Michael Rubin, M.D.
Neurologist Specializing in Neurocritical Care in Dallas
Severe brain injuries and illnesses that leave patients unconscious for days, weeks, or even longer pose some of health care’s most heart-wrenching dilemmas. To address and ease the stress and uncertainty of such situations, Dr. Michael Rubin is dedicated to complementing specialized medical expertise in neurocritical care with comprehensive assistance to families struggling to make decisions on behalf of their loved ones.
As a member of UT Southwestern’s Division of Neurocritical Care, Dr. Rubin works closely with colleagues to provide intensive care for patients with life-threatening conditions such as traumatic brain injury, cerebral aneurysm, stroke, meningitis, and spinal and brain tumors.
“A disorder of the neurologic system affects the entire body,” Dr. Rubin says. “So you have to have some understanding of all of the body’s systems to understand how to help the brain.”
Collaboration in treating such complex conditions is crucial. “Traditionally, a hospital patient’s care is guided by one physician, and specialists come by to consult,” Dr. Rubin says. “But with the intense pace and complexity of neurological intensive care, members of the neurocritical care team work in close collaboration with physicians and surgeons of different specialties. This way, we can share multiple perspectives at the same time and figure out how to put them together for the benefit of the patient.”
The division’s highly skilled nurses, Dr. Rubin notes, are key members of the neurocritical care team. “The most crucial aspect of neurologic intensive care is the ability to recognize subtle changes as they are happening so that we can intervene rapidly,” he says. “Our nurses have superb abilities in this area – they are specialists in their own right.”
Dr. Rubin and his colleagues see patients at Zale Lipshy University Hospital and Parkland Memorial Hospital. At both institutions, dedicated, state-of-the-art neurologic intensive care units are staffed 24/7 with fellowship-trained neurointensivists. “Whether a patient has been referred to our team due to a severe vascular condition or has sustained a traumatic brain injury, we approach all of our cases with an open mind,” Dr. Rubin says. “Each patient is treated as a person, not a biomedical puzzle.”
As Chair of the UT Southwestern Ethics Committee, Dr. Rubin helps families and fellow team members work through the difficult questions that arise during the care of neurocritical patients, especially those in a coma or vegetative state. “We are there to help in moments of crisis,” he says. “We are all trying to figure out when it makes sense to persist with treatment, and how to recognize when what we’re doing is not providing a real benefit to the patient or is not what he or she would have wanted. It’s important to fully understand the situation to foster agreement on how to navigate through it.
“Typically, when you think about successful patient care, you think of good outcomes,” Dr. Rubin reflects. “But there is only so much that medicine can do. And even when it turns out that a patient will not recover, families appreciate our emphasis on ethics at each stage of treatment, our palliative and pastoral care resources, and our sharing of their emotional experience.”
It is an often difficult and yet gratifying aspect of his work, Dr. Rubin says: “Families come back and tell us that, even at such an incredibly stressful time, they felt supported. They did not feel alone.”