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Resonance is a student-run podcast aimed at showcasing the science at Baylor through the eyes of young professionals. Each episode is written and recorded by students who have a passion for research and the medical community. Guests on the show include both clinical and basic science research faculty who are experts in their fields.

Dr. Musher discusses his experience as a clinical researcher, some of his discoveries that he made during his career as an infectious disease doctor and some of his outside interests like music and literature.

Clinical Discovery | Transcript

Roundtable Discussion

Erik: And we're here.

Brandon: We are here.

Erik: This is the Baylor College of Medicine Resonance Podcast; I am one of your hosts Erik Anderson.

Brandon: And I'm the other host Brandon Garcia.

Phillip: And I'm Philip Burkhardt, writer for this episode.

Erik: Yeah so today we're going to be talking with Dr. Daniel musher who is an infectious disease doctor and also teaches some of the infectious disease course to the medical students here at Baylor College of Medicine. We're really excited because he's a bit of an institution here so…

Brandon: He's very colorful fellow.

Erik: Yes, and has given us a lot of great clinical pearls about you know how to detect things from syphilis to…

Brandon: Hemophilus, it doesn’t seem like that much of a jump, but it might be.

Erik: And pneumococcus.

Phillip: And every Gram stain in-between. We're excited to talk to him today because we're gonna be looking a little bit about performing research as a clinician, which is one of his big topics he likes to bring up in class, and to start that off we're gonna talk a little bit about the history of kind of what the physician and the relationship to medicine has been kind of in the past and how it still reflects that today a little bit. The physicians in the past where were always kind of learning and trying to seek new knowledge and doing experiments of their own with patients or with what they saw. And we're gonna talk to Dr. Musher on how he's still doing that today.

Erik: Yeah so, I guess to start with do you want to tell us a little bit about maybe some famous physician scientists if you will in history?

Phillip: Yeah, I think my favorite one by far is Dr. Jon Snow famous for his cholera outbreak map and father of Epidemiology. I think he's a really cool story on how that even before germ theory you know he didn't know what was causing this illness and everyone was thinking that this cholera outbreaks in London at the time in the 1850s were due to the bad air and he didn't really have a good microbiology understanding, nobody did on what could be a different answer to that question but he was able to just map out kind of what he saw and realized that it had to be this water the famous one being the Broad Street pump.

Brandon: Like he found like one single source that was the source of all the cholera in the in the city.

Phillip: Yeah for one specific outbreak, yeah he just kind of went around talked to his neighborhood, it happened to the neighborhood he was practicing near, and he has a famous map where he has the little black bars of every case and it all just centers around the pump. And a couple of the pieces of evidence that were very helpful to him were people that were outside of this area but had traveled and used this water and it kind of spurred the idea that illnesses could be from something else and it was just something else other than this bad air, that we know now it sounds really silly but was the predominant, you know, idea at the time and I think an interesting to hear from Dr. Musher is going to be that a lot of times you know we look back on these stories and it seems obvious like bad air you know we know so much better than that now how could they have thought that but there's things that are still being discovered now that you know in a couple years then look pretty obvious and I think it's interesting to hear how people make those realizations to start with I think that's interesting thing.

Erik: Well in a really interesting thing about this too is that it's all before the germ theory was really like yeah Koch and Pasteur and all the doctors in the late 19th century who came up with this yeah.

Phillip: I like to hear from it as kind of like a way to look at things, like a way to notice these discoveries that you know kind of changed the way people think about certain things and I think Dr. Musher himself, just to kind of further plug him, did that with Hemophilus in a way that he kind of discovered that it was an infectious cause of pneumonia when other people weren't looking at that and so I think that's something we're gonna hear from him you know and later in this podcast and I really like to hear about how he approaches these questions.

Erik: Yeah so you want to lead us in?

Phillip: Yeah so you know like we've been talking about; Dr. Musher is with us today he's an infectious disease clinician who works primarily at the VA here in Houston he originally got his medical degree from Columbia University and his residency and fellowship at Tufts University and we're really excited to have him on the podcast today.

Interview

Phillip: All right, today with us we had a Dr. Musher. I'm very happy to have him here so Dr. Musher just to start us off can you describe to us how you came to Baylor and the VA and what your current position is?

Dr. Musher: I was raised in Northeast I almost never been west of the Hudson River and never south of bottom of Manhattan, except to go to museums in DC. The military stationed me in Texas, and I loved the place. The people are so nice especially after having been raised in Manhattan. So I actually met my wife in Laredo Texas went back to Boston for training and since my professor was well known I was offered jobs at a lot of places, but my wife's family was in Texas, mine was in Manhattan, and I didn't think I could afford to teach medicine and raise a family in Manhattan and I loved everything I saw about Texas. Baylor offered me a wonderful job it's been wonderful since the day I arrived in 1971 it's been my only job and I love it and that's why I'm here that's why I've stayed. My specialty is internal medicine, my subspecialty is infectious diseases and a lot of younger folks forget that but we are internal medicine physicians first, and the subspecialty is something that's on well.

Erik: Many of us first years, and really anybody that's come through the Baylor program, will know that you give many lectures for the infectious disease block, we're curious can you tell us a little bit about some of your research.

Dr. Musher: May I first tell you how I selected infectious diseases as a specialty

Erik: Absolutely

Dr. Musher: I love internal medicine and I didn't even think about quote sub-specializing when I was younger. I thought I would practice internal medicine but it did seem to me that if there was some area in which I could have special expertise I would feel more fulfilled as a physician and among the sub-specialties infectious diseases is the broadest because it's not based on a particular organ or organ system, and I think that was actually part of my conscious reason for choosing infectious diseases of specialty. Now when I went to my fellowship, I never planned to do research. I majored in college and medieval studies, I took the briefest number of the shortest number of requisite science courses to be able to apply to medical school, and I did adequately in them just by cramming for exams. But I did love medicine the more I got into medical school the more I loved it and by third and fourth year and by internship I just was totally in love with internal medicine. When I decided I wanted to sub-specialize I picked infectious diseases, for the reason that I told you, I still never planed to do research. Dr. Lewis Weinstein who was one of the two great infectious disease physicians in America the last century offered me a fellowship, and his fellowship program was one year as a chief resident, his chief resident, working personally with him every day and then two years in research and when I arrived he switched it I think he had the feeling that Musher would take that first clinical year and then vanish, so he made me do research the first two years. And at first I thought it was like cooking, and I hate cooking, but what I realized is it's research is though gives you the opportunity to answer clinical questions that are unanswered and I will say that throughout my internship and residency every day I was raising questions and they my fellow residents would comment on it the attendings would tell me that like “Musher why are you asking so many questions”, I said because it's interesting and there's a lot of stuff that's not known so any of the research that I've ever done has been based on clinical problems specifically, and from the very first research that I did you can see the clinical basis for all of it some has been laboratory intense some has been new techniques that are widely used developed by me in the laboratory but they were all to answer clinical problems.

Erik: You make a good point about how you can discover new things that maybe people haven't noticed and specifically you know we know about your work on Hemophilus influenza and I'm curious with your work, I think some papers that you released in the early 1980s, that showed that it was a common cause of pneumonia and older men can you tell us how you notice this trend.

Dr. Musher: I love the question the way to do it is to look at data. So patients are admitted to the VA hospital they have pneumonia, they cough up a good sputum sample and you look under the microscope and you see zillions of little teeny-tiny gram-negative coccobacilli and then the culture plate shows just about pure Hemophilus influenza and the textbook says well Hemophilus influenza doesn't cause pneumonia in adults and I said well but it does I mean here I've got a case here, I've got another case, and here I got another one. So I did for a period of a year look at all the gram stain's of all the patients have been with pneumonia, not every single one, my subsequent research I tried to do every single one for one of the studies I did, but I looked very conscientiously at the Gram stain and the culture results and there were a lot of them that had Hemophilus influenza. Now at the time, this was in late 1970s, I began doing this research the Hemophilus vaccine the little kids had not been introduced and Hemophilus influenza type B was a major cause of disease and little kids but nobody thought it was a cause disease in adults because by adulthood almost everybody had acquired antibody that was reactive against the polyribosyl phosphate capsule of H flu type B, whether by having been exposed to H flu type B or by being exposed to other bacteria that had capsules that reacted immunologically similarly. So adults didn't get the flu type B disease and these Hemophilus when we set about to be typed they were non-typable and quite seriously they were regarded as laboratory contaminants. But I said look they got a pneumonia syndrome, they got inflammatory exudate accumulating in the lungs, what they coughed up reflects what's in the lungs and you look on the glass slide and there's loads of polymorphonuclear leukocytes that's not present in a normal lung, and there were loads of these bacteria and there aren't any other bacteria. So it seems to me that's indicating that those bacteria are causing pneumonia. Well it wasn't so easy I have to, quote, convince people so I decided that I would try to determine whether people who had Hemophilus influenza pneumonia had antibody to their Hemophilus at the time they were admitted and if they didn't did they develop antibody when they got over it. In other words an acute and a convalescent serum. So to do this you've got to go through an institutional review board and a lot of work and a lot of the research I've done it's just because I've got no particular brilliance just a lot of hard work and energy. So I'd identify patients get their permission take their blood, spin down the blood, store away the serum, collect blood from them a few weeks later, save their organism and then look to see the bactericidal effect of serum because antibody to Hemophilus kills Hemophilus because it's a gram-negative organism. And I showed that a lot of them had some minimal or moderate bactericidal activity at the time of admission, but two weeks later their serum just wiped out these organisms so it was a very distinct documentation of emergence of antibody and that is basically the way in which I got the work published. So I showed it was just clinical observation with looking at laboratory results myself and thinking about them, but then the way to get the world to accept it was to develop a laboratory technique and show that antibody did emerge. I also had to learn how to do studies of opsonization in which you exposed the Hemophilus to serum when the patient's just were admitted and then exposed Hemophilus to the serum obtained a few weeks later, and then incubate those Hemophilus with white blood cells and had to radio label them first, it's kind of complicated. You radio label and incubating with white blood cells and you see which ones are taken up by the white blood cells. And the ones exposed to the convalescent serum were taken up very nicely by the white blood cells, and the ones that were exposed only to the acute serum we're not taken up by white blood cells. So I showed antibody in two different ways and that's what made the world accept it.

Erik: And just for people out there who might be unfamiliar but that basically shows because they took it up that shows that the immune cells had been exposed to it prior.

Dr. Musher: it shows that there was not only bacteria present in the lung, but there was an immunologic response to those bacteria proving that they weren't just quote colonizing they were actually getting into the system and the body was making an antibody to them.

Phillip: From just sitting in your lecture you always bring up things that you've worked on almost in every aspect of the field and major discoveries like this that you've made and I think obviously there's other people treating these patients that aren't making these discoveries that you are. So I'm wondering if you could kind of describe to us your mindset on how you approach your day-to-day work with these patients that helped you come up with these questions and these discoveries.

Dr. Musher: Okay how I work with patients is I like take care of patients. I like people I sit and chat with them I visit with them but that doesn't necessarily affect my scientific thinking. I ask how does the disease come about and that's why in my lectures I emphasize pathogenesis. Why is this person getting a disease and somebody else isn't getting a disease? So, I'm as interested in why some people don't get disease as in why some people do get disease. And then I go looking for the differences. I'd also say that it's just having a, just being very curious, curious about things, intellectual curiosity. I'm Jewish and the Jewish religion literally forces you to ask questions. I don't think a lot of people who aren’t Jewish know that. You're forced to ask questions. That Talmud which is that very lengthy series of books written by the rabbi's in the 2nd to the 5th century is not full of answers it's full of disputes and discussions and a lot of questions go unanswered so somebody who takes that stuff seriously, has been raised that way, says oh there's a question and you ask questions and maybe get an answer you may not get an answer.

Erik: That's a very interesting point and actually I think I remember from a previous conversation with you, you in your undergraduate studies were studying an ancient Jewish scholar is that correct?

Dr. Musher: it is, I did medieval studies at Harvard and I was studying Christian theology because that's what was taught and it actually, I was really an expert on St. Augustine, like I was a super expert on St. Augustine. Once when I was a junior the chairman of history at Harvard called and asked me a question about St. Augustine, amazing. But anyway, I came to the end of junior year I had to write an honors thesis and I was gonna write one on Meister Eckhart, the Christian mystic theologian from the 13th century. And one day I said, you know I'm Jewish why should I write on that Christian mystic I'm sure I can find some Jewish mystic to write on, so I did. I don't know, you can eliminate all this from the podcast if you want, my grandfather was a very famous rabbi and professor in the twentieth century. He's the one who first had girls become botanists for they never had been botanists before. He was the first one to found a Jewish Community Center, I mean he had a major influence but he was kind of very non-mystical in his thinking. So I went to visit him at the Jewish Theological Seminary I said grandpa I'm interested in writing honors thesis in college on a Jewish mystic, so he basically laughed cause he's so anti-mystic he says, “but let's ask Abraham Joshua Heschel.” And you guys may be too young to know that name but he was the great mystic Jewish theologian. He's one who marched with Martin Luther King, a very, very big name. He said let's go down the hall and they asked professor Heschel if he's got an idea for you. So Heschel was the one who suggested that I do my honors thesis on Bachya ibn Paquda, who was in fact 10th to 11th century Jewish, Judeo-Arabic philosopher with certain mystical tendencies. So yes, I was interested in theology. I think the liberal arts training is a much better discipline to be a good and thoughtful physician then the usual pre-med training. The usual one that's not someone who really loves science and is interested and there's taking science because he or she loves biochemistry or biology or whatever it is, but lots of pre-meds are just taking a certain number of courses so they can get to medical school and I don't think that's any kind of good training at all.

Erik: I mean I'm also partial that I was a music major

Dr. Musher: There you go.

Erik: And I remember taking a class on historical performance practice which is essentially how there nobody really knows the, quote, true way a Bach song is supposed to be played right because there aren't any notations modern notations people sort of just infer them and so you have to think like, well like what is the true way and then you basically get to the point where there is no true way. Nobody really knows what it was in his head and I think you could probably get a lot of parallels to medicine with that in some ways.

Dr. Musher: One of the most important philosophers of history was in the in the 1950s was a British historian / philosopher named Collingwood and he helped to clarify what we all knew. He said you've got to put yourself into the shoes of the person whom you're writing about to see what he possibly was thinking and how he or she might have reacted and why, so if again you can see to questioning what's one of the reasons what's the motivation and that's the same kind of reasoning that applies in medical investigation as well. How do these things come about. How does it happen that this person does this, or this immune system does this, and that immune system does something else, or this organism does one thing and that organism does something else? In class you might remember, although I am absolutely not an expert in virology, herpes one virus and herpes two viruses are almost identical just ever so most minimal differences and they behave biologically differently. The reason still not know I think that's fascinating, if I was a younger guy I think I might take that on as an investigation.

Erik: So, Dr. Musher, why do you like to teach medical students

Dr. Musher: I love teaching medical students because they ask questions that are different and interesting. They haven't yet brainwashed but a medical establishment to accept all the stuff that's in the textbook of medicine, so it's a great experience and I get asked questions at the end of my lectures first of all you've heard me I get asked questions which I don't know the answers but I get asked questions sometimes nobody's ever asked before to my knowledge and they're just fascinating.

Erik: Well I like you always tell us to email you after.

Dr. Musher: Precisely, I get questions by emails and about practicing. And when you talk to patients you get ideas about the way the disease evolves.

Erik: Well I have a historical question that I think we have to ask because we're here at Baylor and I know you're an institution at Baylor now yourself.

Dr. Musher: I've just survived I'm a survivor.

Erik: Did your time at Baylor overlap with Dr. DeBakey?

Musher: My time at Baylor overlapped with Dr. DeBakey and I had a couple of experiences that I'm willing to describe. It was a search committee for a new chief of staff at the VA and Dr. DeBakey was on the search committee. So I got to sit on a committee with Dr. DeBakey and the two final candidates were a surgeon and a psychiatrist and Dr. DeBakey listened to people discuss it and he said, you know a surgeon works in an operating room works with nurses, OR nurses, and residents, and post-op patients. A psychiatrist works with patients and psychiatry wards, but he or she does consultations all over the hospital, works intimately with social workers, and with social support, and with pharmacy, and with all kinds of other issues. So says dr. DeBakey, I think in general a psychiatrist is a better choice to be chief of staff of a hospital than a surgeon. And how do you like that, isn’t that amazing. Subsequently my wife and his wife became friendly, so we were invited to his house a number of times he was a fascinating man, really, really brilliant. He was the one who engineered the separation of Baylor College of Medicine from Baylor University I don't know if you know that

Erik: Familiar with it okay, but don't know details.

Dr. Musher: Well the reason is that Baylor University, because of its religious requirements for students and faculty, was not allowed to accept federal grants and that DeBakey said a medical school can't survive without federal grants so obviously it took a lot of negotiation I'm sure there were a lot of egos that were involved but he did get the medical school to separate from the College of Medicine. The next thing he engineered was incorporating the VA fully into the Baylor teaching system a College of Medicine doesn't have enough money to pay all the salaries for all the faculty it needs but a federal hospital needs to be covered by physicians so he created the idea of a dean's committee in which they were representatives of the VA and in the Baylor College of Medicine and all appointments of physicians at the VA hospital since 1969 have been made by or approved by the deans committee, which means they've been approved by the Baylor College of Medicine and by the VA. So everyone at the VA basically is involved in some way or another in teaching. Now if you think about that, I told you originally I wanted to teach medicine and I did by the time I finished this fellowship of mine I wanted to do research, so I needed an institution that would support me would give me sufficient time to do my teaching and do the research well. The VA was willing to do that under these guidelines, so I was therefore willing to come and be a VA physician. Boston VA didn't have this arrangement and I wouldn't have dreamed staying in Boston to the Boston VA. Houston VA was first class faculty, first class citizens because it was fully integrated as a teaching system that was DeBakey's doing so the guy was obviously a brilliant surgeon who was apparently a very good engineer. Also yeah some of the stuff engineering skills and he also had brilliance and foresight in his administration, yeah so I  think the guy was a super genius he actually was very nice when you met him personally and socially.

Erik: Wow well thank you for sharing that. We're always curious here to hear about the great Dr. DeBakey we see his name all over the place right.

Phillip: I kind of had a question more about staying up to date on current papers and being able to I guess pull back from those later papers as well. How do you in medicine, and being in practice as long as you have, how do you make sure that you're up to date?

Dr. Musher: It's a very good question it's harder, it's much harder, because there's so much more that's known and that does drive people to sub-specialize. I do think it's unfortunate because a lot of folks who are doing subspecialty medicine forget the fact that I emphasize at first we were internal medicine specialists before so specialized. When I graduated medical school the whole textbook of medicine I think was 1,100 pages long with big print and big margins. The infectious disease textbook at the present time is four thousand pages with tiny print no margins whatsoever and it's just incredible. When I started on the faculty I did read 12 or 13 journals regularly I'd sit down at 10 o'clock at night after the kids went to bed and I would either read literature or write manuscripts from 10:00 until 2:00 every morning so I really pushed myself and I deprived myself asleep, because when I'm on vacation I sleep eight hours a night like everybody else, but I just didn't let myself do it. And as an intern and as a resident I read voraciously every night no matter how late it was. I had a resident who inspired me and drove me to do this when I was an intern. First week “Musher would you read last night”, “Dr. Greco I went to bed at two o'clock in the morning how much could I have read”. “Musher you could have gone to bed at 3 o'clock in the morning, what did you read last night”. That guy ferocious, he became the head of medicine at Roosevelt St. Luke's in New York he was really, really good so he got me started on this path, but I read. We were on every other night but we didn't work anywhere near as hard as you guys work when you're on at night because I just covered my patients and the other one other interns patients and not that much happened. Now you're on every fifth night which means you're covering your service and four others so what's all night long. So I was there at Bellevue and you've worked for a few hours and Bellevue had a wonderful library I sit there and I read I remember reading Goodpasture's original article, I think it was American Journal in medical sciences 1919, I'm sure people are pulling out their computers to fact-check me. I remember Harvey Cushing's experiments on increased intracranial pressure and the effects on blood pressure and pulse I think that was nineteen o- four to five it was nineteen o-four to five and that was American Journal of Medical Sciences I read it was something called Hamman-Rich syndrome, which is now really acute onset of interstitial lung disease. It was described by two pathologists at Johns Hopkins, Hamman and Rich. Rich was also the great pathologist to describe TB. I read their articles, I read circulation beginning in volume 1, I just read it 13 years of circulation. I mean every thought was a bit crazy, but I loved it. Then for six months I was in the Bellevue chess service and we were on every third night. This was an unbelievable luxury so I work one night I'd read one night and I'd go out one night I go see Shakespeare productions in Central Park and wintertime I go ice-skating in Central Park. I went to theater movies whatever it was, so I loved my internship and residency. Anyway I did read a lot when I was junior faculty. I read 12 or 13 journals and that was beginning in 71 when I first came to Baylor and I kept up that pace through the early 80s and then I started to reduce the amount of reading because journals that used to publish once a month we're now publishing every two weeks, some of them every one week, that it just wasn't possible wasn't it humanly possible to keep up. And now I read the major medical journals which is Annals of Internal Medicine, New England Journal of Medicine, JAMA, and the major journals in my field which is Clinical Infectious Diseases journal, Infectious Diseases, Lancet Infectious Diseases, and every article they refer to that I'm interested in and I read. I do write a number of sections for Up To Date so I have to stay up-to-date in those. Because I write articles I've got to be reviewing literature all the time. I'm upset I just submitted an article to Lancet Infectious Diseases they wanted only 30 references, I had 50 references. I had beautiful, I had references back to the 1915 I mean oh guys it, gorgeous references. I had to cut them out, it bothered me to cut them out.

Erik: I've never heard of a journal wanting fewer reference, wow.

Dr. Musher: They do. Clinical infectious diseases allows you forty references new English journal of medicine allows you only forty references.

Erik: I wanted to just quickly, you mentioned Bellevue and it's a historic hospital and I think it's important for people at Baylor to know about it because you know I think that's where the ambulatory program originated in America and I guess the world and as you were just quoting like the library that it has because it's been around since I think the smallpox in the 18th century. Can you tell us anything special that you noticed about it or was it just like any other Hospital?

Dr. Musher: Well every hospital has its own culture. Bellevue it's interesting there were three medical schools that each had separate services at Bellevue and NYU service, Columbia had a Columbia division, that's what I was on, Cornell had a Cornell division. Each of us thought that we were better than the others and there was a lot of pride we tried to do very good work. Yeah it wasn't beautifully equipped, it wasn't like Columbia Presbyterian which is where the fancy residents and the fancy patients went, it was just Bellevue. And in those days Bellevue was near the Bowery, which you guys probably don't even know about, but now what is now Soho in Manhattan is so gentrified was slums. And at the foot of the third Avenue L as the elevators subway was where what we would now call homeless people would stay, except it was against the law to be homeless you have to go find somewhere to stay at night, but basically that's where they were and that's who our clientele was. We also had lots of patients from Chinatown, the Lower East Side had large Italian population, large Jewish population, many of these were either immigrants or their parents had been immigrants and brought them as little kids or at most they were born here and raised here but they were first-generation and barely. So there were tremendous diversity of population tremendous diversity of disease. We worked terribly hard there were no politics that's what I loved about Bellevue. At Bellevue there was so damn much work to do you have time to jockey for power or importance you just have to do the work and I did love the work.

Erik: Well that's a good point because it's a public hospital and it was like one of the first public hospitals.

Dr. Musher: Exactly right. Historically it was and it was it was a place where they introduced some of the important good nursing practices and I read a history about it and as you say it began they were the precursors were in the late 1700s I think and then by eighteen, mid 19th century mid 1800s it was really starting to grow into flourish.

Phillip: I feel very lucky to be here at Baylor and have that same sort of public hospital training here at Ben Taub.

Dr. Musher: Oh yeah, Ben Taub is amazing.

Phillip: it's such a good you know resource as a student to be able to see that kind of diversity.

Dr. Musher: Ben Taub gives you exactly that experience. I did round at Ben Taub when I first came my first couple of years I rounded at Ben Taub and I sure did like it, but it was just so disruptive to drive from the VA to drive over here park and drive back.

Erik: the VA has also been helpful in your clinical work because you have like longitudinal population that you see for a long time is that correct.

Dr. Musher: Yeah that’s terribly important yeah and that's actually why, well it's one of the reasons, that the VA provides such extremely good care. I will mention that in addition to by working there, in addition to being a veteran, about 20 years ago I stopped getting health care anywhere else in Houston, I get all my care at the VA as well. I think in general the average ordinary VA patient gets better care than my financially comfortable friends and family do in Houston. So I do like the place and we have a way of following our patients because they come to us and they stay with us and you're absolutely right so if you want to do a longitudinal study you can do it at a VA. At the Ben Taub it's hard because people drop in and drop out, and the same thing with the good private hospitals they may choose to go to St. Luke's this month and they may choose to go to Methodists and then go off to the Mayo Clinic or the God knows where and the records are all scattered about yeah and you can't do those same kinds of studies.

Phillip: Transitioning from clinical practice to more a personal life question you mentioned in your internship years you know were able to go out and see some Shakespeare productions and those kind of things and you just want to share with us how you're able to incorporate the rest of your life.

Erik: Hobbies?

Phillip: Hobbies. That was long-winded, I apologize.

Dr. Musher: No, no, I’m long-winded

Erik: You have a lot of cool stuff to say though its ok.

Dr. Musher: You ask me a short question and get a long answer. I played the violin in high school I was I was good I played but I didn't I practiced but half an hour, 40 minutes a day that's all, but very carefully. I got to college I played more. They made me concert master at the college Orchestra, I played much more. It was one week sophomore year in college I played 40 hours of music, I was really proud of it. I decided in medical school I'm certainly not going to stop and even as an intern and a resident at Bellevue I found a room where I could take my violin and practice on nights I was on call I could practice and I have played several times a week ever since. So whole life I have I play string quartets. Almost every week my son Benjamin, who is really good violist, plays in and we play with we're fortunate we play with some very good professional musicians in town, so music is a very big part of my life.

Phillip: I have to ask, did you raise your son to be a violist so he could accompany you. that seems a little too convenient

Dr. Musher: Important question, I raised him to be a violinist and I kept begging him I said, “Benjamin”, he was a kid, “Benjamin please learn to play the viola”, “dad I'm busy”, cuz he's young he's also a wonderful ballplayer - you wouldn't know that he's an astonishing ballplayer I don't know where the genes came from.

Erik: And a physician, on staff here.

Dr. Musher: He’s an astonishing physician, that’s absolutely true. But anyway, and then he went off to college and he actually sang in college so he was in the Harvard glee club and he was one the acapella groups, he was a musical director of the acapella group, so are my other kids, all my kids did singing, so we didn't even play the violin much in college. But he came home one winter when, I offered him $100 when he was in high school said, “Benjamin I can give a hundred dollars, learn to play the viola.” He came home one Christmas break he says okay dad I'll play the viola he picked up the viola, now he plays the viola so that's kind of how that came about, I raised him to be a violinist. Now my youngest one wanted to play the flute I said Debra you know there are two chairs for a flutist in the orchestra and there are hundreds of young people who want that position. There are eight or ten shares for cellists and the back four of them were never filled so it's true I made her play the cello and she's petite and every time she picked it up she gives me a soulful look like daddy why did you do this to me I wanted to play the flute, but she played the cello and she played in the orchestra high school, she stopped in college. The oldest one played piano, I made her play viola so I did have a string quartet when the kids were growing up.

Phillip: The truth comes out.

Dr. Musher: I play violin, Benjamin played violin, Rebecca played viola, and Debra played cello. We had a little string quartet.

Erik: That amazing.

Dr. Musher: So, and then when they set up the Medical Center orchestra. I played, I was the concert master that from the opening until about five or six years ago and we were rehearsing with the orchestra for one night a week. So I played quartets one night a week and rehearse with the orchestra one night every week. I do love Shakespeare I never miss a Shakespeare play in town I read a lot try to read a novel a week and just don't let myself sleep.

Erik: I think you also mentioned that you take part in a lot of activities with the Jewish community.

Dr. Musher: Oh yeah that's true. All three of my kids I'm pleased to say are what you would say their competent liturgically, that means that they can stand up and lead any service in correct Hebrew with the correct melodies, that's what a professional cantor does, but they're able to do that and they've all done that. They can read from the scrolls which requires a special chant, they can read the profits from the book requires a different chant, they can lead services, and I was able to learn those things as a kid so I passed that along, pass those skills along to my kids, it is true.

Erik: Well thank you so much for your time, we know that you're busy, so we really appreciate you taking the time to come over here.

Dr. Musher: I'm honored to have been asked I thank you very much. I'm not sure what a podcast is, I don't do social media, but if anybody's interested I'm glad they'll be interested. You have to call me you know where to find me.

Phillip: We definitely appreciate all your lectures in infectious disease that we just you know wanted to hear more about you.

Dr. Musher: Thank you very much, I appreciate it.

Outro

Jennifer: Alright that's it for now we'd like to thank everyone who took the time to listen to this episode of the podcast. Special thanks to Philip for writing the episode thank you to our faculty advisor Dr. Poythress for helping us put everything together. Thank you to the Baylor communications department for helping with the production and website and thank you again to Dr. Musher for taking the time to be interviewed by us. we hope everyone enjoyed it and hope you tune in again soon. Goodbye for now.