Mauricio Castillo is a professor of Radiology and chief, Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, USA. He is also the editor-in-chief of the American Journal of Neuroradiology (AJNR) and president of the American Society of Neuroradiology (ASNR). Castillo speaks to NeuroNews about how he became a neuroradiologist, the lessons he has learnt from his mentors and the focus of this year’s American Society of Neuroradiology meeting.
What drew you to medicine and neuroradiology?
When I was growing up, most of my friends’ parents were physicians and professors whereas I came from a “business” family. These individuals were US trained and intellectuals to whom I looked up to and wanted to imitate. In medical school I wanted to be a neonatal intensivist but I was lucky to have done my internship at a military hospital which had one of the only two computed tomography (CT) scanners in my country at that time as well as two board certified radiologists. What impressed me most was their ability to formulate a differential diagnosis. While doing my residency I was mentored by two wonderful neuroradiologists, Dr Robert Quencer and Dr Robert Shapiro. Sometimes you just want to become what you most admire in others. I made the right choice and have never had a single doubt about it.
Who else were amongst your mentors and what wisdom did they impart to you?
I have been lucky; all of my mentors have become my friends. From each of them I have learnt different but equally important things. From Dr Quencer I learnt the ability to work efficiently, honestly, and to keep in mind the practical issues at hand; from Dr Michael Huckman to work with fairness, passion, and style; and from Dr Thomas Naidich to continue learning, always reaching for knowledge that others do not have and to always strive for the best quality. Of course, these distinctions are somewhat artificial; what I have truly learnt from all three is to be the best that I can. All of them have helped me achieve what I have and to think that one can achieve it all without the help of others would be silly.
You are the president of ASNR, what are your aims for the association in 2014?
Like most relatively small scientific societies, we are re-evaluating what our role should be and how to accomplish it best. We have retuned our strategic plan; we have created work forces that look into how we can better utilise our resources (both financial and human), how our meeting is structured, and how to improve our international standing and our relationships with the industry.
What is the theme of the ASNR meeting this year and what will the highlights of the meeting be?
Our president-elect, Dr Gordon Sze, was in charge of organising the Montreal meeting. The two-day pre-congress symposium will be on infections of the central nervous system but this year clinical and research tracts will run in parallel. In addition, we are expanding from one research study group (cerebrospinal fluid flow) to four (vessel wall imaging, genomics, translation of advance techniques, plus cerebrospinal fluid) and creating hands-on workshops (fMRI and DTI, bold fMRI, and traumatic brain injury). And of course, Montreal in itself is already a highlight!
What lessons have you learnt as the editor-in-chief of the American Journal of Neuroradiology?
Patience, honesty, and fairness but overall to be (even more) compulsive and obsessive about what I do. The journal is wonderful because every month one has tangible proof and results of one’s work but at the same time if mistakes are made they are there for all to see. I have always been fascinated by work of editors and the business and ethics of publishing and not only have I learnt a considerable amount about these but I think that by looking at all manuscripts that come in I have become a better clinical neuroradiologist too. From other editors I have learnt that we all are passionate about our work and that we feel very protective and proud of our journals. If I had to pick my favourite part of the job in over 25 years of doing neuroradiology, it is being AJNR’s editor.
As professor of radiology, what advice would you give to someone just starting out in the field?
It is no longer possible to do everything one is asked to do. So, choose what you enjoy and do it well. It is better to choose something small than failing at something large. Also, I do not think that it is longer possible to be significantly involved in the local university activities while at the same time taking huge volunteer work responsibilities outside with scientific societies. The time all of these activities demand is great and there simply are not enough hours in the day to do them all.
Have you practised in Central or South America and, if so, what are some similarities and differences between there and the USA?
I have not practised outside of the USA; I came here immediately after finishing medical school and never went back. But I do travel a lot there and I can say that a few years ago neuroradiology in the USA was still much more advanced than in Latin America and that is not the case anymore; the gap has narrowed and in most countries good equipment and American- and European-trained neuroradiologists do excellent work.
What innovations have changed neuroradiology in the last 10 years?
It goes from purely anatomical imaging to functional, biological, and now genetics related imaging. Of course, most neuroimaging techniques are still anatomical and most diagnoses can be made with just them. But all of others are adding tremendously to our understanding about how the brain works and how lesions arise and behave.
Could you describe a memorable case where your expertise came to the rescue?
I do not think that there is one memorable case; this is something that I think happens to all neuroradiologists and perhaps to all radiologists, on a daily basis. Our job is to add value to the medical care delivered to patients by suggesting and guiding appropriate diagnosis and treatment.
What recent publications have caught your eye?
Leaving science apart, there have been some publication-related articles that have really amazed me. The fact that the Chinese are selling the authorship in scientific articles is simply mind-blowing and upsetting, not to say unethical. The issue of the for-profit scientific publishing predatory journals who take advantage of the fear of professional promotion and reduced library budgets is something simply terrible which will impact our “real” journals.
How do you see the field of neuroradiology developing in the future?
It is always difficult (and many times foolish) to attempt to predict the future. Unfortunately I feel that neuroradiology will become more fragmented but no less important. We have seen the breaking off most of neurointerventional, fMRI, and other techniques. As financial pressures continue to rise in radiology we tend to retrench into what we know and can do best which is anatomical imaging, and we tend to pay less attention to other techniques. I think that the study work groups that have been organised for our 2014 annual meeting are a good way to mitigate these problems and create excellent multidisciplinary teams.
What are your interests outside of medicine?
A love of literature and cinema. I try to read three books at the same time, one in English, one in Spanish, and one in French—mostly fiction but non-fiction too. I am very interested in popular culture and read at least seven magazines related to it every week. I have always loved music and still buy about 10 albums a week in every genre but to my chagrin I do not play any instrument. I guess that my wife and I would also be considered foodies.
Is there anything else you would like to add about your career or your field?
No regrets whatsoever. Coming back at the start of this interview, I wanted to be like the fathers of my friends who were doctors and professors. I was promoted to professor early on in my career so everything that has happened after is like the French say: la cerise sur le gateau.
Fact File
Current appointments
Chief of Neuroradiology, University of North Carolina at Chapel Hill, USA
Professor of Radiology, University of North Carolina at Chapel Hill, USA
Education
1988–1990 Neuroradiology fellowship, Emory University, Atlanta, USA
1984–1988 Radiology residency, University of Miami, Miami, USA
1983–1984 Research fellowship, MD Anderson Hospital, Houston, USA
1976–1982 Medical school, Universidad de San Carlos de Guatemala, Guatemala
Editorial positions
Editor-in-chief, American Journal of Neuroradiology
Societies
Past president, American Society of Neuroradiology
Vice president, American Roentgen Ray Society
Perspectives AJNR Series
Castillo M. From hard drives to flash drives to DNA drives, 2014
Castillo M. Cold and hot, 2014
Castillo M. Thinking in different directions, 2014
Castillo M. The benefits of beauty, 2013
Castillo M. Recognizing famous faces, 2013
Castillo M. Apples, 2013
Castillo M. Boosting your brain, part 1. The couch potato, 2013
Castillo M. Boosting your brain, part 2: The hard way, 2013
Castillo M. Overwhelmed by choice, 2013
Castillo M. Do not brainstorm!, 2013
Castillo M. Some things are better left unsaid, 2013
Castillo M. The scientific method: Time for something better?, 2013
Castillo M. The wisdom of crowds, 2013
Castillo M. Predators and cranks, 2013
Castillo M. iConsent, 2013
