When young doctors finish medical school, they have a very big decision to make: what kind of doctor are they going to be? A surgeon, general practitioner, pediatrician, rheumatologist? The list is endless! So what inspires young doctors to become a pulmonologist and specifically a pulmonologist that specializes in interstitial lung disease (ILD)? Laurens De Sadeleer, a young doctor himself, talks about the career he has chosen and what appeals to him most about a disease like ILD. He also provides a little insight into what students learn about this challenging disease during medical school.
New developments are a reason for hope for patients and their surroundings
‘For me, studying medicine was a logical choice’, Laurens De Sadeleer says. ‘Being a doctor combines science and caring for people, both of which have always appealed to me. It provides me with the intellectual challenge, I like so much.’ Two years ago De Sadeleer finished his master’s in medicine at Leuven University. After he completed the first two years of his specialization in pulmonology, he got the opportunity to start his doctorate in ILD. When he finishes those four years in research, De Sadeleer hopes to continue with the remaining two years of his specialization, after which he will officially be a pulmonologist. But how did his fascination with ILD start? De Sadeleer: ‘In my last year as a medical student, I had to do a lot of internships. One of the internships I did was with ILD specialist Professor Wuyts at the Pulmonology Department and that’s where my fascination for this disease was born.’ Because there are about two hundred different types of ILD, it requires difficult and challenging diagnostics. ‘It is quite difficult to find out what kind of ILD a patient has’, De Sadeleer says. ‘It is the complexity of this disease that makes it so very interesting. It has gripped me ever since.’
With his doctorate, De Sadeleer focusses on one specific type of ILD: chronic hypersensitivity pneumonitis. People develop this type of lung fibrosis when they inhale organic material. ‘Especially people who are in close contact with birds or who have fungi in their home may develop this kind of lung fibrosis’, he explains. With their research in chronic hypersensitivity pneumonitis, De Sadeleer and his colleagues try to find out why some people who are in contact with birds, like pigeon-fanciers, develop this disease and why other people don’t. De Sadeleer: ‘In Leuven, we are in a unique position. Our hospital is one of the biggest lung transplant centers of Europe. Because of this, we are able to research the sick lungs that are removed by transplant surgery. Also, because we are able to look at scans of the complete lungs, we can see that some areas are completely destroyed by the fibrosis while other parts of that same lung are not. We hope to find out why that is.’ His research is still ongoing, so it is too early for actual results. But De Sadeleer says they have found quite promising leads which they will continue to investigate.
For De Sadeleer, it was the internships at the Pulmonology Department through which he came into close contact with ILD. Looking back at his time as a medical student, he concludes information on ILD during lectures was sparse, as with most rare diseases. ‘ILD was certainly addressed, but not in detail, and certainly not all two hundred types were discussed’, he says. But he explains that is not necessary. ‘Medical school lays the foundation for all kinds of different doctors: general practitioners, rheumatologists, orthopedists, etcetera. Not all doctors will be consulted by patients with ILD, so they do not all need to know every detail. However, I think it is important for doctors to know that this disease exists. So when a cardiologist sees a patient with shortness of breath and a crackling sound in his lungs, but no underlying heart disease, he should be alerted and be aware of ILD. Awareness of ILD should improve, so patients do not lose valuable time before the diagnosis is finally made.’
For young specialists seeking information on ILD, De Sadeleer indicates the field of ILD is continuously changing, so it can be challenging to get a good overview of the current state of affairs. He says: ‘I think it is important for people interested in ILD to meet each other, for instance at conferences, to share information, study results, experiences and visions. The world of ILD is small and ILD specialists do not always have someone close to them to work together with or to get things organized with. So it is important for ILD specialists to meet each other regularly. The upside of these dynamic times in ILD’, De Sadeleer concludes, ‘is that these new developments are also a reason for hope for patients and their surroundings.’