Caroline George, MD, is an M Physicians pediatric critical care physician who treats a wide array of conditions that require cardiac and pulmonary monitoring and interventions. She is also a child abuse pediatrician that evaluates children who may have been maltreated and differentiates child abuse from conditions that mimic abuse.

“I felt that pediatrics would offer the most variety in my career, and I chose critical care because I really like taking care of sick patients and working with families during a stressful situation,” Dr. George said. 

Dr. George's daily work requires her to overcome stressful situations and work through different diagnoses for patients experiencing trauma and uncertainty. Oftentimes, pediatric patients can seem perfectly fine to a parent, until all of a sudden they’re not. 

“You have to be there and assess the situation quickly to start appropriate therapies,” Dr. George said. With less preparation and a myriad conditions that can be presented, critical care physicians must utilize their expertise to adapt to the situation and communicate next steps to everyone involved.

“In critical care medicine, there is an element of learning how to communicate with children when they're in a very scary situation, but even more than that, it’s about communicating with families,” she said. “You see how important that is from the beginning.”

Dr. George works with children as young as newborns up to 18-year-old young adults. Critical illnesses can require treatments that aren’t offered in other areas of pediatrics, such as managing acute respiratory failure in very young children or septic shock in young adults, which can sometimes complicate a bone marrow transplant course. 

Many surgeons rely on their expertise after a surgical procedure is complete. “We work closely with all of our pediatric surgeons, including pediatric, transplant, heart and orthopedic surgeons. If they’ve had a tumor removed or a spinal fusion, then they typically come to the PICU after that. All of our pediatric surgeons and subspecialists are very good at relaying to our team what kind of surgery they completed and what to look out for during immediate post-management,” Dr. George said. 

Now, she splits her time between critical care medicine and child abuse medicine. A child or their family can be referred to her through child protective services or a nonprofit organization where a child disclosed the abuse. When needed, physicians work closely with law enforcement and child welfare services and are available to consult children if they are present at an emergency department for an abuse evaluation.

Dr. George recognized that there is a steep learning curve for communicating with these types of patients. When asking about personal trauma, Dr. George says it’s important to make sure the child feels empowered to agree or disagree with potential medical plans. 

“I try to work with them and make sure they understand that the goal is to ensure their body and mind are healthy, and I can offer them choices about what to do and what to talk about. Being healthy and safe is the goal” she said. Dr. George can also refer patients to mental health professionals and other experts to advance the situation in a positive way. 

COVID-19 has impacted her work in a variety of ways, but a decrease in the reporting of child abuse has been an unforeseen and unfortunate consequence of many current living conditions. So, Dr. George and several colleagues in the metro area are conducting a research study through the University of Minnesota Clinical and Translational Science Institute to assess how COVID-19 has impacted the overall picture. She is collaborating with child abuse teams from Hennepin Healthcare, Children’s Minnesota and experts in the University of Minnesota School of Public Health to assess data and hopefully improve situations for children throughout Minnesota.