cells but that’s no way to go about things. Centrifugal force? Sure. Sure, that would work. Very good. But how would we obtain the necessary speed of the centrifuge rotor? No? Nobody? Does nobody know this? Well what if I say, ‘Nomogram’? Ah yes. Now you remember. The angular velocity is expressed in revolutions per minute.
The record spins.
Chemists, biologists, record producers. A sedimentation of heterogeneous mixtures.
The remaining solutions may be discarded with a pipette but no mouth-pipetting. Mouth-pipetting is dangerous. It’s not 1943. DO NOT insert an open-ended glass capillary tube into your mouth. DO NOT place the opposite tapered end of the tube into a solution of your choice. DO NOT place the opposite tapered end of the tube into some microbial stew or into some blood or into a cell culture. DO NOT draw a solution upwards through your man-made pipe. DO NOT maintain the tension with your mouth.
Richard Brammer is the author of books such as ‘MDMA and Menthol Cigarettes’, ‘Warehouse Mixes’ and ‘Girl at End‘. He is a co-founder of Dostoyevsky Wannabe. Just lately he likes to fly the flag for the beleaguered and forgotten about generational cohort Generation X of which he is a product. He lives in Manchester. He doesn’t do author pictures. Twiter: @dw_wannabe
Image by Richard Brammer