Imagine a stack of thousands of A4 sheets with each sheet containing a patient code and the results of various blood and urine tests carried out in the previous twenty-four hours. This stack is sorted based on the names and addresses of the general practitioners in the Northern Netherlands, and it is your job to gather the sheets per address, to fold them, and to put them in one envelope. In total, you will end up with approximately one thousand envelopes that you need to close, put in a mailbag, and handover to the mailman.
Now, imagine that you do this almost every working day between 1700h and 1900h for a period of six years, as I did during my student days. Does it then surprise you that I knew the names, addresses, and postal codes of all general practitioners in the Northern Netherlands by the time I finished my studies? Probably not.
In the first years of having this job, I did not only learn addresses and postal codes but also started seeing patterns in the laboratory results. Admittedly, test values that were too low or too high were marked with an asterisk, hence spotting deviations was not too difficult. Nonetheless, most sheets typically contained around thirty to fifty test results, and there were various combinations of deviations that could be deciphered.
These combinations quickly sparked my interest, and after working within the company for almost two years, I created an opportunity to do a(n unpaid) Summer internship to learn more about laboratory testing. One year later, I also conducted my BSc’s research project in a related domain at the University of Groningen, and again two years later, I carried out my MSc’s research project within the department of Laboratory Medicine at the University Medical Center Groningen.
It is probably not a surprise that I got hooked on the field of Laboratory Medicine, and I was not planning to let go when I finished my Pharmacy studies in June 2014. At that time, I was fortunately able to conduct a PhD project in this field, which was aimed at translating innovative analytical technologies to concrete clinical applications. This project yielded several novel laboratory tests which I subsequently applied to thousands of patient samples. The latter resulted in some new and important clinical insights, and I am still proud of what I accomplished as a PhD student. (For those who do not know me that well, I am not often proud of myself or my accomplishments)
Before going any further, I should explain two ‘flavors’ of laboratory tests that are conducted in clinical practice. On the one hand, there is the field of ‘Laboratory Medicine’ which focuses on the measurement of compounds that occur naturally in the human body. Corresponding laboratories are led by so-called ‘clinical chemists’, which are registered medical specialists who have a MSc’s degree in Medicine, Pharmacy, Medical Biology, or Biomedical sciences, who have (preferably) conducted a PhD project in the field of Laboratory Medicine, and who underwent an intensive training program within a medical laboratory lasting at least four years. On the other hand, there is the field of ‘Hospital Pharmacy’ which focuses on the measurement of compounds that do not occur naturally in the human body, notably being therapeutic drugs, illicit drugs, and poisons. Corresponding laboratories are led by so-called ‘hospital pharmacists’, which are registered medical specialists who have a MSc’s degree in Pharmacy, who have (preferably) conducted a PhD project in the field of Clinical Pharmacy, and who underwent an intensive training program within a hospital lasting four years.
When considering my BSc’s and MSc’s studies, one could expect that I would prefer nonnaturally-occurring compounds like therapeutic drugs. However, my side job had drawn me towards the naturally-occurring ones. Moreover, I started to find the first category increasingly boring. To me, the associated analytical challenges seemed fairly simple as compared to those relating to the field of Laboratory Medicine, and by the end of my PhD in 2019, I had turned my back on the field of Pharmacy. Back then, I was convinced that all my next challenges in my research would be aimed at analyzing naturally-occurring compounds, yet this conviction changed quite abruptly by the end of my fourth week in Geneva in June 2019.
In that same period, I wrote quite a lengthy (and tear-jerking) blog post on the life event causing this abrupt change, which started with the following words: “It is bad…Cancer… Not sure which type… Metastases everywhere…Acute problem with the spine… MRI is scheduled for today… Followed by a puncture procedure… Based on those results, we will get to know the type of cancer… In the meantime, spinal stabilization is warranted.” These words represent a translation of a message sent by my father back then, and they reflected the situation my mother was in. Indeed, a bad one.
The disease of my mother changed many things in my life, including my view on what I would like to contribute to this world. Suddenly, tackling analytical challenges seemed less relevant than answering clinical questions, and I reminded myself of the reason why I ended up studying Pharmacy in the first place. Which is, because I wanted to make people better (though without touching them thereby ruling out a study like Medicine or Dentistry). Furthermore, I became intrigued by the first therapeutic drug my mother received between the Summer of 2019 and the Summer of 2020, which allowed her to maintain a decent health-related quality of life. This drug is actually a hallmark of modern ‘personalized medicine’, which I discussed three years ago in, again, a lengthy blog post. Learning more and more about this drug brought me back to my first love, back to the love of my life, back to Pharmacy.
The disease of my mother thus represents a turning point in my professional life and furthermore explains the opportunities I have been attempting to seize ever since. Needless to say, I am looking forward to be, get, and remain inspired by her during the rest of my life, although I would have preferred her to accompany me physically and to take many more tours and detours in our lives together.
* in loving memory of my sweetest mother (May 1958-January 2023) *
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