At a Glance
Title: Assistant Professor
Fellowship: University of Virginia, epilepsy and clinical neurophysiology
Residency: University of Tennessee Health Science Center
Try as we do to relate to our patients, we may never fully be able to comprehend the challenges of living with a chronic disease. Unless, of course, we experience the same diagnosis ourselves. For neurologist Derek Bauer, MD, it was the draw of truly being able to support and empathize with patients who shared his condition that led him to practice medicine and, more specifically, to specialize in neurology.
“I am one of the lucky few patients with tuberous sclerosis complex [TSC] who have minor manifestations, which have mostly been dermatologic and seizures when I was younger. But it is a unique condition and symptoms can be more severe,” he says. “For me, I think the biggest impact TSC has had on me is the trajectory of my career path. I decided to become a physician and focus on epilepsy and neurology because I understand the care needs of adults managing TSC. I also now sit on the board of directors for the TSC Alliance, so I’ve become more involved with care advocacy of patients across the country.”
Q&A with Derek Bauer, MD
You did your fellowship training at UVA. Why did you decide this was the best place for you to practice?
Yes, I did a 2-year combined epilepsy and clinical neurophysiology EEG fellowship at UVA from 2015 to 2017. I was actually trained under an epileptologist in Tennessee who received his training at UVA, and he recommended that I come here for my fellowship to see what it was about. UVA has a long history of excellent epilepsy care with some of the most highly trained epileptologists in the country and the world. In my time here, we’ve sent epileptologists to Washington state to Maine and North Carolina. We really have a huge network of specialists who have grown from this program. That’s a byproduct of the wonderful and esteemed faculty I get to work with here every day. From Dr. Goodkin and Dr. Kapur to Dr. Fountain and Dr. Quigg … these are all esteemed people in the field of epilepsy. They are involved in cutting-edge research, including delineating and treating status epilepticus. So really, my decision was based on the people, the esteemed colleagues I have here.
What is unique about the care UVA provides neurology patients, particularly those with epilepsy and tuberous sclerosis complex?
In terms of the care I participate in, we have, to my knowledge, the only epilepsy dietary clinic for adults in the state of Virginia. We can provide dietary options for patients with refractory epilepsy, so that’s a unique opportunity for patients here. We’re also one of the longest-established tuberous sclerosis clinics in the state. We have a multidisciplinary clinic for TSC care. This is a multisystem disease that involves dysregulated cell cycle tumor growth, which can occur on any part of the body, including the brain, heart, lungs, kidney and skin. So a significant differentiator for us is that we can take a multidisciplinary approach to different manifestations of the disease. We’re able to provide care across the full spectrum in a single building.
Another major differentiator is that we are a Comprehensive Epilepsy Center, so compared to a common practice, we have the ability to address all associated conditions with epilepsy. For instance, anxiety and mood concerns. We have psychiatric providers who specialize in seeing our patients with mood and anxiety concerns related to their disease. We have a really wonderful epilepsy surgery program for patients who have refractory epilepsy and medications are no longer working. We can refer them to the EMU [epilepsy monitoring unit] for characterization of their seizures. And they can have surgery performed by our neurosurgery colleagues. This may include a surgery to remove the part of the brain where the seizures are initiating or using devices like vagal nerve response nerve stimulation, which are means to reduce seizure burden in patients with refractory epilepsy. All epileptologists at UVA are trained in neurostimulation.
How do you feel your TSC diagnosis has impacted your practice?
It’s easy enough to say in passing that you understand how someone feels in any given situation, but navigating the complexities of chronic disease is something very few people can relate to. Because I have the same type of illness as my patients, it provides me an understanding of some of the stresses involved in managing a lifelong chronic disease that many other providers don’t have.
How do you help transition patients from pediatric to adult care?
Typically, adolescent youth transition to adult care between the ages of 16 and 19. This is a unique population with special needs. They are transitioning away from home, away from their parents, going to college or out into the workforce. They have to learn how to care for themselves and we help them learn how to manage all of the normal things that are challenging for any kid to face, let alone those with a chronic medical condition. So this might be managing stress, sleep and other lifestyle factors as well as managing medications. There are also particular health concerns related to women’s health, such as pregnancy planning and contraception. Adolescents are a rewarding population to treat; I enjoy helping them navigate the challenges of living as an adult with a chronic medical condition.
What would you like referring providers to know about your approach to care?
My approach to patient care is patient-centered, but also collaborative. I feel that referring providers are vital. It’s really easy for us to care for an epileptic patient in the tertiary setting, but they’re the experts dealing with the day-to-day management as a primary care provider or local neurologist. I welcome the opportunity to work with them to ensure patients are getting the care they need when they need it.
To refer a patient to neurologist Derek Bauer, MD, call UVA Physician Direct at 800.552.3723.