In Practice: Andrew Rontal, M.D.

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Providence profiles Andrew Rontal, M.D., a neurologist who recently joined Providence Neurological Specialties-East. 

Past lives
Medical degree, New York University School of Medicine; internship, residency and vascular neurology fellowship, Oregon Health & Science University; bass guitar, The Collective School of Music, New York; practiced in Tanzania and Peru 

Distinction
At 34, among the youngest neurologists at Providence Brain and Spine Institute 

Why did you choose neurology?
The brain is fascinating. Unlike any other organ, neurologic pathology alters and disrupts what makes us … us. The challenges and rewards that come with working with such pathology are at times heightened by a lack of robust scientific understanding. In neurology, we often find ourselves standing at the edge of the known scientific universe, staring into the void with limitless explanations for why our patients are struggling. It’s both disconcerting and inspiring, and it keeps me coming back. 

What have we learned about vascular neurology in recent years?
Acute stroke management has revolutionized. At the turn of this century we were just settling into the first generation of devices for clot extraction. Now researchers are studying the next generation of devices, such as clot-retrieving “stentrievers,” which may improve outcomes over standard IV thrombolytic therapy. 

Beyond treating stroke, how else could teleneurology be used?
One possibility may be to mail remote technologies such as an iPad to people’s homes for a check-in might increase accessibility for patients in remote areas. It even may be possible to remotely program implanted simulators for patients with Parkinson’s disease, essential tremor or epilepsy. 

What did you learn from working in Tanzania and Peru?
For one, how incredibly lucky we are to live with the medical technology we have here. But also, American trainees rarely see the end stage of many diseases, either because we can effectively prevent it, or we have systems in place that ease the passage to death. Without chronic treatment or palliative medicine, the full scope of disease is revealed in a way that you could never gather from literature. Experiencing these cases not only broadened my medical experience, it also increased my understanding of the human condition. 

Is there an intersection between music and neurology?
Certainly. Musicians are masterful communicators. A stage musician listens to his bandmates and audience, then draws upon years of experience to craft a delicate mix of rhythm, melody, harmony to reach the audience. 

Similarly, doctors are constantly thinking on their feet. We work from knowledge and principles that are drilled through years of practice to formulate the correct amalgam of facts, vocabulary and empathy to effectively communicate with our patients. 

Why is communication particularly important in neurology?
For one, the disease process often sets limits on cognition or introduces psychiatric variables that need to be considered when communicating. Also, there are times when neurologic hardware does not explain a patient’s illness, such as a conversion disorder. These are tricky diagnoses to make, and you will never succeed in effectively diagnosing and treating these problems without careful communication to bring a patient on board. 

If I weren’t a physician, I’d be …
A full-time bass player and a part-time ski bum. 

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