>> I'm Dr. Bob Bulat.
I work in the division of gastroenterology
and the neuro-gastroenterology group
at Johns Hopkins University School of Medicine.
My specialty is neuro-gastroenterology
which deals with
disorders of the gut that come
from abnormalities of the nerves
that control gut movement
and gut sensation.
I'm originally from Canada
and I've spent,
I did most of my medical training at a place
called Hamilton Ontario McMaster University
and some time at University of Toronto.
But I'm from a small city in northern Ontario
just north of Michigan called Sue Saint Marie.
It's basically right on the edge of the
Canadian Shield Wilderness area.
I get up there whenever I can and I worked
in Canada for a few years and then I got
a faculty job at Tulane University in New Orleans.
I spent 19 years in New Orleans.
That was a real culture shock because
it's hot all the time
and the food was really good and the music was great.
Then I got an opportunity to come up to Hopkins,
which is an excellent, obviously a world-famous
excellent institution to work with some
people I already knew and I had a lot of respect for
and it's been a great experience being up here.
So now I'm trying to transition myself back
to Baltimore.
In a way coming to Baltimore is like going back to my roots
because the places I've all grown up in
have all been seaport towns
and immigrant communities
and basically,
Baltimore looks very very familiar in a lot of ways.
I actually knew people in my home town who
went to work in Baltimore at the steel mills
when they were still functioning here.
So there's a bit of closing of a circle.
Presently the research that I'm involved in is
contributing to a group called a gastroparesis consortium.
That's a number of academic medical centers
in the United States
that are collecting data on patients who
have a condition called gastroparesis
and gastroparesis-like syndrome.
We're collecting information on those patients
to help us devise clinical trials
to help treat these disorders
as well as to help us understand
fundamental reasons why these disorders happen.
From a pretty early age I've said I want
to go into medicine
and I wound up doing basic science research.
I had a Master's and PhD looking at
the fundamental reasons why
the muscle of the gut
and the muscle of the reproductive tract
works the way it does.
From there it was pretty
pretty natural for me to want to go into medicine
and try to apply what I learned in the lab.
Gastroenterology was the field that made
the most sense to me.
I was able to look at all the things that we did
in the lab back in the 70's and 80's
and see how things had progressed
to try to apply some of these in treatment of patients
it is very gratifying to be able to do that.
We get patients here at Johns Hopkins
from the immediate community,
as well as from the region,
from around the country,
and from around the world too.
Everybody shares one thing, they've got a problem
that hasn't been
dealt with by physicians
and with out a lot of success
because the disorders are not that common
and most physicians are not,
do not have the experience and training
to be able to deal with it under these conditions
on a long term basis.
So a lot of these patients come to us.
Everybody's got a story
and they've also got a stack of medical records
and we go through that with the patient
while they're in the room
and we ask them their story
and we probe with some questions
to steer them to certain directions
that we would like to know about more information,
but basically the patient has got to tell
us the story.
Once we've got the story then we can formulate
an idea of what we think is going on and why
and what we're gonna try to do about it.
That requires a lot of listening
and a lot of feedback with these patients.
So we initiate his treatment plan
and we make sure those patients are in touch
with us, electronically if they can't come
back to see us quickly in person.
From there we try to make them better,
that's a simple view of how it works
but that's basically how the process works.
The most rewarding thing is having a patient
who didn't think there was any hope
and being able to tell them that there is hope.
Because quite frequently they're told
"there's nothing we can do for you" or
"we don't know what's going on" or
"we know what's going on but there are no treatments"
and then we come in
or they come in and we say to them
"well there are a bunch of treatment options
and here they are" and there are a lot of options
that are there for them of which they
were not previously aware.
The most gratifying thing is to be able to
tell a patient that "yeah there's something
we can do to help you".