An illuminating episode

Doctor A asks doctor B to carry out some immunohistochemistry tests for a patient that he is treating. Doctor B is a world famous researcher and scientist. He is the director of the pathology department in one of the most important universities in the world.

After having agreed on which tests to carry out, A, without consulting with B, decides to add another test to the request he is sending together with the slides. He does this because he has some spare slides and thinks that, maybe, this other exam, ERCC1, could be useful to understand the drug dosage to administer within the chemotherapeutic regime that he has in mind. When B receives the slides with the tests request which includes the ERCC1 test, he writes this email to A.

 

Dear A,

We have decided against doing IHC for ERCC1 since recent data showed that available antibody does not distinguish between the ERCC1 isoforms. We will be happy to do IHC when antibodies specific to ERCC1-202 become commercially available. I hope you agree. I can email you relevant literature, if you like.

Warm regards,

B

 

As soon as A has read the email, he examines the available scientific literature about ERCC1. This is not hard in the Internet age, especially if one is used to studying and conducting (independent) research.  He discovers that, in recent times, evidence suggests that B is right. He immediately replies with his apologies.

 

Dear B,

thank you very much for the information. I went to see the literature about ERCC1 protein isomorfs and I can only agree with you. By using antibodies available today, the test would have limited usefulness, even in a case like this, where the decision relates only the Dose Intensity of cisplatin in combination regimen.

I apologize for having added ERCC1 in the request without first consulting with you.

Thanks again

Warm greetings

A

 

The answer of B reveals the attitude of a doctor who has rejected the old paradigm of possessing knowledge and considers his professional expertise as something fluid and dynamic. 

 

 

Dear A,

 

Please, you do not need to apologize for anything. I am always amazed of how little I know; it is so hard to keep track of all the new literature.

Warm regards

B