#332 - 🔬 Beyond Dexamethasone: The Future of Immune Therapies in the NICU

Hello Friends 👋

In this episode, David McCulley and Betsy Crouch interview Dr. Benjamin Fensterheim, a neonatology physician scientist, who shares his journey through medical training, the inspiration behind his immunology research, and the importance of bridging the gap between basic science and clinical neonatology. The conversation delves into the challenges faced by physician scientists, the evolving landscape of neonatal care, and the need for innovative therapies in the NICU. Dr. Fensterheim emphasizes the significance of community and mentorship in supporting early-career researchers and advocates for the value of science in improving healthcare outcomes for infants.

Link to episode on youtube: https://youtu.be/_bHqMiK-Nis

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Short Bio: Dr. Benjamin Fensterheim is a physician-scientist and instructor at the Children’s Hospital of Philadelphia. His work focuses on neonatal immunology, exploring how the immature immune system of premature infants contributes to chronic conditions such as bronchopulmonary dysplasia. Combining his background in neuroscience, philosophy, and clinical medicine, he is dedicated to developing targeted therapies that improve outcomes for vulnerable newborns. Dr. Fensterheim is also an active member of the AAP TCAN research committee, supporting and building community among early-career physician-scientists.

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Featured manuscripts from Dr. Fensterheim:

Graduate school publications:

1. Fensterheim BA, Young JD, Luan L, Kleinbard RR, Stothers CL, Patil NK, McAtee-Pereira AG, Guo Y, Trenary I, Hernandez A, Fults JB, Williams DL, Sherwood ER, Bohannon JK. The TLR4 Agonist Monophosphoryl Lipid A Drives Broad Resistance to Infection via Dynamic Reprogramming of Macrophage Metabolism. J Immunol. 2018 Jun 1;200(11):3777-3789. doi: 10.4049/jimmunol.1800085. Epub 2018 Apr 23. PMID: 29686054; PMCID: PMC5964009. https://pubmed.ncbi.nlm.nih.gov/29686054/

1. Fensterheim BA, Guo Y, Sherwood ER, Bohannon JK. The Cytokine Response to Lipopolysaccharide Does Not Predict the Host Response to Infection. J Immunol. 2017 Apr 15;198(8):3264-3273. doi: 10.4049/jimmunol.1602106. Epub 2017 Mar 8. PMID: 28275139; PMCID: PMC5380530. https://pubmed.ncbi.nlm.nih.gov/28275139/

Two recommended publications:

1. Olin A, Henckel E, Chen Y, Lakshmikanth T, Pou C, Mikes J, Gustafsson A, Bernhardsson AK, Zhang C, Bohlin K, Brodin P. Stereotypic Immune System Development in Newborn Children. Cell. 2018 Aug 23;174(5):1277-1292.e14. doi: 10.1016/j.cell.2018.06.045. PMID: 30142345; PMCID: PMC6108833. https://pubmed.ncbi.nlm.nih.gov/30142345/

Olaloye O, Gu W, Gehlhaar A, Sabuwala B, Eke CK, Li Y, Kehoe T, Farmer R, Gabernet G, Lucas CL, Tsang JS, Lakhani SA, Taylor SN, Tseng G, Kleinstein SH, Konnikova L. A single-cell atlas of circulating immune cells over the first 2 months of age in extremely premature infants. Sci Transl Med. 2025 Mar 5;17(788):eadr0942. doi: 10.1126/scitranslmed.adr0942. Epub 2025 Mar 5. PMID: 40043141. https://pubmed.ncbi.nlm.nih.gov/40043141/

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The transcript of today's episode can be found below 👇

David McCulley: Hello and welcome back to the bench. My name is David McCulley. I'm a neonatology physician scientist at UCSD. This is The Incubator Podcast: At the Bench, where we are incubating discoveries. We are very fortunate to be able to interview neonatology physician scientists and hear about what inspired their work. Today we have a special guest that I'll let Betsy Crouch introduce.

Betsy Crouch: Hi, everyone. Thanks, David, for passing the baton to me. I'm Betsy Crouch, a neonatologist and physician scientist at the University of California, San Francisco. I'm quite thrilled today to interview our guest, Dr. Ben Fensterheim, who is currently an instructor at the Children's Hospital of Philadelphia. Ben, we'd love to hear more about you, so if you could take a minute and provide a brief introduction.

Benjamin Fensterheim: Yeah, absolutely. Hey everybody, my name is Ben Fensterheim. As Betsy mentioned, I’m currently transitioning from fellowship to instructorship at CHOP. I completed both residency and fellowship there.

David McCulley: Congratulations.

Benjamin Fensterheim: In order to get more time for research during my training, I completed what’s colloquially called the “fast track” through residency and fellowship—two years of residency instead of three, and then four years of fellowship instead of three, with that extra year dedicated to research. I’m finishing all that up now and hopefully getting a publication out soon from my fellowship work, while also moving on to new projects at CHOP.

Before CHOP, I trained in the MD-PhD program at Vanderbilt University. Two people there were really important to me: my PhD mentor, Ed Sherwood, and Terry Dermody, who was the MD-PhD program director at the time. Both inspired me to continue on this path. Before that, I was at the University of Michigan studying neuroscience. Going back further, I grew up in Rockville, Maryland, just outside Washington, D.C.

Betsy Crouch: I was about to ask where you were from. I was guessing New York City because the University of Michigan is sometimes jokingly called “SUNY Ann Arbor” since so many New Yorkers go there.

Benjamin Fensterheim: Yeah, there are definitely a lot of New Yorkers there. Rockville is right next to Bethesda, so my very first experience in science was a two-month internship at the NIH in 11th grade. I worked in the lab of Bob Cedar—who, it turns out, is friends with my current PI, John Wary. They both work in immunology in similar ways, so I’ve kind of come full circle to my earliest science experience.

Betsy Crouch: That’s a beautiful story. My first scientific experiences aren’t even on my CV because they didn’t produce publications. I spent two summers at the University of Pittsburgh, where Terry Dermody—who I think is now department chair—worked.

Benjamin Fensterheim: Yes, he’s the chair of pediatrics.

Betsy Crouch: He has fantastic stories about being a Dallas Cowboys fan in Pittsburgh, where the Steelers are basically a religion. My first lab experience was with a neuroscientist at Pitt, Károly Mirnics, who’s now chair of neurobiology at the University of Nebraska. My experiments there had negative results—they worked, but we didn’t find what we were looking for. Still, I was inspired by how he was one of the first people to do microarrays on individuals with schizophrenia. That way of thinking about cutting-edge science and its potential to impact lives is something that still drives me today. Early influences like that can really set the trajectory for your life.

Benjamin Fensterheim: That’s amazing. I completely agree. In high school, I wasn’t a great student—not because I wasn’t capable, but because I didn’t care much about school. Music and sports felt more important, and my grades suffered. It was in 10th and 11th grade that I started having experiences that inspired me—especially about the power of technology.

One was an English teacher who let me read what I wanted. Off her list, I chose Walden by Thoreau. As a 10th grader, reading about someone taking complete ownership of his life was inspiring. It made me realize how much one can accomplish with a vision. Around the same time, new technologies like the iPhone and talk of virtual reality were emerging, and I think I saw The Matrix then, too. I realized these things were made possible through scientific discoveries that could translate into helping people’s lives.

That led me to start asking if anyone knew someone in science. My uncle knew someone who knew Bob Cedar, and a few months later I was doing Western blots in his lab. Since then, I’ve been driven by the desire to use science to make tangible things that help people. Some scientists are driven purely by the love of discovery—and that’s probably more important to science overall—but my motivation is applying knowledge in useful ways.

David McCulley: That’s one of the things I like about being a physician scientist—we bridge the gap between pure discovery and practical application. We’re motivated by our patients to take scientific discoveries and find ways to improve health or understand disease better. I like thinking of those as two separate but connected phenotypes.

Benjamin Fensterheim: Exactly. I work with a lot of the “pure science” phenotype now—people who are extremely bright, motivated, and have more time than I do, since I also have NICU shifts and other responsibilities. When I think about pursuing this in a meaningful way, I actually believe it’s better that others focus on discovering foundational knowledge—that’s what they’re here for. I’m not in a position to compete with these incredible people, and it would almost feel like a waste of my training to spend all my time just trying to discover foundational facts. My niche is taking those discoveries and translating them into something tangible. No one else is going to fill that gap except people who understand both basic science and what’s needed for babies.

Betsy Crouch: I’ll give a shout-out to a friend of mine, Kara Marshall. She’s a basic scientist, a PhD at Baylor College of Medicine in Houston. She studies interoception and is both brilliant and a fantastic science communicator. She recently gave a talk at her parents’ retirement home about the history of science in America. She has this fun audience quiz: match the basic science discovery with the technology that eventually led to a groundbreaking human therapy.

It’s fun to hear about things like CRISPR—we’re now familiar with Jennifer Doudna’s work on CRISPR, which began with studying these esoteric viruses that infect bacteria. Or Ozempic, which (correct me if I’m wrong) originated from studying the spit of the Gila monster. That’s the kind of work that might seem more like something from a TV science show or National Science Foundation grant, not NIH, yet it led to a therapy that impacts human health. It’s quite cool.

Thank you, Ben—that was really fun. To focus you a little bit and transition to the next stage: from your broad early explorations in education, what led you down the more focused path of your MSTP and then into, of course, the best subspecialty in the world, neonatology?

Benjamin Fensterheim: Good question. My life story in five minutes? Okay, I’ll try.

When I went to the University of Michigan—after begging them to let me in despite abysmal freshman and sophomore grades—I was interested in science, but what initially inspired me there was philosophy. Specifically, the philosophy of science and how science shapes our worldview. I started out as a philosophy major. One of the most interesting areas to me was philosophy of mind and discussions of free will. As I studied it, I thought: this is a science conversation, not just philosophy. If I wanted real answers about whether we have free will, I needed to be in a neuroscience lab studying decision-making.

Betsy Crouch:I’m on the edge of my seat about how this abstract philosophical stuff leads into t-tests. Take us on the journey.

Benjamin Fensterheim: I was driven by the question of what free will is, whether it exists, and how it manifests. I ended up majoring in neuroscience and minoring in philosophy, but wrote my philosophy thesis on how the brain might manifest free will—how it’s encoded in neural structures, and why we shouldn’t deny its reality just because an older philosophical framework doesn’t fit. Instead, we should update our definitions so free will can exist even in a deterministic world.

I joined the lab of an amazing neuroscientist, Josh Burke (now at UCSF), where I implanted electrodes in rat and mouse brains and recorded activity as they made decisions. It was fascinating, but as I wrapped up, I realized I didn’t know what meaning I had taken from it. I could say, “Yes, neurons exist that control action,” but that didn’t translate into the kind of meaning I was looking for.

David McCulley: So just to be sure I understand—you wanted to figure out how the brain takes a thought, turns it into a decision, and then into an action. You used electrophysiology in rat brains to study that process.

Benjamin Fensterheim: Exactly. The lab’s health relevance was in movement disorders, but it was also deeply philosophical, focused on understanding neural circuitry for decision-making. But without an applied use, it lacked personal meaning for me. I wasn’t sure what to do. I spoke with a guidance counselor at Michigan and told her I wanted to make things. For me, meaning comes from creating something tangible. Looking back, she probably should have suggested bioengineering, because that’s exactly what they do. Instead, she said, “You should do an MD-PhD program—because that’s what they do.”

Betsy Crouch: Aren’t we lucky?

David McCulley: That worked out.

Benjamin Fensterheim: When I started at Vanderbilt’s MD-PhD program, I was a little surprised to find myself just in medical school—it wasn’t some special “translational science” school for people who wanted to make things. But that experience, from the start at Vanderbilt until now, has been driven by my need to apply science to something meaningful. That’s what got me into science in the first place, and I’m still chasing it.

David McCulley: That’s inspirational. One of the reasons we wanted to have you on was because you have such a great story, and you’re right in the thick of it. Can you talk a bit more about your decision to apply for an MD-PhD program? Hearing the suggestion from that counselor sounds reasonable, but what else went through your mind?

Benjamin Fensterheim: When I applied, I considered both PhD-only and MD-PhD programs, but never MD-only. Part of me thought I wouldn’t get in, but it was my dream, so I took the shot. I believed an MD-PhD would be the most robust, thorough way to learn what I needed to make concrete health improvements. I’d probably seen examples of people with both degrees making a difference and was inspired by them. I just hadn’t been exposed to many people in bioengineering, so the MD-PhD path seemed the best fit.

I applied broadly, but connected strongly with Vanderbilt. I didn’t have high hopes. My GPA was about 3.4 or 3.5, well below the “you need a 3.99” advice I’d been given. I happened to be in Nashville, arranged a meeting with the MD-PhD program, and found we shared the same philosophy about training. It felt like a perfect match. It was my first interview, and by the end I knew I wanted to go there. They seemed to feel the same—two weeks later I was accepted and became the first MD-PhD student in my class to enroll. I spent the rest of my time trying to recruit classmates.

David McCulley: It’s helpful to hear how you realized this was the right path—a way to do impactful work and stay inspired for a lifetime. We’re trying to figure out where along the educational path to attract people to the physician scientist pathway. For you, it sounds like the idea solidified as you were finishing undergrad.

Benjamin Fensterheim: Yes, that’s when I first heard about the MD-PhD, but the motivation to use science meaningfully started earlier, in high school. Not everyone starts with philosophy and ends up here, but for me, that was the path.

Betsy Crouch: I do think this is a phenotype. Recently I visited UCSD and gave talks to both the biomedical sciences PhD community and the NICU/pediatric group. I had dinner with David’s neighbor, Dr. Cole Ferguson, a neuropathologist and physician scientist. You two share a phenotype—you’re both fascinated by how microscopic things translate into global principles, very philosophy-driven. I will never be in the same headspace as you! I’m narrative-driven; I think in stories rather than philosophical constructs. But I love your phenotype, too.

Benjamin Fensterheim: Yeah, I was going to say as I've spent time in the NICU, I think I've become more narrative as well. I think I've been pushed by real events and real things that are happening to real people. And that has real meaning for me now.

Betsy Crouch: Yeah, that's very interesting because I do think philosophy is so beautiful and so abstract sometimes.

David McCulley: What I liked about it was the way that you can construct an argument. I really took away from my philosophy class just the way that you can come to a conclusion and that you should think about every aspect of what allows you to come to that conclusion with little hypotheses, construct an argument, see what you can do to support that argument before you can actually make a conclusion. So I saw it as an approach, and that helped me think about how I can use the same kind of ideas in science—using experiments and data to help support my conclusion.

Betsy Crouch: I absolutely love that we never know where this podcast is going to go. And I did not imagine this morning that interviewing an immunologist, we were going to talk so long about the philosophy of mind, but I've really enjoyed this. I would like to hear some about your current experiments and your current vision of who you are and what you want to do as you launch into an early faculty career. You have some challenges ahead of you in terms of negotiating for that first startup package, but I think it's also a fantastic time to think about your five- and ten-year plan, and to imagine how your future and the future of our babies could be different if all of your experiments go to plan—or at least half of them.

Benjamin Fensterheim: So, when I was in graduate school, I ended up moving to immunology. Like you mentioned, I'm now studying immunology, and the reason I did that was because I thought immunology was a better outlet for translation than neuroscience would be. I was just seeing all these new immunology-based therapies coming out at the time—mostly in cancer, but also in autoimmune disease—and I thought, “This is the field. If I want to make stuff, I have to learn about this.”

I became interested in neonatology in medical school because I had experiences in the NICU that were really profound. Talking about searching for meaning—there were meaningful experiences happening left and right. I didn’t see a single one in an adult patient clinic, which felt more like going to a car mechanic. But in the NICU, profound, life-altering experiences were happening daily. I thought, “This is where I want to be. This is what I thought medicine was.” It was a combination of a love for neonatology—totally separate from my scientific interests—and my training in immunology.

I started thinking: how can I do what I originally wanted to do, which was bring immune therapies to patients, but in the NICU? Looking at what we knew about neonatal immune systems when I started my fellowship, I was shocked at how little we understood. People are still trying to profile what’s happening to these cells at various stages in development. Historically, we haven’t had the technology to profile such small amounts of blood repeatedly. And things change so fast—as soon as you're born, within an hour, your immune system is different.

Despite that, I saw so many opportunities for immune therapies in the NICU. Every condition I cared for—BPD, PDAs, necrotizing enterocolitis, sepsis—they all had core immune links driving the pathology. Yet the only real immune therapy that existed (and still exists) is dexamethasone. I think of that as the only real immune therapy, and we use it for literally everything. If something’s going really wrong, we give dexamethasone—and it seems to help.

Betsy Crouch: Yeah, Ben and Daphna talked about this recently—our ancient tools in neonatology, despite having cutting-edge technology. It's a curious contrast.

Benjamin Fensterheim: Exactly. We have the technology—there are antibodies that could help infants that are currently being given to adults. There are gene therapies, CAR-T cells—so many new technologies have come out in the last 20 years. But how many have actually made it to the NICU? Almost none. The last major breakthrough in neonatology that was truly brought to the NICU was therapeutic hypothermia. Caffeine came before that, nitric oxide before that. Since then, we’ve improved how we administer care, but in terms of brand-new medicines—therapies we didn’t have before—there are almost none. If you’re asking about my real goal over the next five to ten years—it’s to start bringing a new therapy to the NICU.

Betsy Crouch: Which one? And please don’t tell us anything that’s protected.

Benjamin Fensterheim: No, none of this is protected—this is all conjecture. I’m going to publish some of my work soon. My fellowship study focused on understanding how the immune system evolves during the first two to four months of life while preterm infants are in the NICU. I wanted to see what was happening in the immune system as infants went on to get things like chronic lung disease or infections. I took a whole picture of the immune system, kept checking over time, and watched for changes as clinical situations evolved.

Two big findings stood out. One: infants with severe chronic lung disease (on a ventilator at 36 weeks corrected gestational age), compared to infants with moderate grade 2 BPD on non-invasive support, had an overactive T-cell system called the TH17 system—a bias toward making certain pro-inflammatory mediators, increasing neutrophils in the blood, and sending them to mucosal inflammation sites like the lung. It made biological sense that this system might be activated in chronic lung disease. Interestingly, some aspects of this TH17 bias were present even at birth—almost like these babies were wired for it.

In mouse models, blocking cytokines in this pathway can reduce inflammation and distortion of lung architecture. Some of these cytokines are already targeted by FDA-approved therapies for autoimmune conditions like psoriasis. I don’t know if it would work in this setting, but it’s at least an option worth exploring as a more targeted alternative to dexamethasone.

Betsy Crouch: Okay, I have an immunologically naive—haha, get it—question. I think of TH17 as the tolerance mechanism. Is that incorrect? Are differences between the adult and neonatal immune systems in terms of TH17 subsets and their roles.

Benjamin Fensterheim: Yeah, so I can explain a little bit about the biology. The TH17 system is a mucosally-focused system. It does play somewhat of a role in balancing the interface of microbes in places like the gut. However, the main cytokines and molecules that TH17-polarized CD4 T cells—just the phenotype of cell that gets polarized this way—produce increase neutrophil production from the bone marrow and activate epithelial cells at sites of mucosal inflammation. This causes those cells to make neutrophil-recruiting cytokines and ultimately drive inflammation in outward-facing or environmentally focused sites.

It’s actually the oldest TH system. Evolutionarily, it came before TH1 or TH2, the two other systems we think about. Its tie-in with neutrophils reflects that history. It was originally explored as a driver of inflammation in inflammatory bowel disease, psoriasis, and other autoimmune conditions, which is why there are so many blocking agents for the molecules in its pathway.

This contrasts with some of the other TH systems. In infants, a system thought to be more anti-inflammatory—or at least not as inflammatory as TH17 or TH1—is the TH2 system. It’s thought that infants are a little TH2-biased at birth. They also have more T-regulatory cells, which are explicitly designed to suppress inflammation by secreting molecules that dampen it. Term infants in normal situations have generally been found to be TH2-biased and have more T regulatory cells than an adult would.

Betsy Crouch: No, it's very helpful. We got to interview Amelie Collins earlier this week, actually with Misty Good. She is focused on the hematopoietic stem cells as the foundation of the immune system. It all comes together—because I think IL-10 is a TH2 cytokine, right?

Benjamin Fensterheim: It’s an anti-inflammatory cytokine. It can be made by TH2 cells or by T-regulatory cells, which actually make a lot of IL-10.

Betsy Crouch: What she found was that at birth, moms make a lot of IL-10. This is one reason HSPCs can’t make enough neutrophils to combat sepsis in our beautiful term babies. It’s so fun to be putting together different themes in immunology here at the bench.

Benjamin Fensterheim: I think the point of all this is that the infant immune system—and even more so the preterm infant immune system—is way different than the adult immune system. It’s wired completely differently and changes very quickly. In an adult, the immune system looks essentially the same a year later unless they’ve had a new disease. In infants, especially right after birth, it can change within hours. That makes it a moving target and complicates things, but also makes it fascinating.

David McCulley: It’s funny because, with adults, the immune system is more established and you can target a disease specifically. You might think you could just translate that therapy to infants, but as you’ve pointed out, preterm infant immune systems are changing rapidly. Plus, it’s required for normal development. So there’s hesitation—people worry about targeting something important for another process we don’t even know about yet. But despite that, we still use dexamethasone, which does a gazillion different things we don’t fully understand, because things are bad, so we treat with it.

Benjamin Fensterheim: No therapy is without side effects. Every decision is a calculus between two outcomes—not necessarily one with disease and one without. Chronic lung disease itself has a range of really unfortunate outcomes: neurologic issues, lung changes, poor growth. Severe BPD can be fatal. If a molecule changes development, it’s important to know whether that change is worse than the disease you’re treating.

The pendulum on steroids has swung a lot—used all the time in the past, then stopped when the risk of cerebral palsy became clear, and now back again in a more thoughtful way. We’re using short courses instead of giving them to all babies at birth.

I’d argue we should be more open to new technologies that might have side effects, but study them carefully. The outcomes we’re trying to improve are already devastating. A recent example was CHOP’s first use of CRISPR gene therapy for a child with a fatal metabolic liver condition. Approval moved quickly because the alternative was death, and it worked. There are parallels in neonatology—we could be helping more babies if we were willing to test new therapies in a careful but timely way.

Betsy Crouch: Thank you for bringing up that amazing story. It was a good day when that came out—it showed how cutting-edge science can change lives and give a child a future. It also showed the importance of working closely with families. That’s how we need to move forward.

In addition to your scientific journey, we wanted to bring you on to talk about your new position in the AAP. I was previously the research chair at TECAN, the Trainee and Early CAreer Neonatologist group, and I was delighted to pass that role to you. Do you want to talk about what led you to apply and what you hope to accomplish?

Benjamin Fensterheim: Absolutely—and thank you for trusting me with this role. I’m excited to be involved in TECAN, especially as research chair. I wanted to get involved because I’ve been feeling—and seeing—pressure on physician-scientists in neonatology. I was seeing people get squashed by the current environment for our career development and the broader funding environment in the United States. There's so much pressure right now and so little support for people that are interested in pursuing a path in research in neonatology.

I really wanted to support this community and I wanted to do it in kind of two ways. One, think one of the reasons why there is a lack of support is there's not great community amongst the physician scientists that are in training or the neonatologists that are in training or the ones that are in their early career and just getting out. I felt, and I know other people feel, very alone doing the work that they're doing. I work in a lab that is really doing cutting edge immunology. The people are making the next cancer therapies and so on. And I'm in the corner kind of preterm infants and I'm doing my own thing and I'm kind of alone. But I know other people are doing similar things. One of my main goals is to connect physician scientists so we can support each other through tough times in their career, including myself.

The other goal is to keep advocating for the value of science in neonatology. Our field exists because of science and translating it into therapies. We live the benefits of science every day. As physicians, we are in the best position to share that story with the public and to start a dialogue about what science really is and how it impacts babies. So I would also like to speak to the public and communicate with the public more to start a dialogue, and share more and hear more about science and neonatology.

Betsy Crouch: We’re excited to partner with you. We’ll be doing some “at the bench” science inspiration sessions, so stay tuned. If listeners have topic ideas—whether about training pathways or how benchtop experiments lead to impact for babies—let us know.

David McCulley: Ben, that was amazing. You seem like a perfect spokesperson. One of the ways we like to close the podcast is by showing a bit of our humanity. Can you share a hobby or interest outside of NICU and lab work that our audience might enjoy hearing about?

Benjamin Fensterheim: My current obsession is the Japanese maple tree—Acer palmatum. If you haven’t gotten into Japanese maples, give them a chance. They’re incredibly diverse, beautiful, psychedelic, resilient trees with a fascinating history and biology. I’ve been growing them at my house in Philadelphia and reading about them in my spare time. That’s my current hobby, coming off the heels of my prior obsession which was birding. And before that—music. I was a radio host for four years, played in four or five bands (none currently), and can play every instrument in a rock band. I’ll even sing (poorly, but I’ll attempt it, which is all that counts). I think being fascinated with something—whether it’s a tree, a bird, or music—is important.

David McCulley: I agree. It’s important to explore interests, sometimes just for yourself. Well, thank you so much, Ben. Betsy, thanks for co-hosting. And thanks to our audience—we look forward to more conversations with neonatology physician scientists.