Only two days into my first intensive care unit (ICU) rotation as an intern, I heard the dreaded “code blue” overhead. “He just became unresponsive and stopped breathing!” exclaimed the nurse. This young man presented with diabetic ketoacidosis but also had a history of untreated AIDS and what would later be diagnosed as disseminated histoplasmosis. Within days he was weaned from mechanical ventilation, continuous renalreplacement therapy, vasopressors, and a plethora of invasive monitors. Three weeks later, this man literally walked out of the ICU in a healthy state. His hospital course showed me the power of critical care thinking and interventions to save many from the most grim circumstances.
A year later, I witnessed how fragile patients with severe cardiovascular comorbidities can be in the perioperative setting. Relatively new to anesthesiology, I drew on my intensive care skills to care for these patients, but found myself with large knowledge gaps in echocardiography, intracardiac devices, and cardiopulmonary bypass. I then realized how a dual fellowship in critical care and adult cardiothoracic anesthesiology will empower me with the skills to become a more complete perioperative physician one who not only understands the complex pathophysiology of life threatening ailments but is also skilled to appropriately diagnose and intervene in the operating room or ICU.
Throughout my residency training in anesthesiology, I have developed a propensity to accept the most challenging cases. Rather than shying away from complexity, I have grown substantially by working alongside our trauma and cardiothoracic anesthesiologists to polish my mindset and procedural skills during our patients’ most desperate hours. Prioritizing the steps in resuscitation and learning to communicate with all the involved treatment teams are pivotal characteristics of a perioperative intensivist which I exhibit in every case. Colleagues and patients have also noted my ability to effectively establish rapport, alleviate anxiety, and distill complex medical pathophysiology into simple concepts. These traits combine with a sincere empathy to help many patients and their families deal with end of life care a reality for many critically ill patients.
I now seek rigorous training in both fellowships to expand my breadth of diagnostics, familiarity with treatment modalities, procedural finesse, and ability to rapidly apply my full array of skills to help in any clinical situation. Starting with critical care will provide an unparalleled foundation in pathophysiology to build upon as a cardiothoracic anesthesiologist. I hope to matriculate to a program which encourages this blend of perioperative care and empowers its trainees to pursue scholarly activity, teaching, and ultimately facilitates finding a job as an academician.
In conclusion, these dynamic fields promise challenges in managing all aspects of a patient’s care. I feel the synergy of my medical knowledge and technical skills coupled with a strong work ethic and laidback persona make me wellfitted for a career in critical care and cardiovascular anesthesiology, and ultimately, as a complete perioperative academician.
I hope you will strongly consider my commitment to excellence at your program.