SleepTalker May 2017

Elliott Bennett-Guerrero, MD

   The 2017 Peter Glass Academic Research Evening takes place on Thursday, May 11, 2017 at the Wang Center. This year's Keynote Speaker is Mark F. Newman, MD, the Merel H. Harmel Professor of Anesthesiology at Duke University and President of the Duke Private Diagnostic Clinic. Dr. Newman's relationship with Duke University began in 1988 when he joined the fellowship program in cardiac anesthesiology following medical school at the University of Louisville and residency at Wilford Hall United States Air Force Medical Center. During his fellowship, he trained under Jerry Reves, MD, and James Blumenthal, PhD. This training stimulated an interest in neurological outcomes research that developed into a lifelong mission to improve perioperative patient outcomes.

   In 2001, Dr. Newman developed the Multicenter Perioperative Outcomes Research Group of the Duke Clinical Research Institute to study strategies that would improve outcomes of patients undergoing surgery and anesthesia. Grants from organizations, such as the National Institute of Health; the American Heart Association; the Anesthesia Patient Safety Foundation; and the International Anesthesia Research Society, facilitated his research on the impact of perioperative outcomes (neurocognitive decline, stroke, myocardial infarction, and renal injury) on quality of life following cardiac surgery. Dr. Newman's research identified the demographic, procedural, and genetic risk factors for neurocognitive dysfunction after surgery. The results have led to several interventional trials attempting to reduce the incidence of this devastating post-surgical outcome.

   Dr. Newman was named Chairman of the Department of Anesthesiology at Duke University in 2001, a post he held for 13 years. During his chairmanship, he worked to further the department’s educational program, develop faculty, and improve clinical operations. Within the residency program, Dr. Newman integrated advanced clinical and research training without prolonging the duration of the traditional residency and fellowship. He has mentored over 30 fellows in cardiothoracic anesthesiology. Many of his protégés have gone on to become successful leaders of academic medicine. Dr. Newman created five endowed professorships at Duke.

   Dr. Newman has received numerous awards, including the Bernard H. Eliasberg Medal for significant contributions to the field of anesthesia, critical care, and pain management; the Golden Stump Award for key contributions to the field of perioperative neuroprotection; and the 2012 Duke Distinguished Faculty Award. Dr. Newman is the senior editor of the textbook Perioperative Medicine: Managing for Outcome and a co-editor of Anesthesiology, a principal textbook of anesthesiology used globally for teaching and reference. He has also written book chapters, editorials, and over 200 manuscripts.

   Dr. Newman's keynote address is entitled "Managing for Outcome: Strategies for Prevention of Perioperative Neurological Injury". Please join me in welcoming him to Stony Brook for our annual Academic Research Evening.

James P. Dilger, PhD

   Jerrold H. Levy, MD, Professor of Anesthesiology at Duke University is our Visiting Professor for May 2017. Dr. Levy earned his undergraduate degree from the University of Michigan and then returned to the city of his birth where he obtained his MD from the University of Miami. He remained in Miami for an internship in internal medicine but then moved to Boston for his anesthesiology residency at the Massachusetts General Hospital. Dr. Levy subsequently completed fellowships in Cardiac Anesthesia and Respiratory Intensive Care, again at the MGH. Dr. Levy spent a large part of his academic career at Emory University School of Medicine where he rose through the ranks to Professor of Anesthesiology. In 2013, he moved to Duke University where he is Professor of Anesthesiology, Associate Professor of Surgery, and Co-Director of the Cardiothoracic Surgical Intensive Care Unit.

   Dr. Levy's research has focused on therapeutic approaches to patient care. His research interests include coagulation, acute inflammatory responses, shock and ventricular dysfunction, and anaphylactic and anaphylactoid reactions. He has published over 160 original research articles, 100 review articles and 70 book chapters. He has edited 7 books, the most recent being Clinics in Laboratory Medicine: Anticoagulation in 2014. Dr. Levy mentored 30 research fellows during his tenure at Emory. He is currently on the journal editorial boards of Anesthesiology (Executive Editor) and the Journal of Cardiothoracic and Vascular Anesthesia.

   We are delighted to welcome Dr. Levy back to Stony Brook (he was Visiting Professor 6 years ago)! He will present a lecture to the residents on May 9, "Anaphylactic and Allergic Drug Reactions" and speak to the department at Grand Rounds on May 10, "Understanding the Coagulation Cocktails: From Anticoagulants to Procoagulants".

Ellen Steinberg, MD

    Drs. Ana Costa, Aylin Gonzalez and Alina Fradlis provided excellent care to a very complicated and potentially critical OB patient. This patient, with a percreta, has been known to our service for a while. The case was planned for this morning but as our typical OB luck would have it, she began contracting late yesterday afternoon/early evening, requiring intervention last night. Ana had been assigned to the case for today and had already spoken to the patient and developed a rapport (patient is Spanish speaking). Even though she was not on call, she stayed to do the case. This is not a surprise because, in my opinion, Ana Costa consistently demonstrates professionalism and dedication to patient care in addition to having good judgement and decision making capabilities.

    After learning that the case was going last night, I decided to come in, if only to show my moral support, and to be available in case of disaster. When I arrived, the case was actually winding down. It went according to plan without complications (at least for now). I was so impressed with the manner in which Aylin and Alina worked together, confidently and efficiently caring for and moving the patient from the OR to Specials with all the wires, pumps, etc. I was so proud that I had contributed to their training and I am 100 percent confident that the skills they learned here at Stony Brook will make them stars in the private practices they will be joining and that they will continue to bring pride to the Stony Brook Anesthesia Department.

Marci Lobel, PhD, Professor of Psychology and Director of the Doctoral Program in Social and Health Psychology sent this thank you note to Dr. Tracie Saunders:

   Heartfelt thanks for your inspiring and thought-provoking presentation in my Psychology of Women's Health course! The students were spellbound, as was I. You are a wonderful speaker and role model for our students. Thank you for this important contribution to undergraduate education at Stony Brook.

   Dr. Ana Costa has been elected a Junior Member of the Donoho Academy of Clinical and Educational Scholars (ACES). ACES funds continuous career development for clinician-educators. The Academy, established by Long Islanders Miriam and David Donoho, actively recognizes and rewards School of Medicine faculty members who display dedication to the education of future physicians and who solve challenges in medical education and clinical scholarship. Her election to ACES was announced at their annual Med Ed Day in April. Congratulations, Ana!

   Dr. Martin Kaczocha has been named an Inaugural winner of the "Young Academic Inventor's Award" by the Stony Brook chapter of the National Academy of Inventors. The National Academy of Inventors (NAI) is a non-profit member organization comprising U.S. and international universities, and governmental and non-profit research institutes, with over 3,000 individual inventor members and Fellows spanning more than 200 institutions. Martin won this award for his discovery and inventions on "Fatty acid binding proteins as drug targets for pain control through modulation of endocannabinoid metabolism". He will receive his award at the NAI-SBU Chapter Annual Meeting on Monday, May 1. Congratulations, Martin!

   The 2017 IARS (International Anesthesia Research Society) abstract of Stony Brook medical student Ryan Lamm and CA-2 Resident Dr. Kseniya Khmara working with Dr. Thomas Floyd was selected as a Kosaka Best of Meeting Abstract Awards Finalist in Scholars Abstract. It was selected from the 650 abstracts submitted to the IARS 2017 Annual Meeting and International Science Symposium, May 6-9, at the Grand Hyatt Washington, Washington. The title of the abstract is “The Underaccounted for Role of Hypercarbia and Hypoxia in the Neonatal Rodent Models of Anesthesia-Related Developmental Delay.” The Kosaka Best of Meeting Abstract Awards Session was instituted in 2006 and is supported by the Japan Society for Clinical Anesthesia and the IARS. Congratulations to all of you!

2017-18 Chief Residents Announced

   Chief Residents for Resident Activities: Justin Smith, M.D. and Minxi Weng, M.D.

   Chief Resident for Medical Student Activities and Liaison for Resident Research: Richard Thalappillil, M.D.

Family News

Shivam Shodhan, MD, MBA

   Dr. Anupam Sharma and his wife, Dr. Nida Shakil, had a beautiful and healthy baby girl on April 10, 2017. Now, things get interesting when we learn the story behind this gem’s name! It all begins when Anupam found out he was scheduled for night float during the week his wife was expected to deliver. He searched high and low seeking for a co-resident or junior resident who was available switch with him for that week. Alas, no one was available. So becoming creative, he approached the CA-3 class, starting with Alina Fradlis, M.D.. Although she was potentially available she wasn’t sure if she would still be free come closer to the week. So, Anupam sweetened the deal by offering to pay off his debt by naming his future daughter after her. That sealed the deal! Alina immediately accepted! Thus, Alina Sharma was born! Perhaps, I’ve embellished this story somewhat, but both Anupam and Nida were always fond of the name from the get-go.

SARAS Clinical Skills Workshop

Srinivas Pentyala, PhD

   It is with great pleasure that I inform you about our 14th Annual “Science And Research Awareness Series” (SARAS). Please check out the program details at the SARAS website. This year, we had an overwhelming response from interested students. We will be hosting 135 of them from various parts of the country for 3 weeks (July 10 - 28, 2017). More than 80 experts from clinical sciences, basic sciences, translational sciences, administration, law and business will be interacting with the students to educate, excite and inspire them.

   Each afternoon, we conduct a workshop related to biomedical sciences. The “Clinical Skills Workshop” is scheduled for Monday, July 24 from 1:30 - 4:00 PM at our Clinical Skills Center. Every year, faculty from our department participate in the Workshop to excite and inspire the kids. Drs. Ursula Landman and Frank Stellaccio are just two of the faculty members who participated last year. Check out some more photos from last year's Clinical Skills Workshop. We need your help to run this Workshop! If you are available on July 24 (on “vacation” or a “D” day or “have spare time”) and are eager to impart your knowledge and skills to the students, please let me know. I guarantee it will be a rewarding experience! Over the years, Anesthesiology faculty mugshots have became screensavers for the kid’s phones, laptops and tablets - yes, they really value you as “Role Models”!

Marisa Barone-Citrano, M.A.

   ShellyAnn Noreiga has been sitting behind the receptionist's desk since last December, but as of April 10, she is officially our new Administrative Assistant/Receptionist. Previously, she worked at Broadridge Financial Solutions in Edgewood, NY as an Executive Assistant to the Director of Productions. She is pursuing a degree in Business Administration majoring in Finance at Fordham University. In her free time she enjoys baking (especially cupcakes), traveling with her family, kickboxing and making the ladies at the Jefferson’s Ferry Lifecare Retirement Community in South Setauket, beautiful (she used to be in the field of cosmetology). Welcome ShellyAnn!

Joseph Gnolfo III, CRNA

   Joreene Jasmin, CRNA is a new graduate CRNA who trained in sunny Puerto Rico only to join us in the April rains of Long Island. Welcome!

James P. Dilger, PhD

   We must bid farewell to Ruth Reinsel, PhD who has left the Department of Anesthesiology to take a position in the Department of Neurology. Ruth joined us in 2009 as a Clinical Research Associate. She has been a very productive asset to the department as a co-author on 6 peer-reviewed publications, 1 case report and 25 meeting abstracts during these seven years. I'm sorry that I cannot tell you how many clinical projects she assisted with. But I can tell you about her expertise in statistics. I remember some discussions we had about fairly obscure statistical tests. In addition, she co-taught with me a statistics workshop for the SARAS program several summers. Ruth's artistic talents also contributed to the department: she created the artwork for the cover of one of our Research Academic Evening programs and several of her pieces were featured in SleepTalker. Ruth was also an active participant (and probably a primary instigator) of some memorable Snake Pit parties over the years! We wish Ruth the best in her new Stony Brook endeavor as she moves up, up, up to the 12th floor of the Health Sciences Center!

Shivam Shodhan, MD, MBA

Can you tell us a little about your background (hometown, college, medical school, etc.)?
   I was born in Tashkent, Uzbekistan, which was formerly the USSR. I grew up in Flushing Queens until I was 14 years old. Then, we moved to Staten Island where I finished high school. I attended SUNY Binghamton for my undergraduate degree where I majored in Psychobiology (Neuroscience). I attended SUNY Downstate for medical school.

What attracted you to anesthesiology?
   I find the fast -paced environment of anesthesiology invigorating and the overall experience with patients to be highly rewarding. I enjoy the balance anesthesia encompasses which is working with your hands and utilizing medical knowledge.

How did you come to be a resident at Stony Brook (Why SB)?
   Stony Brook impressed me with a friendly interview and casual atmosphere. I still remember Dr. Tito saying “you belong here” during my interview. Overall, I did not feel intimidated and I felt at ease here. Therefore, I decided to rank Stony Brook highly.

Since there are several chief residents, what responsibilities of that role do you take on?
   Let me first say I could not ask for a better co-chief resident Scott Licata. I consider him not just a colleague, but also a friend. I hope to stay in touch with him for many years. Scott and I tend to have very similar responsibilities. We collaborate on solving a majority of the problems together. We throw ideas at each other and have discussions over any situation that arises. A majority of the time we make the schedules together, and the late call schedule we take turns creating.

How were you best able to balance the additional chief resident responsibilities with your roles as senior residents?
   I found that as a senior resident, you tend to already know a majority of the information and how to handle cases unlike a CA1. During my CA1 year, I was trying to learn technical skills, medical knowledge and what each attending prefers in their OR. As a CA3 I feel I am practicing to be more of an attending and preparing for private practice. Since skills and knowledge are more automatic, I have more control over how I’ve managed my time.

Do you feel that you were able to play a vital role in the mustering resident comradery as well as the management of resident conflict?
   We have a monthly chief meeting that allows residents to discuss ongoing issues, which we attempt to resolve. My goal for any conflict is to listen to what the person has to say. I find it important that as a leader you should be able to picture yourself in that person’s shoes. This is the first step in trying to fix any problems. Once that’s done, next step is to find common ground and attempt to resolve any issues one step at a time. Through the monthly meetings and allowing residents to openly voice their concerns, I was able to play a vital role in building camaraderie among the residents.

How do you feel your experiences as Chief resident will benefit you in your careers as attendings?
   Being Chief Resident placed me in a unique leadership position that is currently giving me the experience to effectively manage various issues. These leadership skills will assist me in all aspects of my life.

What changes have you seen the program go through during your time here, and what are aspects that are still in development that you hope will pan out in upcoming years?
   Stony Brook has improved a great deal since I was a CA0. For example, the morning Wednesday lectures were expanded to all day lectures. This allowed more lecture and study time. Another example of educational improvement is the cardiac department lecture series. I hope many other departments start to create their own educational objectives and lectures that will benefit the residents. I hope this focus on education will continue to improve, which will show in ITE scores, improved board passing rates, and eventually attract strong resident candidates.

What do you like most about being a resident?
   What I like most about being a resident is the ability to work with a variety of attending’s who have different philosophies and approaches to cases. As a future anesthesiologist, this experience allows me to take from all the techniques I have seen and make decisions about what would work best for my future patients.

What do you like least about being a resident?
   In my opinion, Intern year was my least favorite because I had to get used to working long hours and not having weekends free. In addition, rotating from one department to another can be difficult as the intervals of time spent in one field quickly rotates to another. Each department of anesthesia requires a different mindset as well as approach. Sometimes just as you are getting comfortable with one area, you move to another. Although sometimes this was difficult for me, it did keep me on my toes and made the residency interesting.

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 highly recommend taking advantage of research opportunities in departments that interest you. This will expand your expertise in that field, you will establish a rapport with attending’s in that department and find a mentor to guide you.

How would you describe our Stony Brook Medicine Anesthesiology Residency Program?
   Overall, it is a good program. They are always looking at ways to try to improve educational aspects of the program. I see Stony Brook becoming more competitive in the coming years.

What advice do you have for medical students looking to pursue a career in anesthesiology?
   Take advantage of all the opportunities that come your way and get involved.

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?
   I am going to be in a Pediatric Anesthesiology Fellowship at St. Christopher’s Children’s Hospital in Philadelphia.

Where do you see your career involvement 15 years down the road?
   I will most likely end up in private practice taking care of both children and adults.

As you're soon to enter the real world of anesthesiology, what do you find most daunting?
   Currently, there is always an attending to give you advice on your management plan. As an anesthesiologist there will be no attending to ask for help if you have any questions.

If you could do it all over again (become a doctor), would you? Why or why not, and what would you have done differently?
   When I was in high school, I was considering on becoming an engineer. I think even if I chose that field I would have still gone to medical school and combined both fields to become an extremely competitive and marketable professional. From my point of view, my major in college did not effectively help or prepare me for the world of medicine. Overall, I think I would have ended up being a doctor even if I chose a different path.

What has been your favorite residency memory of your 4 years here at Stony Brook?
   My favorite memory is the day Dr. Gallagher asked me if I would accept the job as Chief Resident.

What will you miss the most about your time on Long Island?
   My brother, sister-in-law, niece, and nephew live in Long Island. I will miss being able to spend time with them.

Is there anything left on your Long Island bucket list before you venture off?
   I never went to the Hamptons and experienced a wine tour of Long Island.

When you aren't running on around the hospital saving lives, how do you like to spend your free time?
   I mostly spend my free time with my fiancé. We tend to do some local traveling, go to wineries, cook together, and pick seasonal produce like apples/strawberries. We also watch Marvel movies and DC shows together.

What do you like the most (and least) about living on Long Island?
   The most I like about Long Island is visiting my nephew and niece because they are nearby.

   The aspect of LI I like the least is the traffic. They need to build another highway.

What is your favorite type of food?
   Sushi

What's your favorite restaurant in LI/NYC?
   Kotobuki

Where would you love to travel to next and why?
   I have always wanted to travel to Europe. I plan to do at trip immediately after my fellowship is completed.

What's your favorite Tourist Activity in LI/NYC?
   My favorite tourist activity is going to the beach.

Who is/are your role(s) models and why?
   My role models are my parents. They moved from the USSR with almost no money and to a country with a different language. They were trained for new careers and started their whole lives all over again so that our family could have a better life. They gave me an opportunity to become a physician and I am forever grateful.

If you could make one wish, what would it be?
   I wish that everybody would just get along.

If you could leave us with one of your favorite quotes, what would that be?
   “Anyone who has never made a mistake has never tried anything new.” - Albert Einstein

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• Stowell C, Bennett-Guerrero E. The Decision to Transfuse: One Size Might Not Fit All. Crit Care Med. 2017 May;45(5):908-910
• McEvoy MD, Scott MJ, Gordon DB, Grant SA, Thacker JKM, Wu CL, Gan TJ, Mythen MG, Shaw AD, Miller TE, Thiele RH, Raghunathan K, Brudney CS, Lobo DN, Martin D, Senagore A, Holubar SD, Hedrick T, Kellum J, Gupta R, Hamilton M, Moonesinghe SR, Grocott MPW, Bennett-Guerrero E, Hopkins TJ, Bergamaschi R, McCluskey S, Gottumukkala V. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1-from the preoperative period to PACU.. Perioper Med (Lond). 2017 Apr 13;6:8
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• Galbavy W, Lu Y, Kaczocha M, Puopolo M, Liu L, Rebecchi MJ. Transcriptomic evidence of a para-inflammatory state in the middle aged lumbar spinal cord. Immun Ageing. 2017 Apr 13;14:9
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• Kanazawa T, Egi M, Toda Y, Shimizu K, Sugimoto K, Iwasaki T, Morimatsu H. Perioperative Brain Natriuretic Peptide in Pediatric Cardiac Surgery Patients: Its Association With Postoperative Outcomes. J Cardiothorac Vasc Anesth. 2017 Apr;31(2):537-542

    On March 27, the Stony Brook Anesthesia Interest Group heard from the 4th year medical students who are going into Anesthesiology. Samuel Taveras, Kaveh Hemati, Nkoli Akaolisa and Ganesh Thippeswamy spoke to the group. They answered many questions and spoke about the interview process leading up to the match. Eugenia Pugach, who recently matched into Anesthesiology, spoke to the NYIT COM Anesthesia Interest Group on April 18. Both Groups got an insightful look at the Match process from the student's perspective. In addition, I gave a presentation to the students on how to shine for their clinical rotations.

   URECA! Undergraduates at Stony Brook have golden opportunities. So do the investigators who welcome these talented undergraduates as partners in research. Stony Brook's Undergraduate REsearch and Creative Activities program program has been fostering this since 1987. In the spring of each year, there is a URECA Celebration featuring exhibits and presentations by the students. On April 26, our department was represented by 11 undergraduate students presenting three posters at the Celebration. Here they are, along with their project titles and lab mentors. Congratulations to all!

   

   Youngs Island is a man-made island formed from dredging Stony Brook Harbor. It is protected by the NY State Department of Environmental Conservation because it is a nesting area for Piping Plovers and Least Terns.