He’s not a physician, and he’s not a detective, but a large part of Alexander Garrard’s job is to stay ahead of the drug dealers so he can help save their customers from bad reactions and overdoses. Garrard, 28, of Syracuse joined Upstate’s Poison Center in 2011 as a clinical toxicologist.
He and his colleagues lecture throughout the 54-county coverage area, teach and supervise residents and medical students at Upstate Medical University, consult on patients at Upstate University Hospital, and – on occasion – answer calls from the media.
How was it, being interviewed on CNN about the dangers of bath salts?
“It still boggles my mind. You look at some of the people who are on CNN, and wow, I was there too. You’re just sitting at this desk looking into a camera, so you can’t really see them on the other side. There’s a 7- or 8-second delay, so it can get very confusing.”
Did you want to be a clinical toxicologist when you were little?
“For the longest time, my dream job was to be a commercial airline pilot because my mom works for Lufthansa. That kind of fizzled. And I ended up speaking to one of the pharmacists at a grocery store where I was a bag boy. I became really intrigued.
“I did a pre-pharmacy curriculum at the University of Georgia in Athens. I got my Doctor of Pharmacy degree at Mercer University in Atlanta. Most people who graduate with a Pharm D usually go into a community pharmacy. To do something like this, you have to pursue more post-graduate education. So that’s where the fellowship came in. I did a two-year fellowship in clinical toxicology and emergency medicine in Jacksonville with the Florida Poison Information Center.”
What is your day like?
“Jeanna Maraffa, Christine Stork-Medicis and I are the only pharm D toxicologists here, so we rotate. Every third week, we’re on hospital service. Anybody who comes into Upstate with an overdose, a poisoning, or an envenomation, we automatically get consulted on those patients and give recommendations on what’s the best way to care for those patients.
“We also have administrative responsibilities. I’m in charge of continuous quality improvement. That means reviewing the cases and seeing — Were they managed appropriately? Could something have been done differently? What did we do well?
“I’m also in charge of death reports for our coverage area. Anybody who dies (from poisonings or overdose), I write up his or her death report for the American Association of Poison Control Centers. That can get kind of depressing. Last year we had 55. That’s a hard part of the job. As health care providers, it’s so ingrained in us to save people and to help people. And unfortunately there’s some people who overdose on so much drug that despite your most valiant efforts, there’s too much drug on board, and you can’t counteract it.”
How do you know so much about street drugs?
“A unique part of our job is really trying to stay ahead of the curve, or at least as knowledgeable as possible about these substances. That means looking through the drug blogs and really kind of getting dirty and getting into that community and finding out — What are people using? How are they using it? What are people saying? What are the effects?
“There is no study out there, no release from the FDA. A lot of it is word of mouth, talking to the patients. A lot of what we know about these drugs comes from patients who have presented to the emergency room. It’s a little bit like ‘CSI’ mixed with ‘House,’ where you have all these weird presentations: Why is this person so aggressive and agitated, with high blood pressure? What drugs out there do we know that can cause this?”
Listen to Garrard’s interview on Health Link on Air radio.