Developing positive relationships with patients and delivering the best care he can is a top priority for Dr. Marat Slessarev. As a critical care physician, his interactions with the critically ill have markedly impacted the trajectory of his career and priorities. Struck by the devastating toll sepsis and other critical illnesses can have on patients and their families, Dr. Slessarev decided he wanted to establish a greater degree of care for those affected.
Setting his sights on research, Dr. Slessarev enrolled in the Medical Biophysics program as a PhD Candidate where he is studying critical illness and the long-term outcomes of Intensive Care Unit (ICU) survivors.
In this Q&A, Dr. Slessarev discusses his research, how he balances being an active physician and full-time PhD Candidate, and why he believes greater advocacy is needed for critical care patients.
Where were you born and raised?
I was born in Kazakhstan and lived there for 13 years, until moving to the United Kingdom to complete high school.
Where did you complete your post-secondary studies?
I moved to Canada in 2000 to start my bachelor of science in human biology and physiology at the University of Toronto, which is also the school I completed my MSc and my MD degrees.
How did you become interested in science?
Science is something I was always interested in, even from a young age. My grandma was a botanist, which was my initial introduction to science. My dad was also a physician, and since my mom was a journalist, I would spend a lot of time with my father in the hospital. So, in a way, I inadvertently got exposed to the medical field pretty early. In school, I was able to apply my interest in science under the mentorship of amazing teachers who cultivated my initial interest and helped guide me towards my chosen career.
As an active ICU physician and a graduate student completing research, how do you balance these roles?
It’s a busy life, as I also have a wife and two young daughters at home. When I show up to my graduate school seminars or to my lab, I put my ‘grad student hat’ on and really focus on whatever it may be that I’m learning about or working on. In general, I find being prepared to learn at all times and keeping an open mind has really benefited me.
After establishing a career for yourself, what motivated you to want to go back to school and complete your PhD in Medical Biophysics?
My experiences as a physician in critical care and my interactions with patients were certainly a factor, but my mentors also played a role in my decision. A number of my senior mentors encouraged me to complete my PhD because they said it would help to focus my interests and allow me to acquire the necessary skillset to succeed as an independent investigator.
Looking back, beginning my PhD studies was a great choice, as I am really passionate about the research I am completing.
What research are you currently conducting?
I’m researching the impact of critical illness and the therapies delivered during this time to see how this impacts long-term outcomes in ICU survivors. Because critical illness is not limited to one organ, we don’t just look at kidneys or the heart. For instance, sepsis, a bacterial infection, can affect multiple organs in one patient including the brain, the heart and the kidneys, which then interferes with their functions and causes long term complications.
Classically, as Intensivists, we focused on improving sepsis mortality rates in the ICU. During the past decade, we have been successful in reducing mortality rates of sepsis from 50 per cent, down to 25 per cent. While it’s great that 75 per cent of people are surviving from their illness, the problem is that the long-term side effects of sepsis cause them to be unable to go back to their ‘regular’ lives, and they become dependent on others. Sometimes people can’t go back to work and have to quit their jobs, or families struggle to deal with the new situation they’ve been given—this is a big public health issue that hasn’t really been addressed systematically.
With my team, I am trying to address this issue and build a program of research in Southwestern Ontario to look at the impacts of critical illness along its entire continuum—from acute illness, through to recovery and into survivorship. Our aim is to utilize multimodal imaging technologies at UWO to identifying therapeutic targets and rapidly select, evaluate and refine candidate therapeutic interventions to improve outcomes of ICU survivors.
How did you become interested in studying this research question?
One of my good friends had a family member end up in critical care, and they survived their critical illness, but when they came out of the ICU, there was no system in place to take care of the multitude of issues that the patient had.
The degree of care differs between patients who have more definable illnesses. For instance, if a patient has heart failure, they will be directed to a heart failure clinic. Or if they has cancer, there are specialized clinics or survivor groups that available to address their needs. But since my friend’s family member didn’t really fit any of the existing care pathways as an outpatient, they had a lot of trouble dealing with the situation. This story really resonated with me and I thought, ‘Why are we not looking at this? And why are we not studying this systematically?’
What interests you the most about your research?
I love innovation and I love doing new things. What I most like about my research is that I can come up with a clinical problem that I see in my practice and say, ‘What can I do differently?’
Being in the medical biophysics PhD program is really interesting because I get to see and work with the latest and most high-tech devices available for imaging. Using these technologies in my work, and being the first person to use them in a specific way is one of the most exciting things for me.
What impact would you like your research to have?
My ultimate goal is to improve the lives of critical illness survivors and increase public awareness about the impact of critical illness on individuals, families and the society. Critical illness is not only limited to those with chronic conditions – it can strike at any time affecting previously healthy individuals, both young and old.
Looking at sepsis—anyone can get a really bad blood infection that turns into sepsis. In the United States, more patients die from sepsis than those affected by prostate cancer, breast cancer and AIDS combined. For us, as researchers, to really impact the lives of others and get our research on the national agenda, it is critical to engage the public and enable our survivors to have a voice.
One of my dreams is to start locally in Southwestern Ontario and build a survivorship group or database for people to share their stories with the public so that we can bring greater attention to the treatment of critical illness survivors and the changes in the health care system that need to be made to accommodate their needs.
Is advocacy work something you would like to be more heavily involved in?
Absolutely. I am so passionate about this topic that even if none of my research worked out, if I could get the problem of survivorship in critical illness and sepsis on the national agenda and educate the public about it, I would be happy.
Everywhere I go I see awareness materials for other diseases and illnesses and I think, ‘Why do we not do this for critically ill people?’ Since I have close interactions with patients and their families, I often wonder how they are doing, what could we have done better? This is information that I think would improve physicians’ work in the ICU.