Catching Up with Ake Grenvik, MD

Ake Grenvik, MD, DJ, MCCM, left his native Sweden for Pittsburgh when intensive care medicine was in its infancy. It was a moment in time when three forward thinkers—Peter Safar, William Shoemaker and Max Harry Weil—had a vision for a new subspeciality that would change the way the world cared for its most critically ill patients.

“I was fortunate to be one of the 28 founding members of the Society of Critical Care Medicine,” said Ake Grenvik in early February 2021. “The first meeting was in 1969, the same year I got a faculty position at the University of Pittsburgh.”

Ake—as he likes to be called because “That’s what everyone calls me”—was recruited to Pitt by Peter Safar. It was the springboard for a remarkable 41-year career in academic critical care medicine. And by his side was Inger, his wife of 62 years, who supported Ake and his career while raising their four children, running her own café business, and working behind the scenes for SCCM.

The 1970s—the formative years of critical care medicine—were a period of rapid development in care practices and technical advances in mechanical ventilation, ECMO and dialysis. The emphasis moved from caring for the terminally ill to treating critically ill patients so they could go on to lead productive lives.

“My philosophy of ‘early in and early out,’ particularly for tracheal intubation and vascular catheters, kept rates low for infection, occlusion and other complications,” explained Ake, who was appointed medical director of the Presbyterian University Hospital ICU in 1970.

Above all, he was leading the post-operative care for cardiac patients who had had open-heart surgery for procedures such as valve repair or replacement, cardiac septum defect repair, and coronary artery bypass grafting.

“In the 1980s when I thought I’d seen everything, Tom Starzl was recruited to Pittsburgh. I knew him from Sweden when he visited our hospital in Uppsala and lectured on kidney transplantation,” said Ake.

Starzl started the liver transplant program at Pitt, which expanded to include cardiac, lung and abdominal organ transplants. By necessity, Ake and his critical care colleagues became experts in post-transplantation critical care.

“We had no less than 572 liver transplantations in 1986, all cared for in four separate eight-bed liver transplant ICUs,” he said. “There were years when we had more liver and cardiac transplants than any other center in the world.”

His practical and pragmatic approach to patient care resulted in many lifesaving innovations. For example, the Condition C and the Rapid Response Team are taken for granted today. Yet, in the 1980s we only had a Condition A code for a cardiac arrest. No code existed to initiate proactive care in the crisis period leading up to an arrest. On Ake’s recommendation, the ICU committee approved (eventually) the addition of a Condition C. The result: decreased mortality of seriously ill patients and a decline in the number of Condition A cases.

During his career, Ake published more that 350 articles including scientific studies, descriptive articles on pathophysiology, ethical dilemmas, physician training, and the use of simulators in medical education. His work continues to be cited.

More than 2,000 critical care fellows owe much of their broad training to the multidisciplinary program championed by Peter Safar and expanded and refined by Ake. In 1972, he became the first director of the Multidisciplinary Critical Care Training program; a role he held for 20 years.

“Pittsburgh became a famous training program for critical care physicians. Originally, fellows mostly came from Anesthesiology then more and more Internal Medicine and Surgery residents came to our training program, and then Pediatric intensive care became more well-known and important. Ann Thompson put our Pediatric program on the map.”

Ake is a map guy, and still is not too old for a road trip. In mid 2020 with son Anders driving and Ake as navigator—with the requisite maps—the pair took a three-week road trip to see family and friends. Adventures and travels are seemingly part of the Grenvik genome.

With more than 700 invited lectures worldwide, these events were the perfect opportunity for adventures in far flung places. In South Africa he visited Christiaan Barnard and Brian Barrett-Boyes in New Zealand. He has walked the Great Wall of China, hot air ballooned in Stockholm, gone on safari in Kruger National Park, and jumped out of boats and planes to scuba dive and skydive. And, in a ‘why wouldn’t we moment,’ Ake and Peter Safar water skied up the Monongahela River from West Virginia to Pittsburgh with Eva Safar at the helm.

Ake Grenvik’s life has been lived to the full—and still is. He gets up with the birds, exercycles, walks during non-pandemic times, and usually swims every day in the backyard pool where he lives in Houston with his daughter Monica and her husband Mike McGinley.

If you would like to reach out to Ake, please email CCMcomm [at] upmc.edu.