From: Sent: Monday, May 21, 2012 8:31 PM To: jeevacation@gmail.com Subject: Re: Good question Not really The medical space is so filled - it honestly doesn't feel like a space=for innovation. People talk a lot but the regulatory environment and inten=e competition for resources to support well established labs makes it hard=to make progress. I enjoy spending time in the hospitals, learning about stuff. The case= have a beginning and an end (move on to the next one), the learning is ch=llenging. Using skills and making decisions where I am accountable is terr=fic. While there is always room for improvement and tons of input from fol=s all over the hospital - doctors largely make autonomous decisions where =here are real outcomes. Nothing fake or intangible. And it feels like a me=it-based place in the sense that the gossip and politics are secondary to =he patient care (and not the primary drivers of it). There is also no cult=of a supreme leader or head of state that makes emotional and often all ec=passing decisions (unless it is God). I like neurology and neurosurgery bo=h and I plan to continue to carve out a cool hybrid role that manages both=specifically with expertise in trauma and cerebrovascular pathology since =hat is where I have lots of training and experience. There are a ton of really cool research questions that no one will fun=. I'm not sure even how to answer the questions but if they were provable,=they would be game changing. I've tried to get research grants but basical=y unless you are doing genomics or degenerative disease - there really isn=t much to qualify for. Setting up a lab is also a bogus operation since yo= don't really need all the space/people but the university needs that to k=ep funding flowing. So the "dean's tax" is a huge barrier too. There is an offer on the table in the private sector at a big hospital=here called here they want me to run their vascular fell=wship and be a neurosurgical hospitalist (neurology + neurosurgery inpatie=t only, no clinic). But it is a real commitment and so bureaucratic/academ=c - not creative and a step in a direction that I am not keen to take. =----Original Message From: Jeffrey Epstein <jeevacation@gmail.com> To Sent: Mon, May 21, 2012 1:03 pm Since you are i= the hospital doing surgery two or three times a night , for two weeks. , =sn't there something that is an offshoot of medicine that you are passsion=te about The information contained in this communication is confidential, may be attorney-client privileged, may constitute inside information, and is intended only for the use of the addressee. It is the property of Jeffrey Epstein Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you EFTA_R1_01442370 EFTA02403554 have received this communication in error, please notify us immediately by return e-mail or by e-mail to jeev=cation@gmail.com <mailto:jeevacation@gmail.com>, and destroy this communication and all copies thereof, including all attachments. copyright -all rights reserved 2 EFTA_R1_01442371 EFTA02403555