By Arthur Lightbourn
Over the course of a career spanning four decades in nuclear medicine, Dr. Michael Siegel estimates, “without exaggerating,” that he has been responsible for approximately 375,000 nuclear medicine procedures, the largest number in the country and perhaps in the world.
Siegel chalked up that impressive record while chief of nuclear medicine at five Los Angeles hospitals, a professor in the department of radiology, division of nuclear medicine, at the University of Southern California’s Keck School of Medicine, and a clinical professor of radiology at University of California San Diego School of Medicine.
So, it’s not surprising that next June at the annual meeting of the Society of Nuclear Medicine in Miami, Siegel will be honored with a “Lifetime Achievement Award” by the American College of Nuclear Medicine.
At a very active 69, Siegel is still a professor at USC and UCSD.
All of which, begs the question, especially for those of us who have never undergone a nuclear medicine procedure, what exactly is it and what does a nuclear medicine physician do?
To find out, we interviewed Siegel at his “empty nester” home in Rancho Santa Fe where he lives with his wife of 45 years, Marsha, and their King Charles spaniel, Chuckles. They have lived in the Ranch for 10 years and have two grown children.
How does he do that, live in Rancho Santa Fe and still be a full-time professor at USC?
“We were the pioneers of teleradiology,” he explained — doing scans digitally, eliminating the expense of films and darkrooms, and being able to connect cameras on all the different floors in the hospital. “I was using teleradiology probably 25 years ago. And this was all before the Internet.
“So that’s why I can sit here at home today with a laptop” to review scans sent to him via computer and “I only have to travel to USC about once a week,” he said.
Nuclear medicine is a medical specialty that came into widespread clinical use in the 1950s. It uses radioactive substances to diagnose and sometimes to treat disease. It’s been described as an “inside-out” X-ray because it records and tracks radiation emitting from a patient’s body rather than radiation directed through a patient’s body to form an image.
In a nuclear medicine procedure, small amounts of radioactive materials, (radionuclides), are combined with other elements to form chemical compounds or are combined with existing pharmaceuticals, to create what are called “radiopharmaceuticals.” The radioactive medicine is introduced into a patient’s body by injection, inhalation or swallowing. As a radiopharmaceutical travels through the patient’s body, it produces emissions in the organ, bones or tissues being imaged and, with a special camera, records the emissions on a computer screen.
Nuclear medicine is unique because it documents function as well as structure. It allows physicians to see how well or not well an organ is functioning, not just what it looks like.
Common NM procedures include thyroid examinations, brain scans, lung scans, heart stress tests, liver, kidney, and gallbladder procedures. Although primarily used for diagnosis, nuclear medicine is also used to treat thyroid cancer, hyperthyroidism, blood disorders and pain from certain types of bone cancers.
Highlights of Siegel’s career include:
• Participation in the world’s first MUGA (Multi Gated Acquisition) scan, a test to look at cardiac function without the injection of dyes or catheters.
• Performance of the first scan using the radionuclide Thallium in the U.S., used to detect coronary artery disease.
• Pioneering the development of Peripheral Vascular Profusion Imaging to determine whether an ulcer in a patient’s leg caused by constriction or blockage of a blood vessel can heal with medical therapy rather than requiring amputation.
• And devising a new form of radiosynovectomy for the treatment of inflamed knee joints which was recognized with congratulations by the Clinton White House.
Siegel speaks rapidly, like “Dr. Oz,” in-a-rush to get out everything he wants to communicate as completely, accurately and enthusiastically as possible, slowing down, only once a while to say: “You want to hear a funny story?” and then proceeding at a renewed clip, complete with chuckles, to relate something that happened in his life, such as the time an acquaintance stopped him while he was walking his dog on Wilshire Boulevard in Beverly Hills and asked: “You wanna be in a movie?”
“That’s how I got a part as an anesthesiologist in the NBC Movie of the Week, ‘Mirror Mirror,’ and later became a technical advisor for the 1980s TV medical drama series, ‘St. Elsewhere.’”
Siegel was born in New York City. His father was in the clothing business — ladies coats and suits — in New York, but later moved the family to Tucson, Arizona, where he became a successful builder and developer.
Initially, the young Siegel had thoughts of becoming a chemical engineer, but, while growing up in Tucson from age 13, he met and was inspired by family friend and surgeon Dr. Jules Whitehill.
“He had been a surgeon in New York, came to Tucson, people came from all over the world to be operated on by him. Very smart. Good sense of humor. I idolized the guy…He kind of inspired me.”
Siegel earned his undergraduate degree in zoology with a minor in chemistry from Cornell University in 1964, and his medical degree from The Chicago Medical School in 1968; followed by a four-year NIH (National Institutes of Health) fellowship in diagnostic radiology and nuclear medicine at Temple University.
Next stop: The Johns Hopkins University in Baltimore, Maryland, as an assistant professor of nuclear medicine for six years while also serving two years as a major in the Air Force during the Vietnam War era before moving to California to join the faculty of USC.
Asked what drew him to and fascinates him so much about nuclear medicine, he said: “You think about it. Every disease, every disease, except one, starts at cellular levels. The only one that doesn’t, is an acute fracture. ... Every other disease starts with some cells going awry…
“Nuclear medicine is basically taking various compounds that the cells use and making those compounds radioactive by putting a radiopharmaceutical onto them either orally or intravenously and getting to watch those cells work because they take up our tracers….I’m looking at the cells [functioning]. I’m looking at what’s going on inside…I can sit with my camera and watch for an hour if necessary [to determine what’s working, what’s not, and what has to be done].
Asked what he likes most about his work, he said, “Two things. Three things, really. First, I love teaching. I really get a big kick out of it…It’s nice to know you’re passing along information to people that are going to take care of people.”
He’s been teaching for 36 years at USC, which includes USC Medical Center, the largest teaching hospital in the world, and has seen many of his students, residents and fellows go on to prestigious positions, both in clinical and academic settings.
“And I like the idea of helping people. You’re a physician. What’s better than that?
“What satisfies me the most? Every once in awhile you’ll take care of a patient, and they’ll grab my hand like this and say, ‘Thanks, doc.’ That does it. I’m a softie.
“People don’t often realize that. Doctors are actually human.”
Name: Michael E. Siegel, M.D.
Distinction: Nuclear medicine physician and professor Dr. Michael Siegel will be honored with a “Lifetime Achievement Award” by the American College of Nuclear Medicine at the annual meeting of the Society of Nuclear Medicine this June in Miami, Florida. He has served on the faculty of the Keck (USC) School of Medicine for 36 years, chief of nuclear medicine at USC, and is also currently a clinical professor of radiology at UCSD School of Medicine.
Born: New York City, 69 years ago
Resident of: Rancho Santa Fe for past 10 years
Education: A.B., with a major in zoology and a minor in chemistry, Cornell University; 1964; M.D., The Chicago Medical School, 1968; followed by a four-year NIH (National Institutes of Health) fellowship in diagnostic radiology and nuclear medicine assigned to Temple University.
Military service: Two years as a major in U.S. Air Force
Family: He and his wife, Marsha, have been married 45 years. They have two children: son, Herrick, chief of orthopedic oncology, University of Alabama; and, daughter, Meridith, a “fitness trainer to the stars” in Hollywood. Special family member: King Charles spaniel “Chuckles.”
Interests: Oil painting.
Reading: Mostly medical journals and business publications
Favorite saying: “Treat every patient as if they were your favorite relative.”
Favorite getaways: Australia and Aruba
Favorite film: “Groundhog Day,” 1993 comedy starring Bill Murray
Favorite TV: “St. Elsewhere,” a 1982-88 medical drama TV series on which Siegel served as a technical advisor.
Physical regimen: “I spend about an hour per day [at the gym] either lifting weights or moving along pretty rapidly on an elliptical machine.”
Philosophy: “Prepare for the worst and be pleased with a positive outcome.”