One of the most appealing aspects of the practice of medicine to me is that it provides the opportunity to establish a unique kind of relationship with persons from diverse corners of society. During medical school and residency the most rewarding patient encounters to me were those with patients and their families at public or county facilities. During these experiences I met people who I would not have otherwise met, much less developed close if professional relationships with. These encounters always opened my eyes in some way.
I have always been interested in the area where psychology, psychiatry, and neuroscience come together. Therefore, after finishing my neurology residency in Texas in 1997, I applied to and was admitted to the fellowship program in behavioral neurology offered at UCLA under Drs. Jeffrey Cummings and Mario Mendez. During the two years of the fellowship, I learned a vast amount, being exposed to a diverse patient population with various neurobehavioral syndromes at UCLA in Westwood as well as at the West LA VAMC. The nature of the training at the VA was in the wider aspects of behavioral neurology and neuropsychiatry, seeing patients with behavioral changes due to focal stroke syndromes, head trauma, primary psychiatric illnesses, Parkinson's disease and other neurodegenerative illnesses. The focus of the training at UCLA, in contrast, was on dementia and on Alzheimer's disease in particular. In addition to Drs. Cummings and Mendez, I was also mentored by Drs. Donna Masterman and Michael Mega and others during this time. Through the extensive exposure to such patients in clinic, case conferences, and the formal lecture sessions, my training allowed me to function independently as a specialist in this area, skills I took to UC Irvine when completing the fellowship in 1999.
In addition to having my own behavioral neurology clinic at UC Irvine, I was involved in a number of activities including directing the general neurology resident clinics at the Medical Center in Orange. Though there is not a formal county health system in Orange County, this clinic was an important site where the un- and under-insured in the County received care for neurological disorders. Again, it was through this clinic that I had the most challenging and rewarding patient encounters. Over time at UC Irvine I worked more and more with Drs. Claudia Kawas, Arnold Starr and Carl Cotman in the CADC there. Attending presentations and working with staff at the (then) Institute for Brain Aging, my training in diagnosis and management of dementia syndromes was fine-tuned, facilitating my advancement at UCLA to Associate Clinical Professor of Neurology. Having undergone training at two CADCs and having collaborated with physicians at all the others, I truly consider myself a product of the system of California Alzheimer's Disease Centers.