Dr. Smita Malhotra is as accomplished as they come. The Chief Medical Director of Los Angeles Unified School District, she’s overseen significant moments throughout the course of the country’s second largest school district. As the guiding force during the COVID-19 pandemic, she also spearheaded the introduction of naloxone to all K-12 schools in LAUSD. Outside of her daily duties as Chief Medical Director that impact the lives of over half a million students, she’s also an accomplished public speaker, writer, and photographer.
In fact, photography was a fulcrum point in her non-linear journey to her role in LAUSD. She began her career as a pediatrician – foreshadowing her eventual service to Los Angeles youth – but she defied traditional narratives and took a leap into wedding photography. While it’s likely difficult for outsiders to reconcile these two seemingly opposed career paths, she sees them as intrinsically related: “A physician saves a life and a photographer preserves life.”
Her work to bring naloxone to all K-12 LAUSD schools is especially lifesaving, so we’re thrilled to welcome Dr. Malhotra as End Overdose’s Youth Medical Advisor. In commemoration of her joining the End Overdose advisory team, we spoke with Dr. Malhotra about her fascinating professional journey and the unreplicable insights she’s collected along the way.
End Overdose: Can you tell us about your background? What initially sparked your interest in medicine?
Dr. Smita Malhotra: I am a first-generation immigrant and a pediatrician by training. I think my immigrant experience greatly influenced and affected my choice to pursue a career in medicine. My family is from a South Asian background and culturally, it was important for my parents that I pursued a career that was traditionally thought of as 'successful' especially because of how much they struggled when they first came to this country. When I was younger, I loved photography, film and theater but I also knew that I wanted to be with people and families during some of the hardest times of their lives-and medicine gave me the opportunity to do that. Throughout college, I spent my time volunteering in hospitals and medicine became a natural path for me to follow.
Now as I've followed a 'non-linear' career path, I've learned that often what we were taught about careers as children limits us and puts us into a box. My career now involves medicine, public speaking and the ability to be creative beyond my wildest imagination. I'm grateful that I've found my own unique career path that allows me to follow my curiosity and fulfills me.
EO: I know your story is non-linear with a career in wedding photography! How do you look back on your pre-medicine years as a wedding photographer? Did any lessons from that field transfer over into your work today?
SM: I became a wedding photographer after I became a pediatrician. In fact, I left full-time medicine for a while to build my wedding photography business! No one could understand why I would do something like that after spending years training in medicine. But here's the thing - years of training in medicine prepared me for exactly this step. The long hours of being on my feet and being on call in the hospital prepared me for being on my feet all day photographing weddings. The ability to think on my feet in the emergency room prepared me to be able to capture once in a lifetime fleeting moments in weddings. I always said 'a physician saves a life and a photographer preserves life'.
So while no one could understand my decision, for me, it felt like a natural next step. And because I have continued to follow my curiosity and I'm able to take risks that allow me to grow and develop as a human being-I've found myself exactly where I'm supposed to be today. Every step has prepared me for the next one.
EO: You worked in pediatrics for a decade and now work as the Chief Medical Director of LAUSD. What inspired you to work with adolescents in particular?
SM: One thing I knew for sure when I was younger was that I would work with children someday. I was drawn to the idea of how impactful childhood can be. I knew that childhood, though short, can impact us for a lifetime. And so if I wanted to impact the trajectory of someone's life, I needed to start in childhood. I knew I wanted to be a pediatrician before I even went to medical school.
Now I get to shape policies that care for the children of LAUSD as well as bring health access to the place where children spend 95% of their days for 13 years of their lives: at school.
EO: You led LAUSD through the COVID-19 pandemic which is a seemingly monumental effort. What insights did you glean from navigating a global crisis for over half a million students?
SM: The COVID-19 pandemic involved adjusting nimbly to the changing conditions of the virus. We had to quickly adjust our policies and procedures as conditions kept evolving and changing.
One of the biggest lessons I learned through all of this was the importance of communication. Even more important than policies themselves—how you communicate them matters. Communication with repetition and consistency creates an environment of safety. Now in my work, it is of utmost importance to me that I communicate clearly and consistently with my teams and that we are communicating clearly and consistently with our communities. I think many people in medicine learned the importance of communication through the pandemic.
EO: You also led the effort to bring naloxone into all K-12 schools. Why is it so important to equip schools with naloxone? And are there any other measures you believe are crucial to respond to the fentanyl epidemic?
SM: I'm proud that all K-12 schools in LAUSD are equipped with Naloxone. In addition, our healthcare staff and many of our school site staff members are trained to administer Naloxone. We also have a policy that students can carry Naloxone on campus without discipline.
However, Naloxone is not the only answer to the Fentanyl epidemic. Before that has to come education. I love how the group 'Fentanyl Awareness Day' states that this isn't a 'Just say NO conversation. It's Just Say KNOW'. And to that end, we have implemented webinars for parents and modules for schools to help educate about the dangers of Fentanyl. I look forward to our efforts to increase awareness and education on this throughout our District.
EO: We’re thrilled that you’re now an End Overdose advisor! How do you think organizations and nonprofits outside of the traditional public school structure can contribute to student safety?
SM: I think it's so important that none of us work in a silo. Student safety and well-being is not just for a school district to handle, it's a community effort. It's essential to collaborate to ensure that we are all working together to contribute to student safety.