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Fellow Spotlight: Muhammad Zafar, MBBS

Thursday, March 23, 2017

As a child growing up in Pakistan, Muhammad Zafar, MBBS, witnessed the devastating effects produced by neurological diseases firsthand, both from an aunt with epilepsy and a friend with polio. These experiences inspired Zafar to pursue a career in neurology to help others with similar conditions. Now a clinical neurophysiology fellow at Duke, Zafar talks to us this week about these experiences, the pulls he feels toward academic medicine and private practice, and on woodworking and wood carving with family when he’s not at work.

Where did get your medical degree? Where did you complete your residency?

I graduated from King Edward Medical College in Pakistan. I did my pediatric residency from Maimonides Infant’s and Children's Hospital in Brooklyn, New York. Later I went to Lexington, Kentucky to do my child neurology fellowship at University of Kentucky.

What are your responsibilities within the Neurology Department?  What does a typical day for you look like?
My responsibilities as a clinical neurophysiology fellow include reviewing adult and pediatric patients that are undergoing continuous electroencephalogram (EEG) monitoring. I also read EEGs and evoked potentials done electively in outpatient and inpatient settings.

My training also involves working with surgical groups for intraoperative or extra-operative neurophysiological monitoring for refractory epilepsy or any other orthopedics and neurosurgical procedures.

A typical day will start with reviewing all the studies from last 24 hours before rounding with an attending. We often join the neurology team for their bedside rounds. The afternoon consists of either seeing the patient in epilepsy clinic or reading the elective studies done for that day. Based on our career interest and goals we spend our free time in the hospital working on our research projects or hanging around operating rooms.

Zafar and his wife Julie enjoy a day out.

When did you first become interested in neurology?
Through a close family member's event I witnessed the devastating and long-lasting effects that neurological diseases can have on children and adults. I was drawn very early in life toward scientific, philosophical and eccentric aspect of this field.

My close friend in school was affected with poliomyelitis very early in life. It was heartbreaking to see a cognitively normal, inquisitive, and bright child falling behind in school because he could not participate in physical activity with other children. It is such an "unfortunate and unkindest cut of all."

My maternal aunt also suffered from epilepsy since she was four. I witnessed the adverse effect of epilepsy on socioeconomic, education and quality of life of a person. Because of complex nature and our limited knowledge of brain and nervous system it’s no surprise that patient like her are still  taken to psychiatry or even spiritual/religious healer.

How did you decide to specialize in clinical neurophysiology? What do you enjoy most about the fields?

As a child, I used to accompany my aunt to her neurologist’s visit. At that time, I was amazed how a doctor decides to treat a person by reading black squiggly lines of EEG on paper. After bringing the test results home I used to gaze at them in an attempt to make sense out of them.  Of course I could not, but the synchronous repetitious tracing often resemble musical notes to me.

Later during my residency I noticed the science had advanced the electrophysiology field with cutting edge methods to acquire, synthesize, and quantify brain electrical signals. However, interpreting this data still remains an art which is being transferred through academic genealogy and learned only by reading EEGs behind the shoulders of epileptologist. My craving to gain the skill to read minds through electric wires on skull was revived and I decided to not just learn but dedicate my career to this amazingly artful science.

What’s been the most valuable part of the fellowship program so far? Can you describe a memory or experience that stands out in particular?
The most valuable part of fellowship is the mentors and colleagues that constantly inspire you. The intellectual stimulation while working with highly qualified teachers and world renowned leaders in the field motivates us to follow their footsteps and continue the great work that they have started.

Zafar, Julie, and their two children Amelia and Ali enjoy a hiking trip.

What plans do you have for after you complete your fellowship?  If you could have any job in the world, what would it be?
I share the same dilemma faced by many physicians at the start of their professional career: to stay in an academic setting or join a private practice. Both settings seem to have advantages, but I am planning to stay in academics.

Although private practices along with generous reimbursements provide the satisfaction by making immediate changes in a patient’s life, still frustrations are inevitable when encountering intractable diseases.

Academic settings promise state-of-the-art, innovative treatment modalities in the form of clinical drug trials, newer methods of invasive and noninvasive monitoring, or cutting-edge surgical techniques. Academic centers not only provide a rich environment to learn but also a place to treat fellow human beings with excellence who trust us to take care of them.

What passions or hobbies do you have outside of the Department?
My two young children keep my wife and I active and on our toes. We take them hiking, camping, swimming, or any other outdoor activities available to keep them busy and promise their full night’s sleep.

I enjoy woodworking and wood carving in my free time and enjoy seeing raw wood transformed to a useful daily accessory or an artistic gift.

Zafar has some help while working on a table, with the final product appearing below.