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Vital Signs

Clinical Observation

Bryan Marsh, M.D.
Associate Professor of Medicine

Marsh is section chief of infectious diseases at DHMC. He specializes in HIV medicine and joined the Geisel faculty in 1995.

What made you decide to become a physician?
I was in graduate school in physical anthropology studying the origins of anatomically modern Homo sapiens, when I realized that I needed to change career plans. First, I realized that the data I would have (the very fragmentary fossil and archaeological record) would never be sufficient to address the more interesting questions about human origins. I also realized that the nature of my work was removing me further than I was comfortable from contributing to the concrete betterment of society.

How did you become interested in infectious disease?
I started medical school in 1986, early in the HIV epidemic, and steadily became more intellectually and emotionally engaged in HIV medicine. The urgency for the translation of basic science into clinical care, and the incredible pace of scientific discovery and improvements in clinical care (though it didn't feel like it at the time, as so many were suffering and dying from AIDS) provided a constant intellectual challenge. But as important, the social context in which the epidemic developed—involving marginalized members of society and stigma—meant that caring for people living with HIV involved developing a relationship with the patient that was both clinical and personal, which was profoundly rewarding.

What famous person would you most like to spend a day shadowing?
Barack Obama. I am fascinated by a man who so clearly wants to do good through the political process but who also so clearly detests much of the retail politics that he is forced to participate in.

What do you like most about your job?
The people. First are the patients, whom I have learned so much from. And then all the other members of the infectious diseases section—a wonderful, committed group, all of whom I am privileged to work with.

Can you describe a misconception people have about HIV?
People sometimes think the HIV epidemic is under control in the U.S.

There are now about half a million people living with HIV in the U.S. who are not in care, half because they haven't been diagnosed and half who have been diagnosed but aren't receiving care. How can we accept that? How can this not be known?

What's your favorite nonwork activity?
So many! Cooking, traveling, but most are outdoors—skiing, mountain biking, paddling. . . . The single most? Probably starting the day with a walk in the woods with my girlfriend, Susan, and our two dogs, Jolie and Beau.

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