Critical Care Medicine
Med School/Year Graduated: University of California, San Diego, 1998
Years in Practice: 16
This is the first year PHOENIX has included your specialty in Top Docs. In layman’s terms, what is critical care medicine?
It’s a specialty that focuses on care of the sickest patients in the hospital. These patients typically have respiratory failure, heart failure, brain failure, overwhelming infections and severe metabolic failure. We use mechanical ventilators or breathing machines to support patients that are unable to breathe on their own [and] have an array of tools to help support patients with advanced heart failure and continuous dialysis devices to replace kidney function.
It appears many critical care specialists have backgrounds in pulmonary medicine. Why is that, and what is the main distinction between the two?
The most common pathway to critical care medicine involves doing an [internal] medicine residency, then a fellowship in pulmonary medicine and critical care. Pulmonary medicine is, broadly, the specialty involving diagnosis and management of lung diseases. It includes hospital-based and office-based care. In contrast, critical care is strictly limited to the hospital in the intensive care units. There are other ways to specialize [in this field]. Anesthesiologists, emergency medicine doctors and surgeons may do additional training to become board-certified in critical care medicine.
Hemodynamics is a professional interest of yours. Any new or exciting developments in this area?
Hemodynamics is the study of blood flows, pressures and resistance through the heart and lungs. It allows me to straddle lung and heart physiology [and] is central to the diagnosis and management of pulmonary hypertension. In the world of pulmonary hypertension, we have made tremendous strides. Whereas 20 years ago, patients with pulmonary hypertension had an average survival of less than three years, the average survival now exceeds 10 years.
You’ve matriculated and/or trained in San Diego, Boston and San Francisco. Do you have a favorite of those cities?
I have been very fortunate to spend time in some wonderful cities. When I attended Stanford University as an undergraduate, Palo Alto was a very sleepy small town. Now it is a bustling hot spot of technologic development. San Diego was a great place to be a medical student. There’s nothing like a jog on the beach to clear the fog of long study sessions. From there, I went to do a residency in internal medicine at Harvard University at Brigham and Women’s Hospital. I loved my time in Boston. I was surrounded by incredibly bright and committed colleagues. [But] if I had to choose a favorite, I would have to go with Stanford.
We hear you love large poodles. Do you have any? Name(s)?
My original standard poodle was Samson. They broke the mold with him. He was a gentle giant with great intellect. I suspect that if poodles had opposable thumbs, they would probably take over the world. I currently have a standard poodle and a giant schnoodle, a cross between a giant schnauzer and a standard poodle.
You’re a bit of a foodie, we’ve read. What are your favorite restaurants in the Valley?
For a formal night out, my wife and I love FnB and Nobuo at Teeter House. It’s hard to beat a quick sandwich at Pane Bianco or a sweet dessert called alfajores at El Chullo.
What are you watching on Netflix these days?
My wife and I have been enjoying Grace and Frankie. My son is really into Miraculous: Tales of Ladybug & Cat Noir. Truth be told, I enjoy it as well.
“If I wasn’t a doctor, I’d be…”
I would love to be a chef, but I can’t stay up past 8:30 p.m., so that might prove a challenge. I also can’t follow a recipe, so each dish is a unique creation. This might prove a challenge for consistency.