Board certification in Clinical Neurophysiology and the Medical Directorship of the UC San Diego Interventional Neurophysiology Service anchor Gertsch Jeffrey MD at 200 W Arbor Dr on the UC San Diego Medical Center Hillcrest campus. Intraoperative neurophysiologic monitoring - somatosensory evoked potentials, motor evoked potentials, EMG, and posterior root-muscle reflexes - supports the complex spine surgery caseload on campus including cases run by Garfin Steven R MD during lumbar interbody fusions and adult spinal deformity corrections where nerve-root injury risk runs highest. Outpatient neurology visits cover headache management, epilepsy follow-up, peripheral neuropathy workups, and altitude-related neurologic syndromes drawing on published research in acute mountain sickness and Himalayan trekking medicine. Acute stroke and new-onset seizure presentations feed into the inpatient neurology service directly through UC San Diego Health Hillcrest Emergency Department, the Level I neurocritical care access point for the region. A faculty appointment in the UCSD Department of Neurosciences held since 2008 layers academic teaching and surgical neurophysiology fellowship mentorship onto the clinical service. The highest-stakes work involves real-time intraoperative detection of spinal cord injury during scoliosis correction and adult deformity surgery, where a single monitoring alert can directly change surgical decision-making mid-procedure.