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Every Voice Builds Shared Situational Awareness

During my brief time in the Air Force, I was impressed how anyone in a leadership position actively sought out criticism, especially from those of lower rank. That made their briefing-and-debriefing culture deeply embedded and highly effective. This culture can improve outcomes in the equally high-stakes world of robotic heart surgery. As the leader our […]

A Pressor Bolus Can Be An Early Signal of a Problem

LIMA-to-LAD bypass grafting through a mini-thoracotomy performed off-pump (MIDCAB) is widely regarded as an important innovation in cardiac surgery. Although most cardiac surgeons have attempted MIDCAB at some point over the past two decades, only a small number of programs have mastered it. One reason for its limited adoption is the need for excellent team […]

The Winner of the Robert Poston Nursing Scholarship

The annual Robert Poston Nursing Scholarship was initiated in 2025 as a small gesture of thanks to the many nurses that have taken great care of my patients, shared their wisdom and made me a better doctor. It is an award for nurses to further their professional careers. There were 52 applications from across the […]

Choosing an Anesthesia Team for Robotic Cardiac Surgery

The Society of Thoracic Surgeons (STS) 2026 Expert Consensus Pathway on Robotic Cardiac Training recommends a dedicated team of board certified cardiac anesthesiologists for all new programs. It makes sense to acquire every advantage you can when considering a robotic CABG program. According to the STS database from 2025, robotics is used in less than […]

The Elephant in the Robotic Cardiac Surgical OR

“Your beliefs become your thoughts; your thoughts become your words; your words become your actions; your actions become your habits; your habits become your values; your values become your destiny.” Gandhi As a surgeon contemplates the destiny of a new robotic CT program, it’s a good idea to keep an eye out for positive, negative, […]

ICU Nurses and Blood Bank Staff Landing a Fighter Jet on an Aircraft Carrier

One of the greatest challenges an ICU nurse faces is the management of patients at risk for cardiac tamponade from ongoing hemorrhage. It demands vigilent monitoring of the patient (chest tube output, vital signs, cardiac output, oxygenation, temperature), ensure the comfort of the patient and family, titrate vasoactive drips, administer blood products, manage the ventilator, […]

Simplicity Beyond Complexity Via Robotics

At the beginning, robotic technology was introduced to surgeons with a simple premise. It was a tool that would help procedures be done through small instead of large incisions. Adoption of robotics was framed as purely a technical challenge. Based on this deceptively simple mindset, marketers at Intuitive Surgical (manufacturer of the robot) targeted those […]

The Untold History of Robotic CABG at Univ of Chicago

The story of robotic coronary artery bypass grafting (CABG) at Univ of Chicago involved three cardiac surgeons that are part of a small group of experts at this procedure: Dr. Sudhir Srivastiva, Dr. Husam Balkhy and myself. The three of us stuck with robotics because we see the value added to our patient’s lives. Less […]

The Advantages of Written Documentation

Every morning, I thoroughly document how my hospitalized patients are progressing in their medical records, something I believe is an underappreciated but critical leadership behavior. It takes more than a small investment of time. Done properly, its around 2 hours a day. Most surgeons would rather be in the OR than spend this kind of […]

Pointing Out the Mistakes of Your Colleagues

Our CT surgery team meets every other week to debrief the most important cases, focusing mainly on those that were high risk or had a bad outcome. These meetings evaluate team members’ strengths and areas for improvement. It can be a humbling experience to talk about your mistakes in front of peers. Sometimes I moderate […]