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As a medical school applicant, Dr. Ben Guedes, like most medical school hopefuls, was required to write an essay. But unlike some applicants, perhaps, his topic took very little thought.

“I had already decided I wanted to take care of children,’’ he said. “That’s just what I always wanted to do. If you can do something really good for a child, curatively, they have a whole life ahead of them.”

That school was the University of Florida College of Medicine and in 1969 Guedes earned his medical degree. The rest, as they say, is history. During the past three decades, hundreds — more likely thousands — of Florida children have benefited from Guedes’ love of pediatrics, and more recently pediatric critical care.

Guedes completed his pediatrics residency in 1972 at Fitzsimons Army Medical Center in Denver, followed by a fellowship in pediatric cardiology in 1976 at the University of Florida.

In Central Florida, he was director of the pediatric intensive care unit at Orlando Regional Medical Center, then Arnold Palmer Hospital, from 1978 to 1985.
He was a senior fellow at Jacksonville Hospital before moving to Florida Hospital, where he has worked since 1988. He was medical director of pediatrics for Florida Hospital East from 2000 to 2004 and currently is medical director for the intensive care unit at Florida Children’s Hospital, a title he has held since 2003.

Guedes also is the new chief of staff of pediatrics for Florida Children’s Hospital —named this year — and works in private practice at Florida Pediatric Associates, formerly Children’s Medical Group, which he established in 1987.

Guedes recalled what the pediatric critical care situation was like when he first arrived in Central Florida back in the late 1970s.

“They were just beginning the pediatric critical care unit,’’ he said. “There were about five beds and no pediatrician was involved. They asked me if was interested and I said yes.” Now, both Florida Hospital and Orlando Regional have “very sophisticated” pediatric intensive care units, he said.

“We have three intensivists, thirteen ICU beds,and are doing things that weren’t even thought of back then,’’ Guedes said of Florida Children’s Hospital.

Take high-frequency ventilation, for example. Guedes recalled a patient who had severe respiratory disease due to chicken pox in the lungs. Florida’s one high-frequency ventilation machine was located north at Shands Hospital in Gainesville.

“The Florida National Guard flew it here, with someone who knew how to use it,’’ Guedes said. “It was just experimental back then. Now that is standard treatment we have. The technology has changed unbelievably. We’re able to save children we wouldn’t have even been able to think about before.”

Hyperalimentation is another such example.

“It’s kind of a mundane thing, a method of total body feeding by vein,’’ Guedes said. “But years ago, we had patients who had severe abdominal surgery or trauma who would wither away and die because we had no method of feeding them.”

Guedes recalled one child in particular, as he often does when he ponders a specific area of technology or a certain disease.

“Now we do that every day — that’s certainly been a huge change,’’ he said.
But often, with those successes come unrealistic expectations on the part of parents.

“Years and years ago people were overwhelmed that you could save them,’’ Guedes said. “But today bad things still do happen and parents don’t always understand that. They just expect that there is a cure. Despite all the technology, we still have bad outcomes. There are some things you can’t stop or turn around. There are still times when we are helpless.”

In 1990, Guedes at Florida Hospital developed the 24-hour pediatric emergency transport team that can be anywhere in the southeastern United States and Caribbean within a matter of hours to deliver ill children to the facilities at Florida Hospital.

Guedes said that when he first arrived at Florida Hospital there were about 150 ICU admissions. “The second year, there were 300 to 400 and then that number kept climbing,’’ he said. “It was obvious we needed a method of transporting these kids in a safer manner.”

Guedes, who has six children of his own, also presently is active at Children’s Medical Services as the assistant director of district 7a and medical director of CMAT, cleft pallet, and primary care programs there.

His has a busy outpatient and inpatient private practice. On the outpatient side, he actively manages a large population of medically fragile and technologically dependant children. In the inpatient setting, Guedes is available for consults and hospitalist work on a 24-hour basis.

One of Guedes’ most memorable patients was a boy who was admitted to the hospital a couple years ago with a bleeding ulcer in his in intestine.

“He bled and bled and bled,’’ Guedes recalled. “It was a huge team effort on the ICU side. We worked with him the entire week and we gave him 87 transfusions — my record for transfusions. I’ve never given anyone that amount of blood.”

The family was told he would have about a 5 percent chance to live.

“He not only survived, he’s going to school,’’ Guedes said. “I just saw this boy last week, which is why he’s on mind.”



June 2008

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