Watching Each Heartbeat

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Randall Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine.
Randall Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine.
Randall Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine.
Randall Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine.
Randall Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine.

On his way to becoming a physician, Randall Clark’s (AeroEngr ’78, MD ’82) road to medical school took a detour via aerospace engineering. But the route was more coherent than it might seem.

Clark is an associate professor of anesthesiology at the University of Colorado Denver School of Medicine and interim chair of the Department of Anesthesiology at The Children’s Hospital on the Anschutz Medical Campus in Aurora, Colorado. His specialty is pediatric cardiac anesthesiology.

“Engineers make great physicians because we’ve learned a specific way of approaching problems that is different than those without an engineering background,” he says. “We learn early on that understanding the connections between the parts of a system is important to understanding the system as a whole. This ‘systems’ approach, combined with an engineer’s outlook that most challenges can be conquered, serves us in medicine very well.”

Growing up in Colorado Springs, Clark was influenced by a friend’s father who was a surgeon. While in high school, Clark developed an interest in medicine as a possible career. As a senior at Air Academy High, Clark studied the CU-Boulder course catalog looking for majors that might make an appealing career in case he decided against medical school. Aerospace engineering caught his attention.

“If I didn’t go to medical school, I certainly wanted a career that would hold my interest,” he says. “It was clear that aerospace engineering was the one for me.”

Clark enjoyed learning about the various areas of aerospace engineering, from the basics of mechanical engineering to fluid dynamics and space mechanics. At the same time biotechnology was beginning to flourish in Boulder. One of his mentors was Marvin Luttges, an aerospace engineer who organized BioServe Space Technologies, a NASA Center for the Commercial Development of Space at CU-Boulder. After watching dragonflies catch mosquitoes in midair, Luttges studied the aerodynamics involved and helped open a new frontier in military aircraft design.

“He had an incredible influence on me and all the students at that time,” says Clark.

For two summers while at CU-Boulder, Clark worked in mission design at NASA’s Jet Propulsion Laboratory in Pasadena, California, where he helped run the first trajectory simulations for the Galileo mission to Jupiter. Clark also was in the JPL control room when Voyager II was launched to the outer solar system and at Edwards Air Force Base for the first free flight of the space shuttle.

Before graduating, Clark received and turned down job offers from some of the space industry’s heavy hitters, including JPL, Rockwell (builder of the space shuttle), and Boeing.

“The people at JPL are some of the smartest people I’ve ever met in my life and they enjoyed what they did every single day,” he says. “Working there was such a fantastic experience, but ultimately I chose to go to medical school. The biggest part of my decision was that I wanted to do some novel things in medicine and I knew that engineering would be a good background for that.”

Through his work on engineering team projects, Clark had developed in-depth technical knowledge, communications skills, and a systems engineering perspective that enabled him to discover effective solutions to complex problems. The human body, as a biological machine, has many functions that can be modeled using engineering methods. Like systems engineering, systems biology teaches ways of approaching a problem in which component parts of a system are better understood in the context of the relationship with each other rather than in isolation.

After graduating in 1982 from the School of Medicine, Clark completed a residency in anesthesiology at Baylor College of Medicine and then a fellowship in pediatric anesthesiology at Texas Children’s Hospital.

Clark has been a member of the medical staff at The Children’s Hospital since 1992. He directs a team of 32 pediatric anesthesiologists, one of whom also has an aerospace engineering degree.

In a hospital the size and scope of Children’s Hospital, Clark and his team of pediatric anesthesiologists are prepared for any type of surgery or procedure requiring anesthesia. A recent heart transplant had Clark working through the night during an eight-hour surgery to replace a child’s failing heart with a donor heart.

Because the physiology, anatomy, and biochemistry of children differ significantly from those of adults, pediatric anesthesiology is recognized as a distinct specialty and pediatric cardiac anesthesia is a subspecialty of that.

“The field of pediatric anesthesiology is a combination of technically demanding work with unique challenges in a very special patient population,” says Clark.

With modern ultrasound technology, prenatal examinations can identify cardiac problems that could be life threatening after birth when fetal circulation ceases and normal post-delivery circulation begins. Obstetricians from University of Colorado Hospital deliver at-risk babies at Children’s where the newborns can be whisked away to either the cath lab or the operating room for immediate intervention.

Occasionally Clark has the opportunity to work on cases such as these with his wife, Joy Hawkins, MD, who is a professor of anesthesiology at University of Colorado Hospital and is director of obstetric anesthesia and the anesthesiology residency training program. They share a deep commitment to their respective careers as physicians and educators.

Clark and Hawkins have been among 5280 magazine’s list of “top docs” in the Denver area. They both received the honor in 2004.

Patient care comes first with the anesthesiology department, but there are equal missions in education and research. The CU anesthesiology residency program rotates four residents through Children’s Hospital at any one time. Children’s also has an accredited fellowship program in pediatric anesthesiology with seven fellows each year.

“We have one of the best fellowship programs in the country,” Clark says. “It’s important that we instill in our residents and fellows the awareness to continually ask how we can make anesthesiology better, because if we all don’t do that, the field does not advance. With the incredible resources we have been given, it’s our obligation to advance the state of the art.”

Several anesthesiology researchers are working on pharmacology projects using high-tech laboratory equipment to measure drug concentrations in microscopic blood samples. That works well with the pediatric population since small blood samples can be placed on a piece of blotter paper to measure drug levels rather than using the old style of drawing a vial of blood from the patient.

“We have a talented and dynamic group,” says Clark. “The things we can tackle are limited only by our imaginations. My goal is to have us recognized as one of the very top departments of pediatric anesthesiology in the country.”

The long hours keep Clark away from home and his two teenage daughters more than he’d like, but the best part of his job is when he gets to see a sick child feeling better after surgery.

“Emotionally, it can be really hard, because we see patients with very complex medical problems that create enormous challenges in their lives,” says Clark. “Seeing a child smiling in the recovery room after a major operation is an incredible reward for me. I can’t think of too many things that equal that.”

Clark continues to keep abreast of aerospace developments, particularly those of CU-Boulder. He has attended two space shuttle launches at Cape Canaveral and has subscribed to Aviation Week & Space Technology magazine since he was an engineering student.

“I read it cover to cover primarily because I’m looking for ways that I might be able to apply my engineering background to medicine,” he says.

In the next few years, Clark wants to concentrate on projects in the bioengineering field, applying engineering principles and techniques to medical problems in order to improve his patients’ lives.

“When I look at some of the bleeding problems we have in the cardiac operating room for example, I wonder if we can apply the polymer cross-linking technology used in oil well drilling to help promote clotting at surgical suture lines,” says Clark.

“The opportunities for cross-pollination between science, engineering, and medicine are nearly limitless,” he says. “It’s funny, but I look back on my career and I feel like I still have much more to do, like I’m waiting to start almost. My engineering education from CU has opened more doors than I ever thought possible.”

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