More than 50 years after he first started studying it, Marvin Rozear, MD, still sees the brain with fascination and wonder. For this week’s “Spotlight” interview, the long-time member of the Duke Neurology Department, Vietnam veteran, and enthusiast of blues, scrabble, and sailing talks to us about how neurology has changed for the better and worse since his days as a resident. He also talks about the health needs of the veteran population he currently treats at the Durham VAMC, and offers advice for current neurology trainees.
What are your current responsibilities within the Department and at the Durham VAMC? What does a typical day for you look like?
Supervising and teaching (and learning from) residents, medical students, interns, fellows, nurses, patients and administrators. Since the COVID-19 pandemic, I spend hours on the phone in a closet at the Durham VA, and rarely come out. Sometimes it can get very boring, giving the sensation of coma, but without the worry and hassle.
What kinds of conditions do you most commonly see at the VAMC? How do the neurological needs of veterans as a group compare to the general population?
- Headaches.
- Headaches
You can probably guess number three. These are followed by dementia and all the other consequences of living too long or too hard.
Our vets tend to have more Y chromosomes, are more old, more poor and more needy. Tragically, we can’t change their genes or make them younger. Once I considered giving them all my money. My wife wasn’t amused.
How did you decide to study neurology as a field?
I love the brain, beginning when I discovered my own. I love to work with my head. The brain is the most important organ. Brains are the last frontier of Biology. It seems we know most of what there is to know about the liver and the heart, but relatively nothing about the brain. For instance, some people know where the inferior olive is but most think it’s what you get in a cheap martini. So many challenges. So many opportunities.
What do you enjoy most about your work?
Hanging out with the residents, God bless ‘em. They help me get through each day. Sometimes they even laugh at my jokes.
What in your opinion is the biggest improvement to neurology since you became a resident?
The biggest improvements I’ve seen have been CT (circa. 1975), MRI (circa 1985). Solutions to the problems of ignorance, bad manners and terrible parking (Date TBA)
How has clinical practice changed since then?
In 1967, to see my patient’s X-rays (hard copy, that is), I had to stand before a little window in Radiology, and beg a humorless clerk to bring me the envelope with the patient’s films. Often they were already checked out or lost, or the clerk wasn’t in retrieving mode. It took about an hour to figure that out. So I cooled my heels in the hall with no cellphone to surf or call my girlfriend. Now, in the clinic with a patient, a few clicks, and I view the images, form a differential diagnosis, and make a plan in about the time that you can hold your breath. Discussing all that with the patient and resident and ordering pizza still takes a little longer.
One downside is that the physical and neurologic exams will wither and die, becoming curious artifacts. Future trainees encountering the name “Babinski” will ask “Is that a new computer game?” Very sad. Breaks my heart.
If you could give advice to today’s neurology residents, what would you say?
- Dance with the person who brought you
- Marry up
- When forced to make certain delicate, tough decisions, don’t forget who you sleep with.
What passions or hobbies do you have outside of work?
My passions include*
- My family
- Games: scrabble, poker, bridge, and billiards
- Sailboats and anything else I can do in or on salt water (fresh water will do in a pinch, especially if it tastes like Yuengling)
- Playing guitar with the kids.
- Loving Duke basketball. Hating UNC
- Quantum mechanics
- Small weapons that go bang
- Miss Piggy
- Travel: some Saturdays we drive out to Hurdle Mills…that place really rocks and you don’t need a passport.
*Not necessarily in that order.
Rozear's Miss Piggy themed mailbox wears a (pre-COVID-19) back-to-school outfit.