American Association for Clinical Chemistry
Better health through laboratory medicine
March 2011 Mentor of the Month: James Ritchie
Biography & Career
  1. With which professional societies/organizations (e.g. AACC) are you involved?
    I belong to NACB, ACLPS, International Association of Therapeutic Drug Monitoring and Toxicology, Society of Biological Psychiatry, Society for Neuroscience, and American College of Neuropsychopharmacology.
  2. How did you get started in these organizations and what advice do you have for young people wanting to get involved?
    I got started with these groups in two main ways. First, I had colleagues or mentors who suggested I submit articles or abstracts to the individual groups. Second, I read the journals and publications from the organizations and saw that I had common interests with the organization.
  3. What area(s) do you specialize in and what initiated your interest in these areas?
    I like to think of myself still as a generalist but in fact over the years I have gravitated to the areas I find most challenging: clinical toxicology and neuroendocrinology. Early on in my career I took a position in a research lab which was trying to develop clinical diagnostics for mental illnesses, specifically depression and schizophrenia. In general these diagnoses are still quite subjective compared to other medical conditions. We were hoping to put them on a firm biochemical basis. We were of course overly optimistic but the more I found out about neurochemistry the more fascinated I was. My interest in clinical tox came out of the same background as many medications are given for these conditions even today, but we still do not have a clear understanding of how they work in the brain.
  4. What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
    I’ve had the pleasure to work on many projects and to help establish state of the art methods for neuroleptic drugs and steroids. However, I think my most important contribution has come with being involved with our fellowship program and the training of young laboratorians. Hopefully they will carry the profession to new frontiers that I can only imagine.
  5. What were some of the most rewarding and/or challenging moments of your career?
    My rewards have been many. I particularly enjoy helping clinicians solve patient problems. Though we may never have contact with the patients, it is very satisfying to know we have contributed to their care. I also find it very rewarding to see something for the first time that no one else has ever seen and perhaps this is what keeps me going on the research side.
    The original work we did on measuring steroids in depressed patients and using the dexamethasone suppression test to predict treatment response that helped direct patients to find the correct kind of therapy was a real case in point.
    Challenging: Early in my career I was working the midnight shift in the stat lab of a local hospital while attending public health school. The lab was responsible for running all stat chemistries including blood gasses. One night a code was called and when the ABG specimen arrived it was not labeled. At the time the lab policy was to not run any sample which came down unlabelled. I phone the floor and told them the problem. A few minutes later another gas arrived which I duly ran. About 45 mins later a physician appeared in the lab and told me I had just killed his patient by not running the first specimen. I argued I was only following policy but was quite shaken by the whole encounter. I mentioned it to my supervisor who passed it along to our pathologist and the next night the physician returned to apologize. Since then I have always been cognizant that there are people on the other end of the work we do.
  6. How would you recommend achieving an optimal work/life balance?
    This is hard since I am not sure I have ever really achieved that balance. I think perhaps setting defined time limits for the various aspects of your day and sticking with them. It has been my experience that very few deadlines are absolute. The other thing is to develop the ability to let go of one thing when you are doing another. Do not let it fester in the back of your brain that you still have the next experiment to do or paper to write.
  7. What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
    I predict that multiplexed assays will become the norm rather than the exception. Along with them will come evidence based treatment algorithms and a greater emphasis on systems biology as the approach to understanding disease processes. Labs will be called upon to continue to do more with less and automation will continue to grow with both molecular diagnostics and proteomic diagnostics becoming mainstays in the Core lab.
  8. What do you see as the challenges facing young scientists in laboratory medicine?
    In the hospital setting I think young laboratorians will be faced with the continued challenge of justifying their existence to administrators. Why do I need a clinical chemist when I have a seasoned Med Tech? You must always know the value-addeds you bring to the equation. In academic centers the challenge is to be scientifically productive with increasing clinical responsibilities. I do believe this is the era of the translational scientist and it will be our job to be sure we are seen as that and not just the “clinical lab guy/girl”.
  9. What specific goals would you set for young scientists to set for themselves? Any suggestions on how to achieve them?
    Intellectually, I think you should strive to master something that truly excites you. Take some time in your early career and try out all the areas you can. Dabble and find your interest(s). Then pursue them with a vengeance and don’t be distracted by others who don’t share your vision.
    I would also strive to keep a foot hold in both the clinical and research sides of laboratory medicine. Finally learn to balance your professional life with the rest of your life. Get out of the lab/hospital and enjoy what the world has to offer.
  10. What is your most effective time management skill?
    I am not very good at this so, please take what I say with a grain of salt. What works for me is compartmentalization and making lists. I try to break each day into work and family. I set a time in my own mind of when I will get to work and leave and then stick to it. Also I make a fresh list every couple of days and each day pick 3 things I will try to complete.
  11. What is the riskiest thing you've ever done?
    Took up scuba diving at age 49. Enjoy it immensely now.
  12. What is the strangest occurrence you’ve encountered in the lab?
    Believe it or not when I came into the lab we still measured CO2 using a mercury manometer apparatus. One day I came to work and someone had knocked this glass apparatus to the floor. The whole lab was down on hands and knees trying to pick up the spilled mercury.
  13. What is your favorite line from a movie or book?
    “We need a bigger boat” Jaws
  14. What was the most interesting place you have visited during your career as a clinical chemist?
    Japan. I went to attend an IFCC congress and stayed an extra week to see the country. I had a great time and really enjoyed the people and the country. Would go back in a minute.
  15. What do you feel has been the most significant breakthrough in the area of toxicology in the last 5 years?
    LC-MS/MS. Goes without saying. The introduction of these systems has just really gotten underway and has already revolutionized clinical toxicology. Our forensic colleagues have already fully adopted this technology and I am sure we have just seen the tip of the iceberg clinically. It would not surprise me to see totally automated MS instruments in Core labs in the next 10 years.
  16. Describe some of the benefits and drawbacks you have found in performing clinical translational research?
    I have found translational research to be very exciting in that projects are y end orientated and quite focused on improving the patient’s condition. The drawbacks tend to center on the administrative hurdles one must overcome to be able to do this kind of research. Also, I am easily bored and with translational research there is always something new to be tried.
  17. Do you have any other specific comments or advice that you like to provide to the members of SYCL?
    I think you are entering our profession at a very auspicious time. The old guard is changing fast, as is the American healthcare system. You will have a multitude of challenges to face in the coming years but please do not forget that with these challenges come opportunities. Just remember to never sacrifice your principles for expediency.