Title:What’s in my white coat with Fernando Pagan

Fernando Pagan (M’96, R’00)

Fernando Pagan (M’96, R’00) is a movement disorders neurologist at MedStar Georgetown University Hospital. He is a professor of neurology, director of the movement disorders program, and medical director of the hospital’s National Parkinsonism Foundation Center of Excellence

1. I carry the penlight to look at the pupillary reflexes and the back of the throat.
2. Neurologists check reflexes and motor restraint, and conduct sensory testing. The tuning fork helps us assess hearing but also the vibration sense in the feet and hands, and because it’s metal we use it to test for cold sensation.
3. I break wooden stick swabs in half and use one end for pinprick sensations and one for soft sensations on hands and feet.
4. Stethoscope—I’m on my third or fourth one by now.
5. Patients often ask for my card.
6. Sometimes I use my iPhone to check vestibular ocular reflexes using optokinetic tests. In the old days I kept a striped paper strip to move in front of the patient’s eyes.
7. I carry pens because we still use paper charts in research.
8. My reflex hammer is the same one I got as a third-year medical student.

I had planned to be a pediatrician, but with the influence of my psychiatrist father, plus the dopamine and spinal cord research I did before and during medical school, my eyes were opened to neurology. I did enjoy pediatrics but I enjoyed the neurosciences even more. I did the next best thing—I married a pediatrician (who is also a Georgetown alum).

I love being part of Georgetown. I’ve been here throughout my training and I’m able to pass along my knowledge to medical students, residents, and now fellows. So far we’ve trained 27 fellows in a field that is underrepresented in neurology: movement disorders.

When I began I was the only movement disorders specialist at Georgetown, but now we are a team of nine. We’ve built a regional translational neurotherapeutics program and we opened up a new area of research in neurodegenerative disorders, not only in Parkinson’s Disease but also Alzheimer’s, Huntington’s, Lewy body disease, and possibly ALS.