The inaugural ‘Crucible Session’ at the recent BSH Annual Scientific Meeting in Liverpool was won by Dr Sonia Wolf and her 'Young, Black and Stigmatised' presentation.
The aim of the session was to encourage reflection amongst haematologists on their practices with a theme of ‘How do haematologists do most harm to patients?’ The five best abstracts were selected for presentation, with the trainees then being questioned by a panel of experts.
We interviewed Dr Wolf to find out a little bit more about her journey in haematology and her Crucible Prize success.
What was your Crucible session presentation about?
My presentation was called 'Young, Black and Stigmatised' and was about how haematologists harm patients with sickle cell disease (SCD). I focused on three main areas: hospital admission, opiate use and lack of psychological input, but these come on a background of socio-economic deprivation, institutional racism and lack of research funding.
Why do you think your presentation theme on ‘how do haematologists do most harm’ is so important and why?
I think it’s important because although sickle cell disease is the most common disorder 'caused by a single inherited genetic mutation in the UK, we still don't really know how to treat it. I think patients with sickle cell disease are stigmatised, partly due to their age and ethnicity, and this directly impacts not only on their hospital care and ability to lead normal lives when they are well, but also leads to a lack of advances in the disease. I wanted to highlight this and start a conversation about how we can improve things for these patients.
What are three practical steps that can be taken to ensure this isn't reality for people with sickle cell disease in your organisation?
1. Examine your own prejudices. 33% of haematologists think over 10% of patients with SCD are addicts and 5% think it's over 90%! Is this you? If so, why? Is it based on your experiences or is there an underlying element of racial bias there? We cannot be effective advocates if we do not get our own house in order first.
2. Call out others. The language and behaviours used by staff to describe these patients is often pejorative. It can be seen across all staff groups, from the most junior member to the most senior. If you witness this behaviour, challenge it and ask the speaker to review their own beliefs about patients with SCD.
3. See the person, not the disease. Does your patient really need to be in hospital today? Maybe they have studies to get back to, or a partner, or children. These patients, who are mostly in their teens and twenties, are at the point in their lives where they should be building their educational and social futures. If we try to take their care out of the hospital as much as possible, we allow them the same opportunities that everyone else at that age has, and let them define themselves by their hopes and dreams, not their disease.
What led you to a career in haematology?
I graduated from Imperial College, London in 2008 not intending to do Haematology at all, in fact I wanted to be a Psychiatrist! I first encountered Haematology patients as an A&E doctor looking after patients with sickle cell disease at Guys and St Thomas hospital. This led me to want to know more so I spent a year in the green rolling hills of the Waikato in New Zealand where I did 6 months Haematology and fell in love with the specialty. What I loved best was the variety of patients, the liaison with other specialties and the problem-solving approach to diagnosis.
After Core Medical training back in London I started Haematology training in the North East Thames deanery in 2013. I am currently an ST6 trainee having had 2 babies along the way!
What advice would you give to someone considering a career in haematology?
Spend some time in the lab. If you enjoy looking at cells and trying to match it to the clinical picture, you'll enjoy haematology. Haematologists love to sit down and think about complex problems - we're not really adrenaline junkies - but if you like taking all the evidence and working it out from patient to lab you'll love haematology. It's a brilliant career and I am very happy with it as my choice of specialty.
What is the most rewarding part of your job?
Spending time with patients and seeing them through their journey - whether that's diagnosis of leukaemia to remission or getting to see a family with a new diagnosis of haemophilia gradually adjust to their disease. You end up building really strong relationships. When I think of my patients I like to remember things like the fact they played their guitar on the ward, or the fact they plan to go travelling after they finish chemotherapy, rather than just what disease they have.
What is the most challenging part of your job?
Seeing patients die, especially young patients, is hard. But it does make you realise that life is short and, although this is a cliché, you should live it to the full.
What does being a BSH member mean to you?
An opportunity to hear about and meet other inspiring members of the haematology community and their work.
What do you plan to do next in your haematology career
After finishing my maternity leave, I am going to start a PhD back at Imperial College in October.