Nicholas D. Caputo, MD

/in /by

For Nicholas D. Caputo, MD ’08, the associate chief of emergency medicine at NYC Health + Hospitals/Lincoln in the Bronx, investigating diseases like COVID-19 to learn more about their origins and health effects has allowed his team to more effectively care for critically ill patients that come through the busy hospital’s emergency room.

Dr. Caputo, along with colleagues, have published multiple articles in various medical journals and based on their experiences and patient encounters within the ER, including several related to findings about the COVID-19 disease.

For instance, in the spring of 2020, the team published the first study on awake self-proning for COVID-positive patients as a means to stave off intubation, according to Dr. Caputo. The study was published in Academic Emergency Medicine (the official publication of the Society for Academic Emergency Medicine) and cited in The New York Times.

Earlier this year, his team published the only reported outcomes data for the New York City public hospital system in the Journal of General Internal Medicine, which had some “gut-wrenching findings in regard to inequities and disparities in COVID outcomes,” he said.

Sharing the correlation between research and emergency medicine, and specifically how it helps him approach his job every day, were among the topics that Dr. Caputo spoke with SGU News about in a recent interview.

SGU: How do you apply findings from your research to your role as an EM doctor?

Dr. Caputo: Research allows me to go into each shift with a different perspective. On the one hand, it allows me to deliver care to patients with the mindset of treating their individual situation based on what we know from previous research findings. On the other hand, it also allows me to take those patient interactions and formulate hypotheses about broader issues that other ER doctors may encounter and ultimately help advance the emergency medicine specialty.

SGU: What lessons have you learned from the global health crisis that can be applied to ongoing patient care?

Dr. Caputo: The most important lesson I learned is that a good scientist always keeps an open mind in the pursuit of truth. Keeping an open mind allows one to critically think outside the box, which may lead to a better solution to treatment—and a positive outcome for the patient.

SGU: What appeals to you about emergency medicine?

Dr. Caputo: The biggest appeal to me in emergency medicine is that on any given shift—no matter where you are working—you have the potential to see anything across the spectrum of medical pathology. That’s the great thing about emergency medicine—we truly see it all.

SGU: What responsibilities do you have as associate chief of emergency medicine?

Dr. Caputo: In this position, I help coordinate the daily operations of the emergency department, and oversee the quality review process, performance improvement, and research, among other necessary roles to help ensure the department runs smoothly so we can deliver the highest quality of care, safely to our community.

SGU: You are also an Army Reservist—how does your medical background help you when you are called up for service?

Dr. Caputo: My working in a Level 1 Trauma Center in one of the busiest single-site emergency departments in the country has provided me the experience I need to treat our soldiers on the battlefield who have similar if not even more devastating traumatic injuries. That’s one of the things I am most grateful for in working where I work.

SGU: How did SGU help prepare you for your current hospital role?

Dr. Caputo: SGU gave me the drive to want to do more—to stand out by showing up early, leaving late, and doing research on my own time in order to better myself.

SGU: What was the moment that you realized you’d made the right decision to come to SGU?

Dr. Caputo: When I matched in the specialty I wanted at the place I wanted for residency and where I still work today.

SGU: What if you hadn’t said yes to SGU?

Dr. Caputo: I don’t really want to think about that!

Natcha Rummaneethorn, MD

/in /by

Although Natcha Rummaneethorn, MD ’20, will continue her career amid the hustle and bustle of New York City, her passion for medicine began during medical mission trips to the rural villages outside of her native Bangkok, Thailand. While the two areas look almost nothing alike, she said there are similarities when it comes to healthcare.

“Ever since those mission trips, I’ve wanted to work in underserved areas where people need the most help and don’t have adequate healthcare access,” said Dr. Rummaneethorn, who is a first-year emergency medicine resident at NYC Health + Hospitals/Metropolitan.

Dr. Rummaneethorn shared what she looks forward to most in her residency and how prepared she feels for the next step in her career.

SGU: What led you to go into medicine?

Dr. Rummaneethorn: My father is a dermatologist, and my mom is an ICU nurse. They influenced me to go into medicine to a certain point, but what really drove me was a medical mission in Thailand through my church. We provided medical care and supplies to rural areas in Thailand, such as villages in the mountains or hills where there’s difficult access to healthcare and hospitals. They are without basic equipment and simple medications like aspirin or ibuprofen that we have commonly, and for them, it’s two to three hours to the nearest hospital.

SGU: Why did you choose to enter emergency medicine?

Dr. Rummaneethorn: I enjoy the fast-paced nature of an emergency department. In general, I try to do things as efficiently as possible, and I like that kind of nature in emergency medicine. Also, there’s always something new for you to see, and we have to have at least basic knowledge for every specialty because we receive patients with a wide array of problems. I’m looking forward to practicing in New York City because of the diverse patient population and the level of training I’ll obtain to handle the most severe situations.

SGU: How would you describe your time at SGU?

Dr. Rummaneethorn: My academic experience at SGU was great due to the rigorous curriculum as well as a number of excellent faculties that provided superb education, such as the biochemistry and pharmacology professors in particular. Also, being on the island of Grenada, the location gave me numerous opportunities to have hands-on experiences with local Grenadians. These experiences allowed me to grow my clinical knowledge and skills as an aspiring physician. On top of that, I had a chance to learn about the Caribbean culture, enabling me to be equipped for taking care of my patients who are of diverse backgrounds during my clinical rotations in Brooklyn.

SGU: How often did you come across an SGU grad during your clinical rotations?

Dr. Rummaneethorn: One of the major benefits of SGU is its large alumni network. If utilized appropriately and effectively, this will turn into a very useful tool in preparing for a residency application. During my clinical rotations, I was extremely surprised at how many attendings I met who turned out to be SGU alumni. They were ready to help me as well as other SGU students rotating with them.

SGU: What advice would you have for a Thai student who was entering medical school?

Dr. Rummaneethorn: Students should also reach out for help early. I prepared myself for my residency application from day one. In my first semester, I attended a lecture with Dr. [John] Madden, who’s an SGU grad and former emergency physician, about emergency medicine, and from there I tried to attend all the seminars that I could. I feel like they really paid off because each helped prepare me for the application process.

Sam Al-Saadi, MD

/in /by

Mixed in with classes, exams, studying, and time to unwind, medical students have to squeeze in all-important sleep. Getting enough sleep, and implementing bedtime habits to do so, is a challenge not only for aspiring physicians but for everyone, this according to Sam Al-Saadi, MD ’05, the sleep medicine director at the University of Pittsburgh Medical Center (UPMC) Carlisle location, and assistant clinical professor of psychiatry for Penn State Health in Hershey.

According to the American Sleep Association, more than 50 million US adults have a sleep disorder, most notably insomnia and obstructive sleep apnea. Dr. Al-Saadi shared his perspective on what people can do to improve their sleep, and also the journey he took to lead the discussion in addressing the oft-ignored health crisis.

St. George’s University: How important is sleep to a person’s health?

Dr. Sam Al-Saadi: Sleep medicine is the secret of all secrets to good health. People have no idea how influential sleep is to the quality of their lives. To compensate, they pick up bad sleep habits, and they don’t believe that they need to fix them. The fact is that when they’re younger they can compensate, but when they get older, it just gets worse and they aren’t able to.

Sleep disorders are associated with each other. If you have one, you likely have another, whether it’s snoring, sleep apnea, insomnia, narcolepsy, or something else. The quality and quantity of sleep impact diabetes, cardiac disease, cerebral circulation, cognitive function, blood pressure, and other systems.

Sleep medicine is a subspecialty that has evolved from multiple specialties. It is a relatively new and evolving field. It started in psychiatry, moved to pulmonology and now includes neurology, ENT pediatrics, family medicine, and internal medicine.

SGU: What are some ways that people can improve their sleep?

Dr. Al-Saadi: Everyone can start by making a few minor adjustments that will make a big difference.

  1. Your bed should be for sleeping and intimacy only. Many people use an iPad or phone in bed or watch TV, but these are bad habits that can disrupt your sleep. If you don’t fall asleep within 10 minutes, you should get out of bed and come back later.
  2. A fixed wakeup time. Yes, it’s difficult for medical students and residents, but it’s good to have the same wakeup time, which will then dictate when you go to sleep.
  3. Be careful with caffeine intake. This can be cultural—you have people drinking tea at night, an energy drink to keep up with studying, coffee, or something with caffeine. The thing is, if you drink caffeine six hours before you go to bed, you still have half that caffeine in your body when you’re trying to sleep. Because of that, you’re more likely to have arousals—when you wake up for less than 30 seconds—that you aren’t even aware of. You may not be aware of these, but you’re likely to be more tired the next day.
  4. Limit long naps. Some people take long naps, but then you’re not going to be able to fall asleep later that night. Naps need to be just to catch up and keep you going for that day—no more than 30 minutes.

SGU: How did you make the journey from the UAE to the US and finally Grenada?

Dr. Al-Saadi: I was born and raised in the UAE. My dad was a microwave communications engineer, and my mom worked at the library, so I didn’t have any medical background in my family. When I came to the US at 17, I was on my own, had no money, and my English wasn’t very good. But I worked hard. I was taking courses to take the MCAT while working and supporting my family the entire time I was doing it.

I was a chemical engineering major at the University of South Florida, but when I got out, I just didn’t feel like I was using the skills I had learned. I was more fine-tuning things that were already set up. So I went and got a master’s in biomedical engineering and then when it came time to decide whether to go for an DO or MD, I went for an MD. I chose SGU because it had a lot of rotations in Florida and New York.

SGU: How was your experience in Grenada?

Dr. Al-Saadi: My experience was great. The campus was phenomenal, and I felt safe both on and off campus. We had a good time, and I think the students who came after me had it even better.

SGU: What advice would you give to a student entering medical school?

Dr. Al-Saadi: It’s important to have a plan for what you’re going to do after you graduate. It could change of course, but where you do your rotations will influence your path to residency, not only in terms of location of the residency but the individuals who you get your letters of recommendation from. I recommend that you have a plan, a backup plan, and overall a clear image in your mind of where you want to go with your career and how to get there.

– Brett Mauser

Ki (Steve) Lee, MD

/in /by

Responsibility has followed and increased throughout Ki (Steve) Lee’s time as an internal medicine resident at Newark Beth Israel Hospital in New Jersey. A year after helping the department through the COVID-19 pandemic as an intern, the St. George’s University graduate is now in a managerial role, overseeing a team of medical staff and full ward of patients. This spring, Dr. Lee will become one of four chief residents in the department, helping to supervise and train its more than 40 residents.

The South Korea native looks back on the path that led him to one of the state’s most high-traffic, high-impact critical care units.

St. George’s University: What has it been like supervising such a critical element to healthcare at Newark Beth Israel?

Dr. Steve Lee: In your first year of residency, you’re learning how to help and figuring out how things work. In my second year, you’re asked to do a lot more. In my case, I’m managing a team that is overseeing the 16 patients on our floor. It’s been a great experience, I have a lot of autonomy, and it has allowed me to grow as a team leader and a decision maker.

SGU: What’s the best part about doing residency at NBI?

Dr. Lee: It’s amazing how much clinical experience we get here. We’re the only lung transplant hospital in New Jersey and the only heart transplant facility too. The most critically ill patients get transferred here, and it’s up to us in the ICU and critical care unit to take care of them. We get a lot of hands-on experience, use all these state-of-the-art devices, and I feel like we learn a lot. If you do residency here at NBI, you can go anywhere else and be comfortable.

 

“You go to Grenada and meet all these new people on day one, and you’re all there to help each other out.”

SGU: You were a first-year resident during the height of the COVID-19 pandemic in and around New York City. What was that like?

Dr. Lee: COVID was very difficult. We typically have a maximum of 16 patients on our list, but at that time we were managing 30-40. Our department was running the entire hospital, and there were so many different teams on the floor—pediatricians, radiologists, and many, many others—helping out in any way that they could. What was so difficult was that patients’ outcomes could change in a matter of minutes. Fortunately, for our staff, we all had each other to lean on. We were able to talk through things and we covered each others’ shifts when needed.

SGU: How would you describe your experience at SGU?

Dr. Lee: You go to Grenada and meet all these new people on day one, and you’re all there to help each other out. The education was great, and many of my classmates are now attendings at these major hospitals. They’re doing amazing, and I feel like everyone has done great.

– Brett Mauser

Andrew Kowalski, MD/MPH

/in , /by

Andrew Kowalski, MD/MPH ’12, knows Chicago. He grew up in the Second City suburbs, went to college at Loyola University Chicago, and now works as an interventional nephrologist and assistant professor at MacNeal Hospital—the Illinois-based hospital where he was born and where he volunteered prior to becoming a medical student at St. George’s University.

Like in many American cities, kidney disease is a widespread issue in Chicago, which is where Dr. Kowalski comes in.

St. George’s University: How big of a problem is kidney disease in America?

Dr. Andrew Kowalski: More than one in seven people in the US have kidney disease—that’s about 15 percent of the population. Of those people, nine out of 10 have no idea they have any sort of disease, and two in five aren’t aware that they have severe disease and are very close to initiating dialysis. I see it a lot. I will tell some patients about significant issues that they face and they’re shocked.

I practice both general and interventional nephrology. As a general nephrologist, I see these patients and discuss ways to change their lifestyle, augment risk factors, and create treatment plans to move forward. Oftentimes we can put in 110 percent into a patient and, for whatever reason—likely their genetics—they still progress to requiring dialysis.

SGU: How closely is kidney disease associated with socioeconomics?

Dr. Kowalski: The majority of kidney disease patients have some issue with diabetes and/or high blood pressure. And it’s usually uncontrolled. Much of this closely relates to socioeconomics; those in the poorest communities tend to not have adequate access to healthcare, or whoever they see might not be the best. A lot of them have advanced conditions and complications that come with them.

Also in the mix, albeit less frequently, are patients from affluent neighborhoods. You see the same diabetes and high blood pressure, but the disease is more related to medications, drug use, and genetics. These patients feel like they know more and tend to try to treat themselves.

 

“SGU blew my mind in terms of the resources that were available, the culture there, the people there. It was fantastic.”

 

How did you get into nephrology?

Dr. Kowalski: What drove me into nephrology was meeting my mentor, Dr. Edgar Lerma. The way that he practiced, the way he carried himself and interacted with patients, it was really something I wanted to emulate. He wasn’t a very tall man, but he had a presence about him. He never spoke at the patients but always spoke with them. By the end, you would think you were speaking to a friend and bouncing ideas off of him. They truly trusted him and knew that they were in the right hands.

Nephrology has many avenues too. As an interventional nephrologist, I get to use both my hands and my head. As an interventional nephrologist, I see these patients and plan and manage their dialysis access. I would place their hemodialysis catheters, peritoneal catheters, and manage their fistulas and grafts so that they are receiving adequate dialysis treatment.

SGU: What’s your favorite part about your job?

Dr. Kowalski: I love teaching residents. I love explaining something that has a reputation of being difficult and seeing light bulb go off in their heads.

SGU: In addition to your MD, you obtained your Master of Public Health from SGU. How has that factored into your practice?

Dr. Kowalski: When I went to medical school, I wanted to have as many career options available as possible, and it helped not only with that, but it made me more well-rounded. I use the principles and practices that I learned in the MPH program more than I thought I ever would have. The coursework for that degree dove into many aspects of medicine that I was unaware of. We had in-depth discussions about population’s access to care, the influence of insurances, and the thought process that patients go through about their diagnosis and overall patterns of disease. An MPH degree gives you more options, and taking into account what you’re taught and the fact that it’s just one additional year, I think it’s extremely valuable to have.

SGU: How would you describe your SGU experience?

Dr. Kowalski: Going to SGU was much, much better than I thought it was going to be. It blew my mind in terms of the resources that were available, the culture there, the people there. It was fantastic. And time really flew by. During the week, you got a top-notch education—it really was phenomenal what we learned. And then every weekend it was like you were vacationing at a beautiful resort.

SGU really set me up for success. A lot of it had to do with riding on the shoulders of the giants who came before me who built a culture where everyone works together and helps each other out. We’re all on the same team, and our goal is to be better and do better as a whole.

– Brett Mauser

Related Reading

Anthony McDonald, MD

/in /by

Dr. Anthony McDonald, a 2013 graduate of St. George’s University School of Medicine, turned in his mixed martial arts championship belt to pursue his dream of becoming a physician. He is now the director of cardiopulmonary medicine at San Angelo Community Medical Center in San Angelo, TX.

“What I used to do with fighting and training, it really ingrained in me the discipline that I needed and the structure that I needed to know what I needed to do to be successful,” Dr. McDonald said. “The contrast is very different, but I feel that the idea is still the same. It’s about not giving up. Medical school is challenging. There’s no two ways about it. And I was very fortunate to be able to do it at St. George’s University, where I felt that the entire island was set up to make you succeed.”

 

 

Published October 2020

John Cush, MD

/in /by

John J. Cush was a member of the second graduating class of St. George’s University School of Medicine in 1981, at which time he received the Robert Hingson Humanitarian Award.

Dr. Cush received his undergraduate degree (BS, Biology) from St. John’s University in Jamaica, New York. His clerkship and residency in internal medicine were performed at Coney Island Hospital in Brooklyn, New York, where he was named Intern of the Year and Chief Resident in internal medicine. In 1984, Dr. Cush began his rheumatology fellowship and was later appointed to the Rheumatology faculty of the University of Texas Southwestern Medical School. Since 1996 he has been Chief of the Division of Rheumatology and Clinical Immunology, Medical Director of the Arthritis Center at Presbyterian Hospital of Dallas and is a Clinical Professor of Internal Medicine at the University of Texas Southwestern Medical School. Dr. Cush serves on the Board of Trustees and is Chair of the Academic Board of Trustees for St. George’s University.

During his fellowship and faculty tenure, Dr. Cush focused his research on the immunopathogenesis of rheumatoid arthritis, transendothelial lymphocyte migration and novel drug development through clinical trial research, with an emphasis on rheumatoid arthritis, the spondyloarthropathies, and biologic agents. Currently his research is focused on novel biologic therapeutics, clinical trials, early rheumatoid arthritis, measuring outcomes in rheumatoid arthritis and biologic safety.

As a result of his efforts, Dr. Cush was voted one of the Best Doctors In America and Best Doctors in Dallas by his peers. In 1998-99, the Internal Medicine Residency Program at the Presbyterian Hospital of Dallas named him Teacher of the Year. He is actively involved in patient care, teaching, medical education and clinical trials research in the rheumatic diseases.

Dr. Cush has over 100 publications on a variety of topics including rheumatoid arthritis, drug-induced lupus, spondyloarthropathies, immunotherapy, Still’s disease, drug safety, biologic therapies and nutraceuticals. He has served or chaired several leadership committees for the National Arthritis Foundation and the American College of Rheumatology. He has been an editor for the American College of Rheumatology “Hotlines” series. He has co-authored two rheumatology textbooks: 1) “Rheumatology: Diagnosis and Therapeutics” (2nd edition, Lippincott, Williams & Wilkins 2005); and 2) “Rheumatoid Arthritis: Early Diagnosis and Treatment” (Professional Communications). Dr. Cush currently serves on the Arthritis Advisory Committee for the Food and Drug Administration and is Chairman of the Corporate Relations Committee for the American College of Rheumatology.

 

Published January 2007

Joseph Mathew, MD

/in /by

For years, Joseph Mathew, MD ’04, has not only enjoyed working in New York City—just a stone’s throw from where he grew up—but getting to know and treating his fellow New Yorkers.

The complexion of his position when the coronavirus disease (COVID-19) pandemic arrived on the Big Apple’s doorstep in March 2020. The director of the medical intensive care unit at Mount Sinai West Hospital, Dr. Mathew called it “an honor” to provide care for these patients when they needed it most.

SGU News caught up with Dr. Mathew as he and his colleagues combatted the COVID-19 pandemic, explaining how the hospital’s preparation assisted in addressing the virus and the numerous roles that each had to play.

 

Published November 2020

Michael Carr, MD

/in /by

Michael Carr, MD ’14, an assistant professor in the Department of Emergency Medicine at Emory University in Atlanta, was on the front lines of the fight against the coronavirus (COVID-19) pandemic. He said that the experience while extremely challenging, brought out the best in his team.

“I’m incredibly proud about the response we’ve had as a specialty and as a profession,” Dr. Carr said. “We were called to perform above and beyond what we ever expected to do in our career. You show up to work and instantly you’re thrown into a team. You’re a family. It’s a relationship that is really hard to describe.”

Dr. Carr earned his Doctor of Medicine from SGU and proceeded to complete an emergency medicine residency at Newark Beth Israel Hospital in New Jersey. He stayed on for an EMS and disaster medicine fellowship before being appointed to the faculty at Emory.

“If somebody asks me where I went to medical school, I say ‘St. George’s University, and I would do it again,’” Dr. Carr said. “I loved it. I had a tremendous experience.”

 

 

Published November 2020

Matthew Rubacha, MD

/in /by