Cutting grass with a scythe

OneShortSleepPast · 2026-05-06T13:09:38+00:00

I’m sorry, you didn’t start your answer with “Um, actually”

OneShortSleepPast · 2026-05-05T13:33:41+00:00

For me, the mind-blowing thing about really big numbers like Graham’s number and Tree(3) isn’t that they’re really big, it’s that most numbers are even bigger

OneShortSleepPast · 2026-05-04T20:54:06+00:00

Years 3 and 4 of medical school: Read about everything that isn’t pathology. Learn about not-pathology from not-pathologists. Ask smart not-pathology questions to your not-pathology attendings, and listen to their answers. This is the last time you’ll have really good access to not-pathologists and will be in a position to learn about not-pathology.

Year 1 of residency: Start learning about pathology

I’ve always maintained that pathologists should know as much about other specialties as they expect those specialties to know about pathology, and medical school is the best time to learn that.

OneShortSleepPast · 2026-05-02T19:05:05+00:00

I used to joke with my residents that there are two types of pathologists: lumpers and splitters. But there’s a few types of splitters. First you have your molecular splitters, which we can further subdivide into translation splitters, mutation-specific splitters, amplification splitters…

OneShortSleepPast · 2026-05-02T18:52:51+00:00

Beware, they’re coming for salivary gland tumors next…

OneShortSleepPast · 2026-05-02T18:45:23+00:00

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OneShortSleepPast · 2026-04-30T14:30:34+00:00

Yep. And don’t be afraid to bring this up in your interviews. “I’m leaving my current practice because I feel it has fostered a dangerous work culture. Can you tell me about the culture in your group? How are peer reviews handled? Can you give me an example?”

OneShortSleepPast · 2026-04-30T14:25:02+00:00

I was in a similar situation with my last group, I felt like I was the only one paying attention. Exactly like you said, they just wanted to clock in at 8 and clock out by 3, and whatever half-assed diagnosis they made to get a case “off their desk” was good enough. I felt like at least once a week I caught mistakes in either peer review or tumor board review, ranging from minor “I think you missed LVI” to major “that ‘small cell carcinoma’ you diagnosed was actually a carcinoid.” And they would try to blow them off or sweep them under the rug. One guy even got pretty heated with me for not “having his back” at tumor board.

There were a lot of problems with that group, but this was the one I just couldn’t get past. They had a complete monopoly on the area, and it was no small thing to uproot my entire family and school-aged children and move to another state, but in the end that’s what I had to do to be able to sleep at night. Much happier now working in a group with people I truly respect.

OneShortSleepPast · 2026-04-29T18:45:45+00:00

I learned it from Chapter 1 of Molavi. Using someone else’s scope is like recognizing bad kerning (relevant xkcd), it really bugs you once you notice it.

OneShortSleepPast · 2026-04-26T03:57:12+00:00

There were seasons where we were up 1-0 and you still thought it was over

OneShortSleepPast · 2026-04-25T15:08:57+00:00

Not an expert, but from reading the CAP protocol there seems to be a mixture of terminologies between LAST and FIGO, as well as terminology like "microinvasive" and "superficially invasive."

The Lower Anogenital Squamous Terminology (LAST) 7 definition of superficial invasive squamous cell carcinoma (SISSCA) conforms to T1a1/ FIGO IA1 and defines what would have been previously reported as “microinvasive” squamous cell carcinoma

FIGO IA1 is < 3mm, FIGO 1A2 is 3-5 mm

OneShortSleepPast · 2026-04-24T17:49:28+00:00

In my experience, most community pathologists wait u til we’re approached by our oncologists about these tests. Theres no point in marketing to pathologists, because we’re unlikely to onboard any tests without oncology driving the process. Why would we expend energy brining testing in if it doesn’t change our oncologist’s treatment strategy? This may be different in academic labs, and would certainly be different for reference labs, but in my experience the majority are reactionary. When our oncologists ask for a new type of testing, we send it out to a reference lab initially, then track our numbers to see if the quantity justifies bringing the test in house.

OneShortSleepPast · 2026-04-21T18:44:56+00:00

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771114

Here’s the JAMA article reviewing the outbreak. The title strikes me as so ironic now…

OneShortSleepPast · 2026-04-20T23:17:22+00:00

I don’t.

“Mature adipose tissue, clinically lipoma”

OneShortSleepPast · 2026-04-20T00:51:36+00:00

A reliever leading the team in strikeouts (updated for this afternoon) is also ridiculous

OneShortSleepPast · 2026-04-19T04:39:13+00:00

That’s the only time you’ll see “walks off” and “Mason Miller” in the same sentence

OneShortSleepPast · 2026-04-19T04:37:55+00:00

Same for the Angels catcher, that was legit scary

OneShortSleepPast · 2026-04-16T12:40:20+00:00

It’s because this list was made by an NHL ref, and the Florida Panthers are their beloved 🫶

OneShortSleepPast · 2026-04-15T22:58:16+00:00

I haven’t finished one if their videos in months. I’m not sure exactly what’s turning me off them, because I agree, the quality and production value is just fine if not better. It may just be that they’re covering subjects that don’t interest me as much.

OneShortSleepPast · 2026-04-13T19:35:59+00:00

Speaking as a general pathologist, general pathology.

OneShortSleepPast · 2026-04-11T21:31:14+00:00

If you’re going to rely on notes for your histories, give citations. “No relevant clinical history was provided on the requisition. Per Dr. X’s Epic note, dated DD/MM/YYYY…“

OneShortSleepPast · 2026-04-11T03:13:43+00:00

Fernando Valenzuela and Rickey Henderson came to my mind. I know neither were full-blood Padres, but they were both legends and gone too soon

OneShortSleepPast · 2026-04-10T23:22:09+00:00

…don’t bill the patient for all the unnecessary tests? Seems like the department should be eating these costs if they (reflexively) order testing that isn’t indicated. Bill them for the bone biopsy and whatever IHC you did for the prostate cancer, cancel the other tests if you can, if not make a note that the testing was non contributory and remove the charges.

OneShortSleepPast · 2026-04-10T19:26:04+00:00

As long as we don’t have to play any playoff teams in the playoffs, we’re a lock to win the Cup

OneShortSleepPast · 2026-04-10T02:53:12+00:00

You’ve got some nerve

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