Agent Of Change
Posted: October 18, 2010, 7:10 p.m., EDT
Photo courtesy of Dr. Brett Cordes
Health scare gives Brett Cordes new direction as a veterinarian
By the time Brett Cordes, DVM, was in his mid-30s, he had worked in veterinary practices for the better part of two decades. He started in high school, worked his way through college and veterinary school, then spent 10 years as a practicing vet.
The way he handled potentially hazardous materials, particularly chemotherapy drugs, was often cavalier during these years, he admits. He wore little or no protective gear when handling chemotherapy agents and often dumped pills into his ungloved hand when dispensing them. He poured oncology drugs down the sink, even after noting how some left an angry red stain that lingered for days.
Then in 2006, a specialist diagnosed an almond-sized lump on his neck as a rare form of thyroid cancer. One of the first questions the doctor asked: Was Dr. Cordes ever exposed to chemotherapy?
Suddenly everything changed for Cordes, from the way he practiced veterinary medicine to the way he thought about workplace safety.
“Most veterinarians really do everything. We’re our own oncologist, radiologist, pharmacist, dentist,” says Cordes, now 39, who is careful to note that although he and his physicians strongly suspect his exposure to oncology drugs played a part in his cancer, no definitive link has been proved.
“So we get exposed to [hazardous agents] all the time, but the real question is, we don’t know how much it takes to cause disease.”
Now, four years later, a fully recovered Cordes has reshaped his career and life. He left private practice in early 2007 and is now an independent consultant and the medical director for the veterinary division of The Apothecary Shops. His goal: Improve pharmacy and safety standards in veterinary medicine while still providing the best care for patients.
Growing up in small-town Iowa, Cordes dreamed of becoming a veterinarian in the James Herriot mold, taking care of all creatures great and small in a bucolic rural community. But when his parents moved to Dallas, he began working summers in specialized urban clinics.
On the Move
In 1996, he graduated from veterinary school at Iowa State University. (He says he got in, even after early struggles with organic chemistry, by visiting the admissions office at 4:30 p.m. every Friday for months during the application process, wearing down the employees with his persistence.) He immediately went to work in small-animal practices, eventually settling in Scottsdale, Ariz.
This was when cancer drugs for animals were becoming widely available and affordable, and usage was increasing dramatically, Cordes says. He figures he was exposed to harmful agents numerous times over his career but was never really trained to handle them correctly.
Immediately after his cancer was diagnosed, Cordes quit exposing himself to anything that might carry health risks—anesthesia, X-ray equipment and chemotherapy drugs. He stopped going into the surgery suite completely.
But with a young family to support, he could not leave his practice until he found another way to use his veterinary training to make a living. He began offering consulting services on the side, correctly identifying a growing market for products and training aimed at safety. Within months, he parlayed his new expertise into a full-time position with The Apothecary Shops, a Phoenix-based chain of specialty pharmacies.
Now, Cordes says, he focuses on several arenas.
He develops workplace protocols for dealing with oncology drugs safely and creates training to ensure that workers, from technicians to veterinarians, know how to handle potentially dangerous oncology drugs. He estimates that as many as 4,000 practices in the United States may administer oncology drugs, and how many of those have safety standards in place for workers is unclear. Many don’t have ventilation systems, he says.
“My best advice is not to touch [them],” Cordes says of oncology drugs, advising that smaller practices refer oncology cases to specialists. “And the next level is if you do handle it, you need to practice 100 percent containment.”
To that end, he helps select and market products adapted from the human health field that have applications for veterinary medicine.
For instance, he is helping to market a closed-system device that confines spray and vapors when a drug vial is punctured, so workers don’t ingest harmful fumes. And he’s working on helping practices dispose of waste more safely. He recently co-authored a paper for the National Institute for Occupational Safety and Health, and this year he served on the AVMA’s National Hazardous Waste Product Database Task Force.
Cordes believes that more regulations are coming, both in the handling of chemotherapy agents and disposing of waste, and that veterinary practices need to adapt quickly.
“It’s already happening in human health care, and in veterinary medicine we’re a little behind,” he says. “I’m afraid we’ll lose the ability to administer these drugs if we don’t” self-police and improve standards for handling them.
Not Exploiting His Past
Cordes typically doesn’t bring up his health scare unless asked.
“If you don’t know Brett well, you’re not likely to know that he had this horrible battle with cancer,” says Albert Ahn, DVM, president of the pharmaceutical company AB Science USA, who has worked with Cordes on several projects. “While he could use that as a selling point, to use as a scare tactic or to earn sympathy points, he just doesn’t do that.”
Cordes says the reason he doesn’t typically volunteer his health history is partly that he doesn’t want to capitalize on his own problems and partly that he doesn’t need to.
“Every veterinarian knows someone who has died at a young age of cancer, or who had a thyroid disease,” Cordes says. “This touches everybody.”