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Toxicology specialist: 'My heart rate jumps to about 130'

graphic
Jeffrey Fay  

Name

Jeffrey Fay

Position

I'm a toxicology management specialist with the California Poison Control System at Valley Children's Hospital in Madera, California.

Years in position

Three

Age

I'm 41 -- a Leo, I think.

  QUICK VOTE
graphic Could you do the sort of poison-control crisis work that Jeffrey Fay does for a living?

No, I couldn't take the pressure. I'd beat the callers to the emergency room.
Doubtful. Even if I could handle the pressure, I'm not sure I could search out the right answers for crises in time.
I think so. I'm sure it's scary work, but exhilarating, too.
View Results

 

Education

I have a bachelor's in biochemistry and cell biology from the University of California at San Diego, a doctorate of pharmacy (Pharm.D.) from the University of California at San Francisco, and a clinical residency.

How did you get your current job?

Purely by accident. During the last part of my residency, I had a desk job near the statewide director's office. One day I happened to ask him what the heck they actually did in those poison center places. A few interviews and a stack of paperwork later, here I am.

How many hours do you work per week?

Forty hours per week, on average. I work nights, 9 p.m. to 7 a.m., eight days (nights, actually) in a row. This is followed by six days off. The first three are usually spent getting used to that bright orange "sun" thing again.

From 2 a.m. to 7 a.m. I'm completely alone. Just me, the computers, a bunch of textbooks and journals, and 38 million of my closest friends on the other end of the phone line. Actually, I have a nighttime counterpart in Sacramento at the poison center there, and we're networked together, so I really only have 19 million residents to potentially deal with.

What's the first thing you do when you get to work in the morning?

Well, it's not exactly in the morning, but the first thing I do is log on to the computer and the statewide phone system. Then I review the cases I managed the night before to see how the patients are doing, and hopefully to learn something in the process. I'll be taking new calls at that time, too.

What time do you have lunch? What do you usually eat?

"Where else could I actually get paid to listen to a reptile handler tell me that he was just bitten by a Burmese green python, right after being attacked by a Komodo dragon? My recommendation to him: 'It's not your day. Go home early. And swing by the emergency room on your way, eh?'"

"Lunch?" What's this "lunch" business? Actually, that's not fair. I take it back. I do eat. And if you want to call it lunch that's fine with me. Usually it's reheated leftovers, sometime when the phone isn't ringing. Four in the morning is a pretty good bet.

What time do things get tense around the office? What makes it that way?

Hmmm, what time is it now? Actually, it all depends on who or what is on the other end of the telephone line when I pick it up. And that really could be anyone or anything.

Mom calls. Her 3-year-old daughter has just ingested two tablespoons of automobile wheel cleaner and is looking and acting just fine. Nothing to worry about, right? Wrong. This could be rapidly fatal. My heart rate jumps to about 130 and my voice probably goes up a half-octave I still need to sound calm, though. If I get Mom too excited she may panic and not be able to function well.

I tell her to hang up with me and call 911 when we're through talking, which will be quickly in this case. While waiting for the paramedics to show up, Mom needs to do X, Y, and Z. We both hang up. Mom calls 911, and I call the hospital and give them a heads-up on what's about to come rolling through their emergency room door.

Two minutes later: "Hello, I've just accidentally brushed my teeth with hemorrhoid cream. Am I going to die?" No, you're not. And no, you're not the first. Really.

OK, one more: Dr. Smith calls from an emergency room. She has a teenager who was depressed and swallowed a whole pharmacy worth of pills two hours ago. Her blood pressure is dropping, the EKG doesn't look good, and she remains comatose. Here's the list of medicines she may have taken. (Dr. Smith rattles them off.) What are my recommendations? (Err, soon, please, she seems to be having a seizure now )

Those are all pretty common scenarios. And I'm guaranteed to get at least three people between 4 and 6 in the morning who swallow hydrogen peroxide accidentally. Don't ask me why. They just do.

All the calls are recorded, which I actually prefer. It's nice to be able to review and confirm what I've said if there's ever a question.

  AID AND ANTIDOTES
Jeffrey Fay tells us that poison-control center he works for provides free 24-hour telephone advice to emergency room physicians, 911 personnel and the public about poisoning emergencies and how to handle them. The California Poison Control System has four answering sites, he says, each linked by computer and telephone networks to the others. In 1997, many separate California poison centers were unified into the present system, which is managed by the University of California School of Pharmacy at San Francisco. And we met Fay when he used our submission form here at "A Day on the Job." If you'd like your day to be considered for a profile here at CNN.com/career, let us hear from you as Fay did.
 

If you're having a good day at work, what is it that makes it good?

Most of them are good. Sure, sometimes I may look (and act) like that comatose patient when I leave, if it's been a rough night. But with most of those moms who call, I get to tell them they can stay home with their child. No need to traumatize everyone with a trip to the emergency room. That saves everyone money, too. Studies show every dollar spent on poison centers saves seven dollars in health care costs. And maybe I can help ensure a good outcome for some folks.

How much work, if any, do you take home?

None. I go home, wind down (usually that's no problem, but sometimes it takes a little while) and sleep. Then I get up about 7:30 p.m to do it all again.

What does your work contribute to society?

We quickly provide information that's not readily available anywhere else. We all have years of experience, access to a vast computer database of toxic substances and appropriate treatments, a good library of medical and toxicology books and journals and medical specialists we can consult 24-seven. We're always here to answer the call, and we can provide translators for more than 100 languages. We have a lot of clinicians and other folks who work here, and poisons are all we do. I like to think that we're all pretty good at it.

We also provide HazMat, public health information, pesticide surveillance and public education services.

"One thing that'll get you a new line of work pretty quickly is giving incorrect or inaccurate information. That can get someone hurt or even killed on the other end of that phone line. The three most valuable words I ever learned are "I don't know." It's far better to use them than to be wrong."

Do you expect to finish your working life in this career?

I really don't know. If I did change careers, I'd miss this line of work.

If you could have two more careers, what would they be?

Cowboy and astronaut. I haven't really changed much since I was in the third grade.

What's an unforgivable trait in a colleague?

I don't know about being unforgivable, but one thing that'll get you a new line of work pretty quickly is giving incorrect or inaccurate information. That can get someone hurt or even killed on the other end of that phone line. The three most valuable words I ever learned are "I don't know." It's far better to use them than to be wrong.

What do you do to relieve stress?

I jog, fish, ski or target shoot, depending on the weather. I also make professional videos. Nobody else would ever call them that, so it's up to me.

What have you been reading lately?

Goldfrank's "Toxicologic Emergencies" (Lewis Goldfrank, McGraw-Hill, 1,917 pages) and "Harry Potter and the Goblet of Fire" (J.K.Rowling, Arthur Levine, July 2000). I just can't put either one down.

When you have one of those days on which you don't think you can face the job again, what is it that gets you out the door in the morning and off to work?

I've been pretty lucky because I don't think I've had a day when I really hated the idea of going to work. Where else could I actually get paid to listen to a reptile handler tell me that he was just bitten by a Burmese green python, right after being attacked by a Komodo dragon? My recommendation to him: "It's not your day. Go home early. And swing by the emergency room on your way, eh?"

graphic

 

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RELATED SITES:
California Poison Control System
American Association of Poison Control Centers

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