Assistant Professor, Department of Anesthesiology
University of Colorado, Anschutz Medical Campus
I grew up in Bloomington, IL, and Japan and decided to pursue US residency training after graduating from medical school in Tokyo. I was already interested in critical care medicine as my subspecialty at the time of my residency application. Then, cardiothoracic anesthesia and clinical research attracted me during my residency in addition to CCM. The Fall of CA-2, the typical time to apply for a fellowship, felt too early to decide which fellowship to choose. After putting off my fellowship application for a year, I ultimately decided to train in all three fields.
When searching for my fellowship destination, I looked for institutions that had excellent clinical training in CCM and ACTA. What I learned through the application process was that many institutions had at least one “ideal” program, but not in both. University of Colorado was among the rare institutions that fit my idea of an excellent training environment. My interest in training at CU grew into a desire to be a part of the team after interviewing with the CU faculty members, who impressed me with their abilities to balance work and life while performing at the highest levels clinically and academically.
I had an aspiration to master evidence-based medicine when I moved to the US. However, my faith in evidence-based medicine slowly faded as I began to understand that most published medical research was fraught with limitations and false assumptions. I also noticed throughout my training that most research findings were not applied at the bedside. It struck me hard one day when I listened to a podcast called Walking Home from the ICU, where Kali Dayton and her guests described an ICU in Utah that transformed into an “awake and walking ICU” after recognizing the long-lasting harm of deep sedation and immobility in the 1990s. Dr. Jason Brainard, my CCM fellowship program director at the time, let me fly to Utah to visit this ICU using my elective rotation. This experience was eye-opening. It taught me how the quality of care can save or break our patients in the ICU and the importance of teamwork, culture, and contextual factors in healthcare. Since then, my focus has shifted from learning the literature to bringing best practices to the bedside.
I feel extremely fortunate to have trained and been surrounded by incredible healthcare staff at CU. My Cardiothoracic ICU colleagues responded with enthusiasm when I shared my vision to bring the “awake and walking ICU” to our unit. The multidisciplinary SOAR (Sedation Off, Awake, and Rehabilitate) initiative was born, and our team received grant support from the IHQSE to operationalize the work. This endeavor continued as I transitioned to the ACTA fellowship, and we’ve had inspiring results from the initiative. The CU ACCM and ACTA fellowship programs and the Department of Anesthesiology have supported my renewed passion for medicine, and I am grateful for the opportunities and mentorship I’ve received throughout this journey. I treasure my fellowship experience at CU and am confident that the clinical, academic, and leadership skills I gained here will help me as I transition into a faculty role.
Instructor, Department of Cardiovascular and Thoracic Surgery
Director of Critical Care for the Emergency Department
University of Louisville
Louisville, Kentucky
I went to the University of Texas in Austin where I obtained a BA in philosophy. I completed a 4 year EM residency at the University of Cincinnati where I had the opportunity to be a flight doctor and compete over 100 helicopter patient transports. My hobbies include rock climbing (with one day ascents of EL Cap and Half Dome) and since moving to Kentucky learning about bourbon.
The well-rounded 2-year curriculum with an emphasis on diversification of critical care experiences in the 2nd year really attracted me. Core months in a Cardiothoracic ICU with a high volume of mechanical circulatory support was also a huge draw as I knew I wanted a strong background in this for my future career.
CU provided solid training in all aspects of critical care, surgical (general and cardiothoracic), pulmonary, burn, and neuro. In addition, due to the excellent relations between the cardiac anesthesiologists and the critical care anesthesiologists (many of whom overlapped) I was able to obtain robust TEE training. I was also provided ample elective time to customize my training to my career goals by doing rotations with advanced heart failure and pulmonary hypertension specialists.
I currently split my time between the ED and a Cardiothoracic surgical ICU with a high volume of advanced heart failure patients, cardiogenic shock, LVADs, Impellas, heart transplants, VV and VA ECMO. It is a challenging unit to work in but my training at CU set me up for success. I am the director of critical care for our emergency department and director of our pulmonary embolism response team and co-director of our ECMO committee where I actively work towards expanding patient access to ECMO/ECPR services.
I obtained enough TEE hands on training that I was able to pass the advanced peri-operative TEE exam and last I checked was the only EM/CC physician in the country to have NBE diplomate status in both advanced TEE and critical care echo.