SleepTalker August 2016

   This month, we welcome Joshua Dubnau, Ph.D. who is joining the department as a Professor in the Research Division. Dr. Dubnau is no stranger to Stony Brook as he obtained a B.S. in Biochemistry here in 1988. He did his PhD degree at Columbia University in the Department of Genetics and Development. This was followed by a postdoctoral fellowship at Cold Spring Harbor Laboratory. In 2003, he became an Assistant Professor of Neuroscience at CSH and six years later he was promoted to Associate Professor. During his tenure at CSH, Dr. Dubnau maintained Adjunct Faculty status at Stony Brook's Departments of Neurobiology and Genetics.

   There are two aspects to Dr. Dubnau's research. He has been investigating the role of genes in learning and memory using Drosophila fruit flies as a model system. More recently, he has been examining mechanisms of neurodegeneration in diseases such as amyotrophic lateral sclerosis (ALS). His current hypothesis is that transposons, pieces of DNA that can move from one area of the gene to another, are somehow re-activated in neurons and this leads to cell death. For this project, he continues to work with Drosophila, but also uses mice, cultured cells and postmortem human tissue. Dr. Dubnau hopes to be able to identify new biomarkers of neurodegenerative disease that might serve as therapeutic targets.

   Dr. Dubnau has published 36 articles in peer-reviewed journals such as Nature Neuroscience and the Journal of Neuroscience. In 2014, he edited the book "Behavioral Genetics of the Fly". He is the PI on three NIH grants with total funding of more than $1 million per year and has a grant from the ALS Ride for Life organization. Dr. Dubnau holds a patent on Gene Chip Technology for Determining Memory Genes and has a provisional patent application for Transposons and Aging.

   We are delighted to have Joshua Dubnau join the research efforts of our department!

Aysha Hasan, MD
   I want to recognize and thank a very special group of people that helped get a case underway on Friday, July 29. We had a critical 7 year-old female with a splenic laceration who was actively bleeding and needed to be brought to the OR emergently.

   As the patient was brought into the operating room, each member of the team was aware of the critical need of a collaborative effort in attaining peripheral and arterial access. The young patient was intravascularly depleted making this an even larger challenge. At no point in time did any member of the team hesitate in assisting attaining access (despite this being a very sick pediatric patient). We successfully placed the lines with the help of Dr. Jeremy Poppers, Dr. Shaji Poovathoor, Dr. Helen Hsieh (Pediatric General Surgeon), and Residents Dr. Gregory Walton and Dr. Jonathan Moy. Furthermore, I cannot overstate the efforts of our amazing CRNA staff, Anna Buono and Ruth Quinones-Weisbrod who performed the difficult and essential work of hand pumping blood and products to replete the blood loss and aggressive resuscitation. The nursing/scrub staff Mikel and Catherine were exceptional as were the nurses Audrey Fischer and the circulating nurse and scrub tech/nurse who took over afterwards. Their fast actions and help in assisting everyone (at the same time) are appreciated.

   The importance of being able to have inputs and outputs (intravenous access, arterial access, and foley), blood and products, and resuscitation tools was clearly demonstrated in this critical case and we could not have attained such great success without the wonderful teamwork and diligence of our OR team that day. The surgeons' incredible skills, clear communication and phenomenal teamwork efforts in collaboration with ours in maintaining hemodynamic stability helped us achieve great success. Thank you to everyone that helped that day. The patient is recovering well. If I have forgotten anyone in the room, please accept my apologies but thank you for being an integral part of the survival and success of our young patient.
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ASC Accolades
   Outstanding job by all who contributed to my procedure being quick, easy and painless for me.
   Anesthesia/Anesthesiologist: I had no discomfort when the needle was inserted. There was absolutely no bruising afterwards. This was a team of excellent anesthesiologists.
   Anesthesiologist - all were very reassuring, and made me feel confident that they were going to take care of me during my surgery.
   Amazing staff from the nurses to the anesthesiologist. Made me feel very comfortable.
   Nurses made sure I had my arm alert bracelet which was checked every time I moved from one area to the next.
   I definitely would recommend this ambulatory site to everyone. Professionalism is unimaginable.
   The people at the registration desk were extremely helpful and professional. If felt so much better the instant I arrived! Excellent.
   My after surgery experience was wonderful. The nurses explained very clearly the post op instructions and were extremely comforting and friendly. Excellent.
   Loved the anesthesiologist! He was so comforting and put me at ease immediately. I was completely "out" and felt nothing. Excellent.

Jeremy Poppers, MD

   The division of Cardiothoracic Anesthesiology has held firm during the current transition period in which we find ourselves following the departure of three cardiac surgeons. While we eagerly await the arrival of two new surgeons who are expected to start sometime this Fall, we have utilized this time to reshape the resident education curriculum, which now includes lectures geared specifically to the experience level of the rotating residents. This coming year we are modifying and expanding the Wednesday 8-11 lecture series, as well as revising the curriculum further to include more hands-on TEE exposure for the CA-3's.

   Dr. Igor Izrailtyan, head of perioperative echocardiography for the Department of Anesthesiology, along with Drs. Elliott Bennett-Guerrero, Thomas Floyd, Renate Kowal, Peter Oleszak, Bharthi Scott, Eric Zabirowicz and myself, are all committed to offering a comprehensive TEE service to our hospital, to our department and to our patients. As of February of this year, the division of Cardiothoracic Anesthesiology will be responsible for all elective and emergent TEEs that occur in the PACU or main OR anytime day, night, weekend or holiday. (The Cardiology division will maintain primary responsibility for TEE coverage anywhere other than the PACU or main OR.)

   Our dedication to TEE education extends beyond the OR arena. Last March, we held our first annual TEE symposium, during which Attendings, CRNAs and residents attended several didactic lectures and mini-workshops. In the course of one morning, the participants learned the principles of 2-dimensional ultrasound echocardiography and gained hands-on experience setting up the TEE machine and probe, as well as acquiring TEE images utilized to diagnose severe pathologies in an unstable patient. We look forward to offering this course again in the Spring of 2017.

Maria Lagade, MD

    Welcome the new AT employees recruited from our Anesthesia Technology program! Ashley Buxbaum and Nicole Mac started on July 14th.

Editor's note. Each month over the course of the year, we will get to know a bit more about one of the CA-3 residents. Dr. David Soohoo has graciously accepted our request to be first in the spotlight!

Shivam Shodhan, MD

Can you tell us a little about your background (hometown, college, medical school, etc.)?
   Originally from Huntington, NY. Been here pretty much all my life, but decided to go up to Maine for college at Bowdoin and loved it. Decided I needed to come back home for medical school and found that Stony Brook was the best fit for me.

What attracted you to anesthesiology?
   Enjoy working my hands every day and able to focus all my attention on a single patient at a time. We provide a very unique hands-on type of care that I didn’t find in other specialties. Plus patients are pretty much always happy to see us.

How did you come to be a resident at Stony Brook (Why SB)?
   Went here for medical school, and met my wife here. Also really loved the cohesiveness of the resident class and decided that I would love to stay and continue my training here.

What do you like most about being a resident?
   Having the opportunity to learn and see how things are done so many different ways. Plus I really enjoy being able to work with people that I’ve become pretty close with.

What do you like least about being a resident?
   Having to eat at Starbucks between the hours of 8pm and 12am. Coffee's all right, though, and Brian got me hooked on those cool lime refreshers.

What pearls of wisdom would you like to share with your fellow junior residents to help them succeed in their time here and future careers?
   As you become more seasoned, never be afraid to ask why some people do things the way they do. It’s a great way to learn different techniques and develop your own style. For the brand new residents, your confidence will develop in time so don’t worry too much if you don’t do everything perfectly the first time. Don’t be afraid to talk to us big kids either if you have any questions. We don’t bite!

How would you describe our Stony Brook Medicine Anesthesiology Residency Program?
   Well caffeinated.

So what’s the next step (fellowship, attending, research) you will be taking as you transition from the role of a resident to fellow/attending next summer?
   Probably private practice.

As you're soon to enter the real world of anesthesiology, what do you find most daunting?
   Holding the coordinator phone. That doesn’t look fun at all.

If you could do it all over again (become a doctor), would you? Why or why not, and what would you have done differently?
   I’m pretty happy where I am now. I don’t really think I’d change anything at the moment.

If you hadn’t chosen to go into medicine, what career path might you have followed?
   I really enjoy pretending that I know how to cook because I watch a lot of reality cooking shows so maybe a chef, or maybe a marine biologist.

What has been your favorite residency memory of your 4 years here at Stony Brook?
   In hospital, the one-time Brian brought Korean fried chicken and pickled vegetables to Kevin and me at midnight on a Saturday call and we ate it at midnight in the OB call room with my wife and the other OB residents. That was kind of fun but we probably should have left the door open.
       Out of the hospital, the time Fradlis, Patel and I tried one of those paint and wine things and I learned that in a past life I was definitely an artist.

When you aren't running on around the hospital saving lives, how do you like to spend your free time?
   Either sleeping or exploring Long Island with my fellow residents. Also lots of fine dining (shout out to Fradlis, Patel and Eldhose for helping me gain that weight back).

What do you like the most (and least) about living on Long Island?
   I love the fact that you can travel an hour west and be in a major metropolitan area or travel an hour east and end up in some of the best secluded beaches or wineries out there. Definitely hate 495 though.

What is your favorite type of food?
   Wine

What's your favorite restaurant in LI/NYC?
   Can’t pick, eat everything.

Where would you love to travel to next and why?
   Just recently went out to California and did a road trip down the west coast over the course of a week. It was definitely not enough time and I would love the opportunity to do it again because there was so much exploring and beautiful landscape that I didn’t get to see.

What's your favorite Tourist Activity in LI/NYC?
   Avoiding major tourist attractions.

Describe yourself in three words
   Really spiky hair.

Who is your role model and why?
   Dr. Poovathoor. I’d be content just knowing half as much about anesthesia as he does, and his advocation for our education has been out of this world. Plus his mustache just makes me jealous.

If you could make one wish, what would it be?
   More flavor options at the frozen yogurt station in the cafeteria.