Dr. Wagner is a certified specialist in Internal Medicine and Nephrology and the Director of the Kidney Institute of New Mexico. My interest is in the molecular and cellular mechanisms of “nephrogenic” systemic fibrosis. This is a severely disabling and potentially fatal disorder occurring in patients with compromised kidney function. It is clearly associated with exposure to gadolinium-based magnetic resonance imaging contrast. Not all patients with renal disease acquire it, however, and the pathogenesis is largely unexplored. Because the fibrotic lesions stain strongly for CD34 and procollagen type I, it was theorized that the majority of the cellularity was from circulating, bone marrow–derived white blood cells termed “fibrocytes.” His laboratory was the first to prove this experimentally. Furthermore, they were the first to demonstrate that bone marrow possesses a ‘memory’ of gadolinium exposure—gadolinium-induced fibrosis is enhanced in those who have had a prior administration of magnetic resonance imaging contrast.