An Honor, Privilege, and Responsibility
The Chief of Pediatric Cardiac Anesthesiology at the Texas Center for Congenital and Pediatric Heart Disease serves as an editor for the latest edition of a leading textbook that will inform care for years to come
Reviewed by: Erin A. Gottlieb, MD, MHCM
Written by: Gene Lazuta
Surgery to correct congenital heart disease, one or more problems with a person’s heart present at the time of their birth, is a serious and exacting procedure requiring a highly skilled and thoroughly trained anesthesiologist as part of the perioperative team. Anesthesia for Congenital Heart Disease is an in-depth reference detailing the intricate work of managing the anesthetic care for a patient undergoing heart surgery to correct congenital heart disease and is considered to be the leading content textbook for clinicians, students, and other medical professionals.
As a student, UT Health Austin pediatric cardiac anesthesiologist Erin Gottlieb, MD, MHCM, carefully studied the textbook’s first edition, highlighting countless sections and filling the margins with notes. Now, as the Chief of Pediatric Cardiac Anesthesiology for the Texas Center for Congenital and Pediatric Heart Disease, a clinical partnership between UT Health Austin and Dell Children’s Medical Center, Dr. Gottlieb’s name is on the textbook’s fourth edition cover as one of its editors.
“I was entrusted with helping capture the best of what our specialty has to offer,” explains Dr. Gottlieb. “This specialty is constantly changing, and the next edition will highlight advances in the field of pediatric cardiac anesthesiology as it evolves with the fields of congenital heart surgery, interventional cardiology, and all other specialties that touch this fragile patient population. The editors of the next edition of this book will build on the work we did to ensure that our specialty is always moving forward.”
A Commitment Born Out of Personal Experience
Along with the first edition of Anesthesia for Congenital Heart Disease, Dr. Gottlieb’s approach to medicine was shaped by her own life experience. “My eldest daughter was only a month old when I began my fellowship training in pediatric anesthesiology, so I understood very personally just how much trust a family places in me as part of the team that is caring for their child,” shares Dr. Gottlieb. “It’s our responsibility to earn that trust by doing the very best we possibly can for every child and parent.”
“After my first fellowship,” continues Dr. Gottlieb, “I completed a second. This time I pursued cardiac anesthesiology at Texas Children’s Hospital in Houston. That’s what set me on my path here, to the Dell Medical School and the Texas Center for Congenital and Pediatric Heart Disease at Dell Children’s Medical Center. It’s our commitment to team-based care, to surrounding the patient, and the patient’s family, with the highest level of expertise at all times, that makes this program so special; and it’s what made me want to be a part of it.”
Dr. Gottlieb’s first responsibility as a cardiac anesthesiologist is ensuring that a patient falls peacefully and safely to sleep at the start of a procedure. Then, working with the other specialists on the team, she uses different medications to maintain the patient’s optimal blood pressure, heart rate, and respiration throughout the course of the operation, all the while ensuring that the patient stays comfortable and unaware. Dr. Gottlieb is involved from the time the patient transitions to and from the cardiopulmonary bypass machine used during the surgery to the time that the patient regains consciousness, which can occur in the operating room or later in the intensive care unit (ICU). Throughout the entire process, she carefully coordinates everything she does with the surgeon and the rest of the patient’s care team, constantly making the finest of adjustments to help the patient achieve the best comfort level and physiologic state possible.
The Foundation of Future Care
In addition to her immediate responsibilities to her patients and their families, as part of an academic practice associated with a major university and its medical school, Dr. Gottlieb always strives to understand, utilize, and teach the most up-to-date and effective techniques available in her specialty.
“As the practice of medicine improves over time,” says Dr. Gottlieb as she holds a brand-new copy of the textbook to which she contributed her effort and expertise, “and as new tools, such as increasingly sophisticated ultrasound technology, allow clinicians to change the way they do things and make them better, we try to capture the totality of our knowledge to date in books like this.
“Working with experts in every aspect of our field, we updated content, organized information, and reviewed all the evidence and data, charts and graphs, and other visual illustrations, compiling the latest and most complete understanding we could into this snapshot of where we, as a discipline in the practice of medicine, have arrived so far,” continues Dr. Gottlieb. “But, it really is a moment frozen in time. What we know is always changing, so there will always be another edition of this book, and other books like it. And that’s what makes being one of the editors of this fourth edition so special.”
“What’s most important about books like this and about a place like the Dell Medical School is that this information, this collective, recorded experience, will be the basis, the foundation of the care future patients receive,” adds Dr. Gottlieb. “Just as they were for me when I was a student, the words on these pages will be the start of a journey of effort and commitment that will find its final expression when a clinician touches and improves a patient’s life. Because that’s what medicine is. It’s putting knowledge into action. Whether by working as an editor of this book or by teaching the students I see every day, contributing to the education of the next generation of medical professionals is a very meaningful part of who I am.”