- With which professional societies/organizations (e.g. AACC) are you involved?
AACC-1994 up to date, and ACLPS since 2005.
- How did you get started in these organizations and what advice do you have for young people wanting to get involved?
My first membership was with AACC when I was a full time student at Northeastern University, I knew about it from my teachers. When I was student, I attended many of the courses offered at the annual AACC meetings to enrich my knowledge. My advice to young people is to take advantage of this membership to build their education as much as possible. Other memberships were by either recommendation or by invitation.
- What area(s) do you specialize in and what initiated your interest in this (these) area(s)?
My areas of interest vary and they evolved over time from either my work as a Ph.D. student or during my fulltime job as a medical director. For example, I have an interest in free radicals research especially related to cystic fibrosis diseases and therapy. I have also studied free radicals impact in khat (Catha Edulis), an amphetamine-like plant chewed in Asia and Africa and now associated with bath salts. My interest expands also to laboratory tests ordering patterns and pre- and post-analytical errors. This interest stemmed from my daily interactions with the clinicians and the difficulty the lab and clinicians both face when the test is ordered incorrectly for one reason or another.
- What, in your opinion, has been the most important contribution you have made to the field of laboratory medicine?
This is a difficult question to answer but I can tell you that these are diverse contributions.
I was the first to discover a new mechanism for the degradation of S-nitrosothiols (S-nitrosocystiene and S-nitrosoglutathione). These are the reservoirs for the storage of nitric oxide in blood. My findings, which were published in the Journal of Biological Chemistry, showed for the first time that nitric oxide, a known vasodilator, is released from its reservoirs in nitrosothiols by superoxide radical. This was the first report to show that superoxide, a free radical, is responsible for the biological release of nitric oxide from nitrosocysteine and nitrosoglutathione. This paper is still quoted by many reports in high impact journals today. The journal of the Proceedings of the National Academy of Science has cited my research in an article edited by Lousi Ignarro, Nobel Laureate in chemistry. The mechanism was confirmed by many subsequent reports including a devoted article by Dr. Peter Wardman of King's College London, published in Journal of Biological Chemistry.
I also coauthored a paper with national and international experts in laboratory medicine "Decoding Laboratory Test Names: A Major Challenge to Appropriate Patient Care". This is an important paper because it highlights and set the stage for the need to improve and standardize test names, a challenge to all health care providers from physician setting level to laboratory bench site.
I also conducted the very early experiments to validate HE4, a test to monitor for recurrence and disease progression in patients with epithelial ovarian cancer. These experiments helped move the test into an automated analyzer and now is available to providers.
I continued to conduct research in cystic fibrosis and search for therapy using fatty acids supplementations. In addition, I'm interested in studying Khat which has cathinone as one of its ingredients associated with many street drugs.
- What were some of the most rewarding and/or challenging moments of your career?
There are many of these moments; the most rewarding one was obtaining my graduate degrees from the United States. I came from a poor country with very limited higher education opportunities. I am grateful for these opportunities which opened new horizons for me.
- How would you recommend achieving an optimal work/life balance?
I asked the same question of a friend of mine. Amazingly, he told me that the minute he leaves his work he forgets everything. Not everyone can do this. Early career this might be difficult to balance because you are just starting a new job and the workload can sometimes be overwhelming. The expectations are also high. Prioritizing work can be tremendously helpful in achieving optimal life.
- What are your predictions for advances in laboratory medicine and/or your area over the next ten years?
I think the field will become more and more automated. I'm afraid that these advances will result in fewer technologists and scientists entering the field. We already have a national shortage represented by low number of technologists in laboratory medicine. Many national medical technology programs have closed in the last 10 years. At the same time, I wouldn't be surprised to see more complex and compact blood testing analyzers with wide range of test menus in outlets drug stores available for consumers to purchase and use at home. We are already seeing these products with blood glucose devices being the simple example of such technologies.
- What do you see as the challenges facing young scientists in laboratory medicine?
I think the amount of knowledge in the field is beyond our imagination, comprehension and grasp. Scientific discoveries are being added almost every day to the field of laboratory medicine and the clinical chemistry menu. Is this a positive or negative trend? In my opinion, it is positive and it is to our advantage. What is important for young scientists is to realize that it is essential to keep their knowledge up to date whenever possible by attending national specialty meetings, reading scientific news briefs from AACC and attending exhibits to keep up with current technologies. In addition, they should also know that our work is challenging because laboratorians are dealing with many interdisciplinary issues on a daily basis. Making sure that you have a strong team around you to assist you in keeping the work flow moving smoothly is essential. Importantly, remember that although the profession of laboratory scientist encompasses many duties, including research, teaching and patient care, in the end it is always the patient who is most important.
- What specific goals would you recommend that young scientists in your discipline set for themselves? Any suggestions on how to achieve them?
Aim high and the sky's the limit. The field of laboratory medicine is dynamic and requires a dynamic personality too. For their first job, my best advice is to adopt simplicity with a "containment approach". That is to ensure your workflow quality is the best operational quality, identify challenges and areas for possible improvements. Once you know your area of work "surroundings" start planning ahead by identifying improvement opportunities in your laboratory or whatever work you do. Planning ahead is the key to success. Know the limitations of your environment and your limitations too. If you are in a small lab your available financial and staff resources might be limited by the institutional support. No surprise that this is a common problem. In a larger lab these limitations can still exist but the chances to move your work agenda ahead is higher. I like to share with young scientists Steve Job's quote: "That's been one of my mantras — focus and simplicity. Simple can be harder than complex: You have to work hard to get your thinking clean to make it simple. But it's worth it in the end because once you get there, you can move mountains".
- Do you have any other specific comments or advice that you like to provide to the members of SYCL?
Be curious and let your curiosity lead you but not consume you. I give SYCL members a quote from Albert Einstein: "Curiosity is more important than knowledge". My best humble curiosity example came from the nomenclature of vitamin D2 and D3. I always wondered why there is a number after the letter "D". It turned out that the first isolated compound was mistakenly identified as VD. When it was realized that it is not VD and it was something else, it was too late and the new vitamin D compound (from plants or ergocalciferol) was named vitamin D2 followed by vitamin D3 (from animals or cholecalciferol).
- What is an average day like in your life?
I wake up around 6:00 AM, exercise, read my emails, have breakfast and am on the way to work by 9:00. Once at work I begin answering clinician requests, interpreting tests, helping them pick the right test, reviewing utilization reports for tests we send outside our lab and determining if the expense of sending the test out can be justified or if we should be doing those in house. If this is the case, I discuss this possibility with the medical director of that area. Spending few hours in my research lab is also part of my daily activity. I arrive home around 6:30 PM.
- How do you handle stress/pressure?
I'm the kind of person who tries to stay calm under stress. Most of the times I've done some of my best work under stress; however, if the people I'm managing or working for are contributing to my stress level, I discuss other options for handling stressful situations with them. The key to shielding yourself from stress is to get organized and forget multitasking as much as you can.
- In your opinion, what is the most important leadership skill?
Humbleness and respect are the two most important players. As a leader you have to respect your colleagues, those who you work with, for, and serve. Leadership also requires making tough decisions, and those are not always welcomed. A leader must take full responsibility for decision taken, either right or wrong.
- What recommendation(s) do you have for new laboratory directors on how to establish and develop positive working relationships with clinicians?
One of the most challenging factors which impact the relationship between a lab and clinicians is the turnaround time (TAT). Whenever possible, try to arrange tours for new clinicians to your lab. This will allow them to be more familiar with your lab and appreciate what exactly you are doing for them and their patients. This will increase clinicians/nurses awareness and satisfaction.
- What process improvement initiative(s) have you found most challenging, and most rewarding?
Laboratory tests utilization review is the most challenging one. Clinicians are trained in different colleges and hospitals. They come to practice medicine with a list of tests that they used to order on their patients. Many of them insist that they send their tests to their preferred laboratory. These approaches can create a conflict between what the lab can offer and what the clinicians can expect. With continuous discussion with the clinicians' and/or their departments, we were able to consolidate these send out tests to fewer laboratories.
- How has being a father of four children helped you navigate challenges in your career?
Without my wife's support I would probably not be here answering these questions. I give her the highest credit for supporting me throughout my career. She takes care of our family at all times.