Carolyn Pizoli, MD, PhD, felt the callings both to pediatrics and toward clinical neurology from the start of her medical career. Now, she puts her expertise in these fields to the test on a daily basis, treating children in need of neurocritical care as well as those in our autoimmune brain disease clinic. In this week's “Faculty Spotlight” interview, Pizoli talks about this work, how re-integrating a normal daily routine can help children recovering from concussion and other forms of traumatic brain injury, and maintaining a busy work schedule while also raising four children (and four pets) at home.
What are your current responsibilities here at Duke? What does a typical day for you look like?
There are a few areas I developed that I consider my main responsibilities. First is the Pediatric Neurocritical care consult (NCC) service. I am on this NCC service 32 weeks a year. I have an ICU follow up clinic once a week as well. As part of the NCC development, I have also worked with many great colleagues to develop a cardiac neurodevelopmental program (heart disease kids have a lot of neurodevelopmental risk/disability) and neuro intensive care nursery programs.
Recently I also stepped into Dr. Gallentine’s old role in the pediatric multidisciplinary autoimmune brain disease clinic. It isn’t an obvious match to my other interests, but I love the ‘big saves’ in there. Seeing kids with devastating illness really improve with treatment is pretty cool. Not that that doesn’t happen in the ICUs, but it is still enjoyable.
So, I usually come in and attend some learning conference/meeting in the AM, check for fires in emails/charts, then we round. Afternoons are either clinic or full of meetings (NCC program meetings, family meetings, etc). I try to hit the inbasket before I leave, mostly. Otherwise, I try to avoid charting all day and leave that to night at home after kids in bed to fully laugh in the face of any semblance of work-life balance.
How and when did you first get interested in pediatric neurology? What do you enjoy most about working in the field?
I knew I would do a peds subspecialty almost immediately. My PhD work was in systems neuroscience, and that really sealed the neuro interests clinically as well. I did consider a PICU fellowship after neuro, but 1) my family had likely had enough of residencies and 2) I really am not into vents or kidneys. My favorite part of my job is working with amazing peds subspecialty colleagues on the super hard cases.
One of your interest areas is concussion and other forms of brain injury. How do children with traumatic brain injury or other injuries requiring neurocritical care compare to adults with the same conditions? How similar or different are these two patient groups?
A major difference in concussion is that the anxiety by proxy from the parents really affects kids’ recovery and the treatment of the child upon reentry to school (by teachers, staff) is also a variable that can really make or break a kid's trajectory. For the more severe TBI patients, I’m not too sure there are that many notable differences.
You also often work with patients who are recovering from traumatic brain injuries who have been released from the hospital. What sort of follow-up issues are most common in these patients? What’s the most enjoyable and the hardest part of working with these patients?
So, the lack of knowledge/acknowledgment of the emotional symptoms of concussion by physicians, families, schools, communities, etc. really holds patients back in their recoveries. I have seen so many kids' recovery trajectories turn on a dime for the better with an approach that sees, normalizes then manages this important part of the “generalized brain dysfunction” and traumatic experience of living with concussion. They just get better with this approach.
So, unlocking recovery with education and support of the psychological aspect of concussion is simultaneously my most enjoyable and hardest part of TBI patient care.
What passions or hobbies do you have outside of work?
I have 4 kids, 4 pets and this job, so the “hobbies” are integrated into the relationships and responsibilities of family life. We hike, we ski, we take trips to the beach and try to enrich the kids’ experiences as much as we can. I can’t wait to retire and enjoy more time with my husband, my dog, myself and find some more personal hobbies though!
Pizoli enjoys a rare moment off in the island of Eleuthera in the Bahamas.