Episode #24: Dr. Alexandra Freeman

Dr. Alexandra Freeman is a pediatric infectious diseases physician at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health who focuses on the diagnosis and management of primary immunodeficiencies.  Dr. Freeman received her medical training at Georgetown University Medical School, completed her pediatric residency training at Yale New Haven Children’s hospital and her pediatric infectious diseases fellowship at Northwestern’s program in Chicago.

She then joined NIH as an attending physician, briefly focusing on pediatric HIV and then changing her focus to primary immunodeficiency. Her primary focus is Hyper IgE syndromes, and she has been involved in the initial genetic diagnosis of multiple of these syndromes, and is recognized worldwide as an expert in the management of these patients due to her large cohorts of patients followed at NIAID.  She also directs the primary immunodeficiency clinic at NIAID in which she educates the allergy/immunology fellows in the diagnosis and management of individuals with complex primary immunodeficiencies. Dr. Freeman has over 130 peer-reviewed journal articles, multiple book chapters and reviews, and has been a speaker in many national and international conferences on the topic of primary immunodeficiencies.


As a physician at the NIH, Dr. Alexandra Freeman treats patients who have exhausted the easy options. As a specialist in primary immune deficiencies (Job’s syndrome in particular), she has seen patients with incredibly rare conditions. Through clinical trials and research, she and her team have made significant progress in caring for these individuals. Part of that is due to the caliber of people on her team, but it’s also due to the NIH’s mission. On today’s episode, Dr. Freeman and I talk about what makes the NIH so different from other medical organizations--and how that positively impacts research and medical discoveries. We also discuss the challenging and rewarding aspects of her job, and why patient-focused care is so important to her.

We end up seeing a lot of people where the easy solutions didn’t work out. So it’s very humbling. There’s no room for egos here at all.


  • Why her work in primary immune deficiencies at the NIH is a little bit like family practice  

  • Why a “thinking” specialty (versus a procedure-oriented one) is a better fit for her

  • Her initial focus on kids with HIV, and why she transitioned to primary immune deficiencies

  • The impact--for both patients and doctors--of the NIH being insurance company-free

  • The challenge of working with patients for whom she can’t provide all the answers — yet

  • Why studying Job’s syndrome — and other rare diseases — relies on the ability to see patterns

  • What is was like to be featured in the Discovery Channel documentary First in Human

  • The most rewarding parts of her job, like treating kids from countries with fewer resources

  • What practitioners sometimes don’t realize about a disease if they’ve only seen severe cases

  • The huge explosion of knowledge from a genetic standpoint, and how that translates to care

  • Why early diagnosis is so life-changing for rare conditions like Job’s syndrome

  • How people who don’t have chronic and rare diseases can support those who do

  • How she balances her own life and family with the responsibility she feels for her patients

Click here to learn more about enrolling in a clinical trial at the NIH. You can learn more about the NIH’s clinical trial specific to Job’s syndrome here.

This is an extremely patient-focused place, as all medicine should be.



Support for this episode comes from Lola. Lola makes feminine care products that are 100% cotton with no added chemicals, fragrances, synthetics, or dyes. With a Lola subscription, products get delivered to your door exactly when you need them. Lola was founded by women, for women, and they donate feminine care products to homeless shelters with each purchase.

krista gray