The rescue imperative: a conversation with Tim Buchman

Tim Buchman

Tim Buchman wants to fundamentally change the critical care process to get better patient outcomes at lower costs in a brand new center at Emory.

Tim Buchman came to trauma surgery by the same route as many of his patients: injured.

When a reckless driver plowed into his car, temporarily leaving him in a wheelchair, the trauma was "a personal epiphany" for the Johns Hopkins surgical resident. He discovered in himself what he calls "the rescue imperative."

Acting on that imperative, Buchman recently arrived at Emory as the founding director of the new Center for Critical Care—the first such center in the nation to focus exclusively on critical care. Emory's goal is to fundamentally change the critical care process to get better patient outcomes at lower costs. Emory is starting to do that by integrating all intensive care units (ICUs) throughout all its hospitals. While existing ICUs will remain geographically separate, the interdisciplinary teams who staff them will be linked under the new umbrella. That approach, says Buchman, will "standardize and harmonize clinical care, optimizing quality and making it easier for patients, families, and their personal physicians to understand and participate in the care process."

As the newest interdisciplinary center at Emory's Woodruff Health Sciences Center, the Emory Center for Critical Care also will "fulfill the Emory mantra of discovered here, practiced here, taught here," says Buchman.

The new director has a unique set of education, training, and research skills that make him an ideal person to lead the effort. He holds PhD and MD degrees from the University of Chicago, and he is one of a select group of trauma surgeons in the country with research experience in molecular biology and genetics. His research passion is predictive biology, and he believes that with current knowledge and "data density," clinical science should soon be able to anticipate which patients will go into seizure or anaphylactic shock. Increasingly, he says, the clinician's job will be to see into the future of each patient and change that future for the better.

"We want to do for patient care what modern meteorology did for weather forecasting," he says. It combined unprecedented observational data with a better understanding of the laws of physics and began to allow people to make plans based on what was going to happen.

Buchman has not only the background but also the energy to carry out his charge. He lifts weights in Emory's Blomeyer gym at sunrise most mornings. In his office, he keeps open four computer displays to move easily among clinical care, predictive biology research, and mountains of administrative details. (Question: How many computers does he have at home? Answer: "You don't want to know.") He maintains an airline transport pilot's license, having learned to fly years before he learned to drive. His wife is Barbara Zehnbauer, an Emory adjunct faculty member who is branch chief of Laboratory Performance Evaluation and Genomics at the CDC.

Despite his high energy, Buchman appears serene, focusing his entire being on what is happening at the moment. When he sits down with a patient, family member, or colleague, he puts down the coffee cup that accompanies him everywhere and does not pick it up again until he is ready to go—an intentional gesture. His eyes do not wander. That person has his entire attention. Nothing is more important.

He knows doctors can be intimidating. He is not. He seldom wears a white coat. He often holds a patient's hand. He introduces himself as Tim. He shares puns, admittedly very bad ones. His mascot, given to him by a team member at his first job as director of the surgical ICU and trauma center at Hopkins, is a beanie baby beaver named, appropriately enough, Bucky. On clinical service in Emory's 5E surgical ICU, he begins rounds every morning at what is called Bucky's Corner, alongside critical care team members and young physicians in training.

"I'm the leader, not the owner; the coach, not the quarterback," Buchman says. "Critical care is best delivered by a team of geographically dedicated professionals, not just intensive care doctors but also nurses, respiratory therapists, pharmacists, nutritionists, and the list goes on. With the right people—our professional "family of choice"—exceptional care will yield great outcomes. That's our plan." —Sylvia Wrobel

For more information on the new center, call 404-712-2654

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