Black History Month Member Interview: Charlene Gamaldo, MD, FANA

CGCharlene Gamaldo, MD, FANA

Professor, Neurology

Medical Director, JH Center for Sleep and Wellness

Vice Chair of Faculty Development, Neurology

Associate Vice Provost, JHU Provost's Leadership - Advancement - Development (L.A.D.) Academy

Johns Hopkins University 


Q. Please tell me about your career path and research.

A. My career path is probably best explained as a circuitous career path. When I completed medical school, and even going into my residency, my plan was to get the training and go into private practice and be a clinical practitioner. I ended up deciding that I wanted to do sleep, and I wanted to get training at what I thought would be one of the best places to do it, so that that's why I landed at Hopkins. My plan was to do the two-year fellowship and move right along to hopefully begin my career as a sleep clinician.  As you can see, that was in 2004, and I'm here at Hopkins now in 2023 - almost 20 years later. So, I'm not that good at predicting the future, my crystal ball isn't so great, but that kind of gives you a the sense of my career journey - I let it guide me where it felt right for the moment.  

The research exposure really came about in fellowship because, ingrained in the sleep fellowship at Hopkins, there was a prominent research component. I was engaged in research with Drs. Chris Earley and Richard Allen, faculty members at Hopkins, who brought me on to work with them and supported my fellowship position, and as part of that I worked with them on their research. It was truly through that experience, and their support, that opened my eyes to a potential that I didn't see myself at first, but getting that support, that sponsorship from them helped me have the confidence to say, “I can probably do this,” so that that's when I came on as a faculty member. With that grew a really core support of faculty who were instrumental in me staying at Hopkins, feeling that I had a formidable path at Hopkins and providing mentorship and sponsorship that guided me in my own leadership path. Justin McArthur, was an extremely, extremely important figure in my path, and in supporting me. And then Nancy Collop, who's no longer at Hopkins. She was a sleep physician, a pulmonologist in a different department and she was extremely instrumental in bringing me on as part of her vision of an sleep program. At the time, sleep was primarily housed under internal medicine, so she brought in an outsider in many ways, so to speak, she saw my potential and I am so appreciative even to this day, because she brought at a very critical care point invaluable advice, development, and tons of sponsorship. When she moved on for another opportunity at Emory, she was extremely instrumental in me being the first neurologist, a non-pulmonologist to run the sleep center at Johns Hopkins while still under medicine. 

While that was going on, what also became clear from a research standpoint, is I got introduced with research by my involvement initially in  RLS research through Richard Allen and Chris Earley, who remain one of the foremost leaders in RLS. That gave me an opportunity to get a taste of research, and whether I liked it, but it also gave me an opportunity to create my own path. I have to give credit where credit is due, Justin McArthur at that time early in my career, said, “well, what's your burning research question? Identifying your burning question can serve as the inspiration to guide your research.” That was the most important question and one that every investigator early in their career should ask themselves. “What's my burning question? What's the question that I’d like to help answer or contribute to our scientific knowledge of, in order for us to get closer to the answer?” So for me the question was how sleep has an impact, not just in the manifestation, but in even the management of other neurological conditions. 

We knew that there are a lot of patients with neurological conditions, whether it's neuromuscular, whether it's headache that, whatever it was, it was very common theme that sleep disruption was a prominent area that was causing them a lot of concern. So I, as a neurologist, thought I was nicely positioned to dig deeper into that and so my research really started in that direction. It started first with Justin, the HIV/ Neuro HIV expert, he said, “You know now that you mentioned that we hear about sleep concerns  quite a bit in our patients, too. So why, don't you take a look in the literature and see what's out there and see what maybe a question you have that that can be built on, based on what is in the literature.” I took that moment to do that and really spent the time to do a deep dive with the research, and it turned out that there really wasn't that much in the literature. And most of that research wasn't specifically about the full breadth of sleep disruption or presence of sleep disorders, what was out there primarily focused on the presence and mechanisms behind sleep apnea and HIV specifically. So that's what I brought to Justin and said my question is, “how does sleep in general, not just specifically one condition in sleep, but the features of sleep, and the presence of other sleep disorders impact individuals with HIV? And to what degree can we learn how it may impact management of their HIV or other medical conditions?” So that's how my career started. We were one of the  first to publish comprehensive sleep research characterization within an HIV cohort who otherwise demonstrated a non-detectable viral load so would conventionally be viewed as “well managed” but still had sleep issue. The studies included evaluation of their sleep from start to finish in sleep research lab settings, using home-based recordings of their sleep, and conducting full sleep clinical evaluations. That served as the prototype for me to now collaborate with other investigators to study the influence of sleep in other conditions -- whether that be headache, Parkinson's disease, dementia and in the inverse how cognitive function present with patients with RLS.  The path also led to collaborations beyond neurology, so I worked with colleagues studying sleep impact on pediatric cancer patient survivors and patients with urological conditions.  It was a great platform for collaborative research and I relished being the “sleep person” to add that element to my colleagues’ research. 


Q. What elements of diversity, equity, and inclusion are most important to you in your career?

A. I will fall back on Dr. Edelman, her famous quote, “You can't be it, if you can't see it,” and I think it is so critical to have presence and visibility, and to recognize that folks are inspired when they see individuals who they share various components of their lived experience, whether it be ancestry and ethnicity, gender identity, or sexual orientation, whatever that be, seeing folks that somehow share some commonality with you, and seeing them at a position that you aspire to, is extremely important. It’s important to remember that in your professional path there is always someone behind you that is inspired by where you are and what you have achieved and these maybe folks that you don't even know are watching. And so that's the biggest element for me in terms of why it’s important - you just don't know who could be watching and inspired for instance a child of a patient walking through the hallways of Johns Hopkins may see a picture of somebody who looks like them – and that serve as their first inspiration. In addition to our students, our faculty members – recognition, acknowledgement and visibility is so important. What is important to me is representation, and not just representation in numbers, but in a very visible way and that visibility is not just that at one level, but it should be at every level, especially levels of leadership, where there's influence, because then folks feel like theirs is no glass ceiling, and that I could actually reach those levels of leadership, or wherever that is. So that's been the most important element for me in terms of equity, diversity, inclusion, and access.


Q. So what's the best career advice you've ever received?

A. Just one? Or can I give a few? I mentioned the one about what's your burning question because that serves as sort of the core principle for what motivates your work and the goals you want to achieve - that was from Justin McArthur. Another one from Dr. Levi Watkins, who's no longer with us, but was really a prominent leader and figure at Hopkins as a cardio-electrophysiologist, who along with Vivien Thomas (another inspiration to me) were the first to successfully implant an automatic defibrillator in a human.  He is also famous for his civil rights efforts and my question to him was “How do I make a difference.” He said, “If you want to make a difference, if you want to get ahead, just worry about doing your own good science, you do your science, you do you, you do the best clinical work, and guess what, that's going to so important to pushing and promoting equity and diversity, because you're helping to show that that pathway is viable.” I really appreciated that because when I met him, he was already at that level, he was such an iconic figure with an amazing presence. He also said, Charlene, “I'm at the pinnacle now that I can focus squarely on diversity, but I do this so it gives more time and focus for the young talent coming through the pipeline to focus on doing your best science, so you can get to this point, and then you can even have a more influential voice in terms of helping to promote EDI principles.” That's something that has been inspirational from me from day one.


Q. So what does Black History Month mean to you?

A. Oh, it means a lot. In some ways I’m sad that it's just a month, because it suggests that you only “have” to or “need” to think about it for just a month and the shortest month of the year to boot.  On the other hand, it allows a time of retrospection and to. Celebrate the fact that there are so many shoulders that I and many folks of color had stood on to get to where we are today. I'm 52 years old.  I’m a woman with a medical degree and spent more years in school and training then most folks in the general population.  I remain shocked when I learn about prominent Black men and Women figures, who have done amazing things that I hear and learn about for the first time during Black History month?  This saddens and quite frankly frustrates me especially when I also hear about questions currently floating around regarding the necessity of having Black history taught in our primary schools and higher institutions of learning.  This should remind us all, regardless of our background, that Black history is American history, and we must continue to press the issue. As a 52-year-old woman, doctor, full professor, and Associate Vice Provost, I remain a student of Black history and that knowledge should be accessible and freely available. 


Q. Who is an inspirational black historical figure that inspires you and why?

A. Oh, my goodness! I saw your question about this, and that was tough, because I draw inspiration from so many. And again, I’m learning about even more of them that I didn't even know about. If I was to look at it strictly from the prism of science and academia, and these are just a some of the few - Dr. Levi Watkins, another is Dr. Bob Higgins, who was the first Black person to chair a department at Hopkins. So that was extremely inspirational, and he was the chair of surgery to boot. He's now moved on to be an executive Vice President at Mass General. I remain inspired by his path.  I had the pleasure to work with him on a few projects. He was so generous with his time, his advice, and his perspective, and was just such an incredibly gracious and poised person, so I’m always inspired by him. Within Hopkins right now I must give a shout out to somebody who constantly I look to as such an amazing figure is Dr. Sherita Golden, she is the Vice President and Chief Diversity Officer at the JHU school of medicine. She has done a miraculous job of making that department not just about a few people, because EDI efforts and progress cannot be put on the shoulders of a few people. She's really built an incredible department, really has shown that equity and diversity and inclusion and access is something that's about the intersection of many identities, and I really appreciate that, because nobody or group is a monolith, so Sherita and her team have done an excellent job celebrating the quilt of diversity.   She does it in a way that is so powerful, she makes the point, and she doesn't do it in a way that puts people on the defensive. She really does it in a way that’s more enlightening, insightful. 


Q. What can professional organizations like the ANA do to support the advancement of black position, researchers, and scientists?

A. Having greater effort in highlighting/providing visibility to Back neurology academicians and neuroscience researchers. It is incredibly important to highlight, to celebrate, and I think also to really think about how the ANA is not only increasing visibility, or even inclusion, but active efforts to show diversity in roles of influence within the ANA speaks this would send a strong message to the neurology academic community.