With the publication of the ninth edition of Goldfrank's Toxicologic Emergencies, Neal Flomenbaum informed us of his decision to step down as an editor in order to be able to devote more time to his growing interests in geriatric emergency medicine and prehospital care, while continuing to fulfill his clinical and administrative responsibilities as Chief of Emergency Medicine at New York Presbyterian Hospital-Weill Cornell Medical Center and as Medical Director of its extensive prehospital care system.
In 1979, Dr. Flomenbaum accepted an offer from Lewis Goldfrank to join him at New York University Bellevue Hospital as Associate Director of Emergency Services and Consultant (later, Chief Consultant) to the New York City Poison Control Center, and their subsequent collaborations resulted in many of the outstanding features of this textbook. Frequently, ideas and concepts Neal and Lewis developed for presenting clinical toxicology were recognized for their value to the textbook and then developed further by both, with considerable input and efforts by Neal Lewin, Richard Weisman, Mary Ann Howland, Robert Hoffman, and Lewis Nelson. Thus, an idea for a 1984 review article entitled “Newer Antidotes and Controversies in Antidotal Therapy,” written to familiarize clinicians with the appropriate use of antidotes in patient management, became “Antidotes in Depth,” a signature feature of this book.
Similarly, the idea for an organ system track in the NYU postgraduate toxicology courses that Neal and Lewis codirected in the early 1980s became “The Pathophysiologic Basis of Medical Toxicology: The Organ System Approach” in the textbook. This section, in turn, suggested another section entitled “The Biochemical and Molecular Basis of Medical Toxicology.”
Additional ideas followed for making Goldfrank's Toxicologic Emergencies more accessible both as a teaching and a reference resource. A monthly case-based consultants' meeting at the New York City Poison Control Center was modeled after the successful format originated in the first edition of this book, and many of the cases discussed there were adapted for the text and related review books. Placing essential reference tables on the inside front and back covers of the textbook proved to be another useful feature, and Neal is particularly proud of the unique way the textbook acknowledges previous authors at the end of chapters. In addition to his ideas and his organizational and editorial contributions, Neal has written, coauthored, or contributed to dozens of chapters since 1982, including those on salicylates, rodenticides, and managing the acutely poisoned or overdosed patient.
In 1996, Neal Flomenbaum became the first Emergency Physician-in-Chief at New York Presbyterian Hospital/Weill Cornell Medical Center and built a multidisciplinary emergency department of over 50 attending emergency physicians, residents, nurses, nurse practitioners, physician assistants, paramedics, and EMTs. He created, developed, and supported traditional and nontraditional subspecialties and fellowships in pediatric emergency medicine, medical toxicology, prehospital care, global emergency medicine, geriatric emergency medicine, wilderness and environmental emergency medicine, and EM/critical care, each of which was heavily infused with the knowledge and information of age-specific poisonings, overdoses, adverse effects and drug interactions, polypharmacy, and environmental hazards found in these pages. Many of the faculty, in turn, have contributed to chapters in this textbook and peer-reviewed research papers in medial toxicology. These activities culminated in the establishment of an academic department of emergency medicine at Weill Cornell in early 2016. That same year, Neal received the Lifetime Achievement award from his alma mater, the Albert Einstein College of Medicine and, in 2015, the annual “Neal Flomenbaum, MD Prize for Excellence in Emergency Medicine” was established at Weill Cornell commencements.
Neal Flomenbaum first became interested in medical toxicology because of the clinical challenges it presented to emergency physicians, internists, and pediatricians, and he has remained focused on these clinical aspects. His creative energies, talents, and contributions to the second through ninth editions of this book have helped transform a case-based introduction to clinical toxicology into the 2000-page textbook it is today, and these contributions will remain an important part of future editions.