Music, Medicine and Mind

Neurologist Aaron Berkowitz, B.A./B.S. ’99, grew up with a love of classical music, especially Romantic composers like Chopin and Rachmaninoff. He also played the piano with dreams of one day dabbling in composition. At the same time, Berkowitz imagined a career in medicine. So when he came to GW as an undergrad in 1996, he pursued a double major in music and biology.

The disciplines of music and medicine don’t seem to overlap in any Venn diagram of possible careers, but Berkowitz has been able to combine the improvisation inherent in some types of music with his work as a physician serving marginalized communities and contributing to global health equity.

But like the meandering melody of a Chopin nocturne, Berkowitz’s path from collegiate neophyte to the seasoned physician he is nearly 30 years later has been a winding one.

After graduating from GW in 1999, Berkowitz took a year off to live in Paris before enrolling in medical school at Johns Hopkins University. By his third year, however, the high pressure, long hours and little sleep began to wear him down. So he decided to turn back to his love of music and attend Harvard for a Ph.D. in ethnomusicology, the anthropological study of music focused on the cultural and social contexts of the people who create it.

After earning his doctorate in 2009, Berkowitz returned to Johns Hopkins to finish his medical degree and then completed his residency in neurology at Harvard Medical School’s Brigham and Women’s Hospital in 2014.

Then Berkowitz was finally able to create his own career Venn diagram of the two, something he says wouldn’t have been possible without his experience at GW.

Berkowitz cites two GW professors as being particularly formative for him, the late biology professor David Atkins and the late music professor Robert Parris.

“The opportunity to pursue biological sciences and music planted the seeds for those parallel medical and creative pursuits,” Berkowitz said. “Both were incredibly generous with their time, mentorship and encouragement both in their respective fields and in supporting me to pursue my other interests in medicine and music.”

The best documentation of Berkowitz’s ability to combine what he learned from both disciplines is his 2020 book, “One by One: Making a Small Difference Amid a Billion Problems,” in which he reflects on life as a young physician working with the non-governmental organization Partners In Health in Haiti from 2010 to 2017 during his neurology residency.

Berkowitz traveled from Boston to the Caribbean nation—one of the poorest in the world—where, he was told, there was only one other doctor in his field.

“At the time, there was one neurologist for Haiti’s population of 11 million,” Berkowitz said. “That would be like having one neurologist for all of Manhattan or Los Angeles County.”

Almost immediately, the conditions on the ground in Haiti offered Berkowitz the chance to put his powers of improvisation to the test. In the book, Berkowitz includes an email from a doctor, Martineau Louine, describing a 23-year-old patient named Janel who he had evaluated for headaches and attacks of vertigo, as well as trembling movements of his right arm and right leg that affected his walking.

Berkowitz describes his reaction to the CT scan of Janel’s brain.

“I’d looked at thousands of CT scans during the 80-hour weeks of my residency. But this CT scan was unlike anything I'd ever seen,” he said. “The ventricles—hollow cavities deep within the brain—were filled with a mass of abnormal tissue…It was complex, its contour bulging out wildly in all directions, compressing and distorting the surrounding brain structures.”

It was the largest brain tumor he had ever seen.

With no neurosurgeons in Haiti trained to perform complex brain surgery, Berkowitz had Janel flown to Brigham and Women’s Hospital. Janel was young, and there was hope he might respond well to treatment, perhaps even recovering and returning to school.

Ultimately, Janel needed five surgeries at Brigham and Women’s, multiple hospitalizations and long-term rehabilitation, but was walking, talking, eating and even singing by the time Berkowitz left Haiti.

“My understanding is that Janel is still doing as he was at the end of the book,” said Berkowitz, who has not been able to travel to Haiti due to the civil unrest that has gripped the country since 2021. “It’s not the huge save we were hoping for [he did not recover in full], but he’s still alive after what was likely to have been a deadly condition.”

But even if the treatment of Janel had resulted in the “huge save” Berkowitz and his colleagues hoped for, it couldn’t have been replicated on a larger scale. So improvising once more, Berkowitz—working with Partners in Health—began teaching neurology courses for internal and family medicine practitioners and trainees, followed by a four-week neurology rotation for five internal medicine residents at Haiti’s Hôpital Universitaire de Mirebalais.

The success of those courses inspired Berkowitz and his colleagues to launch Haiti’s first neurology fellowship, expanding access to neurological care.

In addition to his neurological training, Berkowitz says drawing on his ethnomusicology education helped him succeed by enabling him to understand Haitian culture and communicate across cultural, linguistic and socioeconomic boundaries.

“That anthropological framework is the foundation of ethnomusicology, and I think it gave me the perspective to be able to be a good collaborator and colleague there, and to navigate working in an environment as a foreigner from a high-income country,” Berkowitz said.
 

Today, Berkowitz continues to compose a successful career from the building blocks of his education and early experiences, maintaining his commitment to advancing neurologic knowledge while serving patients as a professor at the University of California San Francisco (UCSF). His varied but interconnected roles range from being a neurohospitalist and general neurologist to a clinician-educator at the San Francisco Veterans Affairs Medical Center and San Francisco General Hospital.

While at UCSF, Berkowitz continues to serve underserved populations—military veterans and urban residents of San Francisco. But Berkowitz’s influence extends beyond the classroom and the hospital hallways, engaging with the wider neurology community through his role on the editorial board of the journal Continuum: Lifelong Learning in Neurology.

Though these days Berkowitz is as busy as he’s ever been, there has been no coda to his love of music—at least not yet. He admits there are times he’ll hear a piece on the classical radio station during his commute and later pull out the score to play it.

“Every time I walk past the piano,” Berkowitz said, “I say just like there was a period of intense piano and then a period of intense medicine, maybe there’ll be a period of intense music again someday.”  

  Photography: Courtesy of Alan Berkowitz