I am a pediatric emergency medicine doctor and the academic director in the Division of Emergency Medicine. Although my career has been somewhat eclectic, my experiences have shaped who I am today. Three main drivers guide my decisions: the fight against injustice, moving medicine forward through collaborative efforts and mentoring, and nurturing the next generation of physicians. My vision is that we can advance the care of acutely ill and injured kids and improve outcomes in the emergency department (ED) and in their communities.
The fight against injustice: I grew up in Mexico City, surrounded by poverty and the vast inequities typical of a developing country megalopolis. I was raised with the stories of immigrant and holocaust surviving grandparents. I was inspired by the work of Doctors Without Borders, which motivated me to become a physician. I spent a year with them right out of medical school, first in Uganda (in a sleeping sickness center) and in Mexico (working with displaced indigenous groups in Chiapas). After my residency in New York City, my internist wife and I spent a year working for the International Committee of the Red Cross in East Timor. This island was re-emerging from a bloody and destructive independence war.
For the past 20 years, I have worked in large academic institutions in the United States, where inequities and disparities in care have always affected and still affect our patients’ outcomes. This experience is particularly palpable in the ED, which is often the last safety net for at-risk children and families, and where the fight against injustice takes place every day. I recently launched an emergency medicine disparity working group at Cincinnati Children’s to abate disparities in our area of influence through research, standardization and implementation programs, and recruitment and retention of underrepresented minorities (URM) personnel. We must be purposeful and unapologetic in addressing and decreasing the systemic root causes of disparities in our workplace and in our communities.
Moving medicine forward through collaborative research: I was introduced to clinical research during my fellowship at Columbia University with the best mentors I could ask for — Peter Dayan and Nathan Kuppermann. As a fellow, I led a 19-center study through the Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC). Since then, I have participated in and led (as a primary investigator (PI) or senior mentor) several multicenter research projects through the PEM CRC and the Pediatric Emergency Care Applied Research Network (PECARN). I led the PEM CRC for six years. I have been the PI on T32, R34 and R01 and a mentor on K-level grants, which gave me a solid understanding of the federal funding process.
My research has influenced the care of infants with urinary tract infections (UTIs), acute gastroenteritis, anaphylaxis and Shiga toxin-producing E. coli (STEC) infections. As subspecialists working in academic institutions, I firmly believe our responsibility is to move medicine forward through translational, clinical or community-based research, QI and implementation projects, or by creating effective education programs. We need to be better at what we do, improve outcomes and continue pushing to ensure all children receive the best and safest possible care no matter who they are or where they live.
Mentoring and nurturing the next generation: Early in my career, I became a Pediatric Emergency Medicine (PEM) fellowship and research director at Washington University in St. Louis. As such, I helped train and mentor several generations of fellows. I also co-directed the Department of Pediatrics’ Office of Faculty Affairs and created programs to enrich faculty careers. I was recently elected chair of the Section on Emergency Medicine of the American Academy of Pediatrics (AAP). In this role, I hope to foster further advancement of our specialty. In Cincinnati, I serve as the PEM senior academic director. My role is to oversee research operations in close collaboration with our educational and clinical leaders. Our research consists of 40-50 research studies, including 15 enrolling in the ED and a group of 22 clinical research coordinators (CRCs) covering the ED 18x7. Our faculty obtains $6 million yearly in grant funding and produces 120-150 publications per year.
During my free time, I love spending time with my family and our three very large dogs. I am a passionate (although not that good) cello player. Bach is my favorite composer, and I hope to be able to play his complete suites for solo cello one day.