As a pediatric neurologist, Daniel Birnbaum, MD, enjoys puzzling out the problems of the mind, and the firings, or mis-firings, of its billions of neurons. But in his private life, through yoga, and daily meditation practice, and sometimes week-long and longer silent meditation retreats, he tries to make peace with the neurons in his own mind and body.

But he does so with a sense of humor. “I’m the person who goes to yoga classes so that other people don’t feel so bad because they’re not as bad as that guy,” he joked.

In between yoga and meditation, and operating and building amateur radios sets (more on that later), Dr. Birnbaum is the director of the division of Neurology at Children’s Hospital & Research Center Oakland. He admits he sort of “meandered” into neurology, even as it proved a perfect match for his skills and interests.

Born in Denver, Colorado, Dr. Birnbaum spent his formative years in Los Angeles. His father was a rocket scientist, turned math professor, which was a little embarrassing when the young Daniel didn’t exactly ace arithmetic. Claims he got Ds in it, in fact, until a junior high algebra teacher clarified the subject for him and suddenly “it clicked.” He sailed through math from there until his second year of calculus, when it became “incomprehensible” again.

No problem; Dr. Birnbaum wasn’t tracked to be an engineer or rocket scientist. Along with his high school buddies, he headed to the University of California, Riverside (UCR), to study biochemistry.

He admits to being “conflicted” about becoming a doctor, but a little pressure from friends helped push him to apply for what was then a new program at UCR, a seven-year biomedical sciences/medical school program that cut one year off the usual eight-year training. He joined the program his sophomore year.

“It was the first years of the program,” Dr. Birnbaum recalled, “and they had a reputation to make. They were determined that we’d be as good as UCLA’s medical students. As a result, they made us work really hard.

“I always joke with people that the year I saved is the year they had all the fun…”
The final two years of the program were at the University of California, Los Angeles (UCLA) medical school. He considered pediatrics and psychiatry for his specialty, but in the end chose a pediatric residency at UCLA. During his residency, he enjoyed the neurology group he worked in, and of course there was the interest in psychiatry, a related subspecialty. After completing his residency, and another year as chief resident at UCLA, a slot opened up in UCLA’s pediatric neurology fellowship program and he took it, setting his course and completing his training.

After a couple of years in private practice in St. Louis, Missouri, Dr. Birnbaum returned to California in 1990, young family in tow, to join the staff at Children’s Hospital Oakland. He became the director of Neurology in 1998.

“One of the things I like about neurology,” he said, “is it is still very dependent on being able to take a good history and do a very good physical exam. That hasn’t gone away, despite all the fancy imaging. Technology hasn’t replaced it.”

“Even though we can take stunning pictures of the brain in an MRI scan, we still learn from the physical exam where problem has to be, and even if an MRI doesn’t show it at first, a later MRI often does show a problem just where we thought it would be based on the history and examination.”

Field evolves

The field of neurology has changed since his fellowship days, Dr. Birnbaum acknowledged.

“The CT scans were very crude by today’s standards.”

But what has changed even more is the reliance on genetics. “In many neurological disorders there may be a genetic basis, so we are now doing a lot more blood testing for genetic problems.”

Sometimes that makes it easier, other times more complicated, he said.

“The testing is expensive; instead of a shotgun test, they’re kind of like a laser beam test. You think something is there, but if you are wrong you’ve spent a few thousand dollars, and still don’t have a diagnosis because that was not the right target.”

It makes him try to think through things clearly, and rely on his very astute colleagues.

“One of things I love about working here are my wonderful colleagues. They are all very smart; once a week we meet and go over patients, present cases, consider ideas. We also meet weekly with radiologists, we do so many MRI scans.”

To him, putting the pieces together, solving problems, is the fun part of his job. “I like to think things through a bit, get information, assemble data, puzzle pieces out.”

“Neurology was a happy choice in the end,” he acknowledged. “It’s really a fascinating area. A very big area, it sounds very sub-specialized—pediatric neurology—but it encompasses a lot, and it keeps you on your toes.”

What else keeps him on his toes is studying Spanish in a group at Children’s. “My goal is to not need an interpreter with Spanish-speaking patients,” he said.

He’s also a long-time fan of amateur radios and can be found broadcasting on one in his Lafayette home.

“It’s even more fringy than that,” he explained, “I like building the radios, I like soldering them together, from kits. It’s an old school kind of thing.”

Even older school is the method of communication his radios are built for. His low-powered, 5-watt or less transmitters are built for Morse Code; as in dots and dashes, simple electrical impulses.

As in, perhaps, the brain.