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Resident Spotlight: Danielle Howard, MD

Sunday, December 23, 2018

Second-year (or PGY-2) resident Danielle Howard, MD, had been interested in neurology for years, but didn’t decide on the field until a month before starting her residency. Her time as a resident since then, however, has allowed her to combine her interests in the brain and consciousness while also still being a “whole body doctor.” In our final “spotlight” interview of 2018, Howard talks to us about how these two interests come together in her work, discusses her desire to reduce ageism in medicine, and shares a story about her first successful lumbar puncture which she performed with the encouragement of our Jodi Dodds, MD.

What are your current responsibilities as a PGY-2 resident? What does a typical day for you look like?
My responsibilities as a PGY-2 vary depending on what rotation I am on. On the stroke team, I act as team leader while the attending isn't around; on inpatient consults I am the consultant, responsible for going to stroke codes and answering the questions of our inpatient providers; and on general neurology I revert to my intern responsibilities, writing notes and moving the patient's care forward. The roles vary some more in the Neuro ICU or outpatient services. However, there is a uniting theme of my PGY-2 year--that I end each day knowing more neurology than when I started it.

How and when did you first get interested in neurology?
Unlike a lot of the neurologists I have met, I decided on neurology as a specialty rather late. I had actually completed my residency application for Internal Medicine and had only about a month left when I realized my true preference. Neurology had always been an underlying theme--my mother had me reading Oliver Sachs as part of my homeschool curriculum, I did neuroscience research in undergrad, neurology was my favorite module in medical school--but I had always dreamed of being a "whole-body doctor,” with a good understanding of every organ system. It wasn't until I completed my chosen internal medicine electives at the end of my third year of medical school that I realized that neurologists often have a better understanding of the patient as a whole than other doctors do.

Your interests include working with elderly patients and in preventive public health. How do you see these two areas being relevant to neurology?
Although the number has varied from year to year, in general >40% of inpatients and about a third to a half of healthcare dollars are spent on patients in the "geriatric" age range (generally considered > 65 years old). With numbers like that, working with elderly patients is relevant to every specialty (not just neurology), and I feel the same could easily be said about preventative public health. My specific interest in older patients actually lies in my desire to fight against ageism. All too often I feel that we--as health providers, as a healthcare system, as a country--put less thought, less effort, and less humanism into caring for our elderly patients. No matter what specialty I went into, I had planned to do my part against ageism. As long as I didn't go into pediatrics, I was guaranteed to have patients in this age range!

You recently completed your first year of residency as an internal medicine resident. What’s one experience or memory from that time that stands out?
I think one memory from my intern year that I still think about quite often is my first successful lumbar puncture (LP). It was March and I had failed about 3 previous LPs, when our stroke attending, Dr. Jodi Dodds, told me I was to perform a spinal tap on one of our patients. I was apprehensive but Dr. Dodds would have none of my hesitation. After a short pep talk she helped me set up the patient and then stepped back. I did the entire procedure by myself and actually got spinal fluid return on the first shot. I think the reason this memory stands out so much for me is that the patient, a very sweet 82 year old lady, was so thrilled by my performance that she asked that I be the one to do the LP she would need a month later. This experience earned me the gold star on my badge, so I think about it quite often.

What other passions or hobbies do you have outside of the Department?

I'm an avid reader and singer. I used to do one of those things publicly but lately they both take place in my room while I'm by myself. I'm hoping to join a musical group at some point soon!

Howard enjoys a train concert in her rare time off.