Each clip=one prostate cancer case.

A small cylindrical plastic container sits on the desk behind me. I am not sure what it originally contained but now it is filled with paper clips. A quick glance tells me it must have a couple of hundred clips inside it, and every day I add a few more. I empty the receptacle a few times a year, but in the meantime, each clip tells me that someone’s life has been changed.

How is that so?

Medicine is more and more digital these days. You complain to your friends about how your internist spends more time typing into their laptop than they do talking to you. Your prescriptions go out to the pharmacy electronically, and reminders about your next appointment zip to your cellphone, instead of coming on a little postcard in the mail.

Here in the lab, we are digital too…but we still use a lot of paper. While most of the blood tests we do are managed without anything written down (each analyzer “talks” directly to the interface that sends results to our docs), we handle our biopsies quite differently.

Our Laboratory Information System (fancy name for lab computer) contains all the necessary information about patient age, and gender, and the site from which a bladder or prostate biopsy has been taken. But when I am looking at cases from 15 or 20 different patients, it really helps to have this data printed out. Also, I like to create paper worksheets for my prostate cases on which I can mark my findings for each of the dozen or so cores from each patient.

When my final diagnosis for the case is benign prostate, I can enter my findings from the worksheet directly into the LIS myself with a few keystrokes, and then add my electronic signature. No extra trees need to be cut for those cases.

But for patients in whom I find cancer, I turn my completed worksheet over to our administrative team. They keyboard the complex findings into the LIS and then print a copy of exactly how my report will appear to the clinicians.

When those printed cancer case reports come back to me, I review the information, correct the rare typos, have one of my colleagues concur on the malignant diagnosis, and affix my electronic signature in the LIS. The report can fly off to one of our urologists through an electronic labyrinth.

But because I need to select the appropriate charge to the patient for the laboratory and pathologist services, the reports are paper clipped to a billing slip. When I separate the report from the billing slip I toss the paper clip into the little container behind me. The container fills, each added clip representing another person given the diagnosis they were dreading and hoping to avoid.

Making those diagnoses is a pretty awesome burden and at times a humbling experience. I just hope that I can be as consistent as a bucket-full of paper clips; doing my job, holding it together, and remembering that there are people whose lives may be altered by every one of those diagnoses. They all deserve the best that I can be.

The above is the opinion of the author and not UroPartners LLC.

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