In this edition, Uwe Platzbecker, MD, shares his long and winding path to hematology – from a stint in the East German army, to a period as a heart surgeon, and finally to the last 20 years as a hematologist specializing in myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) research.
Dr. Platzbecker is professor of Translational Hematology in the Department of Internal Medicine I and head of the Section of Hematology at the University Hospital Carl Gustav Carus in Dresden, Germany, where he also serves as chair of the medical ethics committee at the teaching university. He is co-founder and chairman of the European MDS Studies Coordination Office (EMSCO) and co-chairman of the European Hematology Association’s Scientific Working Group on MDS.
We have spoken with hematologists who took alternative paths to their eventual careers, but yours is quite unusual. Can you tell us how you came to pursue a career in medicine?
I was born in East Germany, the former German Democratic Republic, which was a communist state. Obviously, my life then was very different than what it is now for my children. While there were many opportunities for work, they were all linked to the communist system. For example, if one wanted to become a lawyer, it meant studying within the structure of Communist law and the East German constitution, or becoming a journalist meant writing within the heavily censored, Communist-controlled media. These jobs existed, but the entire system in which we worked was wholly different from how we work now.
Medicine, though, offered independence from the Communist system and, thus, was something many of my classmates were interested in pursuing. It also offered the likelihood that you might be able to travel – at least once in your life – to West Germany for a congress or professional meeting. This was extremely appealing because, as many readers probably know, travel between the two Germanys was severely restricted until the German reunification in 1989.
To study medicine, though, one had to make certain compromises. This was a job that many, many people wanted and there were more applicants than openings in the universities.
The first prerequisite, of course, was to excel at school – which I did. But this was not enough – many people were good at school. At the time, if you wanted to study medicine, law, or another popular subject, the arrangement was that you had to spend three years in military service. In a sense, the East German government said, “Well, if you want something from us, you need to give us something back.”
The typical length of duty was only 18 months, but I offered to serve in the army for three years so that I could study medicine three years after I finished high school.
In 1989, two years into my military service, the revolution in East Germany took place, the Berlin Wall came down, and Germany was unified. So, my time in the army was cut short, but I wasn’t too disappointed.
What was the next step after leaving the army? Did you go to medical school?
I was finally out of the army, but there were no openings. So, I had to find something to do while I waited for an opportunity.
My first job was as a nursing assistant (something between an orderly and a nurse’s assistant), and I worked for almost a year in an orthopedic hospital.
Again, I knew I wanted to study medicine, so I chose to work in a hospital to get some real-world experience. I was basically an untrained guy who went wherever I was needed: I helped patients bathe, assisted nurses in administering injections, and everything in between.
I did that for nine months before I was able to start my medical training. I went to medical school for six years, and spent the last year of my internship in Johannesburg, South Africa. After completing the internship, I trained as a cardiac surgeon.
Yes, it was an unexpected move, but, again, I went where the opportunities were. When I completed my internship, there were no available positions in hematology/oncology. I wanted to do something innovative and exciting – in other words, not a boring type of medicine. So, I chose heart surgery.
I did quite well there, and it gave me the opportunity to complete my education, which I was grateful for because I knew I wanted to try something else in the future. So, I applied again for hematology/oncology positions, and again, with so many doctors vying for limited spots, there were no jobs available. That time, though, I resigned from my job in heart surgery. I had to wait four more months before I could find a position in hematology/oncology.
And, after that stint, did you finally settle into hematology?
Well, I had a few months of unemployment, so I occupied my time by training in abdominal ultrasound. I worked in a radiology practice for three months.
Then, finally, I joined the hematology/oncology department at the University of Dresden, where I have been since 1998 – with only a short two-year break when I completed a postdoctoral fellowship at the Fred Hutchinson Cancer Research Center in Seattle, Washington. Now, I conduct research in MDS and AML, with plenty of trans-Atlantic and trans-European collaborations.
Did you ever consider going into a field other than medicine?
I suppose it was in my genes to study medicine. My parents were also doctors, so for as long as I can remember, I wanted to be in medicine. Back then, it might not have seemed like a completely voluntary decision – and I probably took that push from my parents for granted – but, 45 years later, I can say confidently that it was a good choice.
What kept drawing you back to hematology?
My internal medicine training in Austria and my exposure to hematology/oncology during that training triggered my desire to eventually focus in malignant hematology. I loved what I did there – the contact with the patients, the opportunities to improve their lives, and the complexity of the hematologic diseases.
I also liked that hematology seemed to be an intellectual field. Surgery is as well, of course, but it’s also physical. From the outside, hematology appeared more concerned with understanding the disease and translating those insights into better treatments – which attracted me instantly.
And, of course, the patient interaction is much different in hematology than in heart surgery. Hematology offered intimate contact with patients. I’m a very social person, so I enjoy taking care of patients, helping them, and learning about their lives while I’m trying to get rid of their cancer. In most cases, their disease is not acquired – patients don’t develop cancer because they smoke or are exposed to too many toxins. It develops naturally and unexpectedly, and it can devastate them emotionally. I wanted to be a part of fixing that.
In your position now, what is your rose and what is your thorn?
Each day is different, but the best part is always the time spent sitting with my team to catch up on ongoing projects and make plans for the future. Our conversations can generate crazy ideas; it’s wonderful to see them go from wishful thinking, to grant proposal, to fully funded project. And then the absolute greatest feeling is when we can offer patients an exploratory treatment and see them benefit from it.
If I’m being honest, the worst part of the days is handling the bureaucratic issues involved with clinical research. There are endless forms that need to be signed and constant interactions with the contract research associates that can get in the way of actually conducting research. Our health-care system in Germany is different than the United States, but I think this is a problem that we all have in common.
“The absolute greatest feeling is when we can offer patients an exploratory treatment and see them benefit from it.”
What career advice do you give to early-career hematologists/oncologists?
From the beginning, focus. If you want to be good at something or considered an expert in a particular field, you need to singularly focus on that. Don’t expect yourself to become an expert without dedicating time and effort to it. To truly excel at something requires extra engagement and initiative.
When you have time outside of work, what do you like to do?
I like to travel with my wife and children. We try to discover new places each year, but our favorite place we keep returning to is Paris.
I also play bass guitar in my spare time. It’s not completely outside of work, because I play in a band with other clinicians and researchers from the University of Dresden.
Is that yet another career you might consider in the future?
Not yet – before meeting them, I was never much of a musician, so I taught myself how to play in the last few years. I don’t think I’m quite good enough to consider a career switch, so I’ll leave that to the professionals.