Why Did You Become a Hematologist?

Keith Stewart, MBChB, MBA
Carlson and Nelson Endowed Director, Center for Individualized Medicine, and Vasek and Anna Maria Polak Professor of Cancer Research, Mayo Clinic in Scottsdale, Arizona

I am truly curious as to why doctors in training choose a career in hematology, particularly malignant hematology.

My ASH Clinical News editorial colleague, David Steensma, MD, said he was hooked after witnessing the beauty of an eosinophil under a microscope as a first-year medical student. For me, it was my fascination at the seemingly endless number of color-coded intravenous lines (it was the 1980s, after all) that could be attached at one time to a single, conscious person. I hope I can attribute my decision to the thrill of working in a laminar flow room – and not to a fixation on alopecia.

When I was deciding which area of medicine to specialize in, I had to rule out intensive care because, contrary to popular opinion, I am not entirely the misanthrope I seem to be and actually do enjoy people. Well, I try to – at least once every other day and as long as they don’t ask me difficult questions or expect me to spend more than three minutes in conversation.

That’s probably also the reason I abandoned teaching responsibilities in 1994.

It is also important to remember that, when I was in training, heparin-induced thrombocytopenia and inferior vena cava filters were not a disease yet, so I never expected to actually have to deal with coagulation except for the occasional patient with acquired hemophilia who required cyclophosphamide. We didn’t even know then that we were infusing gigabytes of hepatitis C, so transfusion medicine didn’t resonate with me, either.

So, I knew hematology was for me, but what led me to specialize in malignant hematology? Pediatric hematology was quickly ruled out; I still rate my first night on call as a hematology trainee covering the Hospital for Sick Children among the most terrifying of my career – and that was before I met the children’s parents, or spent an evening watching the current Presidential primary debates.

Now that you know the reasoning behind my decision, I have, for your benefit and in the name of popular science, conducted an entirely non-scientific poll of past and present hematology trainees and Tau protein–replete colleagues selected at random to determine the 10 most popular reasons for joining the ranks of the International Society of Bloody Cytotoxics.

Here are the most popular reasons listed, in no particular order:

  1. I experienced a strange thrill after using the longest needles ever made.
  2. I believed palliative care was only appropriate after two transplants.
  3. I liked impressing people by saying “paroxysmal nocturnal hemoglobinuria” 10 times really fast.
  4. Hand cleanser gives me such a lovely, tingly feeling.
  5. I enjoyed irritating pathologists by leaving immersion oil on the scope.
  6. I thought MDA, DFCI, and MSKCC were all rap stars.
  7. I looked at my bank account and realized I couldn’t afford the designer wardrobe of an oncologist.
  8. I misspelled “hepatologist” on my fellowship application.
  9. I’m a movie buff and thought “amphoterrible” was a B-movie I hadn’t seen yet.
  10. “Blood doctor” sounded rather sporty.

So, what about you, dear readers? Are there any more reasons for selecting hematology as a career that you would add to this list? You can send me your novel – and printable – reasons on Twitter (@akeithstewart and @ASHClinicalNews). Only “sort-of-funny” or “vaguely rude to some other sub-specialty” submissions will be entertained for publication. Sappy submissions (e.g., “My cat died of feline leukemia.”) will be disregarded.

Questions on eligibility, insults, or petitions for my immediate removal from ASH membership can be sent to Remove.Stewart@HematologyForLife.edu. In the likely scenario that that inbox is full, you might also want to try ashclinicalnews@hematology.org.

The content of the Editor’s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated.

Have a comment about this editorial? Let us know what you think; we welcome your feedback. Email the editor at ACNEditor@hematology.org.