Basic research is a major part of my career, currently accounting for about 70-75% of my total effort. For nearly two decades, my research has focused on the mechanisms responsible for general anesthesia, particularly their actions at fast neurotransmitter-gated ion channels, which are responsible for neuron-to-neuron synaptic communication. Currently, my lab is studying anesthetic actions on both nicotinic acetylcholine receptors, which are responsible for excitatory transmission in nerve and muscle, and gamma-aminobutyric acid type-A receptors, which are responsible for inhibitory neurotransmission in the brain and spinal cord. To investigate both how and where anesthetics affect the function of these ion channels, my research combines electrophysiological techniques with recombinant ion channel expression. I have pioneered advances in ultrafast superfusion of excised patches and patch-clamp electrophysiology by developing methods and building equipment for sub-millisecond switching among up to four independent flowing superfusates in an "artificial synapse." This advance has enabled demonstration of novel mechanisms of drug action. By creating mutations in specific protein regions of recombinantly expressed ion channels in living cells, my research has tested hypotheses about sites of anesthetic action. I was the first investigator to provide solid evidence for such a site on a ligand-gated ion channel, and the rigorous demonstration of these sites on receptors in brain remains a major thrust of my current research. My current research also includes collaborative projects with scientific colleagues in and outside my department. My research has been funded by the Foundation for Anesthesia Education and Research, the Medical Foundation/Charles King Trust, as well as a Scientist Training Award (K21) and Individual (P01/R01) Awards from the National Institutes of Health. I have been invited to present my research at regional, national, and international meetings. In 2004 I was awarded a Presidential Early Career Award for Scientists and Engineers (PECASE) for my research. I serve as an ad hoc reviewer for a number of scientific journals. As a member of the Dept. of Anesthesia Executive Committee on Research and the Beecher/Mallincrodt Research Laboratories Executive Committee, I have dedicated time to encouraging and supervising research activities within our department and mentoring young researchers, including students, residents, and research fellows.
From 1995 through 2002, I was responsible for coordinating "Ten Minutes of Science", presented along with Dept. of Anesthesia & Critical Care Case Conferences and Grand Rounds on Thursday mornings. This program was presented weekly from 1995-99, and bi-monthly thereafter and provides a forum for basic and clinical researchers working within the department to keep colleagues up to date on their progress. Currently, I chair the DACC Grand Rounds Steering Committee, which is responsible for setting a departmental educational agenda, and recruiting speakers to our weekly Grand Rounds. As a staff anesthesiologist, I supervise, teach, and evaluate residents and medical students who are rotating through the operating rooms of the Massachusetts General Hospital. Each year, I dedicate two weeks to tutoring a new first year Clinical Anesthesia resident, usually during their critical first two weeks of residency. I also act as clinical advisor and career advisor to residents in Anesthesiology, particularly those with strong interests in academic research careers. I have extended my mentoring activities to advising and guiding undergraduates at MIT who are planning careers in medicine. My specific areas of teaching expertise, which I have been invited to speak on both at departmental didactic lectures, other clinical departments, and at Harvard Medical School CME courses, include How Anesthesia Works, Awareness During General Anesthesia, Thermoregulation and its Anesthetic Impact, and Basic and Clinical Pharmacology of Nitrous Oxide. By participating as an examiner in mock oral exams, I have also helped prepare senior residents from the Harvard Teaching Hospitals for their oral board examinations.
As Staff Administrator of the MGH ORs several days each month, I am responsible for the deployment of over 100 Anesthesia personnel (staff, residents, and CRNAs) and efficient management of OR time in over 50 anesthetizing locations. I am also a member of the DACC Quality Assurance Committee, which reviews reports of actual or potential harm to patients associated with anesthetics administered in our department and decides how best to prevent such incidents. As a member of the General Surgery Anesthesia Team one day per week, I provide anesthesia care for patients undergoing a wide range of surgical procedures. These are frequently critically ill patients from various intensive care units at Mass. General Hospital or trauma patients from the emergency ward. The range of procedures includes thoracic and major vascular as well as neurosurgery, orthopedic surgery, and cancer surgery. Combined epidural and general anesthesia cases are my clinical forte.