This is what happened up to now.  Yesterday morning, fairly early, I finally
managed to get through to my doctor's surgery.  Actually to speak on the
phone to one of the doctors is like getting an audience with the Pope so I
explained to the receptionist what my request was, i.e. that someone,
*anyone* for gawds sake, should finally get round to telling me, since the
surgeon's secretary said that my docs had been sent all his recent letters.
She then obviously brought up my records on the computer, because after she
said "bear with me a minute"  she was obviously reading things to herself,
you know how people do.  It goes a bit like this.  "Mmmm.  uh, uh, uh, uh,
mmm.    Uh, uh..."
I interrupted to ask if she could view the letters on the computer, and was
that what she was reading?  She said yes.  I asked her if she felt she could
share this information with me.  She said, no, she was not allowed to.
Aaargh, so she *is* allowed to read it but not tell ME!!

She said she would get a doctor to call me that morning.  I hardly dared go
to the bathroom in case I missed the call, but needless to say, I heard
nothing and the facility I have on my phone said no-one had called since a
call I could identify from a friend the day before.

This morning I began to get annoyed.  I am slow to anger as a rule, but to
know whether I might live or die is important to me.
I rang the surgery again, spoke to the same receptionist - she has a
distinctive voice.  She did not remember taking a call from me yesterday, so
I explained all over again that a doctor had not called me and the
circumstances.  She said that the doctor had acknowledged on her message
request that she had called me.  Not so.

I got a phone call from a doctor.  " Is this Christine?  (omg how I hate
being called that, only because it's not my name..)This is Dr T, how can I
help you?"
I asked her if she knew what it was about.  After all she had two messages
explainingly everything fully.
She then said  "No, why don't you tell me?"
I saw red at that point but hid it.  Explained everything again.  She said
"why don't you ring the hospital?"  I said I had done, and the consultant's
secretary said that my local surgery had all the information.  She said she
thought it would be a good idea if I rang them again.  I said not, and that
*you* have the information I need there, at that surgery, so please tell me
one way or the other because I feel I can't wait much longer.

Well, believe it or not, she said no, that ethically she would not consider
discussioning a diagnosis on the telephone and besides that, she did not
have the relevant information to hand!!!!  2 days notice of what I wanted
would seem enough time to me to gather all the info she needed.  She said
that she would  "find time to see me in the surgery to discuss it over the
next few days if I could make an appointment with the receptionist."  She
was unable to transfer me back to reception "because she was fairly new and
had the worst phone "and told me to ring in again.
Of course, it was engaged for hours.

I did get through eventually, spoke to the same receptionist again and
explained that Dr T had said I must come in to the surgery to find out.
"Next Monday?" was the innocent reply.  I said no, before that, it's
important.  She said "No, I can't fit you in until Monday."

My fuse finally blew, my very slow fuse.  I said why can't you find me an
appointment until Monday?  She said because all the doctors are busy until
then.

I remembered what you said  "give them hell."  So I said I was not happy
with this, and that I did not care who told me, but I wanted to know soon.
"Bear with me.."
"You can have an appointment with a clinical nurse at 11.20 tomorrow
morning."
I said that will do for me.

Tweed
BTW Jean Hobbs is having her op today, please purr your heads off.

In most cancer surgery, there are at least two phases of testing.  
Here's the problem: the pathologist has to make extremely thin slices of
tissue so light will come through them under the microscope. In
addition, they need to be stained, usually with a combination of dyes
that makes, for example, the nucleus one color and the cell wall another.

How could anyone possibly make that thin a slice, even of a piece of
ordinary meat, given that the tissue is soft?  They can't.  There are
two techniques that harden the tissue for slicing.

For specimens that need to be evaluated during surgery, they are frozen
(e.g., with liquid nitrogen or a more sophisticated chilling system),
and then sliced. Unfortunately, freezing can distort cells, and a frozen
section simply isn't as reliable as a "permanent" section, which I'll
discuss next.  Also, there is much less time to examine a surgical
specimen with all sorts of supplementary stains and test, while the
patient is on the operating table.

The more definitive tests are made by putting them in a stabilizing
preservative (typically formaldehyde, but others are used for
specialized tests), and then embedding the tissue in wax.  When I say
embedded, I mean that the wax gets between cells.

Unfortunately, wax is incompatible with the water that's in the cells,
even after the fixative was applied.  So, the specimen goes into
increasingly concentrated solutions of alcohol, which replace the water.
You can't just drop it into concentrated alcohol, or the cells would be
distorted.

When the tissue is fully soaked in alcohol, it then goes into wax, and
taken out to harden.  The hardened wax blocks are then split with a
cutting device called a microtome, which makes slices far thinner than
paper.  These slices are then transferred to microscope slides and
attached there -- a very delicate procedure.  

To stain the tissue, or to do other tests such as applying immunologic
tests, the alcohol has to come out and be replaced by water. The
step-by-step alcohol process now runs in reverse, until the slides come
out of dilute alcohol and into water. They are now ready for staining.
Some stains are immediate, while others have processing time.  Only
after the staining is complete can the pathologist evaluate them.

When I prepared slides like this by hand, the whole process could take a
week or more, mostly up and down the "alcohol ladder".  I haven't done
this for a while, and there now seem to be automated machines that are
much faster -- but still take 48 hours or more.

You can't be sure of the diagnosis until a pathologist has examined the
permanent slides. It may be appropriate to get additional opinions, or
to perform additional tests.  For example, in breast cancer, you do  
microscopic tests that will tell you if the tumor cells react to various
hormones.  If progestins accelerate their growth, for example, you
prescribe antiprogestins. If estrogens suppress them, you give
estrogens.  These are usually supplementary tests, where the cells have
a radioactive or fluorescent antibody (simplifying a little).  

So, realistically, it will take days or longer to get the final
pathology report. Once it's done, however, there is no excuse not to get
the results to the patient as soon as possible.