Professor of Medicine and Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School
On the wall of Dr. Paul Marik’s office in Hofheimer Hall is a beautifully illuminated and calligraphed rendition of the Hippocratic Oath, a gift to the graduating students of the Witwatersrand Medical School in Johannesburg, South Africa. Medical school was a foregone conclusion for Dr. Marik, from his earliest years as a student. “It was just my destiny,” he says. “There wasn’t a particular moment when I decided – I just always knew I’d go.”
Students in South Africa studied six major subjects: English, Afrikaans and four other courses they could choose. “I always went for the sciences: maths, science, algebra,” Dr. Marik says. “That’s what I liked to do.”
When standard vocational tests indicated the student should pursue pharmacy, it made perfect sense. But first came medical school.
In South Africa, that meant six years plus an internship. At the time, South Africans had compulsory military training, so Dr. Marik served as an Army doctor during the time of the Cuban intervention in Angola. He served most of his tenure at a teaching hospital in Pretoria, but then spent three months in Angola, with a gun on his shoulder and a bucket of medicine at his side. “We looked after the local people, like a free clinic,” he explains. “We’d see as many as 200 people a day, with injuries that needed to be sewn up and infections that needed antibiotics. And we’d treat soldiers who’d been injured in battle, stabilizing them so they could fly out for treatment. It was invaluable training.”
Next came residency – four years at the University of Witwatersrand, in Johannesburg. He worked in a tertiary care hospital in Soweto, caring for patients as far away as Nairobi. “It was the only hospital between Soweto and Cairo that could do dialysis,” he says, “and because testing wasn’t as advanced as it is today, we had to hone our clinical skills. We got enormous experience and exposure there.”
After residency, Dr. Marik became an attending in Critical Care, and took advantage of the many opportunities the University offered for additional training. He earned a Diploma in Anesthesia in 1989, and a year later received a Bachelor of Science in Pharmacology, as well as a Diploma in Tropical Medicine and Hygiene. “I just liked learning,” he says, “and these were opportunities I couldn’t pass up.”
Realizing that in South Africa, the future for academic medicine wasn’t bright, Dr. Marik decided to leave his homeland. After interviews in the US (New York City) and Canada, he chose to pursue a fellowship in critical care at the University of West London in Ontario, where he studied with Dr. William Sibbald, a noted critical care physician.
A projected physician surplus resulted in a cutback on medical school positions, and Dr. Marik returned to the US, ultimately leaving Philadelphia to assume the role of Professor of Medicine and Chief of Pulmonary and Critical Care at EVMS.
“There’s a far different atmosphere here than in Philadelphia,” he says. “There are four medical schools within miles of each other in Philly, and sixty hospitals in greater Philadelphia. Here, there’s one tertiary care facility for all the people on the southside of Hampton Roads. And because there’s such diversity in the field of pulmonary and critical care medicine, we see an enormous spectrum of pathology from all over. It’s not the same thing every day.”
In fact, Dr. Marik says, even after over thirty years of practicing pulmonary and critical care medicine, he still sees conditions that he’s never seen before. “There aren’t many specialties you can say that about,” he says. “That’s why it’s so fascinating, and why there really is nothing else I’d rather do.”
Dr. Marik is the author of The Handbook of Evidence-Based Critical Care. Now in its 3rd edition, the Handbook is widely used throughout the world. His scholarly contributions also include 380 peer reviewed articles and 308 lectures at national international meetings, and invited grand rounds, serving as a reviewer for a number of major medical journals, and authoring 81 book chapters. His contributions have resulted in his twice receiving the SCCM Presidential Citation for Outstanding Contributions to the Society of Critical Care Medicine.
Most recently, Dr. Marik was invited to present at the National Institutes of Health on hemodynamic assessment and fluid management.
He is currently working on a project that he says has the potential to be the most significant and exciting accomplishment of his entire career – an incredible claim for a physician who has been recognized throughout the world for his contributions to the field of pulmonary and critical care medicine. “Sepsis affects about 20 million people across the planet,” Dr. Marik explains. “It has a mortality rate of about 40 percent, except in the most underdeveloped countries, where the death rate is around 60 percent.” Sepsis kills nearly 250,000 thousand Americans every year. Pharmacologists and scientists have spent years and invested millions of dollars looking for a cure. Dr. Marik and his team have been doing studies, he says, “and if we’re right, we may have a novel way of managing sepsis.” He and his colleagues are in the process of finalizing their findings, and intend to publish before the end of the year.
Of his estimable career, Dr. Marik says, “Being a physician is a great privilege. After thirty years, I am still excited and amazed by it.”