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Alexandra Duffy, DO: The River Runs Through the Heart of This Movement Disorders Specialist



DR. ALEXANDRA DUFFY: “When youre fly fishing, youre in the river and you can feel the water rushing around you. You get in this rhythm of casting and looking at the ripples in the water, waiting for the slight tug of the fish on the line and the interplay between you and the fish. Youre lost in the moment, just completely present. Its one of the only activities Ive ever found where Ive been able to achieve that, and its so therapeutic.”

When she is not seeing patients or doing research in movement disorders, Alexandra Duffy, DO, finds peace and calm as a fly fisher. Here, she discusses how and why she found a passion for casting her rod in the clear, rushing waters both near and far from her home in California.

Alexandra Duffy, DO, assistant clinical professor of neurology at University of California, Davis in Sacramento, spends her working hours caring for patients with movement disorders — particularly Huntington's disease, which is a primary focus of her research. She also is director of the neurology residency program. And her job is both demanding and challenging.

But when it's time to cast her neurology tools aside, she seeks out a different kind of challenge. On weekends, you'll find Dr. Duffy knee-deep in a river with a fly fishing rod in her hand. The calm of the rushing water around her allows her to find a certain rhythm, to be present in the moment, she says.

Dr. Duffy spoke to Neurology Today about the joy she finds off the clock casting about in the cool, clear rivers she calls home.


No, it wasn't! But my husband grew up fishing and has great memories of being out with his grandfather and father, and I'd just see his face light up when he talked about it. I went out fishing with him occasionally, and when he got started fly fishing about five years ago, it seemed like an activity we could share, rather than him just going out by himself. I wasn't that into the kind of fishing we had done before — we'd go out and I'd sit with him and read a book while he was fishing. I thought finding something I would love to do with my partner would be amazing.

So we took a trip up to Clearwater Lodge, a fly fishing lodge in Fall River Mills, a few hours north of Sacramento. I wanted to have someone else teach me to do it. You can love your partner but having them teach you something is different! At the lodge, they take you through how to tie flies, then casting on the lawn to get a feel for it, and then they take you out on the water. We spent a few days doing this and I fell in love with fly fishing!

The lodge is also woman-owned and has a lot of female presence. You tend to think of fly fishing as a traditionally male sport, so to have the added layer of having a woman own the lodge was amazing. We went back within a month for another several days, all driven by me. My husband was a bit in shock!


In our busy lives, we're always thinking about what to do next, about our to-do list, our work, the next deadline. To completely let all that go and be present in the moment is so difficult. When you're fly fishing, you're in the river and you can feel the water rushing around you. You get in this rhythm of casting and looking at the ripples in the water, waiting for the slight tug of the fish on the line and the interplay between you and the fish. You're lost in the moment, just completely present. It's one of the only activities I've ever found where I've been able to achieve that, and it's so therapeutic. And being able to share it with my partner in parallel is a gift.


Any time you find something you love outside of work, I think it makes you more a complete person. It allows you to balance your personal and professional life, which to me contributes to being a better physician and care provider. In fact, some of my more memorable interactions with my patients have involved sharing our mutual love of fly fishing. It's one of those things that just lights the spark in someone's eye when you ask about it. I have a particular patient who actually ties his own flies, and one day he gave me a box of flies that he had beautifully hand-tied himself. I was awestruck! It was the most phenomenal gift I have ever received from a patient. At first I said, “I don't know if I can use these!” But he said, “These flies are meant for catching fish.” So I've caught some fish with them!


To me, fly fishing is about being fully present in one's self rather than focused on the external. The concentration and rhythm of the practice allows that, and being enveloped within the water grounds you physically. That's a mind-body connection that I keep coming back to, and that appeals to me as a neurologist.


Shortly after our first few trips, I got pregnant with our son, who will be 3 in February. At five months pregnant, we went to go fly fishing in Belize. We wanted a different area and a different type of fish, and this is saltwater instead of freshwater fishing. We found a nice lodge there and stayed for a week and went fishing every single day. We'd go out on a boat in the morning and go wading through the flats of the ocean to fish. When I first got in the boat, the guide said, “Sorry, I have to ask, but are you pregnant?” He has quite a few kids himself so he was very protective and avoided driving the boat where it was too choppy.

The next areas we would like to go are Oregon and Montana. We've looked into renting some places along the rivers on the Oregon coast. We also travel extensively to Europe, because my husband has family in Serbia and I have family in France, and to be able to integrate fly fishing into European travel would be wonderful.


Oh yes! His middle name is River, because of how drawn to the river and fly fishing we are. We thought we would try to get him to love fishing from an early age! We also continued to go fishing locally when I was pregnant. And then when he was three months old and I was still on maternity leave, we took him to the same fly fishing lodge we had first gone to. He was the youngest guest the lodge had ever had! At 18 months, we were able to put him in a hiking backpack and take him out on to the water again. So you can see, he's been fly fishing his whole life. I love that the whole fly fishing experience can be part of being a mom and having a family. To me there is such great meaning in having a passion that I can experience with my husband and child.

I see a family tradition of fly fishing as something that we can give to our son, and perhaps our son to his children, and for me that gives the practice so much more meaning and weight. It's a lifelong gift.

“Off the Clock” is a continuing series featuring neurologists and neuroscientists who pursue a rich array of hobbies, interests, and passions outside of their work. Want to nominate someone for a feature? Send your suggestions (and why they are good candidates) to [email protected].


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