Tell us a little about the work that you do.

There are four facets to my work:  clinical, teaching, research, and administration.  As a pediatric intensivist, my clinical work is caring for critically ill or injured children, who are in the Pediatric Intensive Care Unit (PICU).  The illnesses I treat include medical problems like asthma, septic shock and diabetes, and surgical problems like post-op heart surgery, orthopedic surgery, and multiple trauma. 

I love teaching almost as much as my clinical work.  I teach medical students, residents, nurses, paramedics and many others.  Mentoring and advising are also big parts of what I do.  I enjoy advising young pre-med students, hoping to guide and develop the doctors of tomorrow.

Most of my current research is in clinical medicine. The first paper I ever published demonstrated that children with TBI could do better than expected, even after severe injuries.  It showed me the importance of aggressive acute management and inspired my interest in TBI.  I am currently involved with the study of a new scorpion antivenom. I’m also conducting a study on medication errors.

Most physicians view administrative work as a dirty job best handled by someone else!  I guess I’m that someone else.  As medical director of the PICU and Chief of Staff at UMC, I participate in quality improvement activities with amazing people who are “behind the scenes” in medicine.  In fact, we have developed a TBI multidisciplinary team involving both Tucson Medical Center (TMC) and UMC to insure that all children with a head injury get referred to an Office for Children with Special Health Care Needs TBI Service Coordinator for coordination of their care upon discharge.  Time consuming? Sure.  Worthwhile? Absolutely!

What does a typical day look like for you?

When I’m on clinical service, I work at either TMC or UMC every day for 1-3 weeks in a row, taking night call every other night.  When it’s busy, I could be at the hospital for 24-60 hours.  I usually see my patients early in the morning and conduct rounds with my students and residents from about 9 a.m. until noon. 

Managing critically ill kids is a continuous process, requiring re-evaluation and treatment all day and night.  Clinical teaching occurs all throughout the day.  The administrative responsibilities don’t go away during clinical time, so I’m constantly running to meetings, although the care of patients always comes first! 

It must be difficult to juggle your clinical and administrative responsibilities, not to mention finding time for yourself and your family.  How do you manage?

One word – coffee!  Actually, my family is very important to me and I make sure I have time for all the concerts and open houses and activities my three kids have.  I’m even the youth director for our church.  My wife is also a pediatrician so we both have tough hours, yet somehow we make it work.

What drew you to pediatric intensive care?  What keeps you coming back, day after day?

I had a mentor back in Detroit, Dr. Ashok Sarnaik, who inspired me to go into critical care.  His dedication was second to none and his knowledge was unbelievable.  I saw all the good things he did for kids, and I knew that that’s what I wanted to do.  I also tend to stay calm during life-and-death situations.  Hence, I went into pediatric intensive care. 

Watching kids come in near death and then go home healthy is the reason I come back everyday. Many of my TBI patients are in that category.   They come into the PICU comatose on ventilators, and they come back from rehab, months later, walking, talking and looking great.  It’s a great feeling.

Unfortunately, some kids die.  Those are the tough days.  But Dr. Sarniak once told me after a really bad day, “Even in death, we can make a difference.”  He was right.  The way we help a family during that difficult time is a critical part of our job.  The ability to show caring and compassion can make a lifelong difference to a parent who has lost a child.  I know we can’t save all the children we care for, but if at the end of the day, I can say I did the best I could, then I’m OK. 

I know you’ve taught a great deal to your patients, their families and your students.  But what have your patients taught you?

My patients and their families have taught me how to be brave and have faith, despite horrible odds.  I have seen parents stay at the bedside of their sick child for days, weeks and months, never giving up.  I have seen kids of all ages tolerate all the pokes and tubes associated with the management of critical illness.  I don’t know where they get their strength, but they are my heroes. 

I once knew a fellow with Cystic Fibrosis, whose name was Matt. He had terrible veins and often needed many pokes to get an IV started.  I asked Matt how he dealt with that, and he said that he would rather get poked a dozen times by someone who treated him as a person than once by someone who treated him as a disease.  A lesson I never forgot.