Gary (00:01)
Hi, it's Gary Stocker. Welcome to another podcast from Medical Laboratory Science 2030. We're doing a series of our interviews, and today we're doing one for the first time. We're doing an interview, a career interview with a cytologist. And I want to welcome Marisa Lea, who is a trained and experienced cytologist with the major medical center here in the United States. Marisa, welcome to the podcast.

Marissa Lee (00:24)
Bye!

Gary (00:26)
So, cytology, we're gonna talk about that in a minute, but just kind of give the audience a feel for how you got to where you are. Talk a little bit about high school, your college decisions, then we'll talk about cytology.

Marissa Lee (00:38)
So in high school, I was really interested in science and art. So I was trying to find a career that could somehow meld those two together. And I quite literally stumbled upon cytology. So it's a super visual field with lots of pretty colors, which goes with art. And it's a very science-based field for the science geeks out there.

Gary (01:05)
And what about colleges? What's the college process like for someone thinking about a career as a cytologist?

Marissa Lee (01:12)
For colleges, there's a lot of different options. There are certificate programs, there's bachelor programs, there's a big push to get to master's programs because most of the programs are going to master's, but it's a very science-based degree. And it's, anybody in any kind of science-based degree field understands.

There's a lot of science. There's lots of chemistry, biology, organic chemistry.

Gary (01:45)
And Marissa, tell us about your college experience.

Marissa Lee (01:47)
My college experience was phenomenal. I went to college in the Northeast at a college called Albany College of Pharmacy and Health Sciences, uh, with the medical director, General LeBlanc. She's amazing. And she just, that experience just really ignited a love of what I do and where I am and this profession, and it was a lot of fun and

It was very, I would say it was very informative and very structured and very, I don't want to say easy because it was difficult, but there was a lot of support, a lot of support from that college. I had gone to other colleges here and there to get different degree, not different degrees, to get different credits out of the way. Like I went to community college to get my chemistry credits out of the way.

I went to a different community college to get my English credits out of the way. Um, and they took all of that in stride and I just kind of bounced around until I found Albany College of Pharmacy and Health Sciences and it's stuck.

Gary (03:07)
Well, before we go any farther, there are a lot of listeners to the podcast that we do on medical laboratories that really won't know what cytology is or what a cytologist does. Can you take a couple of minutes to talk about both?

Marissa Lee (03:21)
So what cytology is, is the study of cells and the difference between cytology and a very common sister field, histology, is cytology views the cells outside of the normal architecture, whereas histology sees them kind of within their structures of their tissues, whereas we don't see that. They're just kind of free floating in space. So you're looking at all these different cells.

floating on a slide and trying to figure out whether or not they're cancerous or if they're infected, they have some kind of infection or if they're reactive or if they're normal. And then, cytology as a field is playing where's Waldo with cancer. It's finding the little ugly oddballs within a field of normalcy.

and trying to find where is it, how bad is it, and what can we do about it? Like, what, how can we identify it? Is this a lung carcinoma? Is this a skin cancer? Is this a pancreatic cancer? Is trying to figure out where it came from and where it's at and how that affects the patient.

Gary (04:47)
And I know that this podcast is listened to by a lot of folks in college, in their upper-class years or junior, senior years. And Marissa, what about a college student today listening to this who's a junior, senior, maybe even a sophomore in college, and they're getting that BS in biology or chemistry or microbiology or something. Is a cytology career possibly a good fit for them once they get that bachelor's degree completed?

Marissa Lee (05:11)
Oh yes, definitely. It has a lot of job stability, has a lot of job opportunities. It's a Monday through Friday, nine to five job with major week, major holidays and weekends off. And it's just a phenomenal career and you can move pretty much anywhere from in the hospital from it.

I could like, for instance, I could move up and go corporate within the laboratory. I could, I could pivot and maybe go over and be a pathology assistant or a histotech mission or a histotech. Um, and.

Gary (05:52)
So you're saying there's a lot of career flexibility in cytology.

Marissa Lee (05:54)
There's so much career flexibility there's and then there's also good pay with great benefits and there's lots of options so like what I do I'm running around all day and I really enjoy that but for people who might not want to run around all day there's options where you can just sit in a lob and screen you all day. There's so much flexibility it's absolutely crazy.

Gary (06:19)
and you use the word screen. Can you describe to the listeners what you mean when you say you screen all day?

Marissa Lee (06:25)
to screen is to look at these slides and try to find the cancers or the infections in them and figure out whether or not they are negative, meaning they are benign, there's nothing there, or if they are atypical, meaning hey there's something a little wonky, or if they're suspicious, which is this might be malignant and something that is positive, which is malignant, and it's trying to figure out what that

particular case is that would be screening is trying to find out where this case falls. Is it negative? Is it positive? Does it have an infection? So there's

Gary (07:06)
And of course, I'm sorry. And of course a pathologist is the medical leader of a laboratory and that's kind of a generic term. How does a cytologist interact with a pathologist in a hospital laboratory?

Marissa Lee (07:12)
Yes.

In my hospital laboratory, we interact in a way in which we will do the primary screening on most of the cases, if not all of them. And then on certain cases such as pap smears, if it's negative, they won't see it. But if there's any kind of reactivity, any kind of infection, any kind of cancer,

any other specimen that is not a negative pap smear, they will see it. And so we work very closely together. And if I go out on a fine needle aspiration, I'm on the phone with them and they're screening with me to give a rapid on-site evaluation, which is something called a ROSE. So we can give a patient a preliminary diagnosis within 15 minutes if need be.

So if you're coming from far away and you don't want to have to make the drive back in two weeks, we can give you that diagnosis right then and there. So we work very closely together and they give us a lot of feedback about how we're doing and what we can improve on. And hey, I noticed you over called this. Can you explain it to me? Because there's been instances where I've convinced pathologists, hey, this is, this isn't right.

Gary (08:25)
Interesting.

Marissa Lee (08:43)
This is, this is weird. We need to look into this. And there's been instances where they've said, no, Marissa, you're wrong. Here's what we see. So you work very closely with the pathologists.

Gary (08:56)
So I'm gonna go back, we've talked now about cytology to give our listeners kind of a better handle on what that is. I'm gonna go back to the education piece. Cause again, most of the listeners for this podcast and the other MLS2030.com podcasts and videos that I put out there are helping folks decide if a medical laboratory or in this case, cytology career is for them. And let's go back to the high school days. And I don't need to know what high school it was, but can you think back?

Marisa, to your high school days, and whatever science courses you took back in high school, have they been valuable as you developed your education and career in cytology?

Marissa Lee (09:34)
So from high school, I hated chemistry. I still hate chemistry. And I would say that is probably the least useful science course that I took. I will say with all basic science courses, there is some value, such as molarity, dilution, you know, those kinds of things. But electron fields?

No, forget about it. That was probably the weirdest and most useless information I could have learned science wise for this field. But

Gary (10:15)
And then you mentioned the courses that you took. Let's go to college now. And the science and even the math courses you took in college, have they helped you prepare and be a better cytologist?

Marissa Lee (10:27)
Yes, the courses that I took in college definitely were more foundational and were much more helpful in understanding how certain chemicals work and how they are structured and how certain cells work and certain aspects of the cell work. They were just much more in depth and much more educational than, sadly, my high school experience.

Gary (10:58)
So in a word, you're saying fight your way through the high school classes, the real good stuff is in college. Yeah, and I know.

Marissa Lee (11:02)
Yeah, there's value in high school education. It sets a very good foundational basis. And but you kind of get a taste of what kind of science you like. I knew after my first year in chemistry, I was like, I don't want to go into anything chemistry based. And go ahead.

Gary (11:21)
And then, excuse me, of course, I'm a medical laboratory scientist by training, a really old medical laboratory scientist, and we had internships. And again, I'm still focused on the education piece. Is there a cytology internship? And if so, what was that experience like for you?

Marissa Lee (11:39)
there was a cytology internship and it ran from, I wanna say July, very beginning of July, like July 1st until right before Thanksgiving. So it's about five months, if I'm doing my math correctly and probably not. And it was so helpful. You get so much hands-on training, you develop so many skills.

and so much experience. And there's such a big difference from going from learning about cytology and practicing it in a educational setting to. Practicing it in a real life setting and working with cytologists that have already passed their boards. And there's, there's a huge informational gap. There's a big difference between learning about something and actually doing it.

because it doesn't work, it doesn't always work the way you think it should or you think it might. So as an example, when I was in college, we were taught that like the pathologists would come with you to do FNAs or these fine needle aspirations with the roses where you give that preliminary diagnosis. And when I got to where I'm at now, they use telepathology, meaning there's a camera,

phone call that occurs and the pathologists don't leave their office. So, and I had learned about that in college. It just, I had no idea how it worked or the methods of which it worked and what happened. So it's just very, it's very, it's like seeing it online and then seeing it in person. It's two completely different things. They're both amazing, but it's just two different things.

Gary (13:32)
Interesting. And I wanna go back to your first day. And I worked nights right out of college many years ago. And I can still vaguely recall the fear maybe, challenges maybe of working in that first medical, my first medical laboratory, those first few weeks and months. What was it like for you? You finished the education, you've got the certification, you're sitting down and working in a real cytology department in a real hospital laboratory.

and yours is at the forefront of cancer diagnosis and cancer cures, what was it like in those first few weeks and months?

Marissa Lee (14:08)
terrifying and exciting because I got to work with some of the best cytotechs in the field and I got to work with some awesome cytopathologists and I got to see patients for the first time. So it was terrifying knowing my diagnosis is going to be affecting them possibly for the rest of their lives.

But it was also exciting knowing I finally get to step into this field that I've been studying for the last two, three years and get to make these changes and be a part of the team that helps people hopefully get better. So it was simultaneously terrifying and exciting. So kind of like a roller coaster.

Gary (14:52)
Hahaha

And then again, using the analogies for medical laboratory and the amount of automation in the medical laboratory these days is stunning. And when I do tours of medical laboratories for potential students.

It's amazing for them in lots of ways. And is there much automation in cytology?

Marissa Lee (15:17)
There is some automation. So most of the automation comes from big companies like Hologic, who have the imaging microscopes or imaging fields. And those essentially only apply to pap smears. Anything outside of pap smears, there is imaging technology that may be not very good. And I only say not very good because we don't use it here. So I don't.

I cannot speak on it, I think is a better way of saying that.

Gary (15:48)
Okay.

Marissa Lee (15:54)
But imaging, like the imaging fields are, you see those much more in private laboratories. Like we do everything by hand here and we have a massive volume for a hospital. So there's some automation, but not as much as one might think.

Gary (16:11)
All right.

Okay, interesting, because I'm not familiar with the cytology automation at all. So, Marissa, I want you to think back to your life before you even knew what cytology was. And I want you to think of someone in your position today, a high schooler, junior, senior, college, maybe junior, senior. Think back and from the perspective when you were much younger, or younger period, to where you are now, give these folks some guidance.

They're thinking about a healthcare career, maybe it's in the laboratory, maybe not, but give them some guidance that would help them understand whether cytology is something they should look at or not.

Marissa Lee (16:55)
So, wow, that's a phenomenal question. Play to your strengths. Find out what you're good at and find a field that will encapsulate what you're good at. For me, I am a very visual but very analytical person. So being in a field that is qualitative rather than quantitative.

was important to me. And finding a field that encompassed both science and a visual aspect was important to me. And anybody that is very visual or really enjoys microscopy, microscope work, would enjoy cytology. But there are other options for other people who might have different strengths. And I will guarantee you there's a field out there with your strengths in it.

the medical field is much bigger than you are led to believe.

Gary (17:58)
Amen to that. Amen to that. And I want to wrap up with a best and worst question. And thinking back on your experiences, both education and your professional career now, what do you think is the best part of working in a cytology laboratory in 2024?

Marissa Lee (18:04)
Oh.

The best part about working in a psychology laboratory in 2024 is definitely being able to come out of a procedure in which there's a patient who has a big concern for some kind of recurrence and you get to come out and tell their team, like their medical team, that's cheering for them that their biopsies came back negative.

and watching the entire team just light up and celebrate for that patient. That is the best part of this job.

Gary (18:55)
And of course, I'm going to follow up with the worst part. I might be able to guess what that is, but share with us, what's the worst part of working in a psychology? The worst part is the other, the opposite of what you just shared about the best part.

Marissa Lee (19:01)
What do you think the worst part is?

Well, you're not wrong, but I would say the worst part is, is the kids is when I have to tell a team for a child that this is probably malignant or any young person.

So.

Gary (19:26)
Well, interesting. And then one last question, and you did a nice job of play to your strengths a minute ago, but say I'm a college senior and I'm about to finish my Bachelor of Science in a science discipline. What's the one piece of a dice, in addition to play to your strengths, you would give me about thinking about cytology as a career?

Marissa Lee (19:47)
Find a good program that has a well-respected teacher. Because you can get into programs that have bad teachers and you can get into programs that have amazing teachers and that will make or break your entire experience learning.

Gary (19:54)
Beautiful.

Interesting, interesting. Well, that concludes this podcast. We've been speaking with Marissa Lee, who's a cytologist at a major medical center here in the Midwest. We've been talking about cytology, and it is one of the many hidden careers in the medical laboratory. And we'll continue to have interviews with maybe Marissa, some more cytologists across the country, certainly with some more medical laboratory scientists in the coming weeks and months. Marissa, we thank you for your time. We wish you the best in your career.

Marissa Lee (20:32)
Thank you.

Gary (20:34)
And this is Gary Sokker with Medical Laboratory Science 2030.com. We'll talk next time.