1.) What's your name? Profession? Where do you currently work?
Chris Giordano, M.D.
Division Chief of Liver Transplant Anesthesiology / Critical Care Clerkship Director Department of Anesthesiology
University of Florida, Gainesville, Florida
2.) Where did you go to medical school? Residency? Fellowship?
Medical school at University of South Florida in Tampa, Florida. Residency in Anesthesiology at University of Alabama-Birmingham. Fellowship in Liver Transplantation at University of Florida, Gainesville.
3.) How long have you practiced?
4.) When did you know that you wanted to practice anesthesiology?
Like many other anesthesiologists, I was not exposed to the field until later in my medical school training. I gravitated toward fields that had technical/procedural skills, but I wanted a career that kept my interest in physiology, pharmacology and pathology. When these interests were coupled to my enjoyment of high-acuity situations and team-based care, I found myself thoroughly enjoying my critical care clerkship. I thought the quickest and most applicable route to becoming an intensivist was through an anesthesiology residency. However, after a few years of anesthesiology training in the operating rooms, I discovered that the O.R. was much more than I expected, so I shifted my career focus to the operating room and away from the ICU.
5.) Why did you decide to do a subspecialty in anesthesia?
During my CA-2 year, I began looking around at private practice jobs but nothing seemed to interest me. I reached out to colleagues at the University of Florida and discovered that they were looking for faculty specializing in liver transplantation. At UAB, I had developed a niche in liver transplantation because of a great affinity I developed for the complexity of the case, the degree of sickness of the patients, and the profound depth of team cognition between the surgeon and anesthesiologist. Subsequently, I elected to do a 12-month fellowship at UF under the directorship of Mark Rice, and I stayed to become a member of their team.
6.) What attracted you to pursue fellowship training in liver transplantation?
Liver transplantation is a newer fellowship, and many people perform these procedures without being fellowship trained. The advantage of doing a fellowship is that it provides you with protected time to develop mastery in this arena. During my fellowship time, I collaborated with multiple other specialties to enrich my understanding of the patients, procedures and hospitalization.
I also engaged in multiple research projects to develop a footprint in the subspecialty. Recently, ASA has requested that Division Chiefs of Liver Transplantation be fellowship trained, which adds further value the fellowship.
7.) Can you describe your typical work day?
Liver transplants don't occur every day, and when they do, they often fall outside working hours. In the meantime, liver team members are usually assigned to high-acuity cases like esophagectomy, hepatectomy, whipple, pheo, major vascular cases, etc. Every liver division has ways to accomplish call requirements, and in our department, we have elected to follow our surgeon’s call model. We take liver call one week at a time, which allows us to work closely and continuously with our surgical partner.
8.) How do you balance work and personal life?
Liver call is a form of home call, so those weeks I entirely leave open with the expectation of coming in to work. And those weeks can be challenging because most of my surgical cases are very involved and highly complex, which is very cognitively taxing. However, they are also very exhilarating and rewarding. I spend most of my free time with my wife and two kids, although I make it to the gym most days and golf whenever I can. All that being said, if you enjoy your professional life, it is hard to call it work. My balance keys are: exercise daily, cook what you eat, and read something each night that is not medical.
9.) What's your favorite aspect of your work? Least favorite aspect?
These cases and patients are vigilantly worked up by the team. Each week, a room full of professionals (nurses, pharmacists, social workers, hepatologists, cardiologists, pulmonologists, surgeons, anesthesiologists, etc.) discuss each patient’s candidacy for a liver transplant. Taking the patient from this discussion to the operating room is a very gratifying process because you are working as a very high functioning team to do something incredibly important. So, putting into operational action this multidisciplinary, multiprofessional plan is one of my favorite parts. It’s hard to ignore the satisfaction received from the total emersion experienced during these cases: Mihaly
Csíkszentmihályi identifies this as Flow. The most frustrating part is the ebb and flow of transplantation. There may be weeks without a transplant, and your partner does three to four in a week. It is also a shame that these cases can’t all be done in daylight hours because nobody functions at their peak at 3 a.m.!
10.) What advice do you have for aspiring anesthesiologists?
1. Approach your career with curiosity and humility: everyone has something you can learn from.
2. The best anesthesiologists that I know are the ones with the highest Emotional Intelligence: you must work on this daily.