Past the Bench: A dialog with Audrey Brumback | Spectrum
Assistant Professor, University of Texas at Austin
Audrey Brumback wasn’t about to follow in her father’s footsteps – a doctor, scientist, and founder of the Journal of Child Neurology. She attended medical school but tried new fields – gynecology and then ophthalmology. Ultimately, however, these forays into healing were unsatisfactory compared to what she discovered to be her true calling.
“It wasn’t until I did neurology, then pediatrics, and then pediatric neurology, that I felt my shoulders relax and I could breathe a sigh of relief,” said Brumback, assistant professor of neurology and pediatrics at the University of Texas at Austin.
Brumback is now a medical professional and scientist studying how the brain circuits are disrupted in neurodevelopmental disorders such as autism. She hopes to one day develop therapies for autism that target these circuit differences.
She spoke to Spectrum about volunteering in Mexico, a lab next to her husband’s, and why she sometimes cries at work.
spectrum: What big question drives your research?
Audrey Brumback: Can we locate different parts of cognition and social and emotional functions in order to develop targeted therapies for symptoms?
In neurology, we are trained to localize, which means that we don’t first find out what the problem is, but where it is. Once we know where something is happening in the nervous system, we can make a list of the things that could be causing it. In mouse models, we use a number of techniques – optogenetics (stimulating neurons with light), calcium imaging, electrode recording – to understand where and how the brain’s circuits are disrupted in various diseases. I hope that one day this work will lay the groundwork for brain stimulation in people to address problems with things like attention, memory, and sensory processing.
S: How did you come to focus on autism?
AWAY: When I finished my neurology training for kids, I felt pretty undifferentiated. I loved all of neurology. I’ve been training to record the electrical activity of the brain so it would have been natural for me to study epilepsy, but I figured that there are already a ton of great physiologists out there in the epilepsy field. The field didn’t really need me.
So I started thinking about the areas of neurology that could use a good electrophysiologist, and I was drawn to these conditions that are at the intersection of psychiatry and neurology. Conditions like autism, where the overall structure of the brain is fine, but the way it works, the physiology, is clearly very different. I thought, “This is one condition where my skills could potentially make a difference.”
S: Do you have a personal connection with autism?
AWAY: My brother had what my parents described to me as a “non-verbal learning disability” as a child, and it wasn’t until I became a child neurologist that I realized he was likely to be autistic. I never knew! My brother’s condition was not a conscious reason for my decision to specialize in autism, but it certainly influenced me. As a doctor, I see many children and adults who remind me – fondly – of my brother.
S: What does a typical day look like for you?
AWAY: Get up at 6:30 a.m. Wake the children at 6:50 a.m. Pick up the kids at 8 a.m. At home by 6 p.m. to relieve the babysitter. Family time from 6 p.m. to 8 p.m., then an episode of “Ted Lasso” or Stephen Colbert, then back to work until I can no longer keep my eyes open.
During the day I meet people from my team, hopefully write ideas and suggestions and analyze data. I go to the clinic one day a week and look after children with autism. I am on call for general neurology at Dell Children’s Medical Center in central Texas about two to three nights a month.
S: What do you eat or drink while you work?
AWAY: Instant coffee.
S: Do you listen to music while writing or analyzing data?
AWAY: I was recently listening to the instrumental version of the “Hamilton” soundtrack while writing on the scholarship. I found it very stimulating.
S: You are fluent in Spanish. Was that helpful?
AWAY: Speaking Spanish has certainly helped with patient care – around half of my families speak mostly Spanish.
And I was able to spend about a week a year in Mexico volunteering for the Rotary club’s annual Proyecto Niño medical service mission. Child neurology is a niche area in medicine, so it was very special for me to make this specialist knowledge available to people who otherwise might not have access to it. We visited the same place year after year and were able to develop relationships with patients – I’m really sad that I haven’t been able to go for the past two years because of the pandemic.
I felt we could do something good and it was just incredibly rewarding. I feel like I’ve learned so much about how disability, risk, and death are viewed in different cultures. I also learned how different the practice of medicine is when you don’t have access to technology. In neurology, CT scans and MRIs are routine in the United States, but when I volunteered I had to create a treatment plan based solely on a person’s history and physical signs.
S: What do you think is your most valuable or most unusual collaboration?
AWAY: My husband, MacKenzie Howard, has a lab next to mine and it’s great. It was so nice to have someone to talk to, exchange ideas and get a second opinion. It’s funny – when you mention to others that you work with your husband, the first reaction is, “Oh, how is this going?” As if it is definitely going to be a challenge. But it was fantastic. We have joint laboratory meetings where each of our employees receives feedback from the entire crew.
S: In a 2019 article in Spark magazine, you talked about impostor syndrome. Are you still struggling with it?
AWAY: My cheating syndrome, that feeling of self-doubt, has diminished over time. That’s partly because I don’t do brand new things anymore. Medical faculty and interns and postdocs and as a new PI (Principal Investigator) are all new experiences where you only see the tips of everyone else’s successful icebergs and wonder how they deal with it when you can’t. Now that I’m in my fourth year as a PI, I feel like I have that.
S: Are you active on social media?
AWAY: I follow a lot of people on Twitter. It was helpful to find out about new work that I would otherwise have missed. I’ve tried to amplify the voices of people who are often ignored, for example by retweeting the Black in Neuro-Crew and what black doctors, nurses and researchers are saying about the COVID-19 vaccine in The Conversation.
S: Does your lab have a mascot?
AWAY: We get a monthly delivery of chocolate from Cocoa Runners – does that count?
S: What are you doing for fun?
AWAY: I like to write haiku in my head when I have a moment. I used to write a haiku every day as a journal entry.
S: How do you get your news?
AWAY: Doom scrolling.
S: What are you reading when you are not scrolling under the doom?
AWAY: Lots of graphic novels. My current favorite shows are “The Witch Boy” and “Sanity and Tallulah”.
I also read to my children all the time. I think reading to children is really important and I give a book to all of my children in the clinic. I like to start my visit to the clinic by writing the child’s name in the book and giving it to them as a present. At the moment I only buy books or bring them from home, but I just received a grant from the Texas Medical Association Alliance to buy books for children at our clinics.
S: I see you have an acting loan on the Internet Movie Database?
AWAY: Yes indeed! My high school friend Russell Barrett attended film school at New York University, and when we got home for holidays we made films. It was great fun. I think my father must have made this IMDB entry! He was the best hype man and promoter.
S: What do you think is important for others to know?
AWAY: I have depression that is super easy to control with antidepressants. Thank god for modern medicine!
On another but related note, I’m not ashamed of the fact that I cry sometimes at work. It is normal to cry with strong emotions. I don’t think it’s healthy to hide this and wear a poker face all the time.
Quote this article: https://doi.org/10.53053/GLEK2047