March 25, 2014


When a boy arrived at Texas Children’s with massive, progressive swelling caused by a bite from a southern copperhead, toxicologist Dr. Spencer Greene knew just what to do.

“Doctors at an outside hospital minimized the significance of the bite and had no intention to treat him, even though he was very symptomatic,” said Greene. “We started antivenom, and he responded well. Not only is he back to playing sports and acting like a normal boy, he now is fascinated with snakes, which I think is pretty neat!”

32514toxicologist6403Greene’s passion for helping those who suffer from accidental poisonings and his enthusiasm for the obscure field of toxicology make him an exciting addition to our medical staff. He joined Texas Children’s as a consulting medical toxicologist this past October, and the timing proved fortuitous. Texas now leads the nation in number of snakebites per state, and with the addition of Greene, Texas Children’s boasts the only board-certified medical toxicologist in Houston.

But Greene’s role will extend well beyond the treatment of snakebites. He will diagnose and manage the effects of other poisonous or harmful substances that are hazardous to children and adolescents. Also board-certified in emergency medicine, he will be called upon for his expert opinions on treating accidental and intentional ingestions, toxic substance exposure, envenomation, occupational and environmental exposures or severe alcohol and drug abuse reactions. Greene also will continue his roles as director of medical toxicology and assistant professor of medicine at Baylor College of Medicine.“I consider my consultations to be an opportunity to educate everyone involved in the case, including the patient and/or his or her family, the nurses, the students, and the physicians,” said Greene. “By consulting on patients with toxicological emergencies I can help the admitting physicians and the doctors in the emergency department diagnose and treat patients efficiently and safely.”

Greene takes pride in collaborating with physicians from other specialties and using his unique fund of knowledge to help diagnose and treat patients with an illness or injury that is rarely encountered. His varied list of successful cases range from a young girl who ingested her father’s muscle relaxant and presented to the hospital with altered mental status, and a young man who was having a rare idiosyncratic reaction to the medications he had been given after sustaining a major trauma, to a high-profile case of a man with massive bee envenomation who was stung over 3000 times.

“Medical toxicology has a whole body of knowledge that is not commonly taught to most physicians, and often times toxicologists get to use this information to arrive at some pretty obscure diagnoses,” said Greene.

With his involvement, the goal is to reduce the amount of unnecessary testing that is often performed on patients with toxicological emergencies. Greene also hopes to dispel some myths that may surround toxicology patients and recommend therapy that is evidence-based rather than done “because we have always done it that way.”

In previous positions, such as his post as the program director for the University of Arizona Medical Toxicology Fellowship, Greene worked with adult patients who have chronic psychiatric illness or substance abuse, meaning even if he helped treat the acute toxicological condition, it was often only a matter of time before the patient returned with a similar emergency. He’s looking forward to focusing on pediatric patients, many of whom are victims of accidental poisonings and can expect a full recovery with proper treatment.

“It is very gratifying to know that I can make a real difference in my patients’ lives,” said Greene. “I hope that my involvement will help prevent poisonings at home and will give health care providers some information they can use whenever they treat toxicology patients in the future.”