Poison Is My Profession : A Doctor Pursues His Mission to Expose the Dangers of a World Filled With Killer Chemicals

A TYPICAL Wednesday afternoon at Olive View Medical Center in Sylmar: A nurse opens Dr. Marc Bayer’s office door, leans in and says, “Someone’s drunk a jar of furniture stripper.”

Bayer rushes to the hospital’s psychiatric ward and meets the sullen poison victim, a patient on the ward who smuggled the jar out of a crafts class. The woman complains of nausea but otherwise seems fine while she reluctantly permits Bayer to examine her. She refuses to tell him how much she drank. Bayer checks her breathing and pulse rate and quickly decides that the woman was making a rash gesture instead of attempting suicide--”she may even know the stuff wouldn’t kill her.” The real problem, he says, is that furniture stripper contains methanol--wood alcohol. “Someone can drink it and feel fine until 12 hours later,” Bayer says. “Then it can cause permanent blindness.”

The woman’s stomach is pumped and she is given powdered activated charcoal, which prevents absorption of poison. Several days later, tests results reveal that her vision will not suffer. By that time, Bayer is already treating a boy who drank liquid cadmium (a heavy metal found in batteries) and developed kidney damage; a woman who overdosed on antidepressants, and two people whose car was sprayed with poisonous fumes by a stray crop-dusting plane.

IN A WORLD filled with toxic substances, Marc Bayer, 42, is one of the country’s foremost experts in the medical subspecialty called toxicology--the science of poisons and their effects and antidotes. Bayer divides his time among three posts: medical director of the county’s only poison information center; clinical associate professor of medicine at UCLA, and department chairman of emergency medicine at Olive View Medical Center in Sylmar. Drawing on his skills in clinical, environmental and forensic toxicology, he also serves as a toxic trouble-shooter when poison-related problems arise anywhere around the country.

Bayer’s long-range goal, however, is heightened public awareness of an increasingly toxic world. Science, he says, continually develops potential poisons without paying sufficient attention to the repercussions. “Drugs and chemicals are ever-present in our lives,” he says. “Pick a disease, we have a chemical to make it better; your dog has fleas, we have a chemical; you want your apples to grow better, we have chemicals; you want to kill someone more efficiently, we have chemicals for that, too. Every year, we see increasing numbers of incidents, accidental or intentional--the Tylenol lunatic, Alar on apples, Chilean grapes--but there simply aren’t enough people monitoring it all.”

Bayer’s solution would be the formation of an independent federal regulatory agency to test chemicals, toxicants and poisons. “The Food and Drug Administration is often criticized because it doesn’t approve drugs fast enough, because it over-tests,” he says. “The same regulations don’t apply to chemicals; they don’t have to pass rigorous tests. Our knowledge of most chemicals is primitive,” in part because much of the research on them is performed by chemical companies, much of it protected by trade secrets.

“We need definitive experts who can say what has to be studied, such as a surgeon general, but for chemicals. The testers should take into account risks versus benefits; we can’t just eliminate all chemicals because most are helpful to society. But I would like to see a world where no chemical is released without extensive research on its effects on humans, its effects in laboratory settings and any known effects it has on animals.”

Few colleagues have heard Bayer’s call because toxicology is a relatively new field. According to Dr. Lewis Goldfrank, director of emergency medicine at Bellevue Hospital in New York and director of that city’s poison center, the medical specialty is so recent and so rare that it has not yet been approved by the American Board of Medical Specialties. The American Board of Toxicology has certified only 130 toxicologists, all of them previously certified in a specialty such as emergency medicine, internal medicine or pediatrics. Today, only half a dozen toxicologists practice in Los Angeles; 10 practice in New York City. “Many people don’t yet understand what we are doing,” Goldfrank says, “but we are being slowly accepted by the critical people”--those who have the money to finance educational programs and poison centers.

In New York, growing acceptance of the importance of the field has meant increasing funding for research. Los Angeles, Goldfrank says, is lagging far behind. “It has not been as committed to solving toxicological problems,” he says. “Bayer was brought to Los Angeles by UCLA to develop the field of toxicology.”

BAYER WAS born in Chicago and attended Washington University in St. Louis, where he majored in zoology. In the mid-’70s, he enrolled in the University of Colorado School of Medicine in Denver with ambitions of becoming an internist. But his attention was diverted by the urgency of the emergency room.

At that time, the medical Establishment regarded emergency medicine as a second-class discipline. “It was for those who couldn’t make it in traditional medicine,” Bayer says. But the exposure to the emergency room hooked him. “Where else can you get people in a crisis situation, blood and gore all over, you go boom, boom, boom, you make the decisions? My personality,” he says, “is dominated by a short attention span. Emergency medicine always gave me a rush.”

After an internal medicine internship at UCLA Medical Center, Bayer enrolled in an emergency medicine residency program at Denver General Hospital for two years. In the emergency room, he encountered drug overdose victims, “people crying out for help, but about whom we knew little--we could save a cardiac arrest easier than an overdose. I found a general lack of knowledge, a need for medical and public awareness in the toxic area that wasn’t being attended.” And so toxicology became his specialty within the larger field.

Bayer left Colorado to become the founder / director of the Oregon Poison Center in Portland and an associate professor of emergency medicine and associate director of emergency services of the Oregon Health Sciences University. He moved to Los Angeles when UCLA offered him his current position in 1987.

Bayer gets up at 4 a.m. every day, usually misses lunch, works nights and weekends and drinks as many as 20 cups of black coffee a day. In his first year in Los Angeles, he logged more than 40,000 miles in his black Porsche (license plate: POIZN) teaching classes at UCLA, lecturing at every major hospital in Los Angeles, testifying in court, and working four shifts a month in the Olive View emergency room and on 24-hour call for the poison center.

Founded in the late 1950s, the center was operated by Children’s Hospital, but private financing made its position constantly tenuous. By 1980, after the patron who had been financing the center died, the hospital announced that it could no longer pay the center’s bills. At that point, says Marshall Morgan, director of emergency medicine at UCLA, the medical community in Los Angeles “dropped the ball. The proper home for the poison center is a major university, and for whatever reasons, no leadership in either place--USC or UCLA--picked it up.” Three weeks before the poison center was scheduled to close, it became part of the Los Angeles County Medical Assn., which, Morgan says, “simply does not have the resources of a medical center.” The yearly budget is $900,000, and Bayer says funding remains a difficulty; he is constantly trying to raise enough money to curtail cutbacks in the center’s services.

Under Bayer’s supervision, 13 staff members, all nurses, attempt to assist 80,000 callers each year from a phone bank at LACMA headquarters at Wilshire Boulevard and Alvarado Street. If they can’t answer a question themselves, they consult Bayer.

The calls range widely in tone and urgency: attempted suicides who have changed their minds; bulimic teen-agers wanting tips on what will make them throw up; the 3-year-old who tasted from each of his mother’s 20 bottles of cologne; the woman who mistook her eyelash glue for ointment and spread it between her toes; or the child who ate a bottle of vitamins, then four cloves of garlic, then a box of 22 dog deworming pills, and then the box. Callers are most commonly advised to get the victim to an emergency room for stomach pumping and a dose of activated charcoal.

Sometimes following warning labels can make the problem more deadly. Bayer points out that “vinegar used to be recommended (as an antidote) for Drano until it was discovered that, in the right situation, it can cause a giant hole in the esophagus.” Corrine Ray, the center’s chief administrator, recalls a baby girl who swallowed rubbing alcohol. The child, however, became excessively ill for the amount of alcohol consumed. Her father then explained that he had given the child salt in a glass of water to induce vomiting, as recommended on the alcohol label. He was unaware that too much saltwater can induce sodium chloride poisoning.

Ray was so incensed that she called the manufacturer and demanded an explanation for the antidote. “My mother-in-law told me to do it,” the company’s director explained. Ray consequently discovered that no government regulation controls curative labeling--companies can recommend whatever concoction they wish; the consumer is always at risk.

BAYER LIVES ON top of the Laurel Canyon hills, in a rented house with a Dalmatian, a German shepherd and his wife of 10 months, movie executive Marie Jansen-Bayer. On their first date, Jansen-Bayer asked about undetectable poisons well-suited for murder--she was developing a movie about a woman who poisons her husbands, which eventually became Fox’s “Black Widow.” Bayer froze.

“He then looked at me and asked, ‘ Why are you asking me this?’ ” Jansen-Bayer says. She explained that she only needed a plot device, but Bayer still wouldn’t reply. “I get constant calls from Hollywood, from script writers, producers,” he says. “But I don’t like the idea of dispensing information about undetectable poisons--there are too many, too many that can be abused.”

The deliberate abuse of poisons is another of Bayer’s specialties. He is a frequent expert witness in such trials as that of an Oregon weightlifter who claimed that his steroids intake deranged his body chemistry and caused him to kidnap and kill a rude shop clerk. (Bayer testified that the man hadn’t consumed enough, and the man was convicted.) He also testified in the case of a Portland politician who shot his lover but claimed that his confession was obtained under the influence of too many painkillers. (Bayer disagreed; the man was also convicted.) Bayer investigated the poison laboratories at the Oregon commune of guru Bhagwan Shree Rajneesh, whose acolytes had been accused of sprinkling salmonella bacteria around salad bars to prevent non-Rajneesh voters from participating in local elections. Rajneesh was deported in 1985 and no formal charges were filed.

Bayer’s forensic investigations also take him into the world of unintentional tragedy, such as the baby boy admitted to a hospital with an unidentifiable ailment. The boy slowly weakened and, after about a month, died. Called in for consultation, Bayer eventually discovered that the infant had swallowed a small piece of lead; the lead poisoning caused a full-blown case of toxic brain syndrome. A family of Vietnamese refugees put charcoal in their fireplace and contracted carbon-monoxide poisoning; Bayer recommended that some of them be treated in hyperbaric chambers pumped with high levels of pure oxygen. The more pressing problem, the long-term effects of carbon-monoxide poisoning, was untreatable and could surface only a few weeks later in the form of a brain tumor. Occasionally, Bayer’s encounters verge on the tragicomic: A Beverly Hills woman whose dog ate her pet duck wanted Bayer to feed the dog a substance that would force it to regurgitate the duck intact, like Jonah emerging from the whale.

“Toxicology,” Bayer says, “provides limitless perspective on the human condition.”

THOSE WHO KNOW and work with Bayer describe him as passionate and committed. In part, he says, he is motivated by the sense that people remain unaware that their environment might be slowly killing them. When Rachel Carson’s classic precautionary book on DDT, “Silent Spring,” was published, “people didn’t take it seriously,” Bayer says. “Decades later, people still don’t understand how toxic the environment is. I won’t rest until they do.”

Los Angeles’ Dr. Poison, toxicologist Marc Bayer: “Our knowledge of most chemicals is primitive.”