is Building 1 which is the clinical center where we take care of patients under research

protocols at the NIH. So I'm focused on combating the disease known as vasculitis which is a

family of rare diseases that are characterized by inflammation inside of blood vessels. And

these diseases can lead to life-threatening outcomes for patients.

So I grew up in Charleston, South Carolina. It wasn't something that I thought I was going

to be a scientist from the get-go, from birth. I wanted to be a musician and spent some time

playing in rock n roll bands around the country and then kind of meandered my way into medicine

and came at it much later in life.

So vasculitis, among doctors it's a scary disease. It's one that many doctors don't

know anything about because it's quite mysterious. Wherever you have blood vessels, you can have

a problem and you have blood vessels throughout your entire body. So you can get a lot of

bizarre symptoms. And typically what happens to a patient is they get something where they

got a painful red eye and then they lose sensation in their foot. And then they start coughing

up blood, and then all these crazy, bizarre things happen in sequential order.

They go see millions of different specialists. There's a long delay and finally somebody

will put the pieces together and realize that this is a vasculitis. And we have made a lot

of progress in the last 20 years. It used to be that these diseases would kill you with

a few months of contracting them, and now patients do not die from the diseases anymore.

And we're faced with a whole new challenges of managing these diseases if they turn into

long-term illnesses.

So this is the heart and your aorta is this big tube that comes off the heart and comes

down here and splits into the blood vessels of your legs. These are the blood vessels

of your arms and these are neck blood vessels going up to your brain.

For patients that have a type of vasculitis called large vessel vasculitis, they can have

problems and disease in the big blood vessel of their body.

And so if vasculitis affects a big blood vessel known as your aorta, it can cause it to swell

up and form an aneurysm. It can cause things to close down and form blockages. And so a

patient will come in and they'll have no blood pressure in their right arm or no pulse in

their left leg. We can comprehensively image all the blood vessels in their body.

And we do these kinds of imaging studies and figure out where in their vasculature there's

disease. Where we are with these diseases is that people survive them but they relapse

and they relapse unpredictably. And so we're trying to figure out things that allow us

to predict what happens over time. So you're trying to actually figure out something within

an individual patient that you can target treatments to.

And I think in that setting this is kind of a new age of discovery in medicine. Before

we used to be limited with what we could see or a couple of simple blood tests we can do,

but now we're not constrained by hypotheses and by what people have done before us. You

can actually really in an agnostic fashion, yes categorize what's happening at a cellular

level.

[British guy] Wait a little bit longer. The IV contrast gets excreted by the kidneys.

The way things are right now, there's so many different aspects of research that are going

on that you can't know everything. But it's great if you're sitting at a table where you

have representations from all the different kinds.

When you're in medical school, they tell you that 50 percent of what you learn in five

years is wrong, and that's kind of daunting because you're sitting there trying to study

and take all this in and you're trying to figure out which half you really need to know.

But what that means and why that's really cool is because we're rewriting medical history

continuously, you have the opportunity in medicine and medical research to change the

textbooks and to change the course of medical history in a very short time. And that's what

conceptually that really excites me.

If you find something that's surprising and interesting, it opens up a whole new box and

you go down this tunnel and there you're off and running and doing a totally different

thing than you were doing the day before. And that aspect of the job is great. It's

extremely challenging. It's constantly shifting. There's constantly interacting with new people

who are bringing in new ideas. You just don't know what the next day's going to be and that's

really, really fun.

Really, the journey is the destination. I mean you just have to stop thinking about

where you're going to be and what milestones you're going to hit in your career and just

enjoy the ride because it's a really incredible experience. Once you relax and realize that

you know you're in a very fluid field, that sort of rewards creativity and rewards hard

work, and it takes you into just unexpected places, I think we're often trained to want

to hit milestones in our lives.

And once you sort of let go of that a little bit, I think you realize how exciting this

career is."