This week’s faculty spotlight shines on pediatric critical care medicine physician Caroline Ozment, MD. Ozment talks to us about how her road to medicine was a long and circuitous one. Once in medical school, she realized that she thrived in an atmosphere where life-changing results were seen immediately, which led her to pursuing her career in critical care medicine. She also talks about her responsibilities within the department and her current research interests, focused on transfusion medicine and anticoagulation in neonatal and pediatric ECMO patients. She describes her relationships with her most significant mentors and offers some advice for trainees, most importantly, do what you love.
How long have you been at Duke? How did you decide to come here?
I came to Duke in 2006 for my pediatric critical care fellowship and never left! I did my residency in Oregon but am originally from Alabama and was interested in returning closer to family. Duke was my first fellowship interview, and I immediately felt at home with the critical care group, both the faculty and the fellows. Although I went on to interview at 10 other programs, I think I knew from the beginning that this was the best fit for me. After I completed fellowship, I again interviewed at a number of programs around the country but, in the end, I was offered the perfect position here and knew I wanted to continue working with my amazing colleagues.
What are your current responsibilities in the Department of Pediatrics? What does your typical day look like?
I work as an attending in the PICU and serve as the medical director of pediatric extracorporeal membrane oxygenation (ECMO) at Duke. I don’t have a “typical day” which is one of the things I love about my job! When I am on-service in the PICU, my day is spent rounding on up to 16 critically ill patients, teaching, and caring for patients and their families at the bedside. Our days are usually long and very fast-paced. In addition, I work several nights a month and, while these shifts can also very busy, they provide an excellent setting to teach on a more one-on-one basis. When I am not on service in the PICU, I spend time teaching within the division and the ECMO team, which includes perfusionists, respiratory therapists, and other physicians; doing research; and participating in various institutional and national committees.
How and when did you initially become interested in medicine? What made you decide to pursue a career in pediatric critical care medicine in particular?
The road to medicine was long and circuitous for me. After I graduated from college, I took several years to figure out what I wanted to do working as a waitress, a technician in a basic science lab, and a veterinary assistant. My family still refers to this time as my “standardized testing phase”. I ended up taking the GRE, LSAT, VCAT (MCAT for veterinary school), MCAT and the foreign service exam all in one year! After much soul searching, I finally decided on medicine. I started veterinary school at Auburn University but realized after about 6 months that I would be more fulfilled caring for humans. I have always loved kids, and thought I would become a general pediatrician, but quickly realized in medical school that I needed a bit more action in my day than most and that I thrived in an atmosphere where life-changing results were seen immediately. After my PICU rotation, I was hooked.
What do you see as the biggest current challenges and opportunities in the field of pediatric critical care medicine?
I think one of the biggest challenges in pediatric critical care is finding the balance between utilizing all of the amazing medical advancements that we have to help keep patients alive while still recognizing when to help families let go. I also think there is great opportunity for developing physician wellness strategies for pediatric intensivists. We deal regularly with the sickest children in the hospital, and I think the emotional toll it takes on us is underrecognized by many (including ourselves) at times.
Can you tell us about the research you are currently involved in?
My research is focused on transfusion medicine and anticoagulation in neonatal and pediatric ECMO patients. I am currently assisting in the development of 2 multicenter, randomized trials comparing restrictive versus liberal red blood cell and platelet transfusion thresholds in ECMO patients. I am also working with several of our fellows designing an ex vivo ECMO study correlating thrombin generation rate to laboratory measures of anticoagulation and heparin or bivalirudin dose.
Who was your most significant mentor and what knowledge did you gain through collaboration?
My primary research mentor, Phil Spinella, who is a pediatric intensivist and hemostasis researcher at Washington University and took me under his wing when I was a fellow. He has guided me through my research career at all stages, introduced me a wide network of other professionals in the field, and helped me find opportunities to lead within the larger ECMO community. Clinically, Patti Massicotte, a pediatric hematologist at the University of Alberta and pioneer in the field of pediatric device anticoagulation, was a particularly special mentor. She was always available for an ECMO anticoagulation question or discussion, even by text late at night, and really gave me the foundation for my current practices.
What do you enjoy most about your work? The thing I enjoy most about my work is the opportunity to get to know the families and patients in my unit and to, hopefully, help them through some of the hardest times in their lives. I also love the “shift” aspect of my clinical time. It allows me to be present for my family when they need me.
Do you have any advice for trainees?
Do what you love. Life is too short for anything else.
What passions or hobbies do you have outside of Duke?
I love to entertain. I’m pretty sure I was a party planner in another life. On any given night, our house (or yard during COVID times) may be filled with extra kids, neighbors, or residents and fellows, and I wouldn’t have it any other way. In addition, I have 3 daughters (13, 9, and 4) who keep me busy with all of their activities and shenanigans. My husband and I like to run, hike, travel and cook together, and I am an old house aficionado and lover of interior design.
