The layman generally regards blood simply as just a red fluid. In fact, however, this bodily fluid is an extremely complex mixture of fluid and solid components. Via the veins, blood is transported into every organ and every tissue, it supplies the body cells with nutriment and transports pollutants away. Because of these outstanding properties, one could therefore regard blood absolutely as fluid tissue, which naturally - like any other organ - can become diseased.
Particular examples of benign blood diseases is a lack of blood platelets or white blood corpuscles and the various types of anemia - Wilson's disease or hemochromatosis. The former is better known as an accumulation of copper in the body and the latter as iron deficiency. Delayed blood coagulation may have physical causes which would need to be identified. As for the malignant diseases, hematologists identify acute and chronic cancer conditions (leukemia), plus myelodysplastic syndrome, malignant lymphoma, multiple myeloma and various forms of myeloproliferative diseases.
The key elements of diagnosis in hematology are, apart from a detailed examination of the blood count, ultrasound examinations and, where applicable, puncture of the bone marrow. However, the approach differs according to where the specialist works. For example, a registered specialist treating patients in his own surgery only carries out part of the diagnosis himself. For detailed examinations, he will then refer his patients to a hospital where the patients that hematologists treat include severely ill patients on an intensive care ward. As soon as the patient's in-patient stay has finished, the registered hematologist will continue the treatment himself.
It is essential to examine the blood because the hematologist can already recognize diseases by the composition of the blood and may even be able to estimate how far advanced the disease already is. Through the ultrasound examination, those organs which have a direct connection with the blood, for example the spleen, can be scrutinized more precisely. During the bone marrow examination, bone marrow is taken from the patient, dyed and then examined microscopically. The reason: changes in the bone marrow can also have an impact on the blood and its health.
Particularly in the case of malignant blood diseases, it is important for the hematologist to choose a therapeutic concept which is ideally suited to the individual patient. The classic forms of therapy for cancer conditions include chemotherapy, though this comes with significant side effects. Transplantation of stem cells, also performed by a hematologist, may be necessary. In some circumstances, the hematologist must also remove a lymph node and examine it thoroughly in order to confirm or rule out the suspicion of lymph node cancer. In these cases, the hematologist works closely with oncologists. However, with benign blood diseases, such as anemia, it is often enough simply to give the patient a transfusion with blood from a donor.
Even so, general practitioners consult hematologists if the blood counts of a patient give rise to concerns or doubt. In this case, the specialist will write a detailed medical report describing the examinations performed and the findings obtained. Beyond that, the specialist will recommend a further treatment scheme if this is necessary.
The most important basic quality that a prospective hematologist should possess is a good degree of empathy. The reason: for most of the time he is treating severely ill patients. Medics aspiring to become hematologists must first complete the basic course in general medicine, which concludes with an examination after twelve semesters. Success in the examination is an absolutely indispensable prior qualification for the license to practice as a doctor.
Next, the doctor must complete a course of specialist study. Because there are very many centers of emphasis in internal medicine, each area must be studied individually - which also takes six years. Furthermore, the prospective specialist in internal medicine, hematology and oncology has training for three years in the fields of general medicine and internal medicine and a further three years in the fields of oncology and hematology. After this training, the student must pass yet another examination.
As soon as the hematologist has successfully completed the training, more opportunities for further training for additional qualifications are available. For example, there are further training courses in rescue medicine or acupuncture. But he will also have the opportunity to follow a specialist course of study in the field of internal medicine.