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Clinical: I care for critically ill Veterans as Co-Director of the Intensive Care Unit and attending physician at the San Francisco VAMC. I see outpatients in our general pulmonary clinic and direct the Pulmonary Amyotrophic Lateral Sclerosis (ALS) Clinic, which is part of the SFVAMC Multidisciplinary ALS Team. ALS (Lou Gehrig’s Disease) is twice as common in military veterans than in the general population. Our interprofessional ALS team approaches care with a patient-centered philosophy and treats all aspects of healthcare for our Veterans with ALS. In addition to patient care, I am actively involved in ICU quality improvement, clinical education and research.

Education: I am actively involved in undergraduate and graduate medical education at UCSF because teaching students, residents and fellows is one the best parts of my job. I am a medical student coach in the UCSF Bridges Curriculum, course director for the VA Critical Care Medicine student elective, and teach a variety of topics in small group-format courses, including ethics and point-of-care ultrasound for students, residents and fellows. I develop and coordinate the curriculum for the multidisciplinary ICU rotation for residents from medicine, surgery, anesthesia and emergency medicine. I teach clinical simulation in the ICU as part of the UCSF/SFVA Clinical Simulation Program, and I am an ACLS instructor. I am a core faculty member and member of the program evaluation committee in the UCSF Pulmonary and Critical Care Fellowship. I teach a variety of fellow-level sessions on mechanical ventilation and non-invasive ventilation. I recently developed a clinical education track within the fellowship program and I am actively involved in redesigning our assessment process for fellows. My interests include several areas of investigation within education, including patient/family communication, interprofessional communication, patient handoffs, and using clinical simulation to teach ICU care.

Research: My laboratory studies how lung epithelial barrier function is controlled, both in health and in disease. The epithelium in the lung is at the front line protecting the inside of the body from the outside world. Problems with the barrier function of the lung epithelium are at the center of several common lung diseases. Our goal is to develop new therapies that beneficially target the regulatory pathways controlling epithelial barrier function in diseases like ARDS, ventilator-associated lung injury, asthma and lung fibrosis.