In our inaugural episode, Dr. Steven Broglio sits down (virtually) for a get-to-know-you chat with Dr. Robert Stern from Boston University.
In our inaugural episode, Dr. Steven Broglio sits down (virtually) for a get-to-know-you chat with Dr. Robert Stern from Boston University.
(whimsical music playing)- Welcome everybody to our inaugural fireside chat with concussion experts. These are designed to be casual conversations and intended more of a get to know you format of some of the most well known and well respected concussion researchers in the world. My name is Steve Broglio. I'm the director of the Michigan Concussion Center, and I am excited and honored that our very first guest for the fireside chat is Dr. Bob Stern from Boston University. Welcome Bob.- Steve, it is such a cool thing being able to, number one, be here, kind of be here, and number two, to be the inaugural fireside chatter. So thanks so much for inviting me to do this.- Yeah, so we just got done with your great lecture on CTE, appreciate you doing that and spending some time with us and our audience. I had forgotten that you trained at North Carolina, so we are fellow Tar Heels.- Yep.- But where did you grow up? Did you grow up?- I grew up outside of Boston in a suburb called Newton, Massachusetts.- Yeah, okay.- And have spent all but five years of my life in New England, not just Boston, but New England, and so, yeah, but those were wonderful, sky blue five years.- Yeah it is a different color of sky, for sure. And they do promote it, no doubt.- (laughs) Yes, they do. But you know, I don't know about you, you experience Tar Heel life and it's hard to not become completely ingrained in it. As I mentioned in the talk kind of jokingly, my bracket name was Towel Heels Forever.- Well played (laughs)- [Bob] Yeah (laughs)- And they have gone on, they have quite a legacy in the concussion space. I think as most of our audience knows. So they continue to do great work down there.- They sure have leaders and Kevin Guskiewicz, as most of you know, is I think the, well I know, the only concussion specialist who becomes a chancellor of a huge state university.- It's incredible. I like to be able to say I knew him when so, yeah. So you're trained as a neuropsychologist, is that what you wanted to be when you were growing up or did you have other aspirations?- I was gonna be either a surgeon or a Broadway star. Well, first, earlier I was gonna be a baseball player. I mean, you know, I was going to Red Sox games at Fenway when I was like eight years old. It was safe enough to just hop on the streetcar and go. And then I realized, yeah, I'm not gonna be the best baseball player. And so then I was wanting to become a surgeon or a Broadway star and then went to school, to college, and decided, you know, that's stupid. No one ever gets to be a Broadway star. Let's go to med school. And I kept on kind of shifting from being pre-med to learning about the whole kind of brain behavior and complexities and was turned on by that. And when I went to grad school, it was really to focus on behavioral medicine, not on neuropsychology. I had no clue what neuropsychology was. I also had no desire to get involved with testing of any type when I started graduate school. And then I realized I didn't like behavioral medicine or health psychology. Didn't do it for me'cause it wasn't the brain as much as just looking at behaviors and health outcomes. And the brain was what turned me on. And I was fortunate enough to kind of follow the direction that people were giving me in that area and was able to do an internship with the pre-doctoral internship training with Dr. Edith Kaplan at the Boston VA and many people here might know, she didn't like to be called the grandmother of neuropsychology, but she really was. But the whole place at the Boston VA was where it all started, where behavioral neurology started really with Dr. Geschwind and physiology was really central there and memory, one of the first memory research centers was there, Laird Cermak, and then things just kind of spread out from there, and so it was just an amazing place to train. And then when I got my PhD and I was looking at things, specifically looking at the lesion location using CAT scans, which dates me, it was pre-MRI, but lesion location and post-stroke depression, but looking at specific aspects of the depression syndrome because depression's not one thing and if we broke it down into different things, it became a little more complex than what was previously described when looking at these brain behavior relationships. So I did that and published in that and created a little visual analog mood scale to be able to get mood state assessments in neurologically impaired people and aphasics. But my first wife who subsequently died from cancer was finishing med school at Harvard and she and I needed to then match together or create something together where she would do her residency and I would do my postdoc. And so she got into residency at Duke, the bad side, the wicked side. And I then did my fellowship training at UNC and we had a mixed marriage for sure of the two different blues.- Yes, challenging times.- It was, indeed.- (laughs) In the best way though. Were you good at school throughout?- No, I worked hard. I was good at doing extra stuff.- [Steve] Yeah.- I could be a leader. Ya know, I was a leader, I was able to bring people together wherever, you know, whether it was in elementary school or high school or college and then grad school. Things didn't come easily to me. I had to really do a whole lot of extra stuff to be organized and to try to remember things, but I put that effort in and I was able to actually do really well in grad school. And I was able to get into a very good undergraduate school. I went to Wesleyan in Connecticut. But I worked my tail off to just be able to move forward. But I liked complex things and I liked to try to come up with new ways of doing things or addressing complex questions by bringing people together who might be able to answer each of the parts so we can move whatever question it was forward.- Yeah, so you mentioned that some of your early work was stroke lesions and then depression. Where did the transition come in to CT? Now obviously like the modern CT cases weren't until early 2000s, but how did that work for you? Maybe there was something in the middle there between.- There's a lot of things in the middle. When I was at UNC, I had these incredible mentors, which is what it's all about, is having great mentors like you are to all the people who you've trained. And my mentors were doing things that I wasn't really inherently that interested in, but the concept of multifaceted cognitive and neuropsychiatric manifestations of things were what turned me on. And so one thing that I first started to get involved with was HIV and AIDS and NeuroAIDS. It's actually before HIV as a virus was discovered and then it was when we were starting to do the work. But it was looking at (chuckles) neuropsycho endocrine immunology.- Interesting.- Which is a lot of different things.- Let's unpack that a little bit. Could you give us some detail?- So I was fortunate to be able to then become one of the associate directors of the NIMH funded clinical research center and the research center focused on psycho neuroendocrinology, hormones and behavior with a special focus on thyroid hormone axis and behavior, as well as adrenal access for some of the folks there. So that's the psycho neuroendocrinology part. And so I started to get involved with thyroid related things and then a colleague, Dwight Evans, who then went on to become the chair of psychiatry at Penn, who recently retired, he started to do work right at the very beginning of looking at the effects of endocrine changes on the immune system and vice versa and how both of those had an impact on the neural milieu for HIV to then take hold. And then how all of those complex cognitive and neuropsychiatric manifestations could then be addressed. Complex models, right? So then I was doing that stuff, I was able to get an Hour One grant early on to look at using exogenous thyroid hormone to prevent or decrease the memory impairment side effects of electroconvulsive therapy. I had previously done an animal model with it and a human clinical trial kind of pilot study and things looked pretty good and I took that with me when I moved up north and was on the faculty at Brown Medical School for 10 years and did that type of stuff for a while. Really stopped the HIV/AIDS things except I did another study looking at women,'cause that's always been a big issue for me, is that so much of biomedical research is, you know, pretending that there's only males in the world. And so I really wanted to look at the effects of HIV and brain in women so we did a study on that. And along the way, when I was at Brown, I won't go in to the details about it, but I had published a couple neuropsychological kinds of tests and then was asked by a test publisher what I thought the next thing is needed in the field of neuropsychology. And I stupidly said a whole new neuropsychological test battery started from scratch, listening to what the users want. Stupidly but it was also terrific that we were able to get NIH support to do it and we created what's called the neuropsychological assessment battery or the NAV. And that was almost 20 years ago, say 18 years ago. It was a seven and a half year, multimillion dollar project with people all over the country and it's now used, which is really cool, and making an impact. But that was a sideline in many ways because I was always doing neurodegenerative disease stuff along with those complex things. And then I was recruited from Brown to come to BU School of Medicine and its Alzheimer's Disease Center where it was great. I could focus on neurodegenerative diseases and help run a great center. And then I met a guy named Chris Nowinski and I met Chris because I was giving a lay talk for, I don't know, a couple hundred elder care attorneys and estate planners, financial planners, about Alzheimer's Disease. And I would give lay talks about Alzheimer's disease all the time. It's really important to me to get the word out so people know about that. And in it, I said something that I always would include in those days, that having a traumatic brain injury was a risk factor for developing Alzheimer's Disease. I don't believe that anymore but I did then. And the next day, or that night or something, I got a call from the Merrill Lynch folks saying, hey, there's a roommate of someone who was in the audience who heard about what you said about something and would love to meet with you. It was Chris Nowinski.- Wow, what are the odds?- And that was.- 2007, so it was right around the time, it was right after, Andre Waters' death.- [Steve] Yep.- And right after the Mike Webster case was published.- [Steve] Yeah.- And I didn't know anything about it. I wasn't reading the newspaper, I guess. But it wasn't making a big splash in the science and the medicine. I had seen a couple former boxers clinically,'cause I all along had had a clinical practice and I ran a memory and cognitive assessment clinic at Brown, but it was dementia pugilistica, ya know?- Right.- That's what we learned in school, dementia pugilistica. Didn't know much about it, except that yeah, okay, boxing is gonna do something. And then meeting Chris Nowinski was this unbelievable experience.'Cause I could see in this guy, who was really quite young at the time, I guess he had just finished writing his book called "Head Games" about his experience as both a Harvard football player and a professional wrestler and post-concussion syndrome and the lack of knowledge out there and the lack of people diagnosing anything or never being told what a concussion was or that he had any concussions and no nothing through all of childhood, through an Ivy league Division 1 program, nothing about concussions, no one ever had concussions. And then as a professional athlete, you know, those are real hits in the WWE. He was so impaired. And he met Dr. Robert Cantu who a lot of people listening to this probably know as one of the major players in sports concussion through the last decades. And Bob diagnosed Chris as having post concussion syndrome. Changed his life. And Bob and Chris together created something called, at the time, Sports Legacy Institute. They were just developing that when I met Chris.- Gotcha.- Long story short, we put together this thing called the Center for the Study of Traumatic Encephalopathy. That was a formal affiliation between the nonprofit Sports Legacy Institute and BU. They had asked me, or Chris had asked me, hey, do you happen to know a neuropathologist who'd want to look at former football player's brains? I said, well, I work with this great neuropathologist but I had no clue that she was a football fan or that she had a Brett Farve bobblehead on her desk. I'd never been to her office, which was in a different place and so we'd always be meeting here. And so I called Anne and she said, yeah, love to. So Anne joined and we created this thing with Bob Cantu, Chris Nowinski, Anne, and me as the co-founders and directors of this center. Then the affiliation ended and we now have the BU CTE Center that Anne directs here and I oversee clinical research. And that was the beginning of it, by my saying, a TBI is a risk factor for Alzheimer's Disease, something that I don't believe anymore. To all the stuff that we've been doing over the last many years.- That's a lot of serendipity.- You know, I give a talk every year for some Harvard medical student postdocs on career trajectory and I call it serendipity.- (laughs) Yeah, and I mean, I know those three colleagues reasonably well and all great people, you know, I mean just the rain power and the drive to find solutions. It's pretty neat to see. It's great to hear the story behind it. So if you could go back to your early years as an investigator, knowing what you know now, what would you tell yourself? What advice would you give yourself back in the (audio cuts out)- We talkin' about early, early days? Pre-CTE, just as a new investigator?- Take it where you want it but.- Yeah (sighs heavily) You know, I'd say "Follow your gut." Because that can be really meaningful."Don't forget about family." Because I learned how fragile life is throughout this whole process because my first wife died of cancer when she was 42. And we had two little kids at the time I then married a woman who also was a widow from cancer and she had two kids. So, you know, life does have wonderful changes and shifts but what I learned from that death and from other people's lives around me, that life is really, really short and family really needs to come first and relationships need to come first with all kinds of people. The other thing that I'd tell myself is the most important thing now, in retrospect,"Don't try to be a perfectionist. Don't expect perfection from me or from others." No, one's perfect.- Yeah, so clearly you're incredibly successful in this space, in your talk a little bit ago, you highlighted a number of significant grants that you have including Diagnose which is 17 and a half million, which is huge. Great, good for you, and I'm excited to see the results coming, but outside of work, what hobbies? Do you collect things? You mentioned Broadway, maybe you do, you know, maybe you pop down to New York on occasion and sing a little Hamilton, I don't know. What do you do on the side?- (sighs heavily) I used to have so many hobbies(laughs) photography, running, singing, playing the piano, go to the gym, and then life happens and there needs to be some prioritization. When I was in my fifties, early fifties I guess, I came back into doing a production at our synagogue, had a production of some musical, and I tried out for it and it was fun. You know, first time I'd been doing anything for a long, long time. I haven't done anything since, but I did that. Exercise is always a big part of my life. I have always loved kayaking and we have a little place in Rhode Island that allows me to take my kayak and explore all of the incredible little waterways all around Rhode Island. To me, just being out on the water is key. And also being in the mountains used to be a huge part of my life, camping and backpacking and it hasn't been for a long time, but my whole family, all my four kids and my wife and I went to Yosemite this past October to celebrate my daughter's 30th birthday. But being back at Yosemite reminded me of how much I need to do that again. There are a lotta the things I need to get back to and work is busy, you know, and trying to maintain a relationship and be an adequate father to adult kids. And, you know, I wish I could say I'm doing all the things I'd like to do, but not all the time.- I think this is.- [Bob] Oh spin, spin, I forgot about that.- Spin guy, all right.- Yeah, I'm a spin guy. Pre-COVID, I was at the spin place every morning
at 5:30, 5:45 in the morning. Then COVID came and I actually got myself a Peloton.- All right, I was just gonna ask if (audio cuts out)- Yeah, it's good, but you know, I wish we could turn the clocks back to feeling safe in a spin studio.- Hopefully we'll get there sooner rather than later. So, you know, I think you touched on an important part. I think there's this misnomer, you know, successful people and having it all and great family life and all these outside activities and it just comes so easy and success, particularly at the level you're at it, it carries a cost, right? And sometimes you miss a birthday or you miss an anniversary or something and yeah.- I haven't missed those things.- Good for you.- I think ever. Games, you know, I was a Little League coach for a long time. I would go to all of my son's and my daughter's soccer games. Then believe it or not, my eldest son, who just got engaged, was a football player.- Congratulations. Thanks, he played Pop Warner, he played in high school, he was, you know, part of our great Needham High team and I would scream and yell and be the craziest of parents on the sideline. And that was before any of this started.- [Steve] Sure.- And he was concussed a bunch of times, fortunately he was too small to be a lineman, but he got some big hits as a running back and a D back. And so, you know, I never missed any of those things and I still don't miss the kids or my wife's things. What I've done is I've had to put a lot of my own stuff away. And I'm not the best scientist because I do too many things. I am so passionate about so many different things and it took me a long time to learn to say no. Which is something that all scientists have to deal with. And so I've said yes to lots of really great things, but I can't possibly be great at all of them.- Yeah, very true. What would you view as your greatest accomplishment in life? Professionally, personally.- My kids.- All right.- That's the greatest. Professionally? It's been an incredible honor to be able to study the long-term consequences of repetitive head impacts. It's been so amazing to be able to be part of a team that's made some pretty big advances in science. But I'm not there yet and so I don't think I've made my greatest contribution to the area of CT and other long term things associated with the earlier stuff. I'm hoping that I will in the next year or so.'Cause we have some pretty amazing data. So I don't feel like I really made it yet. You know, I think the neuropsychological assessment battery, as I mentioned before, is kinda almost like this sideline where I've developed tests. It's not what I do, but it it's a way to answer a question. So I developed this thing and it was like co-parenting and birthing a baby with Travis White, my co-author. So that was a baby, but I don't think my greatest professional accomplishment has happened yet. And I probably will be saying that my grandchildren are my greatest accomplishments, if and when that happens.- Yeah, no pressure though, right?- [Bob] No, no, no, no.- All right, we're getting close to the end of time, but I have a few more, you can give shorts answer if you want. What have you failed at?- I've failed at some professional relationships. Because of a variety of reasons. And I will always try to take my responsibility for any of those kinds of failures. And it's sad when that happens.- Yeah, who do you admire?- Boy (sighs heavily) I'll tell you what immediately came to mind and it's really true, Barack and Michelle Obama.- That's a good one, yeah. They seem to be doing it the right way.- [Bob] Yeah.- Yeah, and their youngest daughter's a student here. I just need to throw that in.- Oh really?- I've never seen her but I know she's here.(both laughing)- [Bob] That's great.- All right, I got two more for you. If you could do anything you wanted as a profession, money was not a problem, what would you do?- Right now or earlier on?- Let's say right now. You're like, I'm done, I'm not gonna be a researcher, I have all the money, I won the lotto, retirement's not an option, you gotta go do something.- Yeah, so I guess it's a cliche but I'd do what I'm doing, but not with the stressors and not with the financial stuff and not with the constant meetings and needs for, you know, money and infrastructure support and all that kinda stuff. But what I get to do as a scientist and as a person through what I'm doing, I'd wanna do it. The other things though would be, I'd be a, believe it or not another cliche, an innkeeper or a bed and breakfast keeper.- Great.- [Bob] Yeah.- All right, I was waiting for you to tell me you were gonna walk down the street to Fenway and join the Red Sox.- Well no, we're talking right now So that's what I would if you asked me a while ago.(both laughing)- Fair, fair, all right, here's the last one for you.- Okay.- 50 Years from now, what do you wanna be known for?- Very sincerely, being a kind person.- I like it.- Forget about professional accomplishments or if there is, I would hope that my professional legacy too, through my trainees, through their trainees, and through my colleagues that people would say, oh yeah, ya know, he was a nice guy, he was kind.- I like it, I'm sure they will.- Some (laughs)- Or they're dumb. All right, Bob, well thank you. This was great, really appreciate it.- Hey, Steve, I gotta say, you know, you have a new career.(Steve laughing) Ya know, forget about it Kimmel, and Fallon, and Colbert. You are incredible interviewer.- I don't know about that, but thank you. I appreciate that. That's really nice of you to say. But you have been a great guest on your lecture a little bit ago, and then obviously through this and we're hoping to do more of these. So I think there's, you know, there's not often, particularly for our young investigators, and trainees, you know, they don't get to engage with people at this type of level. So this is kind of the intent is we can share some of that and appreciate you being very open too,'cause you shared a lot so.- It's a great pleasure. Thanks for letting me do it.- All right. We'll see you around probably some meeting, sometime soon I'm sure.- Sounds good, take care.- [Steve] Take care, Bob.- [Bob] Bye-bye.(whimsical music)