Shortly after she earned her undergraduate degree in biology and was about to enter medical school at UC Irvine, Hollie Lai (then Hollie Powers) auditioned for seasonal work at Disneyland as a character performer.
She nailed it and went on to perform as Eeyore, the glum and pessimistic donkey from “Winnie the Pooh” whose personality couldn’t be more different from her warm, caring, can-do disposition.
Hollie was being groomed for Snow White and Cinderella look-alike jobs at the Anaheim theme park, but there was the small distraction of medical school to attend to.
Who knows how far she would have gone at Disneyland had she chosen that route.
These days, after a planned career in neuroradiology morphed into all things concerning pediatric medical imaging, Dr. Hollie Lai is working her magic as director of CHOC’s Nuclear Medicine program – a long-needed service that marks its one-year anniversary in December 2022 as a key component of the hospital’s Radiology Department.
Dr. Lai, nationally regarded expert
Longtime mentors and colleagues describe Hollie, who joined CHOC in 2017, as a nationally regarded expert in her field who is helping to advance CHOC’s stature in the often-overlooked field of pediatric radiology, which provides specialized imaging through ultrasound, X-ray, magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine (NM).
The launching of CHOC’s NM program in December 2021 essentially completed the Radiology Department and made it free-standing (along with the recently added interventional radiology component). NM uses noninvasive procedures to assess and diagnose many conditions, from epilepsy to cancer, as well as to treat thyroid and other conditions.
The goal of NM is to identify conditions earlier with precision diagnosis before a disease has progressed out of control. For example, NM, with a variety of treatments and immunotherapies, has allowed children with neuroblastoma, a cancer that develops from immature nerve cells found in several areas of the body, to survive longer.
“It’s been a pleasure to see Hollie rapidly advance in her career to provide state-of-the-art technology to the children of Orange County and surrounding areas,” says Dr. Barry Shulkin, section chief of NM at St. Jude Children’s Research Hospital in Memphis, Tenn.
Dr. Shulkin has been a mentor in Hollie’s professional development and has worked with her on numerous national boards, including the Society of Nuclear Medicine & Molecular Imaging (SNMMI) Pediatric Imaging Council, as well as the Children’s Oncology Group (COG), a National Cancer Institute-supported clinical trials group that is the world’s largest organization devoted exclusively to childhood and adolescent cancer research.
“I’m a mentor of Hollie,” says Dr. Shulkin, “but I’m also an admirer.”
Dr. Marguerite “Meg” Parisi mentored Hollie during her pediatric radiology fellowship at Children’s Hospital Los Angeles, encouraging her interest in pediatric nuclear medicine. Dr. Parisi’s departure from CHLA led Hollie to pursue additional training in NM, a field in which Hollie has, according to Dr. Parisi, become “one of the leaders of tomorrow.”
“Over the course of time, Hollie has really developed tremendous expertise in pediatric radiology and nuclear medicine,” says Dr. Parisi, professor of radiology and adjunct professor of pediatrics at the University of Washington School of Medicine, and an attending radiologist and division chief of nuclear medicine at Seattle Children’s Hospital.
Hollie is somewhat of a unicorn in her field, Dr. Shulkin adds.
“She’s a multi-technology expert,” he says. “She’s good at neuroradiology, she’s good at general radiology, she’s very good at nuclear medicine – she’s a triple-threat, so to speak. Her expertise spans technologies.”
“Usually, one would be an expert at one of these things. Some people are experts at general and nuclear medicine, but there are relatively few people who have expertise in both neuroradiology, general radiology, and nuclear medicine, because that involves a lot of training.”
Hollie moved to Orange from Buena Park when she was 9 and attended El Modena High School, so coming to CHOC five years ago was ideal for the hometown girl.
Born with poor hearing and a bad speech impediment, Hollie overcame both in special education classes and sessions at Providence Speech and Hearing, now part of CHOC. She initially was told she would never speak normally.
Hollie’s mother was legally blind her whole life and now almost is completely blind. But she never used her condition as an excuse to not do her best.
“I think I got my fight and drive seeing my mom prove people wrong,” says Hollie, who recently spoke before hundreds of people at an SNMMI webinar.
“My mom saw the webinar and was blown away by how far I have come,” Hollie says.
She recalls facing roadblocks as an undergraduate.
“I asked a professor for a letter of recommendation for medical school and he asked me, ‘Don’t you want to get married and have kids?’”
In medical school, there were other naysayers.
“Oh yeah?,” Hollie recalls thinking. “I’m going to prove you wrong.”
For the record, in addition to having a distinguished career in medicine, Hollie has two adult children from her first marriage. She is married to vascular surgeon Dr. Kin-Man Lai, who works at Kaiser Permanente in Baldwin Park. They met in medical school at UCI and reconnected years later.
Hollie says one of the main reasons she came to CHOC was to launch the NM program.
“I have the kind of personality that if I’m going to do something, or be in charge of something, I’m going to be the best at what I do,” she says.
A multidisciplinary approach to nuclear medicine
CHOC is the only nuclear medicine program in Orange County dedicated specifically to pediatrics. All of the NM equipment is calibrated so that children receive smaller and safer doses of radiation.
Imaging produced by NM is very precise and cannot be replicated by other exams.
Nuclear medicine procedures are performed by injecting a small number of radioactive materials called radiotracers. After injecting the radiotracers, they emit an energy called gamma rays. State-of-the-art equipment captures the gamma rays to create images of the organs inside the body.
On the day in November 2022 when Hollie sat down in a conference room in the Radiology Department, located on the first floor of the Bill Holmes Tower at CHOC Hospital in Orange, for an interview, a young female patient with epilepsy was being assessed by her team.
“She has intractable epilepsy and we thought she may have a subtle abnormality on her brain MRI,” Hollie explains.
Hollie and her team performed nuclear medicine tests on the girl when she was having a seizure, and more when she wasn’t. They were trying to identify an area in her brain that most likely was the cause of her seizures. The girl went on to have a successful surgery and is currently seizure free.
Depending on what’s going on with a patient, CHOC’s NM team will have multidisciplinary meetings with specialists from neurology, neurosurgery, psychology and other disciplines and decide what the next steps will be.
“I love nuclear medicine because it brings together and integrates multiple disciplines of science and sheds light on phenomena we previously did not understand,” says Hollie, who is board certified by the American Board of Radiology and American Board of Nuclear Medicine with certificates of added qualification in pediatric radiology and neuroradiology.
“Its evolution is fascinating and fun. I like the idea of solving problems, and nuclear medicine involves physiology, anatomy – everything kind of rolled into one.”
CHOC is the only pediatric hospital west of Chicago that has been designated a Diagnostic Imaging Center of Excellence® (DICOE) by the American College of Radiology (ACR) for best-quality imaging practices and diagnostic care, says Laureen Smith, supervisor of Nuclear Medicine and CT.
And CHOC is one of a few medical centers in the country to have a child life specialist working in a dedicated pediatric radiology and imaging department. Child life specialist Ashley McGee is assigned full time to the Radiology Department.
CHOC’s nuclear medicine program growing fast
Hollie has been a member of SNMMI since 2002 and was one of the first physicians asked to helped lead the organization’s recently formed Value Initiative, which aims to bridge physicians and industry and bring more awareness of NM to the world.
She also is one of eight directors of the American Board of Nuclear Medicine. As such, she is in charge of advancing the high standards that are a requirement for certification by the American Board of Nuclear Medicine.
Meanwhile, NM volume has skyrocketed at CHOC since the department went live in December 2021, says Andrew Ruiz, director of imaging services.
From fiscal years 2019 through 2022, when CHOC relied on St. Joseph Hospital for nuclear medicine services, annual volume averaged 428, Ruiz says.
In fiscal year 2022 at CHOC, the volume totaled 692, with fiscal year 2023 projected to total 1,222, based on the NW program going live through February 2022.
“We’re growing so fast,” Hollie notes, “and I think the word is getting out in the community that we are able to provide full nuclear medicine services in a pediatric hospital.”
Outside of work – which can total 80+ hours per week – Hollie loves spending time with her family.
Her oldest daughter, Sara, 23, is working toward a career as a physician assistant, and Lauren, 21, is fluent in American Sign Language (ASL) and seeking work in that field.
An avid cook who loves to bake, Hollie says one of her biggest personal accomplishments was having a well-regarded chef ask for her recipe for financiers – small French almond pastries.
Although she’s a prime candidate for recruitment at multiple major medical centers at highly prestigious universities, Hollie intends to remain at CHOC and dedicate the remainder of her career to the pediatric patients of Orange County.
She loves coming to work and is usually one of the first to arrive and the last to leave.
“We provide great pediatric care and are a very welcoming hospital,” Hollie says. “And I love my colleagues. I think we have a really good family at CHOC.”
Learn more about CHOC’s nuclear medicine program