WINNER IN FOCUS

Interview with Jacqueline Marie Morano, MD

Marie Angele Theard, MD

Dr. Theard
Marie Angele Theard, MD

This quarter, I would like to share an interview with Dr. Jacqueline Marie Morano, one of our SNACC members active in the Trainee Engagement Committee, where she provides valuable information for residents interested in a neuroanesthesia fellowship and helps to spotlight SNACC and its many offerings through social media.

Dr. Morano will soon be joining the neuroanesthesia team at Northwestern University in Chicago, Illinois, after some time as section chief of neuroanesthesia at the University of Chicago. During her two years at the University of Chicago, she provided learning objectives for the neuroanesthesia rotation and a lecture series for the residents. She also set up several protocols for intraoperative TBI management and High-Risk Spine management.   

Dr. Morano
Jacqueline Marie Morano, MD

What/Who influenced you to choose a career in neuroanesthesia and at what point in your career did you meet your first mentor(s)?
During the first call of my first week of anesthesia residency, I met my first mentor, Dr. John Bebawy. He helped me float a swan on a vasculopathy patient that was having an intraoperative MI. I have had so many wonderful mentors - there are too many to count, like Dr. Jamie Uejima, who was one year ahead of me in medical school. I followed her to Northwestern for residency. She has also been one of my dearest friends and a huge influence in my career. Antoun Koht, MD, introduced me to neuroanesthesia, and after completing my residency at Northwestern Memorial Hospital, Chicago, IL, I decided to stay on to complete a Neuroanesthesia Fellowship.

How has your mentor(s) helped you in your career in anesthesia/neuroanesthesia?
They have helped shape and direct my career.  In addition, they have introduced me to amazing colleagues who have given me wonderful academic opportunities and become amazing friends.

How did you find out about SNACC and when did you join?
I found out about SNACC during the beginning of my fellowship and joined at that time - in 2016. By the end of my first year in SNACC, through the mentorship of Dr. Shobana Rajan, I became involved in some of the SNACC committees.  Since then, I have had some wonderful opportunities to work with her on a number of different projects. 

Which area of clinical neuroanesthesia interests you the most and why?
A high-risk spine is very interesting to me. These are difficult cases that test a patient's physiology while testing the anesthesiologist's ability to maintain hemodynamic stability and utilize their strong understanding of pharmacokinetics.  There is no better feeling than waking a patient up at the end of a 14-hour case and for them to not only follow commands but to do so relatively pain-free and neurologically intact.

What has been the most challenging aspect of your educational career and/or training?
Finding a balance: whether it be academic pursuits, clinical workload, family and friends, or self-care.  Whenever I am excelling at one thing, there is always something else that can use a little bit more of my time and energy.  This is a challenge that many academic clinicians face, especially women, and not just for those with careers in neurosurgical anesthesiology.

What has been the most gratifying aspect of your academic career?
The residents, I love teaching!  The residents are amazing and watching them learn concepts and then apply them is just awesome! Teaching them concepts unique to neuroanesthesia cases which at first appear difficult, and watching them over the course of the rotation, learn and apply these concepts.

What advice/story would you like to share with medical students, residents, fellows, and junior faculty choosing a career in neuroanesthesia?
The opportunities I have had because of my fellowship training are endless.  Halfway through my fellowship year, I received many job opportunities in very competitive markets. These opportunities were a mix of academic jobs, which I anticipated, and private practice jobs that were looking for neuroanesthesia fellowship-trained individuals to join their groups. I was able to have my pick. I advanced to section chief while at the University of Chicago and became an OR leader and a pivotal part of my hospital department. Soon after starting at the University of Chicago, I was given the opportunity to take over the neurosurgical anesthesia section there as section chief!

There are so many new surgical techniques unique to neurosurgery, from treating Parkinson's disease to interventional treatment for stroke. As a fellowship-trained neuroanesthesiologist, you are the one working side by side with surgeons and interventionalists improving the lives of your patients. Neuroanesthesia is such a growing field, and many neurosurgeons want neuroanesthesia fellowship-trained anesthesiologists managing their cases. The opportunities in academe and private practice are endless!

What is your advice to women interested in pursuing work in this field?   
This is a sub-specialty that is extremely supportive of women! There are so many successful women in neurosurgical anesthesiology, many of whom have progressed to become chairs of anesthesia departments. In addition, I have amazing mentorship and friends all over the country, who I can reach out to whenever I have a difficult case or want to collaborate on a project.

What does the future hold for the Neurosciences in Anesthesiology and Critical Care?
The opportunities are too many to count.  Whether we discuss the ongoing work in post-operative cognitive dysfunction (POCD) or the advancements in the management of traumatic brain injuries or the role of caffeine in inhalation agent reversal, neuroanesthesia has a front seat in understanding, developing, and using these advancements to improve the care of surgical as well as neurosurgical patients.

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