The Surgical Critical Care Division runs the Surgical Intensive Care Unit (SICU) at Beth Israel Medical Center. Patients with complex surgery, complications of surgery, and major organ dysfunction (for instance, heart, lung, kidney) may require a stay in the SICU where they can receive breathing, blood pressure, kidney and other support not available elsewhere in the hospital.

Surgical Intensivists: 24/7 Coverage and Acute Care Operations
Surgical intensivists staff the division. These intensivists are physicians who are trained and certified in general surgery, and who have completed further training and certification in surgical critical care.

Every morning at Beth Israel Medical Center, the attending intensivist leads a team of residents, physician assistants, respiratory therapists, nutritionists and pharmacists through a review of each SICU patient’s status. The team monitors the brain, heart, lung, kidney, liver, gut, nutritional, infectious, fluid and electrolyte, blood and clotting status, and formulates a plan for the day. Care is coordinated between the SICU team and the surgical team on a twice-daily basis. The surgical intensivist’s office is next door to the SICU and an attending intensivist is present in the hospital 24 hours a day, seven days a week.

Surgical intensivists also perform surgery, mostly on patients who require acute care surgery, and who often have come in through the Emergency Department or via direct referrals from doctors’ offices. Such acute care surgeries include:

• Appendicitis
• Perforated ulcers
• Bowel obstruction
• Diverticulitis (small, bulging pouches in your digestive tract)
• Gallstones and gallbladder disease
• Various kinds of abscesses

Surgical intensivists also perform elective surgery on high-risk patients. For instance, a patient with severe heart failure or emphysema or one who has kidney failure and is on dialysis may require elective colon, hernia or gallbladder surgery. The safe management of their surgery may require several days in the SICU to closely monitor the heart, artificial ventilation or dialysis in the immediate period of instability after surgery. In these cases, the SICU team provides both the operative care and the SICU care.

Interdisciplinary Support
Because of the nature of critical care surgery and the collegial environment of Beth Israel Medical Center, surgical intensivists assist many other divisions in the care of their high-risk, complex disease and organ-failure patients. Such surgical cases include general abdominal, vascular, bariatric, colorectal, breast, orthopedic, spine, urologic and gynecologic procedures.

Division Staff

• Simon D. Eiref, MD
• Asaf Gave, MD
  
• Marvin A. McMillen, MD (Director, SICU)
• Nathan Boucher, (Chief PA)
• Barbara Gerbier, PA
• Ezra Gillego, PA
• James Scott Gould, PA

To make an appointment with one of our surgeons, please complete the appointment scheduling form. A staff member will contact you within 48 hours to schedule an appointment.