Caring for the most critically ill patients

When
Dr. Mouhib Naddour was in medical school, still considering what his specialty would be, his father developed a rare lung disease - and was ill for a few months before anyone knew why. The doctor who would eventually put the pieces together for a diagnosis was an intensivist - a doctor with advanced training in caring for critically ill patients.

"I experienced firsthand how an intervention in the
ICU can change someone's life and that of their families around them," says Dr. Naddour, an intensivist with
Sharp Grossmont Hospital, who is board certified in
internal medicine, pulmonary medicine and critical care. Later this year, he'll receive board certification in neurocritical care.

Following his personal experience with his father, Dr. Naddour's eventual residency rotated him into an ICU, where he recalls witnessing phenomenal medicine happening in front of him.

"I used to tell myself, 'If you are going to be a doctor, you should be like these doctors.'"

Intensivists such as Dr. Naddour are directly responsible for their patient's care, rather than working as a consultant, and lead multidisciplinary teams of clinicians that include registered nurses, respiratory therapists, physical and speech therapists, pharmacists, case managers and social workers. Beginning with 6 years of medical school in his hometown of Damascus, Syria, followed by more training in the United States, it would take him 12 years to complete his training for this role.

"We're able to provide the best, most well-rounded and individualized patient care to the critically ill," says Dr. Naddour. "We often rely on our colleagues in other subspecialties as well, and are constantly working together to optimize care and improve outcomes."

ICUs have borne much of the brunt of
COVID-19. While their advanced care model and vast toolkit of specialties solve and diagnose complex and peculiar illnesses, the pandemic has proven that even seasoned intensivists can be thrown a curve - but as a patient or loved one, you want them on your team.

"The COVID-19 virus is an evolving subject and there is growing research, even on a daily basis, regarding treatments for this horrible disease," says Dr. Naddour. He says the virus has resulted in an even stronger team approach, teaching him and his colleagues to rely and trust each other more so than ever before.

"Along the way, we have gained a better understanding of the mechanism and course of the disease, which has helped us to better assess our patients earlier after their diagnosis," says Dr. Naddour. “I sincerely want to thank all of my colleagues in the group for their support and expertise throughout this pandemic.”

While not all outcomes for ICU patients are positive, Dr. Naddour says intensivists and their teams are committed to the same level of care, determination and dignity for patients at the end of life.

"We see patients who are very sick, despite everything medicine has to offer, and we are often the doctors taking care of them at the end," he says. "We as intensivists never stop providing the most respectful and diligent care to our patients even when the outcomes are not always what we hope for."

And that is the central nature of what an intensivist is meant to do for all patients, in response to all ailments. For those patients with successful outcomes, these specialists and their comprehensive approach to patient care can mean shorter stays in the ICUs and reduced complications, thanks to the multidisciplinary expertise they're equipped with.

"The beauty of critical care medicine is that we are uniquely qualified to provide early and lifesaving interventions in critically ill patients," says Dr. Naddour. "These interventions, when successful, have far-reaching impacts on patients and families."