It is with great pleasure that this SonoFiler edition – profiling leaders in bedside ultrasound – is none other than “The Prez”, “The Holy Stone”, “The Mikester” (as we like to call him) – Dr. Mike Stone, current President of the ACEP US Section, and best described as “husband and dad” as he puts it. His nickname is simply, Stone – “because it’s my name and let’s face it, sounds cool.” It does have a nice ring to it! Kind of like Cher, Madonna, Sly….ok, maybe a bit more important to the world than that. So, lets talk a bit about Stone…
Stone first started using US on day 1 of his internship at Highland by learning how to perform a DVT study by one of his attending physicians (I wonder if that attending realizes he was a part of creating a guru). Yes, Mike, I just called you a guru. But, youre not the first Mike to be a guru – so dont feel too special. Those attending physicians were none other than Barry Simon, Eric Snoey and Brad Frazee – “some of the original leaders in point-of-care ultrasound.” – as Mike puts it, feeling quite fortunate to have trained with them; leaders who had a desire to provide better patient care. “They bought a machine in the 90’s and taught themselves how to make diagnoses more rapidly and accurately in a high-acuity limited-resource environment.” Wow – inspirational, I tell ya.
I see why he was inspired to continue to spreading the gospel of the ‘sound, especially after a specific case of an elderly woman who came to an ED that did not have an US machine after a syncopal episode, transient hypotension, and diagnosed with ruptured abdominal aortic aneurysm “but not without an hour or two delay that would’ve been avoided entirely if we’d had access to point-of-care ultrasound.” from that point on, he vowed to never practice medicine in a place that did not have an US machine. Hear Hear, brotha!! The one case that he brings up as one of his best examples of US importance is of a 52 yr old with hypertension who syncopized and hit his head after sudden ripping chest pain. Hypotensive, lookin’ bad, his colleague asked him to look for dissection – aorta looked fine, but the RV, not so much – it was dilated, and with a positive DVT. Despite a scalp laceration and neck hematoma from a failed EJ attempt, they gave thrombolytics as the patient had ROSC after PEA arrest. Walked out of the hospital 4 days later with a normal echo. “While I’ll be the first to admit that we need more research focusing on patient-oriented outcomes for point-of-care ultrasound, this was all the proof I’ll ever need for my own clinical practice.”
Well, since that time, Stone has been involved with A LOT with regard to point-of-care ultrasound. You’ll see his written word and hear his spoken word throughout research studies and podcasts, and I’ve heard his SonoTerm of choice is the “coochie-coo” sign. Not sure exactly where that comes from though, and Id hate guess – Arun, do you know the story? Well, one of the things he is most proud of is teaching it to students, residents, fellows and colleagues here and abroad. As he puts it best: “I dont think anything’s more rewarding than when a former ultrasound student tells you about a case where their point-of-care ultrasound skills made a huge difference for their patient.” He always speaks of how much his residents and fellows have accomplished in point-of-care ultrasound education and research as well. Stone, you are a huge part of why they love it and live it.
Of course, we cannot go without talking about he, Arun Nagdev, and Andrew Herring’s work on US guided nerve blocks in the ED. Holla!!! They truly are the experts in this as they study it, teach it, and, thank God, talk about it every time I see them – even after a few drinks. Talk about passion! “Its a lot of fun to push the envelope for what you can do with ultrasound in the ED and at the same time give people some of the most profound pain relief you’ve ever seen.” You’re right, Stone. Thanks to these efforts, we made it a priority in our disaster deployments as well as in our ED.
When asked about who his heroes are, paraphrasing his statement would not do it justice, so I’ll quote it:
“There are so many people it’s hard to list them all (and apologies in advance for those i’m sure i’m forgetting). There’s those who were instrumental in my own ultrasound education (barry, eric s, brad, dave e, dan p), those who’ve done so much important advocacy and policy work for emergency ultrasound (vivek, mike b, paul s, vicki, resa, jerry, steve h) those who’ve dedicated incredible and often selfless effort to educating the world about point-of-care ultrasound (rob b, bob j, chris f, rob r, dave b, mike m, matt d, geoff, brett, luca, daniel, dick, pat, tom c, beatrice), and those with whom i’ve had the great privilege to learn with along the way (arun, ralph, jeff c, otto, nate, jen h, mike s, jyoti, mikaela, ninfa and dimitri)”
Where Stone sees the future of US going? A true culture change in medical education involving point-of-care ultrasound. “How much more evidence do we need that this is something we should all learn at an earlier stage in our medical education? I feel lucky to be involved in such an exciting time in medical care and medical education, and can’t wait to see what happens next.” I cannot wait to see where it goes either. Thankfully, we have you. What you have done with bedside US, the way you inspire others, and the passion and determination you have for its future is what makes me excited to see what is next for point-of-care US. It is great to see you join the Ultrasound Podcast guys too!
SonoSpot: Topics in Bedside Ultrasound 