Provider Stories: Audrey Foster-Barber

Written By Kim Wong

Published February 2014

Dr. Audrey Foster-Barber found her calling early. As a teen she could even pinpoint her future specialty — neurology. Today Foster-Barber is a pediatric neurologist and a palliative care specialist for the Integrated Pediatric Pain and Palliative Care (IP-3) Clinic, at UCSF Benioff Children's Hospital San Francisco. Below, she talks about her fascination with the brain and her dedication to serving patients and families in the toughest circumstances.

When did you know you wanted to become a neurologist?

I knew I was a neurologist from a very young age. I was just fascinated with the brain. I took notes on the language and motor development of the children I babysat. Then my grandfather was diagnosed with Alzheimer's disease when I was 14, and I ended up culling through medical journals. I wrote a 75-page paper on Alzheimer's disease my freshman year in high school and my teacher handed it back to me saying, "I don't know what to do with this."

When I realized that there was a profession where you took care of children and understood the brain and how to make the most out of a child's development, I knew it was for me.

Why did you choose pediatrics?

Kids are the population that is the most vulnerable and the most important. With their long lives ahead of them, they have the greatest likelihood of benefiting from the good things you can do for them medically.

I love that my clinic tool bag has an Etch-a-Sketch, Koosh ball and a rattle. They're as important as my stethoscope for connecting with the patient and getting what I need to understand how to help them.

How do you define palliative care?

Palliative care is not end of life care, it is good care in a situation where end of life may come too soon. We do our best to make the child and family live the best that they can, even if it is shorter than we expect.

Palliative care is what gives the family the right tenderness, the right compassion, the right closure. As someone else put it, palliative care is not the icing on the cake of our hospital — it's the eggs and the batter.

What drew you to palliative care?

I was trained in neurology but sort of fell into this world of palliative care.

In neurology, there are times when we can make things better and there are times when we can't. Unfortunately, there will be children who will die too young of their disease. I started realizing that I wanted to do a good job taking care of these patients and families for the long run. I didn't want to be the neurologist that could figure out the interesting rare diagnosis and just say, "I am sorry this is bad news and hopefully someone can help you." I wanted to be the neurologist that says, "I am sorry it is bad news, but this journey you are on, you won't be on alone."

What do you love about UCSF?

I love the people. Lots of places do very good medicine. I think we do very good medicine. But I stayed here from the beginning of my training because of the people. Everybody pushes to do the best all of the time.

How do you take care of your own brain?

I read voraciously — everything from fiction to the journals. It's a running joke in my family. I have been caught reading in the shower when I should be getting ready for work, holding the book very far out.

Reading is like push-ups for your brain. It's what keeps you active, alive and strong, what keeps your brain working as long as it can.