It was such a beautiful day, I decided to go out and make the next phone call from the closest patch of grass, which happened to be situated in The Octagon. I plonked myself on the steps in front of the statue of Robbie Burns, which today was artfully adorned with some unfortunately placed bird poo. I wondered if the Scottish Bard ever imagined his likeness would be prominently positioned in a city on the other side of the world to be admired by tourists and pigeons alike. He’d written ‘To a mouse’, and ‘To a louse’, so perhaps his sense of humour would extend to a poetic ode to the indiscriminate bowel habits of birds.
Before I worked up the gumption to make the call I enjoyed watching humanity walk by. People-watching was one of my favourite sports. Dunedin seemed to bring out some superb fringe specimens. The advantages of living in a city that wasn’t too up itself.
I was getting heartily sick of being a desk and phone jockey and was really missing being out in the field. I felt highly envious of Paul, Smithy and the crew out interviewing people in person, visiting sites and following up on leads. I had a cunning plan that would hopefully get me doing something a bit more interesting than exercising my fingers on a keyboard and my eardrums on a phone, but still at the low-risk end of the spectrum to keep the cotton-wool brigade happy.
‘Michael speaking.’
‘Hi, Michael, it’s Detective Sam Shephard here.’
‘Oh, hi, Detective. Naomi said I might get a call from you.’ Great. At least I didn’t have to explain from scratch, which made life easier. It wasn’t so much of a cold call, but a luke-warm one. ‘She said you were researching lab testing and amniocentesis.’
‘Yes, if that’s something you can help me with.’
‘Hopefully I can help a bit. My work at the lab is fairly generalist, but fire away, what were you wanting to know?’
‘I think for starters just a basic run-down of the procedures you use to process the samples. Is it okay just to talk about this over the phone? Or I can come down to the lab and talk with you there if that works better, see how it’s done?’
My fingers were crossed in the hope he’d give the desired answer and invite me down to the lab. I loved looking in labs.
‘The phone is fine, I can describe everything. For security reasons and sterility reasons, we’re not allowed to have any unauthorised people visit the lab, other than med students and people in training, so unless it was extraordinarily important I can’t accommodate you there.’
Damn, that’s where my cunning plan fell down. I felt ridiculously crushed at not getting the chance to go in person. But I supposed it was worth a crack.
‘That’s okay, and understandable. It’s just a general enquiry really,’ I said. ‘Phone it is, then.’ Hopefully my disappointment didn’t show in my voice. ‘So what happens with the samples once they get to you?’
‘Let’s take a little step further back from that. The samples are collected at the hospital – they’re clearly labelled at the time of the procedure with barcodes and identify the donor with their name, date of birth and NHI number. As you can imagine, getting the samples mixed up with anyone else’s would be an utter disaster, so the chain of identification is very careful.’ I imagined there would be serious consequences, far beyond the embarrassment of stuffing that up, if samples were accidentally swapped. People were making some serious and life-changing decisions based on that information. I shuddered even thinking about it. ‘We have our own courier who picks them up, so that is all very secure.’
‘So you don’t reply on a commercial company?’ My own experiences with so-called same-day or even overnight delivery hadn’t been too flash. And the fact you paid more for the super-service that failed to deliver always grated.
‘God, no. When samples can be temperature sensitive, they can’t guarantee delivery within the time frames we need.’ I guessed pre-cooked specimens weren’t a good thing.
‘So what happens when you receive the samples?’
‘When they come to us we process them by first separating out the baby’s cells from the amniotic fluid and then undertake the testing from there. There are specific proteins that can be found that indicate some of the chromosomal disorders. We undertake DNA analysis, and do a broad sweep of tests in addition to any specific tests the physician may have requested if there is a family history.’
Like in the Newman case. It sparked a vague thought in my mind, but one I couldn’t quite put into words, so I went for the simple.
‘And how long does it take for results to get back to people?’
‘Some things are quite quick, a matter of days, but some of the more complex analysis, where we are growing cultures of cells, can take up to a couple of weeks.’
‘So you’d report those as they come, or wait until they were all ready and notify in one hit?’
‘Oh, definitely as they come. As you can imagine, people can be really anxious about the tests and what they might mean for them, so as soon as they are verified, we pass them on.’
‘So who do they go to?’ I was guessing it wasn’t straight to the patients.
‘They are sent directly to the obstetrician, who then contacts the family and any other medical providers involved in their care. They get the job of explaining the results, and then, if they are not great news, talk about the options available, that kind of thing.’’
‘I wouldn’t envy them that task.’
‘Me neither. I’m happy doing the invisible bit behind the scenes.’
And with that I finally pinned down the thought that had been skittering around the edges of my consciousness.
‘So in terms of the information you get from the testing, who has access to it? Obviously the obstetrician and whoever they pass it on to.’
‘Well, yes and whoever can access their computer records there, I suppose.’
‘What about with your systems at the lab?’
‘Here?’ He paused for a bit. ‘The person who actually does the testing and enters the results, and the person who verifies the results for anything that was complex, or who does quality-control testing, which is a continuing process. I guess most people here have access to results. But we have to sign confidentiality agreements as part of our employment contract.’
‘What happens in the lab stays in the lab?’
‘Haha, yes indeed.’