Career Spotlight/Interview: Neurology

By Natalia Pepe, 2028

Published 1/28/25

Neurology is defined by the University of Rochester as “the branch of medicine concerned with the study and treatment of disorders of the nervous system.” While the study of neurology dates back to ancient times, it did not become popularized until the early to mid- 19th century, with the father of modern neurology, Jean-Martin Charcot pioneering the field with his contributions, from differentiating tremors found in Parkinson’s disease with those of patients with multiple sclerosis, to being one of the first physicians to set up rehabilitation clinics for patients, and introducing ideas on trauma that mirror modern concepts of PTSD. Within neurology, there are many career paths to choose from that focus on helping people in different ways:

• Neurodegenerative neurology focuses on helping the elderly and uncovering neurological conditions that may result from aging. 

• Child and infant neurology aids young children with birth defects, nervous disorders, developmental delays, and neuromuscular disorders. 

• Sleep neurology treats sleep disorders such as insomnia, narcolepsy, and sleep apnea through different methods of treatment such as CPAP, which is a machine that keeps breathing airways open while sleeping, and CBT, or cognitive behavioral therapy, which targets the reconstruction of negative thoughts related to sleep disorders.

• Vascular neurology evaluates, treats and studies diseases which affect the structure and function of the blood vessels supplying the brain such as stroke and other cerebrovascular diseases.

• Movement neurology is focused on treating neurological conditions that cause abnormal movements. While Parkinson’s disease and essential tremor are among the most common movement disorders, this field treats a wide range of movement related issues through physical and occupational therapy, medication, non-invasive procedures, injections, or surgery.

Duarte G. Machado, MD, is a neurologist that specializes in movement disorders at Hartford Healthcare’s Chase Family Movement Disorder Center, where he is the Director of Program Excellence and Recognition. Dr. Machado received his Bachelor of Science at Trinity College and his medical degree at the University of Connecticut. Dr. Machado was a chief resident at Yale University School of Medicine due to his “commitment to clinical and academic excellence,” and received the Lewis Levy Award from Yale for displaying “clinical excellence, personal integrity, and dedication to advancing the care of patients with neurological disease.” Dr. Machado and his team are based here in Cheshire, and are making a positive impact on the lives of people in our community. For this article, Dr. Machado kindly answered questions about the life of a neurologist for Cheshire High School’s Rampage, and gave advice for students interested in the field of neurology.

Q: Can you please describe your area of focus as a neurologist and tell us about your practice?

A: My area of focus is a subspeciality of neurology called Movement Disorders. This required additional specialty training in this area after completion of my residency in Neurology. I spend most of my day seeing patients, and I also teach medical students, residents, and fellows. Finally, I also participate in clinical research projects. 

Q: What inspired you to pursue a career in neurology?

A: When I was a freshman in high school in Waterbury, my grandmother was diagnosed with Parkinson’s disease. This set me on a path to learn all that I could about this condition, but also what it means to pursue a career in neurology. I became fascinated with neuroscience, and knew then that I wanted to major in this in college which I did at Trinity College. My interest in neurology grew stronger in medical school at the University of Connecticut School of Medicine, and I was one of only two students in my medical school class to enter neurology. I then enjoyed my training in neurology at Yale. I cannot imagine doing anything else - it is my true calling.

Q: Can you walk me through a typical day in your life as a neurologist? What does your daily routine look like?

A: A typical day for me involves seeing patients in consultation, a mix of new patients and existing patients. I may see up to 24 patients a day, so it is busy! I also do procedures, from lumbar punctures to skin biopsies to injections.  

Q: What types of cases do you most frequently deal with in your practice?

A: My practice now primarily consists of seeing patients with a variety of conditions, the most frequent of which are Parkinson’s disease, essential tremor, and restless leg syndrome. 

Q: What is the most rewarding part of being a neurologist?

A: Regardless of how busy my clinic is, I never forget that it is a privilege to do what I do, to figure out what ailment a person has and prescribe a treatment plan to help them improve. The patients I see generally have a progressive, neurodegenerative disease, and so the most rewarding part of my work is to be with them throughout, to empower them to do the things they love while providing a unique, comprehensive treatment plan that begins with a careful diagnosis.

Q: What advancements in neurology most excite you and how do they impact your work as a neurologist?

A: There are exciting developments in the treatment of movement disorders which employ amazing technological advances. One example is the development of a specific surgical technique to deliver doses of a type of stem cell (i.e. autologous induced pluripotent stem cell derived dopaminergic neuron precursor cells) in people with Parkinson’s disease in order to restore brain function. Another example is advancements in deep brain stimulation (DBS). DBS involves implanting fine wires called electrodes into the brain at specific locations. These wires then deliver electrical signals that can help reduce the symptoms of Parkinson’s disease. A new technique called adaptive DBS uses data taken directly from a person’s brain and uses machine learning to adjust the level of stimulation in real time as the person’s needs change over time. These are some examples of how treatments will be much more specific and personalized for each patient.

Q: How do you stay current with new research and technology that may help your patients?

A: I read as much as I can! New research gets published in medical journals, and so I read several per week cover to cover, including the New England Journal of Medicine and the journal Neurology.  I also attend conferences throughout the year to exchange information with colleagues from around the world. Just last week, for example, I attended the International Congress of Parkinson’s Disease and Movement Disorders.

Q: Aside from your expertise in neurology, what other skills are most important to being a successful neurologist?

A: Observational and organizational skills are very important. The work I do is very visual, such that neurological clinical practice is based on phenotype-driven investigation, diagnosis, and management. It is also critical to be well-organized given the tremendous amount of data that is collected every day on patients. Sorting through and cataloging this data for retrieval and analysis is key to achieving the right diagnosis and developing the right treatment plan.

Q: Were there any particular challenges that you faced on your path to becoming a neurologist, and how did you overcome them?

A: My biggest challenge was finding my own path. My parents were immigrants who only completed the 4th grade, and so I had to find the discipline and consistency to keep forging ahead and never losing sight of my goal. Fortunately, I found mentors along the way who helped guide me along this path, including two of my high school teachers who were so instrumental to my success that I still keep in touch with them to this day, over 25 years now!  

Q: How do you maintain a work-life balance in such a demanding job and what would you recommend to students that struggle with burnout?

A: The key to maintaining a work-life balance is to set expectations for yourself and your family. For example, my family knows not to expect me at the dinner table every night because I get home late, but I make every effort to attend my children’s sporting events and other special events. Yet the consequences of overwork are real and can result in burnout. The way to avoid burnout is to pursue goals and activities that genuinely bring you joy and fulfillment.  I recommend to students struggling with burnout to focus on prayer, connection, gratitude, and curiosity, for these will help keep your internal fire burning and shield you from burnout.

Q: What advice would you give to high school students that may be interested in a career as a neurologist?

A: To be a neurologist, you have to be dedicated and stay motivated. Find your passion because this fires the soul and fills the spirit to perform at the highest level. Dedication helps overcome our problems with renewed energy and keeps us focused during stressful times. The way to feed this force inside you is to have a vision of that which you want to accomplish, and keep going for it.  You will live your most fulfilled life once you recognize your mission and dedicate your early life to pursuing it.