Editor’s Corner
My First Eosinophil
W
10
ASH Clinical News
HEN A SHOCKING historic event occurs, many can remember
exactly where they were and what they were doing when they
heard the terrible news. I, too, can recall intimate details of awful
incidents like the September 11th attacks or the Space Shuttle
Challenger disaster.
But I also remember times when I was surprised by joy –
startled out of day-to-day routine by unexpected grandeur, startled
into a sense of wonder.
For instance, I remember not only where I was but what I
was wearing and what song was playing on the car radio when I
first saw the Northern Lights open up in the sky in front of me
as I drove down a dark rural highway in northern Michigan. The
aurora’s shimmering curtains of green light were so spectacular
that I pulled over to the side of the road, walked into a cornfield,
and – to the distant sounds of Paul Simon’s Graceland – watched
the sky for as long as I could stand the frigid December air. It was
not nearly long enough, due to the threadbare teal L.L. Bean parka
I was wearing at the time.
Another memorable highlight was the first time I bit into the
succulent meat of a fresh lobster, plucked from the sea just minutes
before it appeared steaming on a paper plate at a roadside picnic
table during a childhood late-summer vacation in Maine. I had
never tasted anything quite like it. A glimpse of the rare “green
flash” at sunset, a lunchtime spent watching the improbable aerial
dance of a hummingbird at a backyard feeder, and, in retrospect, a
far too close encounter with a grizzly bear while camping in Alaska
were also undeserved gifts from the Univ erse.
One of the best surprises of all was the first time I saw an
eosinophil.
I was a first-year medical student at the University of Chicago
when it happened. Our class had just begun the hematology block
of a basic histology course. As a lab exercise, I dutifully pricked
my finger with a lancet, spread the blood on a glass slide under
the watchful eye of a lab tech, and stained the smear with a pair of
dyes that we had been sternly warned not to spill on our clothes.
Once the slide dried, I slipped it onto my rented microscope and
started to search for each of the cells listed on a purple mimeograph handed out by the teacher’s aide, using the classic Wheater’s
Functional Histology textbook as a guide.
I quickly checked off all the assigned objects except one: an
eosinophil. In the next few minutes, I am sure I was as much of
a nuisance to the course director, James Vardiman, MD, as an
impatient child in the back seat of a car asking, “Are we there yet?”
I spotted a granulocyte that seemed to have a few more burgundy granules than others and raised my hand.
“Um, Prof. Vardiman, is this an eosinophil?”
He bent down and looked. “No, that’s a neutrophil.”
A moment later, my hand shot up again: “Okay, how about this
one – an eosinophil?”
Another patient look through the lens. “That’s a neutrophil,
too.”
Then, certain I’d finally hit the jackpot: “What about this other
one? It seems really red.”
He offered a quasi-compliment: “David, you’re really good at
finding over-stained neutrophils.”
Finally, after what seemed like an eternity of painstaking searching, when I was ready to assign eosinophils to the same crypto-category as Bigfoot, Mel’s Hole, and Mr. Snuffleupagus, I saw it.
There was no mistaking it for anything else. The eosinophil was
so much better in real life than the one pictured in Wheater’s. Red
enough to make Stalin blush, its granules glowed in the microscope’s halogen lamp as brilliantly as theater Exit signs, and its two
thick nuclear lobes bulged like chewed Dubble Bubble. It was an
awesome, stunning sight. I didn’t even need to ask Prof. Vardiman
to confirm it.
“n this age of flow cytometry and
I
molecular genetics, we’ve come
to distrust the meaning of cells
that we see with eyes aided only
by a lens.”
Back in the classroom the following day, I listened as John Ultmann, MD, gave an introductory lecture to hematology that was
worthy of a TED talk. I found his sweeping overview of the field –
from sickle cell disease to leukemia, drawing on anthropology and
genetics, and invoking ghosts from Virchow to Von Willebrand
– absolutely inspiring. That day, I finally knew what I wanted to do
with my life. My career decision – instant, never once regretted,
inflamed by an eosinophil – was to become a hematologist.
John died in October 2000 – ironically, of complications of one
of the diseases he studied, lymphoma. He was a strange, curious
person, yet so charismatic, full of interesting stories and passion
for his life’s work. Over the years, I’ve met several others whom
John “converted” to hematology and have wondered how many
of us have made career choices based as much on the passion of a
gifted teacher or role model as interest in the discipline itself.
I hadn’t always known I wanted to go to medical school, let
alone what field to specialize in. I studied physics and astronomy
as an undergraduate, which was fascinating and mind-expanding,
but not very lively. When I was 19 years old, I had the best job I’ve
ever had (and probably ever will have): running the astronomic
observatory at Calvin College in Michigan. My role, similar to the
May 2015