Assistant Professor, Department of Neurology Co-Director, Traumatic Brain Injury Unit
Education and Training
· 1970, Bachelor of Arts, Cum Laude, University of Maryland, College Park, Maryland
- · 1976,Doctor of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Post Graduate Education and Training
- · July 1, 1976-June 30, 1977,Internship- Straight Internal Medicine, Sinai Hospital, Baltimore Maryland
- · July 1, 1977-June 30, 1978,Resident in Psychiatry, the Sheppard and Enoch Pratt Hospital, Towson, Maryland.
- · July 1, 1978-June 30, 1981,Resident in Neurology, Georgetown University Medical Center, Washington, DC- Mentor: Desmond O’Doherty, M.D.
- · July 1, 1981-June 30 1982,Clinical Fellowship in EMG and Neuromuscular Diseases, University of Maryland School of Medicine, Baltimore Maryland- Mentor: Richard Mayer, M.D.
In my career of 25 years with Kaiser Permanente, I had both clinical and administrative responsibilities. As the first Kaiser chief of neurology in the Washington area, I was involved in establishing Kaiser’s department of neurology in the Washington region. My administrative responsibilities included the selection and management of a staff of six board certified neurologists and a board certified physiatrist who practiced at the various Kaiser centers, throughout the Capitol Area region of Maryland, DC, and Virginia. For the purpose of organizing patient care on both a local and regional basis, I was involved in both weekly and monthly meetings with staff and physicians. The scope of my Kaiser practice included outpatient and hospital diagnosis and management of neurological illnesses. Because of my interest in the psychiatric manifestations of neurological illness, I tended to see a greater percentage of patients who required long term neurological management. These included patients with TBI, Parkinson’s disease, MS, CIDP, chronic spine pain and chronic headache. My practice also included a wide variety of common and uncommon neurological conditions including neuropathies, movement disorders, dementia, epilepsy, spine disease, headache, facial pain, cerebrovascular disease. Patient acuity ranged from severely ill ICU patients to worried headache patients. I am the recipient of the 2007 Kaiser award for exceptional performance. This is an award given by Kaiser to only a very select few of its most respected physicians.
I joined the University Of Maryland School Of Medicine faculty as an Assistant Professor in the Department of Neurology in December 2009, and became the second neurology attending on the Brain Injury Unit at the University of Maryland Rehabilitation and Orthopaedic Institute. In October 2013, I was appointed co-director of the Brain Injury Unit. My clinical responsibilities include managing patients on a busy inpatient brain injury rehabilitation unit as well as staffing an active EMG and Neurology outpatient clinic. In my role as co director of the BUI, I assist with the administrative management of the BIU. In my role as an attending I provide neurological and rehabilitative care to patients with brain injury, stroke, and other neurologic conditions. I regularly read EEGs and perform EMG studies. Recently, due to staffing issues I have also providing attending services on the Stroke Unit. I also teach medical students, residents, and fellows. I am a member of the medical executive committee and the ethics committee at the University of Maryland Rehabilitation and Orthopaedic Institute
· 2000-2004, I served as a preceptor in the outpatient neurology clinic at Kaiser Kensington center. Teaching junior and senior medical students of the Uniformed Services Medical School who were mentored for a 4 week clinical clerkship in outpatient neurology. 1 student 4 hours/day for 4 weeks, 3 months/year.
- · 2000, 2001, Mock board examiner: Assisted in conducting mock neurology oral board examination for Uniformed Services neurology residents at Walter Reed and the Bethesda Naval Hospitals.
- · February 2010, I have assisted my colleagues in the teaching of a PM&R resident from Johns Hopkins Medical School, assigned to the teaching service on the traumatic brain injury unit at Kernan Hospital.
- · July 2010- Present, I have assisted with the teaching of University of Maryland Medical Students, Residents and fellows rotating through the UMROI Brain Injury Unit.
- · In 2014 and again in 2015, I lectured University of Maryland Pain Management Fellows on the interpretation and clinical use of EMG/ NCV studies.
Traumatic Brain Injury, Electromyography
On the TBI unit, we have a mixed population of patients on the 24 bed TBI unit at UMROI. In the summer and peak periods of activity the unit expands to 30 patients, sometimes a few more. Most of the young people who are less than 30 years old have blunt force trauma due to MVA. Older people tend to have fall injuries. We have a small but significant number of gunshot wounds. (Most people shot in the head die). We also have patients with anoxic encephalopathy, encephalitis, hemorrhagic stroke, and primary brain tumors. Injuries to our patients span the scope of neuro trauma, including focal cerebral contusions, frequently associated with diffuse axonal injury, basal ganglia hemorrhages, and multiple trauma with orthopedic fractures. Some of our patients initially are only minimally conscious. We have occasional patients with TSLO braces and halo braces. A significant percentage of our patients are initially non weight bearing in one or more extremities. Many of our patients had premorbid psychiatric issues including polysubstance abuse, including alcohol and opioids. The families of many of these patients have significant issues. These patients require a multispecialty team including neurology, rehab nursing, speech pathology, occupational therapy, and physical therapy as well as psychiatry, neuropsychology and case management in order to develop an individualized treatment program to help the patient and family cope with what is a catastrophic life changing event. As one of two attending physicians on the brain injury unit, my job is to treat all my patient’s neurological and medical complications which interfere with his/her ability to fully participate in his/her rehabilitation program to the best of his/her ability. In order to accomplish this goal, I use the full range of neuroleptic medication, including modern antipsychotic medication, mood stabilzers such as valproic acid, as well as SSRIs and Lithium. My role as attending also requires coordinating treatment on a daily basis including all wounds and orthopedic problems, and most importantly, treatment of the above mentioned behavioral issues that range from agitation, psychosis, disinhibition, restlessness, delirium, and aggression. I not infrequently have to deal with aggressive or inappropriate behavior on the part of patients with frontal lobe injuries. In addition, I am available and frequently assist with the emotional support of families who are trying to cope with changes in personality and behavior, manifested by their loved one. We have team meetings virtually on a daily basis and have frequent individualized family meetings several times per week. As the attending physician responsible for the care of these patients, I and my team create an individualized supportive treatment environment in order to help each patient improve as quickly as possible. We also help the patient and family cope with the reality that he/she may never be the person that the family knew before the injury.
- · 2007, Kaiser Permanente Exceptional Contribution Award for exceptional performance and contributions To Mid-Atlantic Permanente Medical Group and the Community- Given 10/05/2007
- · 2014, Physician of the Year Award - as selected by my peers at the University of Maryland Rehabilitation and Orthopedic Institute.