SleepTalker August 2017

James P. Dilger, PhD

   This month, we welcome Edward Papa, DO to our Faculty! Dr. Papa grew up in on Long Island in Huntington. He received his undergraduate degree in Biology from Fairfield University in Connecticut. He then attended New York College of Osteopathic Medicine where he graduated in 2012 as a Doctor of Osteopathic Medicine. The following year, he did an osteopathic internship at Nassau University Medical Center and then did a Residency in Physical Medicine and Rehabilitation at North Shore/LIJ. He spent this past year at the University of Michigan where he did an Interventional Pain Medicine Fellowship. During medical school, Dr. Papa participated in a Global Health Initiative trip to an underserved area in Ghana, Africa. He has authored several book chapters and review articles on ultrasound-guided injections for knee and hip pain.

   Dr. Papa will work out of Hampton Bays and Southampton Hospitals. He will be our East End pain specialist. We are pleased to have him join the Chronic Pain Division and our department!

James P. Dilger, PhD

    Our Visiting Professor this month is Michael Patrick William Grocott BSc MBBS MD FRCA FRCP FFICM from the University of Southampton in England. At Southampton, Prof. Grocott is Professor of Anaesthesia and Critical Care Medicine and Head of the Centre for Human Integrative Physiology. Prof. Grocott received his medical training at the University of London, receiving his MB BS degree in 1992. With his thesis "Measuring morbidity following major surgery", he earned his MD degree. He is a Fellow of both the Royal College of Anaesthetists (UK) and the Royal College of Physicians (UK). Prof. Grocott is also an Adjunct Professor in the Department of Anesthesiology at Duke University Medical Center.

    Dr. Grocott's did his research training with Professor Michael (Monty) Mythen (our Visiting Professor in October 2015). His current research is focused in two areas: improving patient outcomes after surgery and understanding the physiology of high altitude climbers. The latter has taken him to great heights, that is, the summit of Mt. Everest! He will feature both of these pursuits during his visit to the department. Dr. Grocott has authored over 100 peer reviewed research articles and numerous reviews, editorials, and case reports. He research has been supported by grants from public, industrial and private foundations. Currently, he is has research funds from the British Lung Foundation and the National Institute for Health Research (UK). He has, and continues to, supervise research students.

    Dr. Grocott has active roles in many institutional, regional, national, and international organizations. He is Joint Editor-in-Chief for Extreme Physiology & Medicine. He participates in committees that establish national standards, guidelines and policies. He is an expert medical contributor to television programs on Extreme Weather. He worked on the IMAX film "Return to Everest" which is currently in production.

    We are delighted to welcome Dr. Grocott to Stony Brook! He will present a lecture to the residents on August 1, "Xtreme Everest: Taking Science from Mountainside to Bedside?" and speak to the department at Grand Rounds on August 2, "Fit-4-Surgery: Redesigning the Preoperative Journey".

Jeremy Poppers, MD, PhD

   I would like to acknowledge an herculean effort by four of our amazing residents: Drs. Minxi Weng, Diana Escobar, Demetri Adrahtas and Kseniya Khmara. A patient with a type A (and B) aortic dissection was transferred to SBU Saturday evening. The patient underwent a 14+ hr surgery and received more than 50 units of blood products/components. We delivered the patient to the CTICU Sunday afternoon – hemodynamically stable, metabolically resuscitated and hemostatically resuscitated fused (did not require any further transfusions in the CTICU from yesterday to this morning). What impressed me the most about this group of residents is their commitment and hard work throughout this affair. Both teams of two residents (Minxi and Diana were there on Saturday until 7am Sunday and Demetri and Kseniya were the Sunday team) worked efficiently and selflessly. Moreover, even though one resident could easily have spent time in the call room resting, both were in the room helping to manage the patient unless duties in another OR or in the PACU required their attention. I could not have done this case without their expert assistance.

Patient comments about our staff from the Press Ganey questionnaires:

   Dr. Sherman Park was excellent and very friendly. He was explicit with his part of procedure and precaution necessary.

   The anesthesiologist was outstanding. I was concerned I might vomit during surgery as I had the last time I had anesthesia. The doctor gave me medicine before surgery. I didn't experience any nausea.

   Very good stick, I would say exceptional, and she was very very nice, the best one I have ever met and the. Best IV stick EVER!

   Dr. Barry Florence was top notch.

   Very nice, they listened to my concerns about a bad experience at another hospital and made sure they avoided it. They were excellent!

Shivam Shodhan, MD, MBA

Can you tell us a little about your background (hometown, college, medical school, etc.)?
   I was born in the capital of Haiti Port au Prince, with my family being from a small country town in the south. When I was about two years old, we moved to New York. I grew up in Nassau County and went to Uniondale (Sigh my 10-year reunion is this summer) before going to the Sophie Davis School of Biomedical Education in Harlem. From there I completed my medical degree at New York Medical College in Westchester.

What attracted you to anesthesiology?
   As a young boy I was always in the emergency department getting stitches for lacerations from sports or just my natural clumsiness. On one visit, an emergency medicine physician suggested that I become an anesthesiologist and I listened. My family is full of nurses and respiratory therapists so I already knew I would probably do something in the health field.

How did you come to be a resident at Stony Brook (Why SB)?
   I ranked Stony Brook pretty highly during the match. I'm from Long Island and Stony Brook is in Long Island, so why not give it a shot.

What do you like most about being a resident?
   I like that I'm a resident, and in certain I can always lean or fall back on my attending.

What do you like least about being a resident?
   That I am only a resident and still need to do as I'm told even in situations where there might be a "different" method to get to the same endpoint.

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?
   I would recommend all my junior residents to try and take it one day at a time. Don't let a moment of frustration or other people's shortcomings force you to come out of character. No need to tarnish your good name arguing with others. 3 years definitely flies by fast. It's very easy to get burnt out and neglect your own personal health. Always prioritize your health over everything and try to reflect on how far you have gotten so far. Set out time whether it be weekly or monthly where you can do something fun or relax doing non-healthcare related things.

How would you describe our Stony Brook Medicine Anesthesiology Residency Program?
   Stony Brook University's Anesthesiology program is very well balanced and there are a lot of good things about being a resident here. The clinical exposure is great and the majority of folks are pretty nice people. I think it's a decent size program in terms of call frequency, it isn't too high. Also, it's not a super large program where you get lost in the shuffle of residents.

What advice do you have for medical students looking to pursue a career in anesthesiology?
   I would ask medical students, is this what they really want to do. If so then definitely do an anesthesia elective or rotation. Many students come in not realizing how broad the specialty is. There are so many different aspects of anesthesia from regional to critical care, all the way through obstetrics to chronic pain.

So what's the next step (academic attending, private practice, research) you will be taking as you transition from the role of a resident to attending next summer?
   Currently I am in the midst of pain fellowship interviews. Unfortunately for me, Stony Brook University no longer has a pain fellowship so I will be attempting to take my talents elsewhere but I shall never forget the wonderful folks who have helped me with this opportunity.

As you're soon to enter the real world of anesthesiology, what do you find most daunting?
   The most daunting thing for me entering the real world is that I may have to be responsible for the actions of others. Becoming more vigilant of the people (residents, surgeons, nurses, medical students, etc.) that I work with are doing at all times can be exhausting.

If you could do it all over again (become a doctor), would you? Why or why not, and what would you have done differently?
   If I could do it all over again, I'd probably try to study more instead of watching entire seasons of Seinfeld & Southpark during finals week and close to clerkship exams. I would still want to become a doctor but maybe ramp it up a bit more instead of coasting or being complacent with certain things.

If you hadn't chosen to go into medicine, what career path might you have followed?
   If I hadn't gone into medicine, I would probably have thought about going into finance. Or become a firefighter. They have good benefits and everybody loves firefighters.

What has been your favorite residency memory of your 4 years here at Stony Brook?
   My favorite memory from my 4 years of residency has yet to come. :)

When you aren't running on around the hospital saving lives, how do you like to spend your free time?
   When I'm not at the hospital or on the road coming/leaving the hospital, I like to sleep and eat. I averaged a solid 8+ hours of sleep all throughout undergrad and medical school but unfortunately, that number has taken a hit. It has trended down every each year since 2014 but I can't pinpoint what exactly is the cause.

Who is/are your role(s) models and why?
   My role models are my mom and Dr. Sherwin Park. My mother because she is a true example of the American dream, an immigrant coming empty handed into a new land and building and providing for herself and family. Dr. Park because of his great attitude and demeanor. He never cuts corners and always does what's best for the patient. He is also a genuinely great person and a man of huge character. I see the way he works with everyone and he never complains even when he gets the short straw many times. He one of the most versatile and clinically sound anesthesiologists that I have gotten the privilege to work with.

If you could make one wish, what would it be?
   If I could make one wish, I would wish for more food. Haha, no I would wish that everyone was happy at the job they were at or magically could end up in the job that they really wanted.

If you could leave us with one of your favorite quotes, what would that be?
   "If my future were determined just by my performance on a standardized test, I wouldnít be here. I guarantee you that." - Michelle Obama

Anesthesia Tech News

Melissa Day, CRNA

    Please join me in welcoming Timothy June to the Anesthesia Tech Team. Timothy has worked in the Emergency Department as a Certified Nursing Assistant. He started with us on July 13. Timothy will be working the 1330-2200 shift.

   We are also delighted to welcome Megan Virostko to the Anesthesia Tech Team. Megan has been a Certified Nursing Assistant since 2010, as well as an EMT since 2012. Megan has worked in the Emergency Department for the past 4 years. She will be working Monday - Friday, 1330-2200.

    Our best wishes go out to Anesthesia Tech Sade Taylor who is leaving to continue her education. She will study Biomedical Science at Drexel University in the fall.

    We wish Ashwin Shetty well for the future as he leaves us to further his education at Tulane University for a Masters in Cell and Molecular Biology.

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• *Mitchell D, Perez J, Grau L, Summers S, Rosas S, Ong A, Schneiderbauer MM, Hernandez VH. Systematic Review of Novel Synovial Fluid Markers and Polymerase Chain Reaction in the Diagnosis of Prosthetic Joint Infection. Am J Orthop (Belle Mead NJ). 2017; July/August; 46(4):E190-E198
• Toda Y, Sugimoto K. AKI after pediatric cardiac surgery for congenital heart diseases-recent developments in diagnostic criteria and early diagnosis by biomarkers. J Intensive Care. 2017 Jul 20;5:49