Knives and forks
The cutting desk is where specimens are exposed and manipulated. In academic centers, gross dissection is carried out by pathology residents at various levels of training, perhaps accompanied by pathology assistants (PAs), a relatively new breed of worker that has emerged in recent years [See “THE QUEST ” - Fault Lines in the Ecology - Pathology Assistants]. The operation of the gross room occurs under the supervision (direct and indirect) of pathologists. This means that not every gross specimen is necessarily seen by the pathologist, who might be called in by the resident or PA to examine only selected cases.
To spend one’s day examining and dissecting numerous specimens (many of which are bulky, requiring intense concentration and tedious, repetitive maneuvers), is exhausting. This work truly belongs to the pathologist who, as a result of changing circumstances, has largely ceded the process of dissection to pathology assistants who, although now indispensable, cannot be expected to have the scope of medical understanding or authority possessed by physicians.
The level of responsibility in the gross room is high because it is here that the first macroscopic observations must be made. Everything that needs to be seen must be seen, and if the prosector fails to notice something unusual, the abnormality will not be selected for paraffin embedding and will not appear on the slides given to the pathologist. Further, once a large specimen has been taken apart, it may be impossible to accurately reconstruct the scene, adding to the importance of careful initial dissection. Beyond the failure to record accurate observations, mistakes apt to occur in this area are miscellaneous and emerge from the same human proclivities for error that apply elsewhere.