Mastering Intensive Care 042 with Paul Young

Paul Young is an intensive care specialist at Wellington Hospital in New Zealand where he is the co-clinical leader at Wellington ICU. He is also medical director of Wakefield Hospital ICU, Deputy Director at the Medical Research Institute of New Zealand, and holds a Clinical Practitioner Research Fellowship from the Health Research Council of New Zealand. Paul’s predominant non-clinical interest is in ICU research.

Since starting work as an intensive care specialist in 2010 he has published more than 120 papers in peer-reviewed journals including five papers in the New England Journal of Medicine, two in JAMA, and one in the Lancet. His involvement in clinical research has been instrumental in the development of his belief that intensive care is fundamentally about keeping people alive for long enough for them to recover whilst meddling as little as possible. In his leadership roles he encourages people to find joy in their work and to be nice to each other yet he constantly battles with his own tendency towards sarcasm.

In late 2018, Dr Peter Hicks, the Clinical Lead at Wellington Hospital died suddenly. Peter was an excellent intensivist, a wonderful leader, and a friend to many in the Australian and New Zealand ICU community. His death is sad for all who knew him and most notably his family and colleagues. Paul speaks in this interview about the legacy Peter left behind, how Peter particularly guided Paul in his career and how the Wellington ICU is moving on after Peter’s untimely death.

In this conversation, Paul also discusses:

• Why he became an intensivist
• The cultural differences between Australia and New Zealand
• Telling the truth about his thoughts on the patient’s likely outcome
• Worrying – and when it’s useful and not useful
• The specifics of his ward round
• What it’s like to have consultants changing daily in his ICU
• The start to his research career
• Some insights on designing clinical trials to answer important questions
• Why “negative studies” are so important to advance clinical practice (using the TARGET study as an example)
• How he keeps up with the literature including with Twitter
• His efforts to be more kind and to get on with people
• The effects of running on his general well-being
• A challenge for other units to try a “day about” clinical roster

Paul is clever, incisive, and is delightfully able to simplify many concepts about intensive care practice and research.

People, organisations and resources mentioned in the episode:

• Paul Young on Twitter: @dogICUma
• Paul Young author on LITFL
• Wellington ICU website
• SMACC 2019 – Are the Critically Ill Actually Hungry?
• SMACC 2019 – The Great(est) Fluid Debate
• Tribute to Peter Hicks written by David Pilcher
• ANZICS CTG (Australian and New Zealand Intensive Care Society Clinical Trials Group)
• Rinaldo Bellomo
• Critical Care Reviews
• Rob MacSweeney
• Wellington ICU Journal Club on Twitter: @WellingtonICU
• TARGET study
• Tweetorial on the TARGET study by Paul Young
• Rana Awdish on Twitter: @RanaAwdish
• Book “In Shock” by Rana Awdish
• MIC podcast 3 with Rinaldo Bellomo
• MIC podcast 19 with Alex Psirides
• MIC podcast 20 with Jack Iwashyna
• MIC podcast 23 The Best of 2017 (Part 1)
• MIC podcast 24 The Best of 2017 (Part 2)
• MIC podcast 39 The Best of 2018
• MIC podcast 41 with Rana Awdish

Further reading and listening

• Full podcast collection on LITFL and Libsyn
• The New Normal Project podcast
• More conversation on Twitter (@andrewdavies66) and Facebook