"There's no problem too big if you get the right people together"
This summer Carrie McNeil, DVM, MPH, found herself at a big-city grocery store where the aisles were bursting with fresh fruit
and vegetables, fresh meat and chicken—healthy food everywhere. It may not have seemed unusual to the average U.S. shopper,
but McNeil was brought up short.
Dr. Carrie McNeil, MPH, in New Mexico with the family dog, Joe Friday.
She had just completed a visit to the Navajo Nation as part of a CDC team addressing tribal leaders' concerns about the rising
tide of obesity and diabetes among the Navajo population. "We literally went to every convenience store and trading post in
every tiny town around the Navajo Nation and looked at the food options," McNeil says. What she and the other researchers
found was a lack of options for healthy food.
"[Navajo leaders] recognized the need and I don't think there was any trouble getting evidence," McNeil says. But solutions
are more difficult than gathering proof of a problem. "Sometimes the easiest way to get healthy food is for people to just
grow their own, raise their own livestock to eat and their own vegetables. I'm not sure what their policies will include,
but it will be interesting to see."
McNeil says the CDC's Epidemic Intelligence Service teams are invited by cities, tribes and even countries to investigate
potential health problems. She was deployed with this team because she'd worked with other tribes in New Mexico and also because
she's a veterinarian, even though the trip involved no specific veterinary medicine.
"We have expertise in food availability, food security and food safety," she says. "Those are areas where veterinarians can
play a huge role. We're trained in this. Even if you're a small animal practitioner, you receive some training in the food
animal production world. We all took food safety training. It's something that impacts every person and every animal. In this
case it was partly a matter of understanding how the food system works and how the agriculture system works. Hopefully that
helped me supply some additional insight into the project."
Currently McNeil is transitioning to a new position with Sandia National Laboratories' International Biological Threat Reducation
program, which focuses on global biosecurity. Before joining the EIS, she spent four years working as an emergency veterinarian
in New Mexico, California and Georgia. "You see so much in emergency medicine where you say, 'This is something I could be
preventing,'" she says. "I was really interested in preparedness, and much of that is really a public health focus. So I went
back to get my public health degree."
The public health arena actually helps McNeil close the loop on her longstanding interest in public policy, a thread woven
throughout her veterinary education and her career. In 1997 she was a Jesse Marvin Unruh fellow in the California State Assembly
working for one of her mentors, Assemblywoman Shiela Kuehl. Her undergraduate biology degree distinguished her from the attorneys
in the legislature when it came to science and health issues. She worked on women's health, environmental health and animal
health issues, among others. During veterinary school at the University of California-Davis, she took a yearlong hiatus from
her studies to work with Kuehl again, this time in the California State Senate.
In veterinary school she was smitten by the work students and faculty were doing at UC-Davis in the Wildlife Health Center.
The idea of ecosystem management fit well with the policy work she'd been doing legislatively.
"I was always interested in the One Health aspect of veterinary medicine and after graduation I worked on some water quality,
environmental health, and ecosystem health issues from a nonprofit perspective," she says. "But I really missed working one-on-one
with animals and clients. So I went back and did an internship at VCA in West LA, which is where I got my training in small
animal medicine and my interest in emergency medicine."
McNeil sees a connection between working with animals in veterinary practice and ecosystem management. "Water-quality testing
is similar to testing the blood of an animal," she explains. "It's your diagnostic tool to look at the health of the waterway."
The major connection for McNeil is the role public policy plays, which brings together her veterinary training and her desire
to work on problems at their political source. Her EIS work is like a river fed by all the streams of her working life.
"I feel really fortunate that I've had these opportunities," she says. "Public health has been a great way personally for
me to bring together my policy interest and human health interests and animal and environmental health interests. And, just
like in clinical practice, you don't know what you're going to see day to day."
McNeil has been called to investigate foodborne illness outbreaks, respiratory disease outbreaks and norovirus outbreaks.
She's investigated the prevalence of whooping cough in New Mexico. She's presented a paper on the diversion of controlled
substances in New Mexico and the potential connection to prescription overdose deaths. She's helped investigate and manage
a rabies outbreak in southern New Mexico in which more than 100 unvaccinated exposed pets had to be euthanized and 29 people
had to receive post-exposure prophylaxis.
"At the most basic level of diseases, all of our Class A bioterrorism agents, except for smallpox, are agents that affect
people and animals, and many of our infectious diseases affect people and animals," she says. "So that's always been an obvious
connection to me. Once you get into the food system, food availability, general public health and well-being, you find a lot
of areas where veterinary medicine can play a role in improving human health."
Preparedness policy, for example, requires the combined efforts of experts in human hospitals, veterinary hospitals, transportation,
food access and a plethora of other areas. And while many people are cynical about the possibility that today's divisive policymakers
can work together for effective solutions, McNeil says with a chuckle that she is not.
"The policy work I did taught me the importance of bringing different players together," she says. "At the end of the day,
more often than not, you really can get people to come to the table and work together. I've seen it work. The problems are
too big for people not to work together and figure things out. There's no problem too big if you get the right people together."
John Lofflin is a freelance writer in Kansas City, Mo., with extensive experience writing about the veterinary profession.