INFORMING THE COMMUNITY ON SUBSTANCE ABUSE AND HEALTH DAMAGE: A “DEEP THINKER” IN NEPHROLOGY

Rahul Ravilla*

ABSTRACT

Stepping out from the realm of care of the hospitalized patients or in the dialysis unit, an "above and beyond" unique approach has been adapted by an innovative thought leader in nephrology. Dr. Girish Singhania's accomplishments are multifaceted and go much beyond in excellence of care of his patients admitted in the hospital with multiple life-threatening illnesses, many of which also compromise the functioning of kidneys on an acute or chronic basis. After serving a fellowship in nephrology at the University of Florida, Dr. Singhania served as an Assistant Professor of Medicine at the University of Utah. Dr. Singhania was Medical Director of Bonneville dialysis unit and Farmington Bay dialysis unit in Utah. His polynomial accomplishments in patient care include several scholarly academic publications, which clearly demonstrate an influence on medical sciences on a very wide basis. His books chapters have appeared from the Oxford University Press as well as in standard textbooks published by leading societies like the American Society of Addiction Medicine (ASAM). Dr. Singhania has published on vascular damage to the kidneys in the prestigious Journal of Hospital Medicine. As we discuss below, there is significant overlap in kidney changes seen in HIV infection and opioid overuse. This significant observation of disease pathophysiology overlap was reported in Dr. Singhania’s original study of oxymorphone-induced thrombotic microangiopathy and was presented at the American Society of Nephrology annual meeting in San Diego in 2015. Pain control is an important component in management of my cancer patients, which motivated me to take an interest in Dr. Singhania’s work. Certain cancers like multiple myeloma cause significant kidney dysfunction, where Dr. Singhania and his colleagues have made important clinical observations. Importantly, Dr. Singhania is a robust contributor to social medicine, utilizing the World Health Organization (WHO) recommended policies of mHealth to enhance health literacy. Utilizing the web, Dr. Singhania has made special efforts to enhance and engage audience for cessation of use of illicit drugs. He has relied on managerial principles of nuanced persuasion to hit at the root of problems resulting in the current widespread use of illicit drugs. Digital methodologies are increasingly being utilized for patient empowerment, being feasible due to thought leaders like Dr. Singhania. Dr. Singhania is a Fellow of the American Society of Nephrology ((FASN). In a candid interview, Dr. Singhania has expressed a crystalline vision of the medical issues, especially those related to the malfunctioning of the renal system and the facets of care when the subject presents to the hospital or the emergency room with substance abuse and acute mental confusion. Currently, Dr. Singhania is an attending nephrologist and hospitalist at the Catholic Health Initiative (CHI) St. Vincent Infirmary in Little Rock, Arkansas. He dawns upon us the highly important take-home message that not always dialysis is the panacea for the patient presenting in the ED (emergency department) with drug overdose and in fact, it may be difficult to flush out the dangerous excess of the toxic chemicals from the body. The discussion follows below.

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