Dr. Robert Lull Was
US Army Nuclear
Med Consultant
Sharing Our Specialized Knowledge

By Robert J. Lull, MD
San Francisco Medical Society
Active community participation as a physician, beyond the provision of one-on-one patient medical care, always seemed natural. My concept of "physician" includes being involved with all aspects of our social and political environment. This seems particularly needed today, when our political institutions significantly impact the traditional doctor-patient relationship.
Our privileged position as physicians in our society provides us with a powerful voice in community affairs. When I was the senior officer in a small community of Army families in the Marin Headlands, I learned a lot about the inherent community respect and powerful voice that can be derived from just being a physician. This is particularly true when there is need for our specialized medical knowledge. The Army offered several unique opportunities to utilize my specialized training in nuclear medicine. In my role as the Nuclear Medicine Consultant to the U.S. Army Surgeon General, I became involved with emergency medical teams preparing to respond, if needed, to nuclear weapons accidents. Several times a year, I actually taught classes about the medical aspects of such accidents at the DOD's Inter-Service Nuclear Weapons School.
After leaving the Army to assume my current position as Chief of Nuclear Medicine at San Francisco General Hospital, I continued to use my expertise in radiobiology and radiation risk assessment in my role as physician-citizen-activist. I became the sole physician member of a -appointed citizens' advisory committee that toured and reviewed the evacuation plans of each nuclear power plant in California. It always seemed important to share my knowledge about radiation risk, since misinformation and fear about ionizing radiation often causes political paralysis when the greater public good requires decisive action.
When physicians and scientists avoid the heated public debates about such controversial subjects as ionizing radiation, ignorance and fear too often triumph over science. Dealing with low level radioactive waste (LLRW) is an example of such a contentious issue. There are many benefits to society from the use of radioactive materials. However, these activities do generate LLRW, which requires safe disposal to avoid human exposure and environmental contamination.
I got actively involved in this issue 20 years ago when Congress passed legislation encouraging states to form groups, called compacts, in order to share LLRW disposal responsibilities. California is the host state (i.e. responsible for developing a disposal site within its borders) for the Southwestern LLRW Compact. I was appointed several years ago by the governor as one of four LLRW compact commissioners for California and, am the only physician member of the commission, which controls LLRW disposal within California and the other Southwestern Compact states. Since many of the public concerns about LLRW relate to potential health risks, the presence of a physician commissioner is very helpful at our many open meetings.
I have continued to be a board member and was formerly a chairman of the California Radioactive Materials Management (CALRAD) Forum, a watchdog group of radioisotope users (from medicine, education, research, industry, and utilities) which seeks to ensure a safe and cost effective LLRW disposal solution in California. I represented both the CMA and the University of California on this board. This issue, which has national ramifications, continues to defy the political consensus needed for a permanent solution.
One of my most enjoyable activities is being a board member of my local Diamond Heights Neighborhood >>Association in San Francisco. It has been a lot of fun working with my neighbors. They really appreciate a physician making time for local community activities. We currently are focused on preventing the San Francisco Police Academy from moving out of our neighborhood to distant Treasure Island. This issue has allowed me to meet with elected city officials in a context quite different from my usual SFMS concerns.
In summary, I have found it extremely satisfying to interact as a physician-citizen at various governmental levels and hope that such extra efforts make a positive difference on the world we share with our patients.
- Dr. Lull is the president elect of the San Francisco Medical Society and the chief of staff of the SFGH Department of Nuclear Medicine.



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