Q&A: Seattle Top Doctor Tim Scearce on How to Keep a Healthy Brain

[addtoany]

This article appears in print in the April 2019 issue, as part of the Top Doctors cover story. Click here to subscribe.

Why did you choose this specialty?
In college, I majored in philosophy and biology. The study of the brain and all the ways we experience our world seemed a perfect way to continue my interest in both fields. I haven’t been disappointed.

What are the most common issues that you come across in your practice?
Neurology is the study of the powerful and complex systems we use to experience the world (vision, hearing, touch), make sense of the world (thinking, memory, creativity) and how we interact with the world (speech, writing, movement). The neurological conditions I most often see include multiple sclerosis, stroke, memory disorders, peripheral neuropathy, Parkinson’s disease and migraine.

How do you work with patients with these problems?
The care of persons with each of these conditions requires open-hearted listening and a patient explanation, in language that makes sense to them, of how their nervous system is working (or not working) and what we can do to help. That basic understanding about what is going on helps us make shared decisions about what treatment fits best with each person’s values and goals.

What are your areas of special interest?
What really piques my interest is finding the path to the correct diagnosis and treatment that is both efficient and affordable. I like to tell my patients, “Let’s see what simple, natural ways we can try first to get you relief without asking you to go through dangerous tests, take medications with side effects or have costs that are going to eat into your family finances.” I make sure that, whenever possible, the first three things on my after-visit recommendations are not pills. In migraine, for example, one of the most effective treatments is to actually stop certain types of pills rather than add more. My dream would be for patients to someday be able to see a “cost to cure” score for every doctor they might choose from so they can select doctors who excel at helping people get better with the least number of tests or expensive medications.

Is there a recent development in your field that you’re especially excited about?  
There are many exciting developments in the field of Alzheimer’s that I am hopeful about. I would like to think that sometime in the future, we will be able to identify persons in their 30s or 40s who are starting to develop very early signs of brain changes that will lead to Alzheimer’s and will be able to offer those individuals a treatment to halt or slow down the insidious changes that occur over years before any symptoms arise. We are learning the painful lesson that treatments given after the diagnosis is established do not significantly alter the natural course of Alzheimer’s disease.

What are some key things that we can do to help keep our brains healthy?
I encourage all of my patients to do three things: stay active, stay connected and stay curious. The experts at the National Institutes of Health who study persons in their 90s who remain independent and clear in their thinking repeatedly find similar patterns in life choices. These men and women do something physical on a regular basis, they maintain healthy social connections with family and friends, and they make a habit of trying things that are mentally challenging.

What’s the most fun—outside of medicine—that you’ve recently had?  
Our kids love to spend the Fourth of July at Seabrook on the Washington coast. They love the bike parade and running with the dog on the beach and riding around on the (mostly free of cars) streets and paths. Just simple, unplugged fun. Active, connected and curious.