Clinical Science and Basic Medical Science: Rivals or Partners?
scientist using microscope
Photo by Chokniti Khongchum on

Years ago, I was undergoing industrial training at a particular federal medical center, and there I was first exposed to the importance of the clinical laboratories. Over eighty percent of all diagnoses made were done by the laboratory technologists, who performed rigorous bench works round the clock every day.

Of course, it was interesting and fun to someone like me, who was learning the ropes of microbiology, and who along the line was able to garner more knowledge in other fields like Parasitology, Chemical Pathology and Histology apart from Microbiology that I was. However during this period, I also tasted, for the first time, the bitter pills of rivalry among these clinical pathologists and their medical practitioners’ counterparts, and I realized that all was not really well.

There was always a silent war going on, either a medical doctor was complaining of wrong laboratory diagnosis or a technologist was rubbishing a medical doctor’s assessment. Different cases abounded, several of which are usually related to why the MDs couldn’t first send the patients for tests before complicating issues by prescribing drugs and then later sending them to the laboratory after drug failure or relapsing. It was purely mudslinging activities which at one point almost culminated into a fist fight between a dentist and a medical laboratory scientist.

Years later at a biomedical conference at the University in Ibadan in 2012, the Chief Medical Director of the University College Hospital, Ibadan, Nigeria, Professor Alonge, delivered an opening lecture whose focal message is a clarion call for increased cooperation between the clinical scientists and the basic medical scientists, an evidence that the frictions of yesteryears still very much abound.

A former principal of mine and a retired biochemist, Mr. Kehinde Ojo, once insinuated that a laboratory scientist is like an engine of a car while the medical scientist is like the driver of the car. This viewed was also echoed by an eccentric uncle of mine, a pharmacist who retired early due to what he called “continued disappreciation and non-reverencing of the basic medical guys”. His words, not mine. So the stage was plain enough: the basic medical scientists operate in the background, while the medical clinicians are the show men.

Over the years, however, the basic medical scientists and researchers have been bursting out in numbers to gain recognition, carrying out researches independent of the clinical scientists and setting up limits which the MDs of this world should not even attempt to cross in their own interest. What followed is polarization of works in both camps, with the patients and the public in need of medical and clinical attentions at the receiving ends.

Initially, I thought it was a Nigerian situation, where everyone, including a secondary school class janitor, always pulls ranks to gain undue advantage. But I later realized that it could be a universal occurrence. A particular rumor circulated during the SARS epidemic of 2003, where a laboratory technologist who have likened the symptoms of the infection to those similar to some coronaviruses, the virus family to which the SARS virus belong, was overruled by the medical doctor in charge of the initial investigation. Well, what followed was an extensive epidemic which scourged the world.

The same thing happened at the recent outbreak of Lassa fever in a state in the eastern part of Nigeria where some young MDs flagrantly disobeyed the directive of a laboratory researcher about the viral infection and they ended up paying with their lives.

To avoid sounding prejudiced against the clinical scientists, there have also been evidence and proofs of laboratory scientists and researchers intentionally hoarding or providing misleading results just to prove their own importance. That might sound really absurd and incredible, but it is true. But what is really shocking is the fact that both camps forget that millions of people rely on them daily for their continued existence in this country.

Patients, especially the illiterates or individuals with no medical or scientific knowledge, always heavily depend on the words of people in the medical field, and they always swallow every instruction and drugs given to them hook, line and sinker without looking back. You can see it on their faces and in their body languages the moment they enter a medical facility: everybody, even the president of the country, would drop his or her title on getting to a medical center. Except if the president was to commission a project.

What happened next is unpredictable, since one cannot know who and what you would encounter within the facility: an obnoxious nurse with an I-don’t-care attitude, a friendly doctor with a fixed smile trying to calm you down, a medical consultant or laboratory technologist with an I-know-all look or an indifferent pharmacist who keeps prescribing drugs though he is not listening to you. Life couldn’t get more complicated than this.

But honestly, why couldn’t life be simpler? Even up till now I still get confused trying to differentiate between the terms clinical or medical scientist, clinical or basic laboratory researcher, medical or clinical practitioner and other medical jargons. These are obvious in the previous paragraphs above. If I couldn’t do this, with my knowledge of science, then I doubt if the ordinary man out there seeking medical assistance would be able to differentiate better between these vocabularies.

There was once a time a friend of mine once came to the virology laboratory I was carrying out research, telling me she came for typhoid fever test. She is a learned person, a linguist and a professional customer care representative, but she didn’t know and probably didn’t even care. Basically to her, we in the medical field are all doing the same thing.

Based on all these submissions, it is about time the warring camps of clinical scientists/medical practitioners and basic medical researchers/scientists/technologists sheathe their invisible swords of self-importance in the interest of those who do not even know the difference between a laboratory coat and a ward coat; after all both coats are white and long-sleeved.

Both camps should realized that they are operating in fields and disciplines collectively called the biomedical field, and that they have obligations to fulfill to the public in terms of providing good healthcare and incisive research-based solutions to the hydra-headed health problems in the country and the world as a whole.

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