Volume 39 Number 4 Stony Brook, NY  <       October 2023       > 
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Fellowships Announced Dr. Razak Dr. Poovathoor Kudos
STARS ASA 2023 Presentations Nightlight Spotlight: Education Chief Resident Dr. Zhang
NYSSA News Marathon Charity Dr. Landman's Corner New Publications
Where on Campus is That? Synaptic Communication
Fellowships Announced

Robert Moore, MD

   Please join me in congratulating Dr. Michael Hafeman. He has matched into the pediatric anesthesia fellowship at Laurie Children’s / Northwestern University in Chicago. It is a great pairing of a talented individual and program with a long-standing and stellar reputation for excellence in both clinical and academic pursuits. It will be very exciting to have Dr. Hafeman as a colleague and to see the many wonderful things that he will contribute to the sub-specialty in the years to come.

Amit Kaushal, MD

   Please join me in congratulating Dr. Neil Daksla and Dr. Joshua Rismany on their successful match into Pain Management. Dr. Daksla has matched at Weil Cornell Tri-institute pain management program. We are excited for Neil to go to the city to continue the tradition of Stony Brook residents matching at Cornell. Dr. Rismany will be staying here with us at Stony Brook as pain fellow. We are thrilled that he has decided to stay and are looking forward to working with him soon. Congratulations to Dr. Daksla and Dr. Rismany on matching. We, in the pain department, are proud of your accomplishments and know that you both will keep the Stony Brook legacy strong.

   Our Pain Fellowship program has once again had a successful 100% match this year and has filled both positions for the 2024-2025 year.
Dr. Alina Razak, 2024-25 Research Chief

Zhaosheng Jin, MBBS, BSc

   I am delighted to announce that Dr. Alina Razak has been selected as our next Academic Mentorship Program director (AKA research chief). As part of the program, she will be working with Drs. Bergese, Costa and Schabel. Salutations to our second ever research chief! And, thank you everyone for supporting the Academic Mentorship Program!
Dr. Shaji Poovathoor

Joy Schable, MD

   I am delighted to announce that Dr. Shaji Poovathoor has been appointed to serve as an Associate Residency Program Director for our residency program!

   Dr. Poovathoor, who joined the department in 2004, had been a significant faculty contributor to our program for many, many years. In addition to teaching and mentoring residents on a regular basis, he serves on our Resident Recruitment Committee, Clinical Competence Committee and Program Evaluation Committee. He is our program’s Boards Master for the Basic Exam, Advanced Exam and annual In-training Exam and does an outstanding job preparing our residents for these exams with his comprehensive review sessions and “Poovy Tips.” Dr. Poovathoor has received the annual “Teacher of the Year Award” for over 10 years and has served as Director of Resident Development since 2020.

   In his new role as Associate Program Director, Dr. Poovathoor will be responsible for tracking and guiding the daily resident case scheduling for educational purposes and overseeing the clinical experiences and education of our CA1s. I am delighted to have him join our residency leadership team!

   Dr. Andrew Feit was elected to the position of Secretary for the School of Medicine Faculty Senate. Congratulations!

   Jeannette Blaha, CRNA received a Forensic Nursing Certificate from Penn State. Congratulations!

   Morgane Giordano Factor, MD received a Stony Brook Star Card. Her nominator thanked her for modeling the iCare values of Integrity, Compassion, Accountability, Respect, and Excellence. The nominator said "Thank you for taking such good care of the L&D patients. You always advocate for the patients and truly care about them."
ASA 2023 Presentations

   The annual meeting of the American Society of Anesthesiologists takes place in San Francisco, Oct 13-17. This year, members of our department will be presenting 9 abstracts, 20 medically challenging cases, and 7 additional oral presentations. Notably, residents played a role 4 Abstracts and all 20 Medically Challenging Cases!

  • Espeleta J, Oster S, Divaris H, Landman S, Khan M, Stanley S, Singh SM, Kaczocha M, Bennett-Guerrero E, Komatsu DE. Assessing Variability In Preoperative Self-Reported Pain
  • Hum B, Shibly Y, Taneja K, Patel K, Bergese SD. Tracking Patients with Anesthesia-Related Complications: Real-World Cohort of Over 18,000 Patients
  • Hum B, Shibly Y, Taneja K, Patel K, Bergese SD. Cost of Care Analysis for Patients with Opioid Use Disorder
  • Khan A, Arrigo A, Hoffman D, Jorgensen C, Knipe M, Murphy P, Setaro J, Stanley S, Gnolfo J, Corrado TE. A System Based Approach Quality Initiative in Improving First Case on Time Starts
  • Lin J, Jin Z, Mousumi B, Mukherjee MB, Li R. The Potential Role of General Anesthetics in Cancer Surgery: Meta-analysis of Postoperative Metastasis
  • Lin J, Mousumi M, Mukherjee M, Jin Z, Li R. Systemic Review and Meta-analysis of Postoperative Inflammatory Cytokines in Cancer Surgery Under Inhaled or Intravenous Anesthetics
  • Razak A, Murphy J, Jin Z, Wang M. Efficacy of Liposomal Bupivacaine Versus Local Anesthetics in Transversus Abdominis Plane Blocks: A Meta-analysis
  • Rupert D, Wang K, Hafeman M, Lai L, Schabel JE. Publication Rates and Time to Publication for American Society of Anesthesiologists: A Retrospective Analysis
  • Shibly Y, Hum B, Taneja K, Schabel JE. Identifying Patients At Risk for Anesthesia-Related Complications During Labor and Delivery
Medically Challenging Cases
  • Angelo T, Aravera C, Daoud BE, Factor M. Severe Long Term Sequela of COVID-19 requiring ECMO for CD
  • Bargnes V, Rahman S, Lehman FR. Massive Aspiration Event in the Setting of Undiagnosed Multiple Sclerosis Gastroparesis
  • Bargnes V, Rakhamimova E, Angelo TE, Factor M, Schabel JE, Daoud BE. Peripartum Management of a Patient with May-Hegglin Anomaly v
  • Bargnes V, Rismany J, Schabel JE, Factor M. Peripartum Management of a Parturient with Acute Fatty Liver of Pregnancy and Twin Gestation
  • Bell J, Azim SA. Post Operative Vision Loss in a Twelve Year Old Following Spine Surgery
  • Chen X, Raj A, Oleszak SP, Wang M. Stridor and Cervical Fracture: Worst Combination in Airway Management
  • Elias M, Kim EK, Zabirowicz E. Perioperative Management of a Patient with Factor VII Deficiency Undergoing Cardiac Surgery
  • Elias M, Patel A. Perioperative Management of a Patient with Alpha-Gal Allergy Undergoing Emergency Surgery
  • Elias M, Zhu M, Liu SM. Management of a Difficult Airway in a Patient with Advanced Head and Neck Sarcoma
  • Fardos Y, Elias M, Beg T, Poppers JS. Diagnosis and Management of Intraoperative PE during Orthopedic surgery requiring ECMO
  • Ghaly L, Oleszak SP. Use of Combined Video and Fiberoptic Laryngoscopy for Conversion from Oral to Nasal Intubation in an Anticipated Difficult Airway
  • Ghaly L, Oleszak SP, Fleischer LH. Management of a Patient with Multiple Allergies to Anesthetic Medications
  • Gombert A, Fardos Y, Daoud B, Factor M, Angelo TE. Obstetric Anesthetic Considerations and Management in a Patient with Pompe Disease
  • Hum B, Lee C, Zhang K, Hafeman M, Atkinson DJ. Management of Cardiac Tamponade Following Incidental Puncture of Pericardium During Mechanical Thrombectomy
  • Jacob S, Bell J, Pyo R, Izrailtyan I. TandemHeart for High Risk PCI with LV Thrombus
  • Kim E, Elias M, Atkinson DJ, Poppers JS. Perioperative Management of a Patient with C1-esterase Inhibitor Deficiency Undergoing Cardiac Surgery
  • Raj A, Fiola JD, Mena S, Oleszak SP. Successful Nasal Fiberoptic Intubation in a Patient with an Expanding Lingual hematoma, Extensive Oropharyngeal Injury, and Bleeding From the Upper Airway as a Result of a Penetrating Gunshot Wound
  • Razak A, Urquart D, Winter G, Aravera C, Oleszak SP. Airway Management Strategies for a Patient with a Large Hypopharyngeal Mass with Effacement of the Supraglottic Airway
  • Shibly Y, Ahn J, Factor MG, Angelo TE, Daoud BE. Management of a Parturient with Severe Mitral Stenosis
  • Tsivitis A, Chernoff D, Jin Z, Al Bizri E. Pediatric Regional Anesthetic Management of Femur Fracture with Single Shot Fascia Iliaca Plane Block
Platform Sessions
  • Daoud BE, Factor MG. A Parturient With Multiple Sclerosis Experiences The Highs And Lows Of Local Anesthetics
  • Daoud BE, Goodman SR. Maternal Cardiopulmonary Resuscitation
  • Factor MG, Daoud BE. Pain Management Strategies For The Opioid Dependent Parturient
  • Nada E. Disseminating your work: case based publications advise (Session: Educational advances in anesthesiology: PBLD, simulation, flipped classrooms and beyond)
  • Nada E. Posterior and Anterior Plane Blocks for Spine Surgery (Session: Regional Anesthetic Techniques for Neuroanesthesiologists)
  • Nada E. Obstetric Anesthesia and Epidural (Session: To Do OR Not To Do : Neuraxial Anesthesia in Patients with Coagulopathy?)
  • Richman DC. Perioperative Management of Patients with Alpha-Gal Allergy (Session: Medication Management Conundrums: New Agents, New Indications)
Nightlight Spotlight: Education Chief Resident Dr. Zhang

Vincent Bargnes, MD

   SleepTalker’s Nightlight Spotlight continues the journey of highlighting our chief residents. Up this month is our Education Chief Resident Dr. Kalissa Zhang!

Can you tell us a little about your background?
   I grew up and spent most of my life in Southern California about 15 minutes from Laguna Beach. After attending undergrad close to home at the University of California Irvine (Go Anteaters! Zot zot!), I made the trek to the East Coast where I attended medical school at Virginia Commonwealth University in Richmond, Virginia. There I ended up meeting a very handsome and suave (his words) classmate who you may know, Chris Lee, and we ended up couples matching here at Stony Brook (shout out Dr. Schabel!). The rest, as they say, is history.

What attracted you to anesthesiology?
   Going into medical school, I knew I wanted to pursue a specialty that was more hands-on. I wanted to feel actively involved in my patients’ care and performing procedures gave me that fulfillment. During my clerkship rotations, I became interested in OB/GYN and Anesthesiology. I liked the mix of clinical and procedural medicine that OB/GYN and anesthesiology both offered but was drawn to the community in anesthesiology. I also found that anesthesiology provided flexibility in future career options which was important to me as someone who grew up with family in medicine and wanted a job that wouldn’t sacrifice time with my family. Since making the decision to pursue anesthesiology, I have only found more and more reasons to enjoy the field – the interplay of physiology and pharmacology, having the ability to diagnose and then treat in a span of seconds to minutes, quickly building rapport with my patients as they quite literally put their life in my hands, and so much more.

What attracted you to Stony Brook’s anesthesiology residency program?
   The match is a complicated process, factor in couples matching let alone couples matching into the same specialty, and it increasingly becomes more of a headache. While on the interview trail, I received mixed responses to Chris and I applying to anesthesiology together. The classic question being “how do we know you’re not going to break up and cause trouble within the program?” Let’s just say there were a lot of skeptics. Dr. Schabel and Dr. DeLemos were by far the most receptive and welcoming to the idea of taking a couple into their program. Though we met a lot of great program directors (PDs) and assistant program directors (APDs) along the interview trail, the warmth and genuineness of those two really stood out and has continued to shine for the past 3+ years.

Now that we’re officially in the fall, what’s your favorite part of Long Island’s Pumpkin Spice Season?
   Pie and apple picking. Brieremere Farm (which happens to do both) is an absolute must-visit when on Long Island. All of their pies are amazing (and yes I do mean all of them). If I had to choose a favorite, it would be the strawberry rhubarb pie, pair it with a dollop of whipped cream and it is *chef’s kiss*.

Tell us more about your responsibilities as Chief Resident of Education.
   My main responsibilities as the Chief Resident of Education are managing the daily assignments for all learners rotating on anesthesia (medical students, residents, fellows, etc.) and optimizing their learning experience. My goal is to give students a diverse experience so they can build a comprehensive understanding of what constitutes anesthesia. For learners who have chosen a specialty of interest, I want them to walk away from the rotation with a better understanding of what happens in the OR or on the other side of the drapes so they can better take care of their patients in the perioperative phase.

What rotations are available to medical students?
   Third-year medical students spend two weeks with us on their anesthesia rotation. In addition to participating in the Main OR, they also rotate through the anesthesiology subspecialties including Acute Pain, Cardiothoracic, Chronic Pain, and OB. If students choose to pursue anesthesiology, they come back for a four-week sub-I rotation with added experiences in Cardiothoracic ICU and PACU/Airway.

Any rotation tips for medical students interested in anesthesia?
   In general, “shining” on your anesthesia rotation is tough because the rotation is very different from any other clerkship that you rotate on and the nature of anesthesia doesn’t lend learners many opportunities for you to truly “shine”. That being said, the most important tip I can give to students interested in anesthesia is to look up your patient and the procedure the night before, and to show up each morning on time with enthusiasm to learn. Students who have stood out in the past are well-read, whether it’s studying the Stanford CA-1 anesthesia guide or looking up videos on YouTube, and have situational awareness, meaning being able to read the room and recognize critical parts of the case.

What’s next for you after graduating from residency?
   Chris and I will be moving out to Los Angeles next year, where I will hopefully have a general anesthesia job. It has been 8 years since I’ve gotten the chance to be home, so I am very excited to be back. Chris and I are looking forward to our next adventure!
Photos from a recent trip to California

Vincent Bargnes, MD

   The New York State Society of Anesthesiologists District 8 hosted a lecture last month by Muoi Trinh, MD on “The Environmental Impact of the Operating Room” with updates from the district leadership. Stony Brook was well represented by residents and attendings. Good times were had by all!
Marathon for Charity

Lindsay H. Fischer, MS, CRNA

Red Door Community
   On Nov 5th, I am running the NYC marathon (gulp!)! I am running on behalf of RED DOOR community Cancer charity (for those of old enough to remember, the late comedian Gilda Radner founded this during her fight against ovarian cancer). I'm trying to raise $3000 on their behalf by end of October and would love any monetary donation (big or small)! Click here for my donation page.

   The Red Door Community is a non for profit charity that raises funds in order to offer FREE cancer support to those impacted by cancer (children, adults, families, treatment, housing etc.). All donations are tax deductible!

   Thank you all so much in advance!!!! And if you plan to attend the marathon let me know and can join the cheering squad at location TBD!
Dr. Landman's Corner

Ursula Landman, DO

   Anesthesia Interest Groups. Both the Stony Brook Medicine and NYITCOM Anesthesia Interest Groups had an Introduction to Anesthesiology meeting in which I spoke to the students. There were 30 students at the SBM meeting on August 28 and 32 at the NYITCOM meeting on September 12. They asked terrific questions! This looks to be a fabulous year. If anyone is interested in giving a talk to these enthusiastic students -please let me know.

   Wellness Committee Update. Let us continue to prioritize our Health and Wellness so that we can wake up inspired and end the day fulfilled by our work! If you have any new comments or suggestions, please feel free to email Dr. Tiffany Angelo or myself or place comments in one of the 3 boxes. One is located on the left side of the wall as you walk into the anesthesiology admin copier room. Another is on the wall in Labor and Delivery between the OB anesthesiology attending and resident call rooms. The third is inside the anesthesiology attending break room located just before the main OR entrance. We hope to engage all of you in the value and wellness of our department. Looking forward to seeing /hearing comments and suggestions.

New Publications

    Fig 3a from Glaser et al 2023
  • Glaser ST, Jayanetti K, Oubraim S, Hillowe A, Frank E, Jong J, Wang L, Wang H, Ojima I, Haj-Dahmane S, Kaczocha M. Fatty acid binding proteins are novel modulators of synaptic epoxyeicosatrienoic acid signaling in the brain. Sci Rep. 2023 Sep 14;13(1):15234
  • Zhu C, Schutz L, Jayanetti K, Takemura K, Doswell F, Wang L, Ojima I, Kaczocha M. Truxillic acid monoamides as fatty acid binding protein 5 inhibitors. Bioorg Med Chem. 2023 Sep 4;94:117464
  • Schwartz JA, Romeiser JL, Kimura R, Senzel L, Galanakis D, Halper D, Mena S, Bennett-Guerrero E. Effect of chamomile intake on blood coagulation tests in healthy volunteers: a randomized, placebo-controlled, crossover trial. Perioper Med (Lond). 2023 Sep 20;12(1):51
  • Brown JK, et al, PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Workgroup, including, Schwartz JA, Bennett-Guerrero E. Adult Cardiac Surgery-Associated Acute Kidney Injury: Joint Consensus Report. J Cardiothorac Vasc Anesth. 2023 Sep;37(9):1579-1590
  • Kimura R, Schwartz JA, Bennett-Guerrero E. A narrative review on the potential therapeutic benefits of chamomile in the acute care setting. J Herb Med. 2023 Sep; 41:100714
  • Krupp S, Hubbard I, Tam O, Hammell GM, Dubnau J. TDP-43 pathology in Drosophila induces glial-cell type specific toxicity that can be ameliorated by knock-down of SF2/SRSF1. PLoS Genet. 2023 Sep 25;19(9)
Where on Campus is That?

James P. Dilger, PhD

Visit the Where on Campus is That? webpage!
Synaptic Communication: A Retirement Project

James P. Dilger, PhD

   I have been playing the New York Times game “Wordle” for about a year and a half. Are you familiar with it? You must guess a 5-letter “target” word in six attempts. After each guess, you receive color-coded information about the correctness and position of each letter in your guess. Here are two of my recent results: one that I’m proud of, the other not so much! Green means that the letter you guessed is in the right place, yellow means the letter is present in the target word but not at that position. Gray indicates letters that are not in the target word. As you can see, luck plays a big role, but so does skill.

   A recent feature of Wordle, if you are a NYT subscriber, is an analysis of your play and some information about the number of players using different starting words. I was struck by the number of players who guessed the target word in one go. Considering that there are 2,315 possible target words, your chances of doing this by pure luck would be 1/2,315 = 0.043%, or even lower if you don't refer to a list of the possible target words (I don’t). About 2 million people play the game, so you might expect about 800 players at most scoring an ace. Yet, between 4,000 and 10,000 actually do so every day! Sounds suspicious! The technical name for these players is “cheaters”!

   I tabulated this data for 4 months this summer, and then decided to write a light-hearted paper about the results. From the title, “Wordle: A Microcosm of Life. Luck, Skill, Cheating, Loyalty, and Influence!”, you can see I wasn’t just obsessed with cheating! I submitted the paper to Recreational Mathematics Magazine, but they haven’t even acknowledged receiving it! On the advice of my Best Man, I posted the paper on arXiv, where you can post preprints of un-reviewed papers. That was a stroke of genius! The paper was picked up by several news sources and I was phone interviewed by three of them (including Discover and the Times UK; the NYT continues to ignore me). Several creative cheaters have written to me, proudly explaining how they do it! It’s been fun but I think my 15 minutes of fame are just about up!

   If you are interested, follow the link to the paper on arXiv. Here’s one of the figures as a teaser; I’ve added an additional month’s data because you are my friends!

Each point shows the percentage of players who guessed the target word on their first attempt that day. The open circles indicate words that are among the top 20 first guessed words nearly every day. The filled circles indicate words that are not even among the top 100 first guessed words on any random day.
SleepTalker, the Stony Brook Anesthesiology Newsletter is published by the Department of Anesthesiology
Stony Brook Medicine, Stony Brook, NY
Syed Shah, MD, Interim Chairman
Editorial Board: James P. Dilger, PhD; Murad Elias, MD; Vincent Bargnes, MD