Thinking small -- say, as small as the tiniest particles of matter -- didn't
immediately occur to Ingrid Koslowsky and John Yuen when they were first thinking
of a career.
Both wanted to become pharmacists, but neither had heard of nuclear pharmacy,
the little-known specialty that would become their area of expertise.
For Koslowsky, who graduated with a degree in pharmacy, it started out
as "something different to do."
"I had just come back from a seven-month backpacking trip," she says, "and
was working three jobs, plus taking a computer science course, figuring out
what to do. My employer suggested I take a residency, so I chose radiopharmacy,
because I knew nothing about it. It was a whim."
Koslowsky now runs the radiopharmacy at a hospital. As the hospital's in-house
nuclear pharmacist, she oversees operations, teaches nuclear pharmacy to medical
residents and develops new radiopharmaceuticals for use in nuclear medicine
procedures.
She finds the latter task particularly challenging, since it involves "experimental
design, lab work, analysis of data and bringing the product to a level for
clinical use."
What she relishes most, though, is the opportunity to do her own research
-- "especially," she remarks, "when the research is moving in a positive direction."
Besides her duties at the hospital, Koslowsky also serves as a resource
person on nuclear pharmacy for her region.
"I communicate with everyone from hospital housekeeping to specialists
in medicine to medical physicists to technologists and students," she says.
Yuen first learned of nuclear pharmacy during his freshman year as a pharmacy
student at the University of Southern California.
"Nuclear pharmacy was mentioned in a fraction of a breath," he says. "I
didn't think much of it again until we were given the chance to choose fourth-year
clerkship rotations."
Since his marks were not the greatest, he opted to bypass the competition
and go for some of the less popular electives. Like Koslowsky, he chose nuclear
pharmacy because "it sounded novel and cutting edge."
The specialty fit him like a glove. Its contribution in fighting diseases
made it meaningful, while its variety and scope appealed to his intellect.
"I think of the nuclear pharmacist's role as three-fold: compounding and
dispensing, clinical care and medication, and drug information and quality
assurance," says Yuen. "All three roles are inherent within the profession,
but based on the practice setting, certain roles dominate over others."
His first job, for a large industrial radiopharmacy, involved only compounding
and dispensing. "To be honest," he says, "it became unchallenging to me 18
months into the job."
He finds his current position with a health maintenance organization (HMO)
"much more diverse and exciting." To the best of his knowledge, he is "the
only practicing nuclear pharmacist in the HMO setting nationwide."
Still, the job is not without its challenges. "The biggest challenge for
me," says Yuen, "is to bring a department and hospital into one single focus
of better health care for the patient and their family and friends."
He believes that if everyone tried to follow "more of the 'right way' of
doing things, as opposed to the 'easy way,' our business of good health would
be dramatically improved."
One thing no nuclear pharmacist can ever take shortcuts on is safety. Working
with radioactive materials on a daily basis, Koslowsky and Yuen must be on
high alert for danger at all times.
"There are many practical and technical ways to decrease one's exposure
inherent with good training, experience and diligence in one's work ethic,"
Yuen says.
"A major part in protecting oneself from unnecessarily high exposure to
radiation is the use of ALARA, which stands for 'as low as reasonably achievable.'
This is a concept in which operations involving radioactivity exposure must
be as safe as possible.
"Another concept in decreasing one's individual exposure," he continues,
"is time-distance-shielding-activity."
In a nutshell, time-distance-shielding-activity states that the level of
exposure depends on four factors: time, distance, shielding and how much handling
the material requires. Less is better when it comes to time and activity.
More is better in terms of distance and shielding.
As nuclear pharmacists, Koslowsky and Yuen must abide by rigorous regulations
in everything from the clothes they wear to the packages they ship.
For many pharmacists, the risks and hassles associated with the specialty
are too much to swallow. "The fact of the matter is that nuclear pharmacy
is not for everyone," says Yuen.
For him, though, it's elemental. "I've committed my life and service to
helping people, and this brings me great joy," Yuen says.