ICU Fellowship

Although I like to say that the decision was never clear cut, I also think my choice to go into critical care medicine was a natural one. Even though I love operating room anesthesia, I miss some of the things it doesn't encompass. My fascination and curiosity with general internal medicine draws me back to the vagaries of diagnosis, the nuances of treatment. My most interesting cases and patients are often the critically ill; when I go home, I don't dwell on the surgeries that went exactly as planned, but I do think about the patient who had unexpected decompensation or the ICU patient whose pressors I adjusted. Ironically, in the last three years, I've focused my education and learning on a narrow slice of medicine and now I want to step back and learn everything else. This year as an ICU fellow is a great opportunity for me to undust those books on infectious disease, engage those rusty neurons on differential diagnosis. The other big draw for me to the critically ill is my interest in the end of life. What do most people want at the end of their life? Is the ICU appropriate for various medical conditions? How do we treat patients and families in critical period? Can we improve the system and the care we deliver? I hope that as an ICU physician, I will be a leader that engages and influences the system to deliver intelligent, appropriate, humanitarian care. Although another year of training will be tiring, I am actually quite excited to re-engage medicine in a different light and round myself out as a doctor.