Long Overdue Follow-Up -- New Internship

only a slight exaggeration

Do you remember my old internship that lasted almost two days, the one in which hazardous materials were being cleaned by untrained interns without proper protective gear or procedures, or even rubber gloves? I don't think I ever followed up on the internship I was doing -- the one my dad didn't want me going back to but that I needed to complete as an unofficial medical school application requirement. I never made it back because before I was to report again, I developed that condition where scar tissue from an old abdominal surgery wrapped itself around one of my Fallopian tubes. My dad considered leaving it alone, but he decided that if any of the other eight interns developed health problems related to the the substandard  procedures used in disposal of waste, he'd have a hard time dealing with the guilt.

In everything that's happened since, the whole issue was shoved on the back burner for me. It wasn't for my dad, though.

My dad  called someone from the health department that he knew wouldn't tip anyone from the lab off that a surprise inspection was in the works. (A surprise inspection is always a possibility, which is one of the reasons the lab was crazy to manage its operations in the way that it did.)  This was to be a little more than a routine surprise inspection, though.  My dad contacted compliance officers from two institutions that accept results from this lab to invite them along on the surprise inspection. I told him that someone was very likely following the identical schedule on Mondays  and Thursdays that I was following on Tuesdays and Wednesdays, and when the most incriminating time to walk in would be.  My dad had the legal department from the local hospital from which he does much work now and which does some business with this lab obtain a search warrant, and spoke with the city chief of police under conditions of what he was assured would be complete anonymity to let him in on what was happening and to inquire as to whether anyone on his staff was qualified to assist in the inspection or whether either the sheriff's department or the FBI would be needed. The chief of police pulled up resumes on his current employees and noted that his lead detective had an M. S. in biochemistry. It was determined that the man was highly unlikely to have any ties with the lab. It was further determined that the lead detective wouldn't be told what or where the inspection was to take place -- only to be available at the specified time.

The inspecting team would consist of my dad, who has about as many different certifications concerning  lab operations as I have white blood cells, the police detective with the advanced degree in bio-chem, a lab official and an attorney from the local hospital, and the same from the diagnostic clinic across the street, and a representative from the district attorney's office. There was consideration given to inviting the professor who assigned students to the clinic to the inspection, but it was determined that there was no guarantee he wasn't part of anything illegal that might be going on.  Instead, his counterpart at another University of California was issued a subpoena and was picked up and transported to the site just before the inspection was to be undertaken, but was not told what the case involved. His role would be to act as an expert in terms of assisting to determine what should be searched once he was apprised as to the situation. (After the fact, he was well-compensated for his time, and he was picked up in a most inconspicuous matter, and his wife was given  a number to call so that his whereabouts could be explained.) Warrants to search the original professor's home and school offices were obtained. That would merely involve detectives removing computers and files from his offices with the names either of labs or of students who had been assigned by him to internships in the past three years - roughly one hundred students.

I was visited by the local police department and warned that I could be charged with obstruction of justice if I told anyone about this in advance, even though I had no specifics concerning time of the inspection. I was more than happy to comply, as being threatened with being charged with anything was more than enough to scare me out of what few wits I have left. This was after I had already blogged about my dad planning to show up at the place. Although I was afraid to do so,  I showed the officers my semi-anonymous blog concerning the matter. They had me temporarily remove it to draft, though  they said it was probably no big deal because that I had no idea it was a police matter when I posted the blog, so I was in no way at fault. When he learned of what I had been told, even though the officers had grown nicer toward the end of our interaction, my dad still had harsh words for the police chief concerning the officers' demeanor in speaking with of me. He said that I was a victim in this alleged mismanagement of the lab, and that, furthermore, I had previously been the victim of violent crime, and that their treatment of me was highly inappropriate. The officers showed up at my house again, (when I saw them at the door, I ran into my bathroom and hid), but they were only there to apologize for frightening me when I had done nothing wrong and they had no cause to believe I would do anything wrong with regard to the inspection.

The inspection, AKA "raid," began at 1:20 p.m on a Wednesday. It was determined that someone  else would likely have assumed the identical duties to which I had been assigned, so it made the most sense to conduct the raid on one of the same days of the week that I  had worked. The inspection was videotaped, and I got to watch the videotape after the fact. The building was cleared of everyone, including clerical workers, except for the eleven interns who were working at the time, who were told to remain exactly where they were told to be at the time and to stay there until someone from the investigating team had spoken to them about what it was they were assigned to do and were asked very specific questions. Some of the guys were pretty laid-back about it, although one got upset enough that he had to be allowed to visit the bathroom. The four females didn't handle it nearly so well. Most just cried or were visibly shaken, but one hyperventilated and fainted. My dad took care of her until paramedics arrived on the scene.  He immediately carried her away from the biohazardous waste she was cleaning with no  gloves or mask, as just breathing any fumes from the stuff would be dangerous, but inhaling it in the manner one would when hyperventilating would be much worse.

This operation was basically being treated like a heroin bust when all it was really about was untrained interns handling biohazardous waste in a manner that might jeopardize their well-being. To me, it was a classic case of overkill. Still, there were things I didn't know at the time about the lab operation. Had I hung around for three  weeks, I would have found that I, as an undergraduate student,  was making determinations as to whether or not patients had leukemia, e coli, or appendicitis without anyone properly qualified confirming my diagnoses double-checking my findings.  All sorts of patients are needing to be retested, and it's possible, even likely,  that a cause of death in a particular case was due to a ruptured appendix and the resulting peritonitis from a misdiagnosis by a third-week intern.. By the time a death was discovered to have been attributable to the mismanagement, the whole affair ended up being far more serious than anyone thought. Someone  -- not an intern -- will be brought up on negligent homicide charges.

The interns were reassured the investigation had nothing to do with them except to the extent that they were being asked to assume duties for which they were not qualified to assume even with on-site training, and to perform some of those duties without proper safety equipment.  They were still scared. Someone called for a crisis counselor, and good old Dr. Jeff and one of his cohorts showed up on the scene to attempt to help the interns understand that they were victims in the scheme, not people on whom anyone would attempt to place blame.  Except for the sick girl, they were all taken to a local pizza parlor with  a private room and fed whatever they wanted from the pizza parlor's menu while being reassured that nothing regarding the inspection was their fault and that nothing that happened as a result of a misdiagnosis on their part was their fault.  The interns who had reached week three were told that they were merely looking at slides under microscopes for their own benefit and training.
If one of them were told to look into a microscope and make a diagnosis, it wouldn't make any difference if he or she had erred, as they had been asked to do something for which they had not been properly trained, and had been assured that their findings were not being considered diagnoses. They were merely, as non-employees and volunteers who needed positive evaluations for their resumes, following directions by people they believed in good faith were following standard procedure.

The girl who hyperventilted spent the next two nights in the hospital. The pathogen of which she was disposing needed to be idetnified, and  herlugs treated for possible inhalation. my dad saw each day until she was reeased and said she was fine both physically and emotionally on the day she was released. She had been, quite understandiblt, terrified by the whole experience, but once everything calmed down, she received her precautionary treatment and was even able to assist in her tretment. my dad talked to her arnts over the phone. He said that he would send them the names and sumbers of several good lawyers, and to to worry about her hospital bill, as it would be sent directly to the lab's accounting department.

The way this and similar labs work is that both the hospital and the clinic run their own labs, but they cannot require patients to utilize their labs, If another lab offers the same procedure for less, the hospital has to allow the patient to choose. Furthermore, there are certain operations that hospital and clinic labs do not undertake on their own. The only obvious thing I can think of off the top of my head is kidney stone analysis, but I know there are many other lab-related services that hospitals, doctors' offices, the main diagnostic clinic here, and other smaller clinics don't handle. They rely on this la and other labs to take care of such diagnostics. In the future, it won't be THIS lab on which they'll be relying.

Any one intern who served any period of time at all with this particular clinic will be given credit for a full internship. In theory, that includes me. My dad told me I should do another internship anyway, because an internship in a lab is a valuable experience, and two days of unsafely clearing pathogens and cleaning restrooms did not give me the worthwhile experience that one should gain from an internship. He said that I should not list it on my medical school resume, but should list the time with no institution or experience attached but, rather,  with an asterisk, and then explain when asked in an interview. He said listing it might appear to be taking credit for two days worth of work and trying to pass it off as an extra internship, but not to list it at all might be considered equally disingenuous in terms of trying to disassociate myself from a highly unethical and dishonest organization, even though I'm way too far down on the food chain to be considered responsible for anything that went wrong.

My dad said he's going to advise those who did not complete the internship but who were given credit to complete at least another short internship. An internship is "recommended' but not required, but a serious candidate needs a lab internship on his or her resume. Which brings me to where I am right now.

I'm doing a weekend internship in a hospital lab up the road about thirty-five miles up the road from where I live,near my Uncle Steve's home and practice. I'll drive up either Friday night or Saturday morning, Spend seven hours a day in the lab on Saturdays and Sundays, when they're understaffed and needy. At first I'll be a gopher, but I'll gradually be trained in their lab's  technique , which is, I hope, not far different from the lab technique of most of my classes. As I progress, I'll actually prepare slides under supervision, and will look through the lenses of microscopes, at first after being told what for which to look, but later, to actually see if I can make an educated guess as to what it is I am seeing.

I'm now completing the first of my eight weekends. (I will be off on labor day weekend.). I went to work at six, and am off now until tomorrow at 6:00 a.m.  I will stay Saturday nights, as well as some Friday nights at Uncle Steve's house with his family. I still have a room there -- Uncle Steve's office that he hardly ever uses -- with a flat screen TV with cable and a Westin bed. It's not a bad place to be. I genuinely like my Uncle Steve, Aunt Heather, and their son and daughter. I haven't spent as much time with them since we all moved from northern California to the central coast of California,and I miss them. Before, they were only about two blocks away from our house, and now they're thirty miles or so up the road. I see Uncle Steve when I'm sick, and we see them for family gatherings, but before, if it wasn't every day, it was several times a week, and Aunt Heather usually took care of me if i was sick and my parents were working. They're two very important people in my history (I was only three when the two of them started dating) and it makes me sad to see them not so often. I'm glad for the opportunity to spend time with them on the weekend for the next eight weekends or so. I hope they feel the same way. 

Over Labor Day weekend, I'm going to stay with their children while Uncle Steve and Aunt Heather go to Santa Cruz, and I hope to provide free babysitting on several occasions while I'm staying with them so that they can go out for dinner or a movie or whatever.

I suppose all is well that ends well, but things didn't end well for the person whose white count was ridiculously miscalculated and who subsequently died of appendicitis, nor will it end well for the person or people deemed to have been responsible for his death.

#

P.S. It  doesn't appear that the professor who sent the students to the lab for their internships acted in any way in bad faith. He possibly should have inspected the place more carefully, but the lab personnel likely wouldn't have allowed him to see what was really going on inside there, anyway.