Behind the Drapes: Anesthesiology and Critical Care Medicine

In this episode, you get to hear from one of my first year residents about an interesting case that they got to experience this past year. Cases like these force residents to think outside of the box and exposes them to interventions we don't use often in anesthesia. Taking moments like these to expand on their learning by turning it into a case report or poster presentation is what truly helps residents excel in their learning. Dr. Rachel Baker did just that and is here to share her experience with you all!

After a long time away, I am finally back to podcasting! I bring with me some old friends with new insights as I begin my career as an attending in anesthesiology and critical care medicine. Listen along as we dive into what it takes to make the most of your career, how my guests navigated the career paths they landed on, and how to keep a steady pace so you don't get burnt out quickly. These guys are always a great listen so I hope you enjoy hearing from them as much as I do!

This is my last episode for a little while. And it's a really special one. An incredible story told from the perspective of my wife and her aunt. A life experience that has shaped our lives and career. It still gives me goosebumps.

In this last episode of interviewing my co-fellows, I bring in Ayesha and Jim to share their experiences this past year. They are two examples of avenues outside of Anesthesia and Surgical training that can still get you into ICU fellowship. Their unique perspectives have really broadened the knowledge base and breadth of conversations that we have amongst ourselves in our fellows office, and they are extremely warm-hearted people I am proud to call my friends.

In this installment of the farewell tour, I speak with my surgical co-fellows, Arfry and Rachel. Listen along as they dive into their unique experiences this past year and how it's shaped the type of attending they will soon become.

Listen along as I say goodbye to ICU fellowship in the form of exit interviews with my Cofellows. In this episode, you hear from my anesthesia cofellows, Jonathan and Anand.

In this episode, I close out this series on death and dying with a bookend conversation with friend of the show, Erin Richman. Listen along as she describes three separate instances where she lost a loved one, how she coped with it, and how those moments impacted her life. (**Trigger Warning** This episode contains a story about suicide. SI Hotline #988)

This one is a special one. I don't normally get this personal. But the decision to interview Jenn for this mini-series was inspired by more than just sharing knowledge about pregnancy. This platform gave me an opportunity to record a special moment with special friends and I get to share a snippet of it with you all. Hope you enjoy, stay tuned to the end.

In this episode, we continue the conversation on death and dying with Chaplain Jamie Riggs. Jamie provides perspective into her role in the ICU and the ED as she describes just how valuable it can be for patients to have a listening ear.

In this episode of CMO, I discuss how my last night float as a trainee went. There were three specific moments that really made me feel like the culmination of my training has prepared me for the transition to becoming an attending. Listen along as I dive into these moments and shed some light on my final thoughts of night float life.

The results are in and I am officially a Board Certified Anesthesiologist! In this episode, I breakdown what the exam day is like with a friend who traveled down with me, Dr. Jessica Miranda. Listen along as she shares her experience on the test day as well as her background coming from anesthesia training in Brazil.

In this episode, I discuss some major takeaways from a lecture I attended earlier this week on Healthcare Policy in the US. We've inched closer to providing access to healthcare for most Americans in this country, but there are still some shortcomings that we will have to overcome to truly say everyone receives equal access. Listen along as I share with you some of the observations that stuck with me from this talk.

In this episode, I break down some take aways from my past two weeks on my TEE Elective (Transesophageal Echocardiography). Listen along to hear my 4 pieces of advice on how to survive a rotation you're not looking forward to.

In this episode, Dr. Imbriale takes us through what women can expect during their second trimester of pregnancy. According to her, this is the “coasting” phase of pregnancy, when you can truly enjoy all the joys of pregnancy. Listen along as she also talks to use about her own second trimester experiences.

In this episode, I give you a small taste of what it takes to prepare for the Anesthesia Oral Boards examination. More specifically, how to come up with a broad differential for treating hypoxemia and hypotension in the OR. This framework has saved me both practically in the OR and when I comes to discussing cases in oral board like scenarios.

In this episode, I talk with clinical social worker, Ruth Mandel, about her role in death and dying in the ICU. We discuss her road to medical social work and end the conversation with some important tips to health care providers for how we can improve the D&D process in the hospital.

In this episode, I delve into the topic of race in medicine - specifically from the perspective of patients and medical trainees. Listen along as I run through two stories that I believe highlight how race plays a subtle but significant roll in the medical world.

In this episode, we revisit death and dying in the intensive care unit from the perspective of a bedside and resource nurse. Alyssa goes through her inspiration to become a nurse, how it led her to the neuro ICU, and the value that nurses bring to patients and families as they encounter the end of life in the hospital.

In this episode, I walk you through the physiological concept that is the Dunning-Kruger Effect. Ever since I learn about this concept, I've seen it play out over and over again in medicine. Listen along as I apply it to my own career.

In this episode, I talked with Palliative Care Fellow, Dr. Katie Waybill, about her perspective on death and dying in the hospital. Listen along as she provides a guiding voice into the intricacies of palliative medicine and its role in helping to navigate medically complex patients.

In this episode of Night Float Round 4, I get into the intricacies of what makes a critical care physician good at their job - when to do nothing. Watching and waiting can be tough, but sometimes it's the right call. Listen along as I go through two scenarios that came up during my recent week of night float where I elected not to take the easy way out.

In this episode we kick off the discussion of death and dying. When working in the ICU, you can't escape death. And the more you sink into it and try and understand it, the more you appreciate life and realize birth and death are massive uniting similarities between the diverse species that we call humans. Listen along as Dr. Richman describes her teaching experience guiding college students understanding the complex topic of human development that ultimately culminates with death.

The first podcast episode of 2024!! My second year in this passion project kicks off with a 3 part series of what to expect when you're an expecting mother and an OBGYN resident. Dr. Jenn Bracken returns to the show to discuss her pregnancy journey while working in a hospital surrounded by pregnant patients. Each part will take us through each trimester of the pregnancy, starting with the first trimester in this episode.

To top of my Best of 2023 series, we go back to my very first episode and by far the most popular and most listened to episode on the show. Even now as I listen back, Dr. Shyamal Asher carries this conversation effortlessly as I begin my adventure as a podcaster. Even if you've heard this one before, it's worth a second listen through.

In the second to last episode of the best of 2023 series, I revisit a conversation with an old co-resident, Dr. Andrew Winegarner, where we talk about his side hustles and how he's able to balance it all. Season 2 of BTD was all about financial literacy, so if you're into that go back and check out the whole season.

In this best of 2023 episode, I revisit my conversation with Dr. Maslow - easily one of my favorite attendings from Rhode Island Hospital. Listening back, I'm reminded by how smart he is, right from the beginning of the episode. He's inspiring and accomplished in his career. This is a must listen (or relisten if you're a true fan).

In this episode, I revisit my interview with my good friend Danie. She's been a mentor and guiding path in my career for over a decade. If it wasn't for her, I don't know that I would've discovered the field of anesthesia. Listen along to one of my top 5 episodes from 2023.

For the next 5 weeks, I'll be giving you my top 5 episodes from Behind the Drapes in 2023! In this episode, I talk with Dr. Rotenberg right before he retires from a 30+ year career in Anesthesiology.

In my last episode of 2023, I bring in one of my good friends from medical school, Dr. Robert “Tyler” Swanson, to talk about radiology. Listen along as we talk about the differences in X-rays, CT scans, and MRIs and what it's like to communicate with the ICU or stroke teams when critical pathology is found on scans.

In this episode, I delve into a scenario that happened on my last night float of 2023. Most patients at nighttime are either vented and sedated and you don't have to worry about them, or are actively crashing in front of you. This scenario was somewhere in the middle. And it's these cases that take hours to declare themselves that can be some of the trickiest to decide on a treatment. Remember, just because you can do an intervention, doesn't always mean it's the right thing to do in the moment.

In this episode of CMO, I talk with our Clinical ECMO Program Coordinator and nursing specialist, Malory Butera. She is someone who is heavily involved in the care of patients at BIDMC who are on ECMO support. She is also very involved in education around the speciality of mechanical circulatory support, including for my fellowship program and the days we spend in the simulation lab.

In this episode, I introduce a new method of providing feedback that I picked up from a recent BIDMC Academy workshop from an expert in feedback. My goal is to hopefully convince you that this new method is going to replace the “sandwich” technique of giving feedback. And to convey the importance of valuable and actionable feedback.

In this episode, I bring back friend of the show and expert in burnout, Dr. Erin Richman, to discuss this topic more in depth and a bit about career longeivty. Listen along as we break down how to recognize burnout, how she overcomes burnout, and how she's been able to sustain a trying but rewarding career.

In my second round of night float, the theme of early morning codes continued. I refer back to one particular code where I felt like the leader of the code did an exemplary job, inspiring this episode. Listen along as I describe three characteristics that make for an effective code team leader.

In this episode, we get to hear from one of our ICU clinical pharmacist about her role in the ICU and the importance and nuances of antibiotic usage in the ICU.

In this episode, I bring you inside what our shock/MCS course looked like this week in conjunction with the Cardiology department. Mechanical Circulatory Support is an evolving field in medicine, especially in the critically ill population. Meaning managing patients with these devices will be a huge part of my future career. Listen along to hear some of my biggest take aways from the day!

In this episode of Collecting My Observations, I take you behind the scenes of what night float looks like in the ICU. Listen along through my delirious thoughts as I take you through my 3 biggest lessons, all applicable to nights in the ICU and all applicable to one particular patient situation.

In this episode, I talk with my good friend Kyle Andrew, creator of @thirty_minute_workouts on Instagram. As the name implies, his page is a library of thirty minute workouts that you can do at home. Listen along as we talk about what motivated him to start this project, lessons it's taught him along the way, and why he keeps going with it. Find him on Instagram: @thirty_minute_workouts (https://instagram.com/thirty_minute_workouts?igshid=MzRlODBiNWFlZA==)

In this episode, I give you my thoughts on how AI is changing the medical education landscape and discuss ways that I use ChatGPT in my everyday life.

Meeting with families is a crucial part of working in the ICU. In this episode, I discuss different techniques and strategies that I believe help make for a successful and purposeful family meeting.

In this episode of Collecting My Observations, I recollect some memories of what got me into anesthesia and critical care. Listen along as I walk you through highlights of my medical career from college to medical school to residency.

In this episode, I talk with one of my best friends from medical school, Dr. Jeremy Silver about what it's like taking care of orthopedic trauma cases. Listen along as he takes us into trauma bay, what serious injuries he needs to stabilize immediately vs what can wait, and how you can avoid finding yourself surrounded by the controlled chaos that is the trauma bay.

In this episode, I share what it's like being in the Cardiovascular Intensive Care Unit (CVICU). During this rotation, I had the opportunity to take care of a couple heart transplant patients. I'll take you through what a typical plan looked like for these patients from each organ system, head to toe.

In this episode of Collecting My Observation, I describe the feeling of being in the crux of both a student and a teacher. Then I look to one of my mentors who seemed to have stayed in this position of both student and teacher for the entirety of his career. Listen along to find out more!

In this episode, I collect my observations about what qualities make for a good medical student rotating on their sub-I or acting intership in the ICU. I start the episode with my own person away rotation story during my 4th year of medical school, and end the episode talking about 3 qualities that will really go a long away in life.

Welcome to the first episode of Collecting My Observations! In this series, I'll be giving you and insider look of what my job as an ICU fellow entails! Each episode I'll go over a personal experience that I believe demonstrates what this year of medical training is all about. In this episode, I go over what it was like describing the first couple of weeks at my new job to my friends and family who don't have any medical training.

This is the official closure to my residency chapter at Brown. Listen along as 10 anesthesia residents ranging from first years to graduating seniors discuss how their year went. There's a lot to learn from each of them. As you watch, you'll hear a common thread woven between their various individual perspectives. I wasn't really sure what to expect when I reached out to these 10 people or sure of myself to actually make this project happen. But as the interviews progressed and I got deeper invested into this project, my smile got bigger and I started to realize I captured something pretty cool. If you're interested in medicine/anesthesia or work alongside anesthesia providers, take a listen to hear how trainees develop over the course of 3 years. I couldn't help but see myself in each of them and at the same time inspired by what made us different. And if you're a brand new resident in July, you just started one of the most rewarding chapters of your life. You learn to selflessly give everything you got to your patients while selfishly try to become the best possible physician you can. You will make mistakes and you will achieve things you didn't realize were coming your way. You will make sacrifices and you will take shortcuts, but before you know it this time in your life will be over and all eyes will be on you when a patient is crashing in front of you.

The season finale for season 2!! Our last episode on financial literacy is a fun conversation with a good friend, Dr. Andrew Winegarner about his ability to juggle residency and a side hustle. Listen along as we discuss informatics, coding, and what his side hustle entails. 00:40 First Job Ever 05:00 Informatics 12:30 Interest in Coding 14:00 Time Investment During Residency 17:00 What is Your Side Hustle? 20:00 10-year plan

Closing in on the end of the season, we talk with one of my favorite guests, Dr. Shyamal Asher, about everyone's favorite topic - student loans. Listen along as we discuss Dr. Asher's personal experience with student loans, basics of repayment types, and if Public Student Loan Forgiveness (PSLF) is for real. 01:30 Personal Experience with Loans 06:30 In-state vs Out-of-state med school costs 09:00 Monthly Budgets 13:30 Subsidized vs. Unsubsidized Loans 16:30 When to Start Planning for Loan Repayment 18:15 Repayment Options & PSLF 26:00 Is PSLF For Real 31:30 How Will the Pandemic Pause Be Remembered?

Welcome back to another episode of Behind the Drapes Season 2 where we are talking financial literacy. In this episode, I speak with Brian Manley about what credit is and how we can use it to our advantage. Listen along as we talk about the typical progression for loans that create credit, different credit card tiers, and how Brian played a huge role in helping me get this podcast off the ground. 01:30 Who is Brian Manley? 07:30 Learning About Finances 12:00 What is credit? 19:30 Progression of Obtaining Credit/Loan 22:30 Credits Effect on Housing 24:30 When Should You Get a Credit Card? 26:30 Credit Card Tiers 37:00 How Do You Use Your Points?

In this episode of Behind the Drapes, I talk with Justin Harvey about contract negotiations and navigating the job market. Justin is a financial advisor who not only works with Anesthesiologists, he had a front row seat to his wife going through the process of becoming a chronic pain physician. He also has a podcast titled "Anesthesia & Pain Management Success" where he talks about financial topics related to the career of an anesthesiologist. 03:30 Red Hot Market 09:00 Academics, Private Practice, Locums 11:30 Private Equity Groups 20:00 Negotiating with Academics 27:00 Red Flags in Contracts 31:30 Who Proof Reads Contracts? 37:00 Timeline for Looking at Jobs APM Success Podcast (https://podcasts.apple.com/us/podcast/anesthesia-pain-management-success/id1444486964)