American Association for Clinical Chemistry
Better health through laboratory medicine
June 2012 Mentor of the Month: Dennis Dietzen
Biography & Career
  1. With which professional societies/organizations (e.g. AACC) are you involved?
    I have been an AACC member since 1993 and have been predominantly active in the Pediatric-Maternal Fetal and TDM/TOX Divisions. I recently joined the Proteomic Division as this group has initiated a focus on one of my favorite subjects, metabolomics. In addition to AACC, I am a Fellow of the National Academy of Clinical Biochemistry (NACB), and a member of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS), the Society for Inherited Metabolic Disorders (SIMD), the American Society for Mass Spectrometry (ASMS) as well as a recovering member of the American Society for Hematology (ASH).
  2. How did you get started in these organizations and what advice do you have for young people wanting to get involved?
    I have been an AACC member since 1993 and have been predominantly active in the Pediatric-Maternal Fetal and TDM/TOX Divisions. I recently joined the Proteomic Division as this group has initiated a focus on one of my favorite subjects, metabolomics. In addition to AACC, I am a Fellow of the National Academy of Clinical Biochemistry (NACB), and a member of the Academy of Clinical Laboratory Physicians and Scientists (ACLPS), the Society for Inherited Metabolic Disorders (SIMD), the American Society for Mass Spectrometry (ASMS) as well as a recovering member of the American Society for Hematology (ASH).

    As for getting involved, I think it’s easy to say just “volunteer” because showing up and delivering is a great way to get noticed. Don’t just volunteer for anything, however. Have a plan. Identify a mentor who is doing what you want to do. Ask them which groups are important to belong to and which individuals are important to know. This approach will make your precious volunteer time count as you build a professional network.
  3. What area(s) do you specialize in and what initiated your interest in this (these) area(s)?
    We have a pretty flat organizational structure at St. Louis Children’s Hospital so I have a hand in most areas of our Core Lab including chemistry, hematology, urinalysis, and point-of-care testing. My favorite place is our metabolic-genetic laboratory and its array of expensive toys. My interests in the clinical laboratory and metabolism both started in graduate school. While many graduate students were flocking to thesis projects that employed molecular-genetic approaches, I quickly became fascinated with metabolic transformations and became a card-carrying “mitochondriac.” In the summer of my second year in graduate school I worked the graveyard shift in an athletic doping lab for the 1987 Pan American Games where my interest in clinical chemistry began. This was the perfect marriage between sports and chemistry. To this day, I root for the drug testers at the Olympics more than the athletes themselves.
  4. What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
    I consider one of my more important tasks to identify and fill gaps unique to the practice of pediatric laboratory medicine. To this end, I hope that the 4th edition of the Biochemical and Molecular Basis of Pediatric Disease that I co-edited with Mike Bennett and Ed Wong, will be a significant and lasting contribution for both lab medicine practitioners and pediatricians. In addition, I take a bit of satisfaction that four of our recent clinical chemistry fellows have pursued careers in pediatric laboratories. I like to think that we prepared them well.
  5. What were some of the most rewarding and/or challenging moments of your career?
    I actually think the most challenging moments end up being the most rewarding. My most challenging and satisfying moment came from consulting with our child protection physicians a few years ago as they were considering taking protective custody of a child. Along with our endocrinologists, they had concerns that an infant with recurrent hypoglycemia was getting exogenous insulin but insulin measurements on multiple samples performed at a reference lab came up empty. Under pretty severe time pressure, we devised a plan to use insulin immunoassays with three different combinations of antibodies hoping we might catch sight of an insulin analog. This strategy did produce evidence of the presence of analog insulin and we collaborated with some mass-spectrometrists in Germany who ultimately identified Humalog in the infant’s blood. This job does not produce many fist-pumping moments, but when I got the data from Germany, I did a little dance (sorry, nobody videotaped it).
  6. How would you recommend achieving an optimal work/life balance?
    This is the question I was dreading the most. If you look up the term “cognitive dissonance” you will probably find my picture. My wife can deliver a very eloquent psychological definition of this phenomenon but for me it boils down to wanting to be two (and often more) places at once. I clearly struggle with this but a few lessons I have learned are: 1) try to delegate; 2) have realistic expectations about what you can accomplish; 3) learn how to say “no” (sometimes); and 4) do fun stuff on a regular basis. There is a poem I like by Max Ehrmann entitled Desiderata that explains this concept the best I think: “Beyond a wholesome discipline, be gentle with yourself.”
  7. What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
    At the 30,000 foot level I see three big waves that present both opportunities and challenges for lab medicine. I call the first wave the information overload phase. We can generate far more genomic and biochemical data now than we can possibly hope to understand or act on. The next wave is the informatics wave. How do we digest all this information and discriminate the influence of multiple genes and environmental factors to diagnose and define pathology? The next wave is the intervention wave. How do we target this pathology? How do we monitor effectiveness of treatment? Lab medicine is key to surfing all three of these waves.
  8. What do you see as the challenges facing young scientists in laboratory medicine?
    I see both scientific and practical challenges. The scientific challenges are associated with the speed at which our understanding of biochemistry, genetics, and physiology is improving. Keeping up is tough and will get tougher. The practical challenges are no less daunting. In the information overload era, I believe labs will become the gatekeepers responsible for identifying and delivering only the most useful medical information. The good news is that the same critical thinking and communication skills you use to keep up with science will serve you well in keeping up with the pace of professional practice.
  9. What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
    I think I would answer this question the same way I talk to my children. Find what you are passionate about whether it is a disease state, a gene, a protein, or a technique. Learn all you can about it and find out where the knowledge, technical, and clinical gaps are. The goals will become pretty clear after that. Finally, once the goals have been defined, keep your eye on the ball (i.e., don’t lose focus).
  10. Are there specific aspects of practicing laboratory medicine that you find unappealing?
    You bet. I will be purposely a little vague here to protect the innocent. The legal/regulatory environment of the lab is often frustrating to me. Labs spend a lot of time with regulatory compliance. Too often, regulations don’t keep pace with technologic advances. I think we are seeing plenty of this as molecular diagnostics matures. In these cases, the regulatory drag makes it difficult to implement procedures and techniques that are clearly in the best interest of patients.
  11. How did you discover lab medicine/science?
    Growing up in a pretty small Midwestern town in the 1970’s my window to the world was television. I got hooked on the excitement of science by none other than Dr. Quincy, M.E. For the youngsters, Quincy was part doctor, part detective (the 70’s version of CSI). My hero in the show was Quincy’s technologist, Sam. Sam made Quincy look good.

    I discovered lab medicine by accident late in graduate school. Mitch Scott from Washington University sent me a letter describing the training program. In pretty short order, I went to St. Louis for an interview. After about 15 minutes talking with Jack Ladenson, I knew that I wanted work at the interface between the lab and the patient.
  12. If you could start your career again, what would you do differently? 
    As I was finishing college, I struggled with the decision to enroll in a graduate program or go to medical school. I ultimately decided that my temperament was more suited to the lab than the clinic. I realize now that these are not mutually exclusive pathways. If I had a do over, I would combine medical and research training. I think the clinical experience and credentials, combined with lab and research experience, would make it far easier to educate physicians and influence the way they care for patients.
  13. What are your top three favorite laboratory tests and why?
    I have a particular affinity for those tests that are packed with information that is not readily apparent to physicians. This is a major reason why lab medicine practitioners are valuable. Tests that fit that definition are multi-analyte profiles such as those for amino acids, organic acids, and carnitine esters. I also have a soft spot for thyroid function assays because during my time at DuPont (now Siemens) Diagnostics, I was responsible for calibrating these techniques on the first version of the Dimension RxL.
  14. What is the riskiest thing you've ever done?
    By no means am I a serial risk taker. Probably the riskiest thing I have done is chaperone my 12 year old son and 5 of his friends on a hike to the shooting range at Boy Scout camp a few years ago. I soon realized that I was sitting 10 feet from a half-dozen 12-year-old boy scouts who barely knew how to tie their shoes, but were now wielding loaded 0.22-caliber rifles. That was a bit unsettling, but I lived to tell the story.
  15. What motivates you?
    I was a pretty lucky kid. I was allowed to play and learn ad libitum. The nuns that taught me in elementary school consistently delivered a stern message that can be boiled down to the following statement: “to whom much is given, much is expected.” I really don’t want to disappoint the nuns.
  16. What is one thing that most colleagues in AACC do not know about you
    While a lot of people know I am a baseball fan, most do not know that I am a Cubs fan. One of my earliest memories is going to Wrigley Field with my father to watch Ron Santo (This Old Cub), Billy Williams, Fergie Jenkins, and Ernie Banks (Mr. Cub). Now, being a Cub fan is a particularly difficult thing to be in St. Louis. It does, however, teach one to be humble.
  17. Do you have any other specific comments or advice that you like to provide to the members of SYCL?
    Sure. There is value in fresh perspective as well as experience. Young scientists have an abundance of the former. Use it. Ask questions. Challenge routine things. The worst that can happen is that you will gain experience in the process.