Director of Toxicology and Environmental Assessment
at Los Angeles County Department of Public Health,
Assistant Medical Director at California Poison Control System, and Medical Toxicologist at Children’s Hospital
Q: You work with a range of different health organizations as a medical toxicologist. Would you explain what a medical toxicologist does?
A: Medical toxicology is a specialty field in medicine that focuses on the diagnosis and treatment of human exposure to chemicals, environmental toxins, venomous creatures, plants, and mushrooms. Essentially anything that’s not an infection that a person could be exposed to, we specialize in the diagnosis and treatment of those patients. Medical toxicologists act like detectives on a multilevel playing field, diagnosing patients or looking at populations of people who may be exposed to something. I like to keep my hand in multiple different areas, which is why I wear many hats here in Los Angeles.
Q: What got you interested in this specialization?
A: When I was in the middle of my pediatric residency at Children’s Hospital Los Angeles, I was looking at all the different kinds of specialties that were available to us, and I realized that one of the areas we didn’t get a lot of instruction in was the field of medical toxicology. I really wanted to learn more, and decided to apply for fellowships and learn about it. There are not a lot of medical toxicologists in the country, just a few hundred of us. Not every hospital has one at their disposal. That’s one of my reasons for being in my current role at Children’s Hospital. I am essentially the 24/7 medical toxicology consultant for that hospital. I do that as a courtesy because, before that, we didn’t have that support when I was originally in residency. I want to make sure that they always have a toxicologist who’s there to help the medical students and the residents.
Q: In addition to working with the hospital, how are you involved with the LA County Department of Public Health?
A: I direct the Toxicology and Environmental Assessment branch of the Los Angeles County Department of Public Health. We’re the organization that essentially prioritizes what it means for humans to be exposed to potential environmental toxins, especially when it comes to things like regional planning, certain industry expansion, or when there are accidental spills or exposures. We are at the front of the line to make sure that the public is as protected as possible.
Q: What are some of the particular concerns you have in your region?
A: Los Angeles is a heavily industrialized area. There is a lot of industry interwoven throughout the residential population, and lead poisoning still is the most important pediatric environmental exposure. Over the past four years or so, we’ve been dealing with a car battery recycling plant that is in the center of Los Angeles County. Lead is a primary chemical in automobile batteries and even though that facility was eventually closed down by the US Attorney General after 30 years of operating without the proper industrial permit, we learned that lead had been coming out of the smokestacks for decades and landing on the soil. That doesn’t simply go away. There is a massive amount of lead contamination in the areas that are surrounding that facility.
Q: How is your team addressing this issue?
A: In this particular community we have entire households where lead has landed on their properties, we are working with state agencies to basically develop a process where all of these homes can be cleaned, where they remove the lead-laden soil and replace it with lead-free soil. The goal is to create a low-lead exposure for these environments and for the members of these households.
Q: You’re also involved with California Poison Control.
Tell us about what you do there.
A: I’m one of the assistant medical directors for California Poison Control. It’s a state organization that is designed to help doctors, nurses, and other medical providers to take care of patients who come into medical settings with a chemical exposure. We also answer phone calls from households. For example, if someone’s child gets into medication X and they need instructions on what to do. We have skilled professionals on the lines who are able to help both the calls from households, and also calls from medical providers to make sure that the right decisions are made, with the right science, and with up-to-date information. I also do a lot of medical education on behalf of California Poison Control, doing lectures on the diagnosis and treatment of victims of poisoning for doctors, nurses, and emergency and medical technicians.
Q: Are there any projects that you’ve become passionate about in your time with these organizations?
A: At the Department of Public Heath we’ve been developing a pilot project over the last couple of years to figure out ways in which we, as a local public health department, can take a more proactive stance to make sure that we can prevent exposures from happening to begin with. As a local department, we don’t have a lot of regulatory authority like some state organizations do, but we have a lot of influence. Because we are the health experts, we can use that influence to hopefully steer the regulatory agencies into more of a prevention mode as opposed to a reactionary one.
Q: How have you focused your efforts to be more proactive?
A: We’re working on a project right now that essentially will, in a very broad sense, look at all of the areas in our county here in Los Angeles, determine which of those are the most heavily burdened by sources of environmental pollution, and then do what we can with state agencies to try to drive down emissions and toxic releases from those facilities. We also are looking for alternate chemicals that these facilities can use that would be safer for the environment in the event of an accidental spill. When you’re trying to protect the health of the community the goal is to not play catch-up.
Q: Were the sciences always a passion for you, even when you attended College Prep?
A: CPS has such a broad range of scientific endeavors; you really got exposed to every area. It was always unique to see how the math that you learned along the way factored into the science as well. I think bridging those disciplines together was always what interested me the most.
Q: When you think back to your time at College Prep, what experiences have stayed with you throughout your life and career?
A: I still always see Rob Crowley as the number one example of what it means to be an outstanding science teacher. He not only taught you science, he taught you how to love science. Debate with Lexy Green ’81 was also a big influence as I speak in front of communities, legislative committees, and politicians. Sometimes these environmental topics of human exposure and industry become very controversial and we get backlash. But that’s okay, because we’re out there defending the science, defending what we do, and defending the health of the people. Debate taught me the skill to tailor whatever I’m saying to the particular audience that I’m talking to. That particular skill is useful in any career path you choose.