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Guido Falcone, MD, ScD, MPH, is a critical care neurologist who treats patients with severe brain injuries from trauma, strokes, hemorrhages, and seizures, among other conditions. “I usually meet patients with these injuries immediately after they come to the hospital,” Dr. Falcone says. He also sees patients suffering from symptoms caused by neuromuscular diseases or complications from brain surgery. “One important characteristic of our specialty is that many important decisions need to be made in those initial few minutes to hours,” Dr. Falcone says. “We also need to factor in the patient’s wishes, but often they are unconscious and cannot communicate.” In those cases, Dr. Falcone relies on the patient’s family for guidance. “This can cause a tremendous amount of stress as they carry the huge responsibility of representing their loved ones,” he says. Dr. Falcone keeps this additional stress in mind when he’s talking with the patient’s family about a diagnosis and what to expect next. “It’s very important for us to be honest and explain to them what we know and don’t know so that this uncertainty can be taken into consideration when we’re making a clinical decision,” he says. Dr. Falcone says he and his colleagues in the Neuroscience Intensive Care Unit (Neuro ICU) frequently update families on the status of a patient’s condition and progress. “Something I came to realize after a few years in the field is that we help patients and families all the time. Sometimes, we help them get better,” Dr. Falcone says. “But another important part of our job is to give the very best end-of-life care, with the same approach we use when curing a disease or saving lives, if that is necessary.” In his research, Dr. Falcone specializes in population genetics and genomic medicine, two related fields that involve analyzing large amounts of data and searching for different variants of genes that might influence human disease. He works with a team that uses information from across disciplines, such as neuroimaging data, for example, to conduct studies. “We want to use data to understand not just what causes disease, but also who is at high risk of developing it,” Dr. Falcone says. “Genes are such a powerful tool in patient care because our genetic information is constant from birth.”
