Dr. Helen Holt

Pathology is often thought to be synonymous with the mortuary and forensic science. However, within this hospital there is a large pathology department and the vast majority of our work is done for the benefit of living patients! In fact if you have ever had a blood test or a biopsy then your sample will have been analysed within pathology. Pathology means “the study of disease” and it encompasses a number of specialities including biochemistry, haematology, medical microbiology, histopathology and immunology. I work in the department of clinical biochemistry which specialises in the analysis of chemicals substances that are contained within blood, urine and other body fluids.

In Clinical Biochemistry we receive over 2000 blood samples per day as well as urine, CSF and stool samples. These samples are received from patients in the hospital and those attending GP practices in the surrounding area. Within the laboratory we are able to measure over 70 different chemical substances that are present in blood and other bodily fluids. These chemicals include minerals, hormones, enzymes, and cancer markers. Alterations in the test results for these substances can then be used to help diagnose and monitor disease.

The most common tests that are conducted within clinical biochemistry are used to monitor kidney and liver function. However, the type of blood tests requested by the doctor is dependent on the patient symptoms. For example, a patient presenting to A&E with chest pain might have a blood test conducted to help determine whether the patient has had a heart attack. A couple having difficulty conceiving, on the other hand, may have hormones such as testosterone measured. We also process tests that are used to assess a patient’s risk of disease, for example cholesterol is measured as part of heart disease screening.

Work in the laboratory is processed 24/7 and the scientists working within the laboratory are always busy! As we receive so many samples per day the majority of the tests are processed by automated machines. However, a significant number of our tests are manual processes and require skilled laboratory scientist to both run and interpret the tests. Scientists are also needed to keep the machines running and to make sure that any urgent or worrying results are communicated to the doctors as soon as possible.

My role as a clinical biochemist is to help doctors interpret any complicated test results and to provide advice on the appropriate tests required to help diagnose (or exclude) certain diseases. As almost every speciality in medicine uses biochemistry tests to assess their patients the type of results I review can be very varied. Much of my work load is involved in the interpretation of hormone profiles for example tests to assess the function of the thyroid (the gland that controls metabolic rate). However, I may also be involved in the investigation of babies with suspected genetic disorders or patients presenting with suspected poisoning. In addition I am a member of the multidisciplinary nutrition team which means I help review patients on the wards that are receiving intravenous nutrition. So whilst you might consider pathologist to be working “behind the scenes” I hope you can see that we are very much involved in patient care.