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March 30, 1979


Author Affiliations

Bronx, NY; La Jolla, Calif
From the Division of Hematology/Oncology, Scripps' Clinic and Research Foundation, La Jolla, Calif (Dr Crosby) and the Hematology Department, Montefiore Hospital and Medical Center, Bronx, NY.

JAMA. 1979;241(13):1394-1395. doi:10.1001/jama.1979.03290390072049

I was fortunate, indeed, to persuade Theodore Spaet, MD, to prepare the hematologic article for CONTEMPO '79. In his opening paragraphs he describes the reasons why Old Guard hematologists can no longer be all things to all people. For specialized considerations we must, from time to time, call on uninhibitedly energetic skilled men like Spaet.

Time was when the borders of hematology were well defined, and its citizens could cover its area reasonably well. Barely 25 years ago, a competent hematologist could give the complete course to medical students singlehandedly. Today this unity has become a group of separate territories inhabited by "clotters," blood bankers, leukemologists, hemoglobinologists, and immunologists (to mention only a few separatists). They have their own exclusive conventions at different times and in different locations; they even have their own journals and subspecialty boards as well.

Much as the Old Guard may protest, however, a wondrous thing appears to be happening. As fragmentation within proceeds, there is a simultaneous weakening of the previously well-defined borders of hematology. Each subspecialty reaches out to the resources of others and to more distant, once forgotten neighbors. As a result the gap between theoretical knowledge and direct patient benefit is narrowing. Some examples of this appear to have farreaching consequences.—W.R.C.