Faculty Spotlight: E. Wayne Massey, MD
While E. Wayne Massey, MD, had an initial career path to become a preacher, his medical school projects and love for neuroscience aroused his interest in becoming a neurologist. He now utilizes his passion for teaching, in the classrooms of medical students and supervising neurologists in training. In this week’s “Faculty Spotlight” interview, Massey introduces us to his life outside of Duke, the risks of scuba diving, and the pros and scope of his work. As a neurologist with more than thirty years of work in his profession, Massey says that his greatest fear is not knowing enough. But in the words of his favorite neurologist Arthur Conan Doyle, “Education never ends. It is a series of lessons, with the greatest for the last.”
What are your current responsibilities within the neurology department?
Just to give you a little insight, I came here in 1979, I’ve been doing mostly patient care for all these years. September 30, 2014, was my last day seeing patients. On October 1, I could no longer see patients at Duke. So that had to be changed. I’ve always been involved with teaching. Most of the time, there are some lectures, but a lot of it is bedside, going and talking to patients, seeing findings. So, changing that, I’m back to mostly giving lectures. But it’s not kind of all I can do in that sense. Here, I lecture med students. Usually at the beginning of the four-week rotation of neurology, on the neurology exam, which is my favorite. Like I do with the residents at the beginning of the year. I enjoy that interchange of teaching and that kind of stuff.
The other thing is that I work at the VA on Monday morning with the residents doing neuromuscular disease. On Tuesday, I do brain trauma, which I’ve done even before 2014; helping the young men and women who come back from war with some kind of brain trauma. Either depression, headache, you know … you can imagine what they’re going through.
The residents see all of our patients first. Like this morning, I think we saw 8 or 10. The residents saw them, and then I helped supervise them, oversee them, and then we talk about how we can help them. For example, myasthenia gravis, we can cure that. We can treat it, not cure it. But we can really do well. There are some diseases like that in neurology. But TBI, traumatic brain injury, is not quite that way. It’s people adjusting to getting back with their life, getting with their kids, getting to work, and those kinds of things. So it’s more than just ‘I’m going to give them medicine.’ We work with psychiatry, and a lot of other fields to try and help these people get back to … hopefully, as good a life as they can get. Some do better than others.
Did you always want to get into neurology?
Ok, that’s a great question. No. In third grade, I apparently wrote a note that I wanted to be a doctor. I have no memory of that. As far as I know, I never thought of it again. When I went to college, my first year, I was going to be a preacher. That’s what I went to college to be. The problem was, I didn’t want to every Saturday night be working on a sermon I said, that’s going to get old. I’m just saying. So, and then I like science. So it’s science. Now neurology, I got interested in in med school. I did a few research history projects that had to do with neurology. And then, what got me I guess is one of which was Arthur Conan Doyle, Sherlock Holmes. But, I guess what got me is that I like neuro anatomy. I still like neuro anatomy. I just love it. And I taught it in my senior year and then I had good people to go around and teach me. The chair and other people were really good clinicians.
So it wasn’t anything personal that made you want to get into it? Like, my aunt died from having a stroke which got me interested.
So what does your typical day look like? You say that you see these patients that have headaches and you talk about it. Is that all, or..?
You mean like today, for example, that’s what we did this morning. This afternoon, I went and did a consult with a resident. Because I’m covering consults. This was in the CCU, so they wanted our opinion as to what was going on. Once in the ER, we just got called to go over to the ER. So that’s sort of them covering that. I do that in the afternoon. I did it all last night too. We got called last night. So, it’s not at anything as frequent as the old days. I mean, I’m not complaining. In that sense. In fact, I miss not being called believe it or not, and coming in on the weekends. I did it for 30 something years, or 40. So yes, it’s a change, but then like tomorrow, I mean, I can do what I want. I can go see my grand-daughter and play in the woods and stuff. So on Thursdays, I do consults all day long, somewhere. So I’m saying, but it’s still less than what it used to be. It’s a change.
So, did you graduate college from Duke or did you go somewhere else?
No, I went to Abilene Christ College in Texas. And then went to University of Texas for med school.
Is Texas where you’re from?
No. Los Angeles.
What made you go to Texas?
It’s interesting that you’ve had such a passion for preaching and then you said ‘no, I don’t want do it because I don’t want to work on weekends.’
Well I was exaggerating, but that is a part of the reason. You know, I just got interested in science. But I mean, I still preach some. But I don’t have to do it every Saturday night.
Do you preach at a church here?
Only when the minister is out of town and they need somebody. But I don’t volunteer to do that like I used to. I did do one wedding here at Duke Chapel for Angie, who use to work for me for 20 years here. When she remarried at 50, she asked me if I would give her away because her father passed away and do the service. And I said I can’t do both. So Mark Skeen gave her away and I marched in and did the service. That’s the only one that I’ve ever done and probably won’t do anymore.
What do you enjoy most about your work?
Patient care and teaching. I really like teaching students and residents. I enjoy the interaction with them. I had a great morning with one of the residents, so I enjoy that a lot. And I enjoy the patient care. Fortunately, I came at a time when you could afford to spend some time knowing the patient. In fact, I still as of today would see, would at least spend a couple of minutes asking ‘where you’re from?’ You know. “How many sisters do you got?” “Brothers?” You know. Knowing them I think is important. And we try to still… I think there are plenty who do that. But you know, time is …. Time is money. In the sense that they’re pushing to do more and more and do faster. Now, I’m not saying that I would do that for an old patient, but a new patient I spend an hour with. And I think most neurologists probably try to do that. But can’t always do it. But you know, there are complicated problems in addition to you know, kind of. I have always believed that if I relate to the people, they’re more likely to one, believe me, and two, follow my directions. Call me when they need it. That’s the way I’ve always worked.
Is there a specific illness that you see constantly being that you’ve been in the field for so long?
There are some diseases in neurology that’s pretty obvious. Parkinson’s disease or something. It’s far enough along. You can say ‘that person probably has-;’ you can do that all of the time. I’m sure maybe a cardiologist can do that about the heart too, I don’t know. I can’t speak for others. But in neurology, you’re watching them walk and I just saw a person in Washington, DC and if you watch him in the street, you can tell. I can remember the guy having a right hemiparesis with a brace, so I knew he had a stroke. You can’t see all of the details, but you can say he’s dealing with something.
So you’ve been in the business for more than 30-40 years?
I finished in 1970. That’s when I finished my medical degree. But I became a neurologist in 1974 and went in the Navy for 5 years.
Did you see patients in the Navy?
Oh yeah, all the time. Even sometimes on the ship. But I was in a hospital in DC most of the time.
So you’ve been involved with the Divers Alert Network for years? What is the scope of your work and how does your background as a neurologist overlap with diving?
When I went into the Navy in 74, there was a major hyperbaric chamber in Washington, DC at the naval hospital. And of course, we had the biggest one on the East Coast right here at Duke. It’s a huge chamber. And of course the chamber, they either do projects with the Navy. Like right now there are three projects with the Navy, but Atlantis 1, 2, and 3, the deepest size ever were done here at Duke back in the 80s and I was involved with that. But, treatment is the issue. When someone dives, scuba dives, they're down at 120 ft. Their nitrogen that they’re breathing is different and it gets out into the system. And if they come up too fast, that nitrogen blows up and gives them what we call the bends or decompression illness. It’s called that because it hurts so badly when they bend over. But the real thing is that their spinal cord is knocked out or their brain. This is called gas embolism. And this is called decompressionism. And we use to do most of them in the East coast and all through the Caribbean here at Duke.
We would fly them in and that’s where DAN comes in. DAN got into this by helping people get to a chamber. Because the sooner you decompress them, the more chance they have of surviving. If they come up from 100 ft. and have nothing, they’re very likely to die. So I deal with DAN a lot. I’m on their chairman right now. But the fact is I get called a lot to say can this person do this, and what do I think of this, and traumatic head injury, can they dive later? If you had a seizure at age 18, and now you’re 25 and you wanted to scuba dive, you’d probably ask somebody. And often they call me from Wyoming or something and they say ‘hey, what do I think of that?’ Now, I’m not saying that I always have the answers--that’s a whole different ball game. But, you know, there is probably some risks, you know?
Now, even if you had seizure disorder, and on treatment, there’s probably some risk. You have some risks going down. Or any activity in fact, diving out of an airplane would be the same thing, or parachuting. I’m not saying it’s unique to dive, that’s just what I deal with more than parachuting. Although we do see a lot of astronauts in the chamber too because that’s high pressure. So the chambers have been a part of my life here. The worst side effects are neurologic. Then there’s other kind of bends like skin, and all that kind of stuff. But the worst ones are when you can’t move. Scuba diving isn’t the most common sport, but for those who are doing it they have to kind of be aware of that. That’s why they kind of come up in steps. Nowadays, the computer will help you come up in steps. And the other thing of course that’s changed big, is down in the Caribbean there’s chambers on every island now, almost. A lot of chambers whereas in the old days, we were the chamber. Miami didn’t have one, now they do. We help people get to other chambers by the way. That’s what DAN is good at, I think, is helping people by phone get to where they need to go.
So have you ever gone Scuba Diving?
I snorkel a lot and I go to the Caribbean with DAN every year, but I don’t go down diving. I just… I’m too old to learn how to. I’m not that fun to swim with frankly. So no, I haven’t. But all of the other people on the board go, and I lay on the beach and tan. Last year, in August, we went down there with one of our board members who has ALS. He can barely move. But he has been a fan of diving for years. But he went diving. He lives in Minnesota. So, some of my colleagues actually took him down diving. Its great pictures.
Do you have a favorite era or figure from history that you especially identify with?
I would say that if I had a favorite era, it would be the civil war. And particularly Dr. William Hammond, who was the sergeant general that was elected in 1862 and was court-marshalled in 1864. And he was court-marshalled and went to NY and hung out the shingle and became the first neurologist in America. First person in America who only saw neurological cases. Most of them were neuropsychiatric. So that was NYC. And then that’s where Silas Weir Mitchell, is the guy that was very famous in Philadelphia.
So I’m just saying, they were the first presidents of the American Neurologic Association. So yes, I’m interested in them and have been for all of these years. And trying to write a book on William A. Hammond, although I don’t get very far. But I’ve been doing that for 10 years and I know a lot about it. But I’m also interested in very much in Sherlock Holmes and Arthur Conan Doyle, was a physician who after being on a ship for a few years, went back to be a doctor in South Sea, England and decided he was better at writing stories about detective. There’s a lot of connections with medicine. And again, I have a chapter on it if you ever want to read it. It tells all of the medicine that’s in Sherlock Holmes stories. He also wrote 20 other novels. So it isn’t just Sherlock Holmes, but that’s the one that we all know. He also particularly picks out neurology. Seizures, pseudo-seizures, all that kind of stuff. Now, I’ve given you those two areas. But I do have a few others that I at least ought to mention. One is on medical freaks. But it’s medical curiosity. Examples are the elephant man. Also, I am very interested in 19th-century neurology. That’s what I talk to the residents about because its food to have some history.
Do you remember your first case as a neurologist?
No. I can remember a few early on, but I can’t remember exactly which one.
Do you remember ever being scared to start working in your field?
I hate to think of scared. As a med student, you’re kind of going into it like ‘boy, can I ever learn this.’ It’s a lot to learn. But you often doubt yourself and compare yourself to the progression of other students. My scare now frankly, would be there’s a lot of stuff coming out… I don’t know. Immunology and genetics is only from the 1990s for neurology. I mean it’s big. And fortunately it’s good cause we can do some stuff. Immunology, you know MS, multiple sclerosis is immunology. We didn’t call it immunology in 1980 or 85. So that’s kind of the other end of the things that scares me a little bit in the sense of I don’t know enough. If I’m still seeing patients with those problems, I kind of limit myself, but… I go to Skeen’s lectures--he gives this course every Thursday night, I’ve been going. But, I still don’t know enough.
What else do you enjoy doing outside of Duke? Like, what are your hobbies?
Baseball. I played third base. I played baseball all the way through college and two years in A-ball in North Texas way. I wanted to try plan the newspaper article when I was 12, where I missed the ball too. But, I was very involved. I loved baseball. That was a big deal. Now, I would have to say that my favorite sport is basketball. We’re at Duke. I didn’t know much about Duke Basketball until 1979 when we moved here. You kind of get into it.
Can you play basketball?
Oh yea, I can play basketball. I did in high school, but I can’t now. I probably can’t, I don’t run to first base anymore. I’d say sports wise. I don’t have anything like golf, or tennis. Don Sanders and I play tennis regularly, twice a year. But I’m not sure we’re going to do that this year. I’m just saying, I don’t do anything that active. We walk most days. Go through the woods. I’d say those kind of things, and I am involved in the church very much so.
Do you still travel often?
We do like to travel. Often, it’s related to work. We just got back from India. My wife taught a course, and I carried her bag. Which is much better within the old days when we both had to give a talk. I’ve been to many diving meetings in Norway, in the old days. Years ago. Because Norway is on the North Sea, and they were sending people down to dive to try and fix the oil rigs that were getting injured. So, they wanted our opinion, and I was involved in those decisions and evaluations. Diving wise, I went to Hawaii about 8 times one year. Maybe over 2 years, seeing different divers at the Scripps institute in Honolulu. But I did that on the weekends. It got to be work. 17 years into marriage, my wife and I adopted 3 children and that was in 1984. So things changed in 84, like responsibilities. Then my wife wanted to work, I wanted to work, but yeah, we still like to travel.
What is your favorite baseball team?
Well, I worked for the Cleveland Indians. That’s about the only contact I’ve had with Cleveland. My favorite team would be Los Angeles Dodgers because when I was 12 years old they moved to Los Angeles from Brooklyn. And so, they were our team. I was a Dodger fan. I kind of keep up with them but I couldn’t tell you every player like I could back then.
I know you said that you were starting a book, you already have one chapter but can’t seem to get through all of it. Are you working on anything else outside of neurology?
Yes. Almost every year, we present history posters. Eric Prince did one in the last two years. I’ve been very interested for a long time in the death of Jesus. And I know a lot about the medical aspects of this too. I’ve written many things on it lectured on this lots of places because I know the medical facts of what happened. I’ve done it at Duke before at the Divinity school. So that’s something I’m interested in. This started when I was in med school.
Communications intern Imani Taylor asks Massey about his time within the Department.