Top Docs Q&A: Alice Flaherty

Flaherty tells us about the future of neurology.

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, life as a doctor, and practicing in the Greater Boston area. 

Name: Alice Flaherty 

Hospital Affiliation: Massachusetts General Hospital

Title: Head of the Brain Stimulator Unit at Massachusetts General Hospital; Associate professor of neurology and psychiatry at Harvard Medical School

Field: Neurology

Specialty: Deep brain stimulators, Parkinson’s disease, movement disorders

Neurologist Alice Flaherty wrote the book Midnight Disease, which is about the neurology behind the drive to write and writer’s block. Flaherty has also taken her medical expertise and personal experience with mental illness to become a media advocate for those with mental illness.

Why did you first choose neurology?

From a very early age I was curious about other people’s minds and that led to an interest in neuroscience. I was too squeamish emotionally to deal with any of the messy psychiatry stuff, like moods and emotions, but later as a neurologist my interest sort of shifted when I realized that I was leaving out like 90 percent of the brain if I wasn’t interested in the psychiatry aspect.

What do you love most about neurology?

I like the really long-term relationships I’ve had with some of my patients. Some of them I’ve ended up becoming pretty good friends with, so I’ve met a lot of people that I never would have if I wasn’t a neurologist.

In the time that you’ve been practicing how have you seen your field change?

One main change is that biology, and maybe even neuroscience, has become sort of the dominant field in science. It used to be all about physics, so now it’s kind of fun being in the one of the most vibrant sciences where so much is being done. I think a lot of that shift has to do with the fact that cognition and mood are now being taken seriously; when I was in college it wasn’t.

What are some of the latest advancements that are happening in the field?

I’ve been working a lot with deep brain stimulators, which is an anatomically targeted way of changing people’s brain function. The stimulators work through electrodes that are implanted permanently in someone’s head which allow us to dynamically, but reversibly, change people’s brain activity. Originally I started working with them to help cure Parkinson’s disease and other movement disorders. It’s been immensely rewording to have someone come in in a wheelchair and then be able to walk. Later we started using them to treat conditions like depression and obsessive compulsive disorder.

What do you hope to see for the future of Neurology?

I hope that it becomes more integrated in psychiatry and we would realize that both of these sets of illness are very real and are very interrelated. It’s very hard to have a neurological problem without it also affecting mood directly, and vice versa.

What made you decide to write your book Midnight Disease?

It was sort of an unusual motivation in that I had a manic break after I delivered twins who died. With that break I developed a condition called hypergraphia, which is the compulsion to write all the time. I felt like everything was so important, and I had to write it all down, even if it was on my arms or toilet paper. I then became interested in what was going on in my brain. I thought that if there’s something in your brain that makes you want to write compulsively there could also be something that makes you have writer’s block.

How did your experience with hypergraphia influence your medical career?  

If anything it’s been a hindrance because it wasn’t possible for me to choose what to write about. I wrote about nutty things that were of interest to me. For example I wrote and published a children’s book based on a story my dad used to tell me about the Loch Ness monster and picky eating. I also worked with a composer and wrote the lyrics to an organ composition. I tried to make what I wrote useful to other people, because I thought even though I was writing wildly if it was published it made me look less insane.

How did you get involved in mental illness advocacy?

So my advocacy work has been mostly me speaking with the media about the abilities of people with mental illness. I got interested in this because with my hypergraphia research I realized how many writers have mood disorders. However, there are a lot of literary critics who get very upset if you say, for example, that Virginia Woolf had bipolar disorder. That’s really offensive to people with mental illness because it suggests that they can’t also be creative. So from being in documentaries and such I would talk about people whose illness is very closely related to their creativity.

What do you hope for the future of mental illness awareness?

I would like it to be seen more as a disease and less as a failure of willpower. Often people inadvertently blame someone that’s mentally ill because it’s very hard to identify with their illness.

What do you love most about practicing in Boston?

I’m so in love with Boston it’s actually hard for me to negotiate my salary because my boss knows that I would never want to move away. One of the more practical reasons is that I can bike almost everywhere.