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Fellow Spotlight: Derrick Fox, MD

Wednesday, August 8, 2018

For Derrick Fox, MD, an interest in neurology, picked up during medical school, was cemented when he took on a postdoctoral fellowship at the NIH, where he focused on Kennedy’s disease. Now, as one of our neuromuscular fellows, Fox is seeing a variety of patients in our neuromuscular, MDA, and ALS clinics. In this week’s Spotlight interview, Fox talks to us about his time at Duke so far, his research on how exercise affected patients with Kennedy’s disease, and his plans for after he completes his fellowship next year.

What are your current responsibilities as a neuromuscular fellow? What does a typical day for you look like?
I focus on neuromuscular diseases that typically cause weakness or numbness that can significantly limit a patient’s ability to function in their daily life. A lot of time is dedicated to spending in the EMG lab where we conduct electrodiagnostic studies to make an assessment of weakness or numbness as well as localize the lesion. There is dedicated time for seeing patients in the Neuromuscular clinic, MDA clinic and ALS clinic. We typically see both rare genetic and acquired disorders as well as more common peripheral neuropathies. At various times will see inpatient consults and we have didactic conferences throughout the week. It is really exciting and I have enjoyed the experience in such a short time.

How and when did you first get interested in neurology? How did you decide to focus on neuromuscular disease in particular?
The first time I seriously became interested in neurology was on my third year clinical Neurology rotation in medical school. After medical school I had an opportunity as a postdoctoral fellow at the National Institute of Neurological Disorders and Stroke at the NIH in Bethesda, Maryland. During this time, I was involved in clinical trials for patients with Kennedy’s Disease and this really sparked my interest towards neuromuscular medicine.

What did your work with the NIH involve?
I was one several researchers in the Neurogenetics branch of the NIH/NINDS and helped to design clinical trials with my Principal Investigator and Clinical Fellow. I analyzed and interpreted data for outcome measures and eventually contributed towards publications. In particular, I saw patients with Kennedy’s Disease (spinal and bulbar muscular atrophy), which is an X-linked, trinucleotide repeat, lower motor neuron disease caused by a mutation in the androgen receptor causing androgen insensitivity and toxic gain of function that affects the muscle and nerve. It affects males typically in their 4th or 5th decade with progressive weakness, atrophy, fasciculations, dysarthria, dry coughing and gynecomastia. We tracked their progress with an exercise trial and other studies. We monitored their laboratory values, hormone levels, utilized the Adult Myopathy Assessment Tool, Beck Depression Inventory-II, hepatic MRS, hepatic ultrasound, thigh MRI and liver biopsy in some patients. The study helped determine the impact of exercise on SBMA patients and also characterize non-neurologic manifestations such as non-alcoholic fatty liver disease. I really like the collaborative approach with the physicians and scientists working towards advancement of research.

What do you plan on doing after you complete your fellowship? If you could have any job in the world what would it be?
Working in an environment that allows me to provide quality care to patients and hopefully be involved in an academic setting would be most ideal. I enjoy teaching and believe this brings a lot of fulfillment. My mother was a teacher so I probably get this trait from her. A dream job would allow me to positively impact many people and inspire others to pursue their dreams. I’m still open to what this type of job may be down the line.

What other passions or hobbies do you have outside of the Department?
I like to spend time with my family and travel when we have the opportunity. Recently, my wife and I had a little girl, who is now 4 months old. She was born premature in early 3rd trimester and stayed in the NICU for almost 2 months. However, she did well and has been home with us for last few months. It is amazing to see how fast she is growing so we cherish these moments while they are here. I like to exercise, especially running, weight lifting and max interval training. I listen to a lot of podcasts, and like to read non-fiction books. Also, I’m a huge basketball fan and plan on going to a Duke game this season.

Fox, his wife, and their new daughter explore a park in Raleigh.