Dr James Siegler is the submitting author for the paper ‘CT perfusion in stroke mimics’ to the International Journal of Stroke which has been published online and allocated to the April edition of the journal for 2020.
We asked Dr Siegler to tell us a little bit about himself in our Seven Minutes in Stroke professional series.
1. What inspired you towards neuroscience?
In high school, I was drawn to biology. At the time, my whole family began to seriously address the dementia symptoms of my great grandmother (who lived to be 106!), and I had wondered why this was. How could such a presumably healthy and active woman spend the remaining few years of her life in a memory fog? In college, my interest in neuroscience solidified as my questions were answered--and yet, even more questions emerged. So began my lifelong quest to understand the brain and the mind.
2. Why stroke?
In medical school, the most accomplished and supportive neurology mentor I could find was a stroke specialist. Dr. Sheryl Martin-Schild who was a recent addition to the Tulane faculty and soon after her appointment as the Stroke Director she led the team to swift approval as a Comprehensive Stroke Center. I initially found stroke interesting on a research level (only later came to enjoy it clinically). At the time, we were exploring the effects of combination antiplatelet therapy for secondary stroke prevention, extending the window for intravenous thrombolysis, and investigating unique tools for endovascular thrombectomy. It would be an understatement to say that stroke was witnessing a revolution in diagnosis and treatment.
3. What have been the highs so far?
Since my initial foray into stroke, as everyone knows, we are closing PFOs, expanding our knowledge of how to manage strokes due to unknown mechanisms, optimizing antiplatelet therapy for secondary stroke prevention, and we can now safely and effectively treat large vessel occlusions up to 24 hours after onset. With the exception of development of the head CT or the testing of alteplase, I can't think of any better "highs" in stroke research or clinical practice.
As far as my personal highs, I have been honored to participate in a number of these pivotal stroke trials (POINT, DEFUSE-3, NAVIGATE-ESUS, ARCADIA) and collaborate with some of these investigators in my own research. Learning from them has been instrumental to my career as a junior researcher.
4. What have been the lows?
Nothing out of the ordinary to say here; difficulties with a rigorous internship, challenges inherent to inflexible mentors. However, some of these are vital to our personal growth and they are informative of our roles as medical educators and leaders.
5. How do you balance work life with the needs of home life?
My wife and I have been fortunate enough to have recently given birth to our first daughter, Sofia, on June 29. My wife, Erika, has been BEYOND phenomenal in caring for our baby girl, and has always supported my academic interests. As a junior clinician, I can't say I've figured it out just yet. But from my early days as a Hopkins undergraduate, where I double majored in neuroscience and history of medicine, worked every semester in some sort of research lab, and still made time to find employment to pay for my room and board, I was forced into a life of efficiency and pragmatism. Taking these things with me through medical school and residency, and building on them, has helped me balance home life with work requirements and academic productivity.
‘If there is ever a choice to be made between life and work, 9 times out of 10 I will choose life.’
6. Who are your most important mentors and how did you find them?
Without a doubt the most instrumental mentor in my early career was Dr. Sheryl Martin-Schild. She took me on as a research assistant as a first-year medical student, where I worked with 3 other medical students developing a local stroke registry at Tulane University School of Medicine. Four years later, our team had grown to nearly 30 students and neurology residents, and we had published more than 20 original research papers.
I have to admit that none of my grades or test scores have ever attracted anyone's attention. I've always considered myself a hard worker, but somehow I could never get past some sort of ceiling created by multiple choice tests. Clinical research provided me with an opportunity to cultivate new skills, and I am so grateful for every mentor who has helped me along the way. No doubt because of our productivity at Tulane, I was able to match at the Hospital of the University of Pennsylvania and collaborate with internationally renown stroke researchers like Scott Kasner, Steve Messe, and Brett Cucchiara, as well as junior faculty Mike Mullen and Chris Favilla. Not to mention the unparalleled research support team of our stroke division!
7. What are your most important collaborations and how have you built them?
While I have been lucky to collaborate with many clinicians, scientists, statisticians, and other researchers, I believe my most important contribution to neurology and my most important collaborations have involved online medical education. As a senior neurology resident at the Hospital of the University of Pennsylvania, and an avid cyclist (spending hours and hours on my bike listening to a variety of music and podcasts) I thought it would be more useful to spend that time listening to clinical content. The state of podcasting in neurology back in 2015 was far less developed than podcasting in other medical disciplines (e.g., emergency medicine and internal medicine). I wanted to create something better.
So I recruited some amazing teachers and friends in neurology to help me produce my own neurology podcast, BrainWaves. Michael Rubenstein, Ali Hamedani, and my wife Erika Mejia, have all been HUGE collaborators and supporters in this regard. Without their help, we would not have been able to produce more than 170 episodes of this podcast with more than 300,000+ downloads. By the summer of 2019, we have collaborated with more than 70 unique clinicians and scientists across the US and internationally to generate this impressive body of work that targets trainees in neurology and medicine.
How have I built these collaborations? I ask nicely. :-) A carrot works better than a stick. It also helps to say "Your episode will be listened to by more than 2,000 people." For better or worse, I find this far more impactful than the majority of my research publications...
