Nearly 20 years after the attacks of September 11, 2001, Khalid El-Salem, MD still remembers the efforts Donald Sanders, MD, took to make him feel welcome and at home when he was a neuromuscular/EMG fellow at Duke during that time. Now back in his native Jordan, El-Salem is balancing his roles as a clinical neurologist with his leadership and administrative responsibilities as vice president for the country’s leading university. El-Salem talks about his time as an EMG/neuromuscular fellow, balancing his administrative and clinical responsibilities, and how patterns of neurological disease in Jordan compare to those in the United States. He also talks about reading classic literature in two languages and exploring historic sites around the world when he’s not at work.
What are your current responsibilities within the Jordan University of Science and Technology? What does a typical workday for you look like?
I am currently the vice president of Jordan University of Science and Technology (JUST), which is the leading university in Jordan. I am responsible for the colleges of Medicine, Dentistry, Pharmacy, Nursing, Applied Medical Sciences, and Graduate Studies. I am also responsible for the medical centers, the Pharmaceutical Research Center, and the Regional Center for Infectious Diseases and Antimicrobial Resistance. My leadership and administrative duties are tremendous.
At the same time, I am a practicing professor of neurology with some teaching duties, and a clinical neurologist at King Abdulla University Hospital, which the university teaching hospital connected to JUST, but with obviously minimized and hyper selected clinical duties (due to heavy administrative load), which are basically limited to certain neuromuscular consults upon special request from colleague neurologists, or difficult cases in the neurophysiology laboratory requiring single fiber EMG or quantitative EMG studies. My teaching duties include occasional lectures for students, and didactic activities with the neurology residents.
So my typical working day starts at 8:00 am in the presidency unit, with a closed meeting with the president to discuss important issues at the time, about twice weekly, and meeting with deans of colleges who report to me, usually once weekly. Occasionally I would “steal” some time to attend the neurology morning report. I try to attend to my clinic once weekly, but sometimes I fall short of that. I make sure that I have at least 3-4 hours dedicated to research, usually meeting with my research team, working on 4-5 projects at a time. I also make sure to secure at least 30-60 minutes of my time during the day to follow up on neurology literature, especially that related to neuromuscular issues. The rest of my day is pretty much filled with administrative duties.
How and when did you first get interested in neurology? What made you decide to focus in neuromuscular medicine?
My interest in neurology only started towards the end of my medical school days. I had been for a long time interested in the human mind and electrophysiology related to the human body. It was very challenging, and in a way satisfied my coexisting interest in physics and electricity, so I thought neurology was a connecting and common area between all of these specialties. It is for the same reason that I actually fell in love with neurophysiology and neuromuscular medicine.
How has your neuromuscular medicine fellowship been most helpful to your career or current work?
As a matter of the fact, the best I got from my neuromuscular fellowship at Duke was not the science itself, although that was outstanding. It was rather the chance to work with great people who had a tremendous impact on my personality and overall maturity as a person, a clinician, and a future researcher. The very first thing I learned in the neuromuscular lab at Duke is discipline, organization, and logical way of thinking and approach to problems. While I considered myself to have possessed these qualities before, my work and training at Duke took it to another level. Therefore, at the same time that I was trained as a competent neurophysiologist and neuromuscular neurologist, my leadership and administrative skills significantly improved and came in very handy as I assumed my duties in administration at JUST. I also used the EMG lab at Duke as a model to establish a similar though smaller EMG lab at JUST. It is because of this that our lab at JUST is probably the best in the country.
What’s one memory or experience from the fellowship that stands out the most to you?
I was a fellow at Duke EMG lab in 2001 during the tragic events of 9/11. Those were very hard days for all of us grieving all the innocent lives that we lost, but especially hard for me and my wife being Muslims from the Middle East. Dr. Sanders and everyone in the lab made us feel home. I still remember very well the gathering that he made in his house for all of us, in which it was so obvious to me and my wife that he made everything in his capacity to make us feel home and that we belong, the things we needed most at that time. He also offered to drive us anywhere in case we needed or in situations when we felt our safety might have been compromised.
When I traveled to New York later that year for my Boards, he was the back up for my wife and little daughter (him and the beloved Masseys) during my absence and was on stand by and on call for anything they needed including day-to-day things. It is this side of DBS, I guess, that a lot of people are not aware of. I am always proud that Don is my teacher. His greatness as a scientist, a clinician, and a teacher, is only surpassed by his greatness as a human being.
Some funnier moments were when we used to enjoy doughnuts brought by whoever forgot to clean after finishing a procedure, such as failure to remove all used pieces of tape from the EMG room.
How do the neurological needs of the people of Jordan compare to those of the United States? What are the biggest differences, neurologically speaking, between these two populations?
Certain infections and some hereditary neurological disorders seem to be more common in Jordan, the latter being secondary to more likelihood of consanguinity. Some other diseases, however, seem to be more prevalent in the United States, such as multiple sclerosis and ALS. Myasthenia Gravis also seems to be less prevalent in Jordan, although no specific statistics are available; it’s just a feeling. The more common neurological disorders such as stroke, epilepsy and Parkinson’s disease seem to have the same prevalence or only mildly differ one way or another. One other thing is that we rarely see neurological complications related to alcoholism in Jordan.
What’s the biggest change you’ve seen in the field of neuromuscular medicine since you completed your medical training? What’s changes do you see coming over the next decade?
Its without doubt the new treatment modalities for neuromuscular disorders, such as spinal muscular atrophy, for which we have what we believe is the first step towards a curative treatment. The promising treatment for muscular dystrophies such as Duchene is also a major change. I believe genetic intervention and personalized treatment with the help of nanotechnology is going to be soon the breakthrough.
What other passions or hobbies do you have outside of work?
I like to travel and see historical places and museums. I am very interested in reading old history of the humankind. I also like to read Arabic and English literature. When I am in the countryside in Jordan, I like to walk long distances and enjoy nature.