There’s an old saying that goes like this: if you understand it, it’s obsolete. Sadly, in this day and age of rapidly advancing technology, this saying is truer than ever. I say “sadly” because what this means for us in the laboratory is that we are becoming less and less likely to be able to troubleshoot and repair our own instruments. This is another thing I sometimes miss about bygone laboratory medicine. Taking instruments apart used to be fun.
Many instruments now are considered “black boxes” by clinical laboratory scientists. They may not understand the principles behind how the instrument works, and even if they do know, they are not inclined or encouraged to attempt to fix it if it stops working. In the early days of laboratory medicine, we could repair most of the instruments we used in the laboratory. Now we can repair almost none of them. Instruments have become so sophisticated, with so many bells, whistles and extras, that even if you know the basics of how the instrument works, being able to fix it when it goes down is no longer a possibility.
For example, most big main chemistry analyzers work on the basis of two principles: some type of photometry and ion-selective electrodes (ISE). Knowing that information used to make it possible to troubleshoot and do some repairs on the photometer system, as well as replace ISEs. Troubleshooting and repair was a matter of checking the functioning of your optics and cleaning as necessary, replacing tubing and replacing electrodes and fluids for the ISE part. Medical technologists were much more likely to repair systems themselves than to call Service in. That ability is rapidly becoming a lost art however.
Modern instruments are much more than a photometer and a set of ISEs. The sheer volume of working parts in current instrumentation is orders of magnitude higher than in old instruments, and most of those parts are robotics in the instrument rather than analytical components. With more sophistication and technical abilities though, come more things that can go wrong. And these are things that cannot be fixed by the clinical laboratory scientist working the instrument.
Of course, for every lost ability is a gained ability. While local troubleshooting may not be possible, many of these major instruments are now connected to the internet. Troubleshooting can be done remotely by the people who do have the knowledge to service them. Honestly, I probably do not want to return to the days of fixing my own instruments in the case of the big chemistry analyzers, but I still do enjoy troubleshooting my mass spectrometers. And it was nice to know I could fix things.
-Patti Jones PhD, DABCC, FACB, is the Clinical Director of the Chemistry and Metabolic Disease Laboratories at Children’s Medical Center in Dallas, TX and a Professor of Pathology at University of Texas Southwestern Medical Center in Dallas.