1. Please share your most interesting case with a patient?
“As an Emergency physician, there was initially a dream to save lives. What I have realized over my 9 years of practice is that probably 75% of what we do is managing illness and not curing. Despite this there are a few moments in one’s career when you can truly say you saved that person’s life. One case I experienced at Ridge Meadows Hospital was that of an elderly gentleman who presented with an upper GI bleed. Although he seemed stable at first and was placed on the usual medications to stabilize the bleed, he suddenly started to decompensate and bleed PROFUSELY in the form of melena and vomiting (the floor was pooling with blood while we tried to stabilize). The vomiting was so extensive that with 2 suctions going, we were unable to clear his airway of blood and it was literally a pond of blood in his mouth. His oxygen saturations dropped to zero and I knew in the next few moments he would arrest if I was not able to protect his airway. With a completely blind technique using straight up muscle memory from previous intubations, I passed an endotracheal tube through the vocal cords only recognizing it as such by the feel of the resistance as it passed through. Once we were able to deep suction the blood from the airway, we were able to provide respirations and prevent the impending cardiac arrest. We were then able to focus on resuscitation through blood products and were able to get him rapidly to the OR where the surgeon was able to sew over the stomach to tamponade the bleed. He was apparently able to walk out of the ICU approx. 2 weeks later with no neurological deficits.”
2. What is the best advice you were given during your time in medical school that has had a lasting impact on your practice?
“One of the first things they taught us in medical school was that by the time we finished medical school, 50% of what we had learned would be incorrect. With this realization that medicine is constantly evolving and recommendations frequently changing, it is important to take a medical career as a lifelong education. Through CME and reading, I have tried to keep up to date with my practice so that I can provide the safest and best care for all my patients.”
3. What are you currently working on that is helping to impact our local medical community and/or local patients?
“I have launched a simulation program along with the Emergency Clinical Nurse Educator, Kelly Van Blanken at Ridge Meadows Hospital that is interdisciplinary and in situ (we hold the simulations in the trauma bay of the Emergency). The goals of this program were threefold: to improve the communication and coordination of a resuscitative team to ultimately provide more efficient and better care for our sickest patients, to provide more experience with rarer cases so that we are always prepared for even the rarest of cases, and to educate all those involved on the reasons for the decisions we make in critical care so that everyone can understand the importance of these decisions and provide feedback when things are not going as planned. The simulation program has so far only been conducted within the Emergency Department and has been very well received with great participation. Our future goals with the program are to expand the simulations to other departments with lots of interest coming from our Internal Medicine and Pediatric colleagues. As well, we hope to run “CPR Quality Improvement Olympics” for all staff within the hospital so that the quality of CPR provided within Ridge Meadows Hospital is always exceptional!”
4. What is some advice or wisdom you would like to share with your medical staff peers, or any new physicians joining our community?
“If I were to give advice to colleagues, especially those who are training or new in practice, I would tell them that most of what we do is managing people’s illnesses. Therefore, the idea that we can cure is an ideal that is not practical in many cases and can feel frustrating especially when all conventional treatments are failing. This is where the interactions we give the patients is most important. We can be the most knowledgeable physician but without buy-in from a patient on what you are telling them, they are going to leave the interaction dissatisfied and perhaps feel hopeless. I believe that through empathy and thorough explanations of the problem’s patients have with very clear discharge instructions, patients are almost always very appreciative and will find value in their experience under our care. Such experiences can have a great impact on a patient’s illness experience and can provide them with the actual therapy that they needed. Providing these kinds of experiences for patients is what brings me the most satisfaction in my career.”