Dr. Soriano holds the Boston Children’s Hospital Endowed Chair in Pediatric Neuroanesthesia and is a Professor of Anaesthesia at Harvard Medical School. He is a graduate of the University of Pennsylvania School of Medicine and Graduate School of Education with a concentration in Medical Education. Dr. Soriano’s investigative work includes the perioperative management of pediatric neuroanesthesia patients, and basic science investigations of neuroinflammation and impact anesthetic drugs on the developing brain.
He is the past president of the Society for Neurosurgical Anesthesia and Critical Care and the chair of ANESTHESIOLOGY 2018 in San Francisco and the past chair of the Committee on Pediatric Anesthesia for the ASA. Dr. Soriano gave the 45th Emery A. Rovenstine Lecture at the 2015 PGA.
When and how did you start your neuroanesthesia career?
During my first year (1990) as faculty at Boston Children’s Hospital, I gravitated towards the neuro rooms due to my training at UC Davis with Drs. Gerald Gronert and James Benthuysen. I was fortunate to be part of the innovative and high-volume neurosurgical program at Boston Children’s Hospital over three decades.
What is the greatest reward of being a neuroanesthesiologist? –
Since joining SNACC IN 1988 as a resident, I witness SNACC develop into an inclusive and scientifically driven international subspecialty society. As a I had the privilege of Past -Presidents, Drs. Jim Cottrell, Dan Cole and Karen Domino appointed me to various SNACC initiatives, which providing me the platform to develop programs for SNACC, SPA and ASA. During my tenure on the SNACC Board, of meeting and engaging young members, George Mashour, Jeff Pasternak, Rafi Avitsian, Deepak Sharma, Oon Paisansathan, Alan Flexman, John Bebawy, and Ines Kromer. These individuals collectively strengthen the diverse programs as they rose to leadership roles in SNACC.
Who are/were your inspirations?
Three individuals from my years as a trainee and faculty.
During my residency training at UC Davis, I had the good fortune of working with Dr. Gerald Gronert, who was a charter member of SNACC. In 1969 Gerry published a Neuroanesthesia review in Anesthesiology with his colleagues, Drs. John D. Michenfelder and Kai Rehder from the Mayo Clinic.
This landmark publication essentially established our Neuroanesthesia as subspecialty based on scientific and physiologic evidence and inquiry. Gerry was an exemplary physician-scientist who was an inspirational role model both in the operating room and laboratory. Dr. Babu Koka was the clinical director at Boston Children’s Hospital and the quintessential clinician’s clinician. Babu was trained by the father of pediatric anesthesia, Dr. Robert M. Smith and guided my development as a clinician focused on providing innovative care to critically ill infants and children.
Finally, Dr. R. Michael Scott was the chief of neurosurgery at Boston Children’s Hospital. Despite his international stature, he was an inclusive leader in perioperative space and engaged all members of the perioperative team. This promoted a team approach to perioperative care and fueled innovations both in technology and patient safety in pediatric neurosurgical patients.
What has been your biggest challenge as a mentor?
Academic anesthesiology demands one to have an appreciation of work/life integration, not balance. Integration of the essential facets of one’s career as a physician-scientist-educator is the traditional approach. However, we cannot deny our family, friends and community in pursuit of academic accomplishments. Finding the balance depends on the mentee. Recently the increasing demands for clinical coverage in rapidly expanding academic anesthesiology departments pose a major challenge to productive scholarship.
Do you feel you are making a positive difference in the neuroanesthesia community?
I truly believe that engaging young faculty and promoting an inclusive neuroanesthesia community. These requires equal representation of our diverse training programs and disciplines in neuroanesthesia. I have been fortunate to engage individuals with a passion for pediatric neuroanesthesia and have been an advocate for integration of pediatric anesthesia expertise in the care of complex neurosurgical lesions, especially in neonates and infants. I applaud SNACC and SPA in supporting a Special Interest Group led by Dr. Michael Chen and Becky Wong.
I have been fortunate to engage members of our international neuroanesthesia community in textbooks on Neuroanesthesia and Pediatric Neuroanesthesia. These individuals have generously shared their insights into their clinical practice and have benefited the neuroanesthesia community.
What is the most creative thing you have done to engage your students?
Training individuals in a highly specialized discipline runs the risk of being close minded and dismissive of other specialties. We need to abandon the notion that we as anesthesiologists work in a silo and need to engage other groups and be part of a team approach to patient care and research.
What do you see as a past, present and future of neuroanesthesia?
Since the 1969 Michenfeld, Gronert and Rehder review in Anesthesiology, innovations in patient care and neuroscience research will continue to fuel growth in neuroanesthesia. It will undoubtedly exciting field to pursue.
What is your advice for budding neuroanesthesiologist?
Secure broad training in clinical anesthesia and strong collaborations with your neurosurgeons, intensivists, neurologists, and neuroscientists (if you choose basic research) in your institution. Creating a collaborative environment that is conducive to multidisciplinary approaches to patient care and research.
If you were given a chance to choose a specialty career once again, would you choose the same or different AND why?
Pediatric Neuroanesthesia has been very, very good to me. I cannot imagine having an alternative career.
