1 December 2023

In his latest blog, Dr Chris Tiplady talks about haematologophobia and if a lot of the fear of blood and tests comes from waiting for the results.

There are few pleasant phrases which include the word "blood". Blood is something that should never be seen, smelt or discussed. Blood is meant to be kept on the inside. Our ability to detect the scent of blood is something primal and quite interestingly, biologically too. We don’t actually smell the stuff; we detect volatile compounds from an oxidation reaction of haemoglobin’s iron molecules with lipids in our skin. While some animals are attracted to the smell, the revulsion we experience hints at our origins as a prey species.

Nearly every mention of blood in our everyday language echoes that primal revulsion; your blood can curdle, run cold or boil, someone can bay for your blood or have it on their hands, we have blood oaths, blood money, blood baths and bad blood. The closest I can get to something nice is “Monkey’s Blood”, Northern slang for the sickly sweet strawberry sauce that goes on your ice cream. Interestingly, a possible explanation for this phrase relates to the legend that the people of Hartlepool hanged a monkey during the Napoleonic wars, thinking it was a French spy. Or maybe it’s just because it is red.

The normal language of blood moves us so easily to anger, violence, fear, punishment, retribution and fundamental primal feelings. And then we walk through the door and say: “Hello, I’m the blood doctor, here to take some blood as you may have something wrong with your blood”.

Many people say they have a fear of blood (haemophobia or haematophobia), but I am not convinced that is what is happening when the doctor, nurse or phlebotomist walks in. It is perfectly rational to be frightened of tests, of seeing your blood on the outside, or of someone saying there may be a problem with it. We must not underestimate the primitive reaction we invoke and must be sensitive, kind and empathic with what our routine is.

The normal language of blood moves us so easily to anger, violence, fear, punishment, retribution and fundamental primal feelings. And then we walk through the door and say: “Hello, I’m the blood doctor, here to take some blood as you may have something wrong with your blood.”

Blood tests are frightening, every stage is fear-inducing. First, you see the doctor, then they mention tests, you see the form being filled in and wonder what tests are being selected and why. What could they all mean? What are they looking for? Then you wait, sometimes even a few days before the ceremony of phlebotomy. It hurts a bit, especially if it takes 2 or 3 tries. You feel the burning of the needle, the weird empty pull on your arm and the nip of the withdrawn needle (I do wish people wouldn’t press when they pull needles out). You see the red on the cotton wool, the little spill of your precious redness and, if you are unlucky, you catch the smell of your own blood.

No test is routine, no results can come quick enough. Keep people informed, be there, be available and know what you are going to do with the results when they come.

Then you have to wait. Wait and think. Wait and worry. You worry about the phone calls for the next 48 hours and you hope no news is good news.

I get it. I have been there. My friends, family and colleagues have been there. Just have sympathy for every single person you are putting through this uncomfortable dance. No test is routine, no results can come quick enough. Keep people informed, be there, be available and know what you are going to do with the results when they come.

I don’t blame anyone for their fears, it’s normal, it was built into your genes thousands of years ago.