Introducing Dr. Nir Hoftman, Division Director of Thoracic Anesthesiology
January 31, 2023
Where did you grow up? Where did you go for college, medical school, and residency?
I was born in Tel Aviv, Israel, 50 years ago, but my dad was a professional soccer player and moved us to Los Angeles when I was 3 months old. We lived in L.A. for five years, most of that time in UCLA married student housing. I briefly moved back to Israel for kindergarten and first grade, and then back to L.A. after my dad’s pro career ended. I went to a Jewish elementary school, then Sepulveda Jr. High, Granada Hills High School, Calabasas High School, UCLA for undergrad, UCSF for medical school, Mount Sinai NY for internship, and back to UCLA for residency.
Funny story, I initially applied for internal medicine until my then junior faculty mentor, now UCSF Chairman Mike Gropper, talked me out of it. It was too late to apply for the match to Anesthesiology, so I met Ronald Miller (then Chairman at UCSF, also Editor of the Miller textbook) in person and worked out a deal for a residency spot, sealed with a handshake. I ultimately changed my mind for personal reasons and came to UCLA for residency instead.
What do you like to do for fun outside of work?
I always wanted to be a movie director since I was 10 years old; I just didn’t have the guts to do it because the probability of failure was too high, so I chose medicine instead. But I never stopped dreaming.
When I was 10 years old, I filmed my first movie, Jaws, in my pool using super 8mm film, then several Indiana Jones flicks on Betamax. In 2002 as Chief Resident, I made a South Park movie spoof as part of the graduation entertainment. A few years later, I did the now infamous Napoleon Dynamite Spoof, and over the years there have been several others.
I have never given up on being a movie director; I have written a book (yet unpublished), which I hope to one day turn into a “Netflix”-type single-season show. It chronicles my life as a medical student, describing the unfathomable experiences I endured during the 1990s in San Francisco.
These days for fun, I watch movies and travel with my family. Recently, we went on an Alaskan adventure that ended with a salmon fishing trek on the mouth of the Kenai River. My kids love fishing, so we had to do it, and now that I have been slowly eating 25 pounds of fresh caught Alaskan Sockeye Salmon, I have to say the hobby is growing on me, too.
What has been your favorite vacation destination so far?
Hawaii by a long shot. I have very fond memories of Hawaii from my childhood. Over the last eight years, we have been to Hawaii six times. That place is just heaven on earth. The minute I hear the Hawaiian music my blood pressure drops 20 points. One day I will go there and likely never return.
Anything planned for your next vacation?
This year is going to be insane. In the spring, we are going on a short trip to Seattle (I have never been). In the summer, we will travel to Jerusalem for my son’s Bar Mitzvah, then Greece and Ireland to continue the celebration. Then in the winter, we will be off to Bali and then Taiwan to visit my in-laws. I’ll have to rob a bank between now and then.
Do you have any special talents?
Aside from the movies, I spent most of my younger years as a student of Seido Karate. That was my passion and really shaped my teenage years and young adulthood. This was during the karate craze of the 1980s, when literally everyone and their mother was doing karate. Most had quit by the time Karate Kid 3 hit the theaters, but I stuck it out for the long haul, all the way to the very early 2000s. The training was intense, and I have fond memories of competing in large tournaments in New York. Just thinking about doing these techniques puts my body into a muscle spasm these days.
What is your favorite book, movie, song, or TV show, and why?
Gosh, I have so many favorite movies that I don’t even know where to begin. But If I had to choose one that is especially relevant today, it is American History X. I suggest that everyone see this movie. First of all, Edward Norton should have received an Oscar for his performance. Second, there is a scene in which Norton’s character is visited by a former high school teacher while he is in jail. It is such an emotional scene—one of the most powerful in modern film drama. Its lessons ring true today more than ever.
Tell us a little about your family (and any pets).
My wife Alice is a pediatric rheumatologist. We met in the PICU when she was an intern, and I was a CA-2. We both work at UCLA, along with my brother the psychiatrist, so be careful when you page “Hoftman.” I have two boys, Jacob (13) and Ben (10). Both are amazing athletes, so much so that I often wonder if I am their real father. I have a CavaPoo dog named Ginger (2), a talking parrot named Rocky (12), and a reef aquarium.
What aspects of anesthesiology do you enjoy the most?
Teaching the residents and working on inventing new products/ideas are most important and fun for me. At the end of the day, our time here is short, and our impact will live on only if we leave this place better than when we found it. The future must be better than the present, and our residents are the future.
Beyond the education mission, I have spent the last 10 years developing a new double-lumen tube, but it is still not available for mass market due to a host of financial hurdles. While I am still fighting the good fight, I must prepare for the possibility that this endeavor will end in failure.
Why do you like to use the SedLine® for almost all of your cases?
This is my 20th year as an attending, and for the first 10, I would quip at those who suggested that EEG was important for day-to-day anesthesia care. Today, when I walk into a room with a general anesthetic, and there is no EEG, I literally feel like someone has poked my eyes out.
At the end of the day, the primary objective of an anesthesiologist is to render a patient unconscious during surgery. All the other tasks—stable blood pressure, mechanical ventilation, temperature management, etc.—these are all secondary objectives that we have to meet as a result of rendering someone unconscious. Other physicians can manage hemodynamics, do procedures, intubate, but only we are the masters of the unconscious. So how odd is it that we have a half dozen or more monitors tracking all parameters of the secondary objectives, and not a single monitor tracking the primary objective?
Anything else you'd like us to know about you?
During my entire stint of medical school, I felt I had made a terrible mistake. I had picked a profession that I was no good at. Read my book, and you’ll see why I was so downtrodden. I nearly quit, and all throughout residency, I had very low confidence in my abilities. In fact, to this day, I am the only resident who voluntarily gave up two weeks of vacation so that I could practice intubation a little more—that is how low my confidence was.
But over the years, I figured that if I was going to do this job, I had better give myself a chance. So for those residents who feel some days are a struggle, know that if I can make it, so can you! If it’s not too late, now that I am finally comfortable with airway management, I would like to get back those two lost weeks of vacation.