I am a clinical psychologist with board certification in geriatric psychology. I am based in the Geriatrics and Extended Care Service of the VA Puget Sound Healthcare System.
I am an adult psychiatrist and palliative medicine physician within the Department of Psychiatry and Behavioral Sciences. I am dual board certified within the American Board of Psychiatry and Neurology and American Board of Internal Medicine. I practice at Harborview Medical Center (HMC) on both palliative care consult and inpatient psychiatry teams. I help lead the HMC psychiatry quality improvement (QI) committee. My main areas of interest and expertise are in: the care and treatment of patients facing serious persistent mental illness (SPMI), particularly those with co-occurring chronic medical illness; complex communication skills with patients and families; the use of person-centered language in medicine; interprofessional teamwork. I enjoy providing clinical teaching and QI mentorship to medical trainees such as residents and medical students. I am the co-director of the interprofessional health-sciences elective “The Healer’s Art.” I am a member of the Northwest Narrative Medicine Collaborative.
Personal Statement
I am a board certified psychiatrist and work at Fred Hutchinson Cancer Center. I am a Clinical Assistant Professor of Psychiatry and Behavioral Sciences at the University of Washington. I obtained a fellowship in consultation-liaison psychiatry, a specialty that focuses on providing psychiatric care for people with complex medical conditions. My primary clinical focus is people with cancer.
I love my work. Being ill is a vulnerable time and my goal is to ease suffering and provide a sense of connection and understanding for all I work with. I believe in working collaboratively with patients and families. We work together to identify what the goals of treatment are. I have expertise in diagnosis, psychopharmacology and psychotherapy and adapt my recommendations to best serve the goals of the person before me.
I am also passionate about education. I am the site director at Fred Hutch Cancer Center for our Psycho-oncology Fellowship Program. I supervise Cl fellows, addiction fellows, psychiatry residents and provide education to social workers and psychology trainees.
Personal Statement
My clinical service and research focuses on the interaction of mental and physical illness, especially in patients with chronic pain. Much of my research in recent decades has focused on the risks of treating chronic pain with opioids. I have developed educational programs and outcome tracking tools to assist with opioid treatment of chronic pain. I have published a book about patient empowerment in chronic disease care, The Patient as Agent of Health and Health Care (Oxford, 2017). I have another book written with Jane Ballantyne forthcoming, The Right to Pain Relief and other deep roots of the opioid epidemic (Oxford, 2022).
Personal Statement
I am a basic neuroscientist, a board-certified practicing psychiatrist, and an Assistant Professor of Psychiatry and Behavioral Sciences at the University of Washington Medical School. The goal of my research is to investigate the neural circuitry of cognitive, emotional and memory processing, particularly as it relates to the cerebellum, and illnesses affecting cerebellum including cognitive disorders, PTSD, TBI and dementia through the implementation of techniques in mouse behavioral genetics. In my clinical practice, I primarily see veterans with PTSD, mild cognitive impairment, and various forms of dementia in an outpatient clinic at the VAMC Puget Sound Geriatric Research, Education, and Clinical Center (GRECC) in Seattle. I have over 15 years of experience in basic science research with most of that time dedicated to the use of mouse models of neuropsychiatric disorders.
Throughout my training prior to and during graduate school, I gained background in many contemporary molecular and biochemical lab techniques, such as molecular cloning, protein biochemistry, protein crystal production, fluorometric measurement of protein kinetics, in vivo NMR spectroscopy, gene targeting, microarray genomics, immunohistochemistry, and mammalian cell culture. I have a foundation in mouse genetics, neural development, and behavior which I developed in Michael Georgieff’s lab by investigating the role of iron in developing pyramidal neurons of the mouse hippocampus. During graduate training, I also received cross-training in child psychological development. In graduate school, I developed two mouse models of nonanemic neuron specific iron deficiency: 1) a conditional knockout of the Slc11a2 gene, encoding the iron transporter DMT-1 in forebrain neurons, including hippocampal pyramidal neurons, and 2) a transgenic mouse with a reversibly inducible dominant negative (nonfunctional) form of the transferrin receptor expressed only in hippocampal pyramidal neurons. I utilized and implemented different versions of the Morris Water Maze to study learning deficits in these mouse models of perinatal brain iron deficiency, a condition that is often a consequence of diabetes during pregnancy.
During my residency training, I expanded my knowledge of neuropsychiatric disorders by directly evaluating and treating patients with neuropsychiatric disorders including PTSD, schizophrenia, Alzheimer’s disease, autism, major depression, substance abuse disorders, and personality disorders. I learned numerous pharmacological, neuromodulatory, and psychotherapeutic interventions and participated in the internally funded Neuroscience Research Track. I then received a NIMH career development award (K08) mentored by Larry Zweifel, Ph.D. In that position, I investigated interactions between catecholamines and the cerebellum in decision making, emotional and cognitive processing. In the 5 years I was in Dr. Zweifel’s lab, I learned many additional new techniques including use of viral vectors, in vivo electrophysiology, and several operant- and threat-based behaviors, and moved forward in my goal of becoming a physician scientist isolating important circuits underlying etiology of specific domains of behavioral function. This work culminated in my receiving an RO1 independent investigator award, without any gap in funding.
My current research utilizes mouse behavior, in vivo electrophysiological recordings, gene targeting, viral vectors, translational profiling, chemo- and optogenetic tools, site-specific intracranial viral vector injection, and protein chemistry. I am now forging my path as an independent investigator, and my primary goal is to understand cerebellar circuits as they relate to psychiatric and neurodegenerative illnesses and utilize this knowledge to inform and improve current and novel psychiatric illnesses, primarily in cognitive and emotional domains. As such, I am pursuing a multidisciplinary approach combining genetic, electrophysiological, pharmacological, and behavioral techniques.
Personal Statement
I have a passion for treating geriatric patients with new onset and longstanding mental health disorders and cognitive disorders. My primary interests are depression and psychotic disorders, especially when these symptoms overlap with cognitive disorders. I value sharing in the life histories of patients and families, the challenging complexity of medical issues as they interact with psychiatric presentations and assisting patients and families in discussions about advanced care planning and end of life issues.
I have particular expertise in working with those living in long term care settings where I have done consultation work.
I have recently joined Harborview’s ethics committee in order to participate in examining difficult clinical, social, and ethical situations which affect patients, families, and staff within the medical system.
As a psycho-oncologist at Fred Hutchinson Cancer Center (FHCC), I serve patients as a psychiatrist specializing in mental health issues arising during the course of cancer and hematologic diseases. My approach to care is person-centered, focusing on your story as a person as well as a patient, and combining psychotherapeutic and pharmacologic approaches to help you navigate your journey with medical illness.
I bring fellowship training in consultation-liaison psychiatry to understanding the interplay between medical conditions and mental health issues, and I believe that partnering with both patients and their medical teams is essential to create a successful plan of care. While I often oversee psychiatric medications during cancer treatment, I also have a background in supportive, psychodynamic, CBT-focused, and meaning-centered psychotherapy, and I incorporate psychotherapy elements into each appointment.
Within the field of psycho-oncology, my specific interests include working with palliative care populations, supporting existential issues that arise during journeys with cancer, and strengthening collaborative care models in oncology settings. I am also fortunate to teach outstanding UW psychiatry residents and fellows who complete clinical rotations at FHCC.