SAN FRANCISCO, CA – After visiting the hospital’s cafeteria, Dr. Jason Greene seated himself in the surgery staff lounge to enjoy his lunch.  But a few bites into his meal, something didn’t seem right.

“I ordered the fish sticks,” said Dr. Greene, “but after eating a few, I thought they tasted more like chicken.”  It was an unexpected finding, so he decided to send a sample to pathology for immediate confirmation with a frozen section.

When the specimen arrived in the lab, it was initially met with confusion.  “There was no request form, no patient information, and the clinical history was blank,” said pathologist Dr. Helen Collins.  “In fact, the only paperwork we got was a napkin with the word ‘FISH?’ scrawled on it along with a tartar sauce stain.”

Once the request was clarified, a portion of the tissue was frozen, cut, stained, and examined under the microscope.  “I saw a mixture of skeletal muscle, adipose tissue, and occasional fragments of cartilage,” said Dr. Collins.  “The nuclear detail was distorted, possibly due to deep-fryer artifact, limiting my interpretation.  The literature in this field is lacking, so in the end I had to hedge my diagnosis a bit.  But given the overall impression of architectural disarray and the surrounding vegetable matter suggestive of breading, I called it back as ‘consistent with processed meat, favor nugget variant.'”

Dr. Greene, who had already finished his lunch and moved to the PACU, was disappointed with the ambiguous result.  “Just another non-committal diagnosis from pathology.  What does it take to get a straight answer from them?  I mean, I haven’t read about this stuff in a while, but chickens have beaks and feathers, and fish have gills and scales, right?  Which is it?  It’s not rocket science.”

When asked if the delayed diagnosis would impact his immediate decision-making, Dr. Greene admits that it would not.  “I mean, it’s just nice to give reassurance to family members.  Pathologists don’t understand that.  But now, if my wife asks what I had for lunch today, I won’t know what to tell her.  She’ll just have to wait until the final report comes back in a few days.”