A little girl with a throbbing toothache, a laborer with a broken left arm, an elderly woman with a broken hip from a fall, a middle-aged man with a failing heart. From a small aliment to a severe and critical situation, every day people end up in emergency rooms across the country. Some do not speak English and many are uninsured. Nonetheless, at the Department of Emergency Medical Services at Staten Island University Hospital (SIUH), small and large miracles occur when these patients get relief from their pain, and when their lives are saved.

And there is a new chief in town. In July, the Board of SIUH named Brahim Ardolic, M.D. as the new chairman of Emergency Medicine. Since 2004, Dr. Ardolic has served as director of the Department of Emergency Medicine, as well as Administrative Director of Emergency Medical Services, with responsibilities for the hospital's North and South campus ERs. Ardolic, who has been a clinical professor and has trained medical students and resident physicians for years, is also the new medical director of the Physician Assistants at SIUH.

The new chairman assumes his position with a wealth of experience and accomplishments. One of Ardolic's major credits since joining SIUH include reducing the average time it takes a patient to see a physician, from 180 minutes to 90 minutes.  "This is a remarkable achievement," said the hospital's President and CEO, Anthony Ferreri in a press release, especially as the North ER-which was built in 1979-"is now treating emergency patients at double the capacity for which it was built." As of 2005, the estimated number of yearly visits to the North ER was a remarkable 70,000.

Ardolic recently took some time off from the mountain of management and administrative paperwork in his office to talk with Industry about SIUH's Emergency Department (ED), and the life of an ER doctor.

For starters, Ardolic did not begin his college education with Med school. A lover of History, he first earned a Bachelor of Arts degree in History from Brooklyn College. He then earned his medical degree from SUNY Downstate Medical Center in 1997. After completing his residency in emergency medicine at SUNY Downstate and graduating as chief resident, he joined their permanent staff and served in various positions, including that of Director of Performance Improvement. Ardolic also gained some invaluable experience as an attending physician at Kings County Hospital Center, which included working under intense pressure, before joining SIUH in 2004.

A Homecoming

When Ardolic found himself back on Staten Island, he was not surprised. "There is a certain allure to coming back to the place where you feel like you grew up," says Ardolic. The doctor, who was born in Montenegro, immigrated with his Albanian parents to the United States when he was two years old; their first home was in Staten Island. He later attended Tottenville High School, and has been an Island resident, on and off, through the years. In his decision to join the staff at the University Hospital, Ardolic says he saw an opportunity to bring "a different style of medicine to the community."

The doctor smiles as he says that he is 35 going on 90; and is a man on a mission. Ardolic's clinical frustrations with the cumbersome medical system ultimately steered him into administration. He says he actually likes this brand of institutional tinkering, and he wanted to help fix problems that were inherent in the system. He wanted to, "get the process to work a little bit better, a little bit faster."

The Team's the Thing

As the former ER director at SIUH, Ardolic has been able to accomplish many of these goals. He introduced the implementation of an electronic information system in the department. He converted the hospital staff from regular medicine training to emergency medicine training. He recruited an extremely talented pool of full time physicians. Ardolic says most of them are happy at the hospital and the staff retention rate is high. Like a proud papa, he admits that he teases and tortures his staff, and that he is proud of their work. He reiterates, "My nursing staff is wonderful; my physician staff is wonderful. They pay a lot of time and attention to detail."

Ardolic stresses he is by no means solely responsible for the many successes of the ER. "My assistant director, Dr. Eric Maniago is spectacular and invaluable," he says. Likewise are the associate vice president of the administrative department, Frank Marisano, as well as the associate director of emergency medicine in the South ER, James Kenny, adds Ardolic.

In a telephone interview, Kenny tells Industry that Ardolic has been of tremendous value to the South ER. He says Ardolic has "provided highly qualified and board certified emergency physicians to the south side." Meanwhile, at the South ER, the average wait time to see a physician is less than at the North ER, and the volume of visitors is significantly lower-about 30,000 per year.

Back in his office, Ardolic is at ease in tan pants and a blue shirt with a pin-stripped tie. His medical coat is within easy reach. He says he gets plenty of joy in working a shift, and on a busy day, he can see as much as 30 patients with the help of nurses and auxiliary staff. In the ER, "you have to be able to solve a relatively difficult problem quickly." Thus says Ardolic, "the most important skill," for an ER doctor is "prioritizing. You have to be able to drop everything you are doing to take care of an emergency notification that comes in."

The doctor's intonation and body language is vibrant as he speaks about treating patients. Like most ER doctors, when he is on the floor, he does not concern himself with whether patients have or do not have health insurance. "Most of the patients who show up at the ER are uninsured, but they still get cared for. When you are working a shift," says Dr. Ardolic, "you are going to see them all; the only priority is that if someone is sicker, you're going to see them first."

Ardolic's voice becomes soft as he talks about the most challenging process of working in the ER department. For him he says, it is when you have to break bad news to someone. "I never get over the look on their faces." For the dreaded c-word-Cancer-Ardolic says, "It is never easy to sit at someone's bedside and have to tell them the thing they least want to hear in their life." It is often helpful when the patients' loved one is around to give them some support, but as a professional, he is always up to such challenges.

A New ER...and a New Era

It is also challenging for SIUH's staff to work in the current ER space, which is small and cramped. As chairman, tantamount on Ardolic's agenda is the building of the new facility-the Elizabeth A. Connelly Emergency and Trauma Center. Ardolic wants Staten Islanders to know that the new center will deliver superior products to them. It will include 24 private spaces out of 56 patient treatment units, a pediatric care center, a psychiatric unit, three trauma treatment rooms and a new laboratory among other amenities. The main differences between the old and the new ER will be better patient comfort and more privacy.

"It's about treating the patient with respect and with state of the arts products," says Ardolic

A big feature of the center is that "it will be an electronic space," states Ardolic; that is pertaining to medical records. There will be faster data accessibility, which will lead to faster patient diagnosis and treatment. There is some funding in place, but Ardolic notes that, "The more money we can raise, the more services we'll be able to offer in the future." He hopes that the new center will be complete and open to the public in 18 to 24 months. Ardolic is also looking forward to continued growth in the hospital's residency and other educational programs in the Regina M. McGinn, M.D. Education Center Building, which will be on the second floor of the multimillion-dollar building. The completed facility will be a place that all Islanders will be proud of, declares Ardolic, and a recognition of the Island's place in a new and increasingly vigorous borough structure.

Staten Islanders can also rest assured that in times of mass crises, they will be well cared for. In addition to taking care of regular emergency patients, SIUH's Emergency Department also manages any large catastrophes, as it did on September 11th and just after the Staten Island Ferry crash of 2003, in which 11 people were killed and 71 injured. Ardolic says, "The hospital mobilizes incredibly well". The hospital beds are usually full 80 to 90 percent of the time. Ardolic was not at SIUH for either disaster, however he notes that on both of those days, the hospital was able to convene within a few hours with "dozens of empty beds and medical supplies," available for use in the ER.

The Power of Home

When the doctor is able to remove himself from his patients and paperwork, he unwinds with his wife, Emma, and his two-year-old boy, Aedin. "He and my wife keep me sane," says Ardolic. Whenever he gets the chance, he enjoys a release in his old love; the theatre. He says it is a way "to escape everything that's going on in the world."

Although a current New Providence, New Jersey resident, besides working on Staten Island, Ardolic whose parents are residents at Prince's Bay entertains his family on the island. Over the summer, they saw Urban Cowboy, the musical at St. George Theatre. He says, "I remember being a 19 year-old going to college in Brooklyn but living in Staten Island; if you wanted to go see a play, you would leave the island." Along with the changes at Snug Harbor Cultural Center, "It's really nice to see the rebirth of some of the cultural activities," in the community says Ardolic.

With such love and pride for the Island, Ardolic is poised and eager to meet the tasks ahead. "This is my island," he claims Ardolic as he stresses that SIUH is dedicated to providing patients with quality emergency care. "If this is your home," states Ardolic, you do not need to leave the Island, "we can take care of you."

For more information, call Staten Island University Hospital's Emergency Department Administrative Offices at 718.226.9158. You can also visit  www.siuh.edu/emergency/ems.html