Peering down the binoculars of an Olympus microscope, and setting the stage for yet another Giemsa-stained slide, you may have wondered, "Do I have what it takes to be a successful haematologist... someday? Or will I just rust behind this microscope till my eyesight begins to blur?".This article attempts to reveal what it takes to become one.

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If the sight of blood makes you squeamish, haematology probably isn’t the career for you. Haematology is all about blood, but not in a creepy horror movie kind of way. Haematologists aren’t vampires (at least we don’t think so); rather they are highly skilled specialists in their field.

Haematologists usually work in specialist departments of hospitals carrying out tests on blood samples and analyzing results to find solutions to your health-related problems. It’s a bit like detective work; they look at the shape, size, function and number of blood cells to help diagnose illnesses.

As a resident doctor in a haematology lab we are mostly involved in interpreting a full blood count. Menial as this may seem after some time, this is the Indeed, the first step in the direction to take for a deeper general view of the specialty at large, as it allows a good visual to cling on to when dealing with a haematological puzzle. It is a back to the basics for everyone when viewing slides- like a trip back in time, right back to the stem cell. In this task, the core skills of the chapter come to the fore: in response to an anaemia, we should be able to explore the possibilities of iron deficiency, vitamin deficiency, and hemolysis. On seeing a thrombocytopenia or abnormal clotting profile, we should be able to make a clinical assessment and perform further appropriate tests with a view to suggesting differential diagnoses. Abnormal white blood cells, or their precursors may trigger a request for a bone marrow aspirate. Diagnosis in these areas is performed by doctors at senior levels via means such as bone marrow aspiration and cytogenetics, and after consultation with other experienced colleagues. Going solo may not be a good idea. There is a lot more to haematology, however, than a blood count.

Haematologists aren’t just involved in the diagnostic process; they are also involved in the treatment and care of patients with diseases of the blood cells and bone marrow. That means that they aren’t just confined to the laboratory, but also treat certain patients one-on-one and work with doctors and nurses. As a junior doctor, there will be regular practical challenges such as prescribing and altering anticoagulation therapy, overseeing the safe delivery of a blood transfusion and managing acute situations such as aplastic crises. The way forward is to be able to master these basics and start to see the bigger picture. This means developing a feel for the more subtle symptoms and signs of haematological disease and becoming proactive in the face of abnormal blood results.

That's what makes haematology so challenging and alluring. I'd have hated being pinned down in some lab behind a microscope, dishing out remarks on smear slides, if it hadn't been for the clinical part of it all. This literally makes haematology come alive and makes me feel like the doctor I am, rather than some medical technicians.
No offense really, but then in this part of the world people are so gullible, they'll believe anyone in white coat is a doctor!

Microscopy can be pretty boring, tiring and exhausting at times. But once you develop the right reflexes, it is like driving a car. The make defines the cruise. And you can do it while chatting with friends or over a cup of coffee; both of which are generally not encouraged though. There is always the element of surprise, which in my view makes it more like fishing. You can let your mind ramble but you have to be on the look-out for that one suspicious cell that could change the diagnosis and henceforth the lives of both the patient and the pathologist concerned.

It's true that a microscope is a pathologist's true friend, but it is always the mind behind the lens that is priceless. The image is God's art-work.

The writer is a Haematologist, Mom of three, blogger @ haemcon.blogspot.com and freelance writer.
Image credits @Twitter: Pushing Glass, MD
Ok, I'm not photogenic, but my microscope wanted to get involved.