Pitt/UPMC Department of Anesthesiology News
December 2015

Message from the Chair
When I was a medical student, this word was the motto of our Department of Medicine and was emblazoned on the ties and scarves worn by the housestaff every Friday. Being young and unimpressed by multisyllabic Latin words, uninterested in tradition, and even less interested in a career in internal medicine, I paid little notice. However, as time passed and I matured (slightly), I once again came upon this odd word in an alumni newsletter, and this time it resonated with me.
Aequanimitas is the title of a famous graduation speech given to the 1889 medical school class of the University of Pennsylvania by Sir William Osler, one of the iconic physicians of the late 19th and early 20th century. The word translates as imperturbability or equanimity. Osler specifically used aequanimitas to refer to two qualities the physician should develop. The first is the outward expression of calm in the stressful situations and difficult circumstances that accompany caring for patients. The second quality is that of calmly accepting life's circumstances, yet continuing to fight for what is right and persistent dedication to improvement.
I have started thinking about aequanimitas even more since I arrived in Pittsburgh. We face a time of unparalleled opportunity to improve patient care and reduce pain and suffering. However, we simultaneously face the unprecedented challenge of reducing the cost and complexity of medical care without compromising its excellence. Here at Pitt, we are leading this charge and have the battle scars to show for it. Tremendous angst has been generated by the transformational changes we have undergone and the uncertainty engendered by those yet to come.
How then, would one propose to keep a sense of calm and optimism in the face of this turmoil when it often seems that we do not control our fate? I would suggest to you that it is by realizing three things: that what we do is essential, that we can and will control our destiny, and that all change presents opportunity.
The services we provide are essential for all aspects of patient care and central to the main mission of medicine: to relieve pain, suffering, and the burden of disease. Thus, the role of our Department in UPMC, as well as of our specialty in caring for all patients, is secure and will become even more highly valued as we evolve from incentive-based to value-based models of practice.
At times, it seems that we are just one small piece of a giant organization, and have little control over how we practice medicine and what our future roles will be. After just a few months here, I can tell you that from my perspective, nothing could be further from the truth. The administration respects our hard work and innovations in practice management. We have led the movement toward greater efficiency without compromising quality and have significant opportunities before us now to continue this leadership role. The ERAS program and WAKE model are just two current examples that also clearly illustrate the idea that all change presents opportunity. Remarkably, we have been able to figure out what those opportunities are and make the most of them. Our successes in education and academic endeavors also demonstrate that despite changes and circumstances that are often difficult, we can and do succeed.
Maintaining calm and optimism in the midst of complex changes is not easy. However, as long as we stay focused on doing what is right for our patients, our group, and our institution, we will never go too far wrong. Clear and frequent communication between all of us will also assure that we take full advantage of the vitality and vision each of us has to offer.
I would like to conclude with a quote from Osler's Aequanimitas lecture. He said: "It has been said that 'in patience ye shall win your souls,' and what is this patience but an equanimity which enables you to rise superior to the trials of life?" I wish all of you a happy holiday season and the equanimity that will enable us all to continue to excel.
Carolyn Garver and UPMC St. Margaret Anesthesiology Department Receive Patient Safety Awards
Carolyn Garver,  CRNP/C received the 2015 Richard L. Simmons, MD Speak up for Patient Safety Award from UPMC at the 2015 Dr. Loren Roth UPMC Quality and Patient Safety Symposium on Tues. Oct. 27, 2015 at the Herberman Conference Center at UPMC Cancer Pavilion, UPMC Shadyside.
The Anesthesiology Department at UPMC St. Margaret also received an award for the project "Educating Post -Surgical Nerve Block Patients about Care of the Ambulatory Nerve Block Pump" at the 8th UPMC St. Margaret Patient Safety Fair on March 12, 2015. The project was summited by Carolyn Garver, Bethany Mitchell, PA-C, Jay Roskoph, MD, MBA, and Darrin Taormina, MD. Carolyn accepted the award on behalf of the group.

Dr. Zachary Cohen Wins President-Elect Seat for PSA Resident Component for 2015-2016

Congratulations to Zachary Cohen, MD (PGY-3) who was chosen as President-Elect for the Pennsylvania Society of Anesthesiologists (PSA) Resident Component for 2015-2016. He assumed his role during the PSA Resident Component Annual Meeting on Saturday, October 24th.

Timothy R. Lyons Selected as New Senior CRNA Director

Congratulations to Tim Lyons, who has been selected as the department's new Senior CRNA Director.  Tim has performed admirably in the Interim Co-CRNA Director role along with Cindy McGettigan (Clinical Director at UPMC East, UPMC McKeesport, and UPMC Monroeville Surgery Center) since August 2015. He is a graduate of Pitt's Nurse Anesthesia Program and completed his MBA in 2014. Tim began his career as a Nurse Anesthetist at UPMC Presbyterian, where he worked for 11 years. In 2011, he received the Pennsylvania Association of Nurse Anesthetists Clinician of the Year award and the UPMC Cameos of Caring Award. His interest in leadership took him to Heritage Valley Beaver, where he worked for two years as the Chief CRNA. We were fortunate to have his leadership return to UPMC in 2013. Tim has worked hard to demonstrate clinical skill, management acumen, and innovation

Dr. Andrew Herlich's Term as 2015-2016 PSA President Begins

Congratulations to Andrew Herlich, DMD, MD, FAAP, who recently began his year term as  President of the Pennsylvania Society of Anesthesiologists (PSA) for 2015-2016. Dr. Herlich's presidency took effect at the annual PSA luncheon meeting during the American Society of Anesthesiologists annual meeting in October 2015.

Marc Wicker Receives 2015 UPMC ACES Award

Congratulations to Marc Wicker, MSN, CRNA (UPMC Presbyterian), who received a UPMC Award for Commitment and Excellence in Service (ACES) at the 2015 ACES Awards Banquet on October 24, 2015 at the Westin Convention Center in downtown Pittsburgh. ACES honors the most outstanding employees within UPMC; winners are nominated by their peers and reflect the highest standards of excellence. The 2015 event celebrated and honored 250 staff members and one team from across the health system whose outstanding achievements support UPMC's values and our commitment to putting patients, employees, members, and community at the center of everything we do.  Marc is shown here with his wife Kristen Wicker, MSN, CRNA, also a nurse anesthetist in our department (Magee-Womens Hospital of UPMC).

Gale Jackman and Marc Wicker Receive 2015 Cameos of Caring Awards
Congratulations to Gale A. Jackman, BSN, CRNA and Marc Wicker, MSN, CRNA (both of UPMC Presbyterian), who received Cameos of Caring Awards at the 2015 Cameos of Caring Awards Gala on November 7, 2015 at the David L. Lawrence Convention Center in downtown Pittsburgh. The Cameos of CaringĀ® Program & Awards honor exceptional bedside nurses who work at acute care hospitals. The program was established in 1999 in keeping with the University of Pittsburgh School of Nursing's commitment to the advancement and promotion of the nursing profession.

Gateway Medical Society's Physician of the Year Gala
Gateway Medical Society (GMS) held their 2015 Physician of the Year Scholarship Gala on Oct. 3, 2015 at the Marriott City Center in Pittsburgh. Nearly 200 attended the gala, where scholarships were presented, members of the Journey to Medicine program were introduced, and two physicians received Physician of the Year Awards. The attendees included GMS President and department faculty member William Simmons, MD, The Honorable Louis W. Sullivan, MD, President Emeritus Moorehouse University School of Medicine and former Secretary of Health and Human Services and Howard B. Gutstein, MD, Peter and Eva Safar Professor and Chair of the department (pictured above, L to R).
New Pittsburgh Courier published a feature story on the event, including photos of the honorees:

Drs. Dave Metro, Erin Sullivan, and Jon W aters Elected into Association of University Anesthesiologists

Congratulations to David G. Metro, MD, Erin A. Sullivan, MD, and Jonathan H. Waters, MD, who were all recently elected to the Association of University Anesthesiologist (AUA) as members.
The AUA's mission is to advance the Art & Science of Anesthesiology by encouraging its members to pursue original investigations in the clinic and in the laboratory, develop the method of teaching anesthesiology, and freely and informally interchange ideas. AUA members are nominated and elected based on excellence in teaching, administration, and research.       
Photo from the 
2015 Shadyside Anesthesiology 
Holiday Party
Click on the photo to enlarge

Two "Good Catches" Save Patients from Wrong-site Surgeries

Congratulations to Ashley Galadyna, BSN, MSN; Jeffrey M. Varga, MD; and Dale E. Heron, CRNA, all of UPMC Presbyterian, who prevented two "wrong site" surgeries the week of November 8-14, 2015.  Our clinical staff's dedication to patient safety is one of the many facets of our department that make us great!
Pictures from 
Recent Resident Events
click on each photo to enlarge

PSA luncheon during ASA on the rooftop terrace

Residents at Dr. Gelzinis' annual  Halloween party

Anesthesiology Professional Practice rotation

For more information and updates on what our residents are up to, please follow 
Recent Publications
Ghisi D, Fanelli A, Jouguelet-Lacoste J, La Colla L, Auroux AS, Chelly JE. Lidocaine versus Ropivacaine for Postoperative Continuous Paravertebral Nerve Blocks in Patients Undergoing Laparoscopic Bowel Surgery: A Randomized, Controlled, Double-Blinded, Pilot Study. Local Reg Anesth. 2015;8:71-7.
Hubbard R, Waters JH, Yazer MH. Heterogeneity in Blood Product Acceptance among Antenatal Patients of the Jehovah's Witness Faith. Obstet Gynecol. 2015 Nov;126(5):974-7.
Khoo NK, Cantu-Medellin N, St Croix C, Kelley EE. In Vivo Immuno-Spin Trapping: Imaging the Footprints of Oxidative Stress. Curr Protoc Cytom. 2015 Oct 1;74:12.42.1-12.42.11.
La JH, Feng B, Kaji K, Schwartz ES, Gebhart GF. Roles of Isolectin B4-binding Afferents in Colorectal Mechanical Nociception. Pain. 2015 Oct 5. [Epub ahead of print]
Lemkuil BP, Gierl BT, Patel PM, Pearn ML, Nguyen LC, Minokadeh A, Drummond JC. The Effect of Clevidipine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in Human Volunteers. J Neurosurg Anesthesiol. 2015 Oct 6. [Epub ahead of print].
Li P, Marsh JW, Boucek CD. Anesthesia Management for Palliative Surgery of Massive Hepatic Metastatic Melanoma. A & A Case Reports. 2015 Oct 29. [Epub ahead of print].
Lichter JR, Marr LB, Schilling DE, Hudson ME, Boretsky RH, Barad RF, Chelly JE. A Department-of-Anesthesiology-based Management Protocol for Perioperative Corneal Abrasions. Clin Ophthalmol. 2015 Sep 11;9:1689-95.
Lim G, McIvor WR. Simulation-based Anesthesiology Education for Medical Students. Int Anesthesiol Clin. 2015 Fall;53(4):1-22.
Ray EC, Abdel-Kader K, Bircher N, Rondon-Berrios H. Case report: Proximal Tubule Impairment Following Volatile Anesthetic Exposure. Physiol Rep. 2015 Sep;3(9). pii: e12560.
Skledar SJ, Lachell CM, Chelly JE. Pharmacodynamics and Clinical Efficacy of Fentanyl Iontophoretic Transdermal System for Post-operative Pain in Hospitalized Patients. Expert Opin Drug Metab Toxicol. 2015 Nov 13:1-11 [Epub ahead of print].
Sung TS, La JH, Kang TM, Kim TW, Yang IS. Visceral Hypersensitivity and Altered Colonic Motility in Type 2 Diabetic Rat. J Neurogastroenterol Motil. 2015 Oct 1;21(4):581-8.
Yazer MH, Deandrade DS, Triulzi DJ, Wisniewski MK, Waters JH. Electronic enhancements to blood ordering reduce component waste. Transfusion. 2015 Nov 11. [Epub ahead of print]
Adams P, Cassara A. Dexmedetomidine-related polyuria in a pediatric patient. Journal of Anesthesia. 2015 2015/11/23:1-4.