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Alumni Spotlight; Larry Goldstein, MD

Tuesday, May 29, 2018

Larry Goldstein, MD, was a fixture of Duke Neurology from 1985, when he came for a fellowship in cerebrovascular disease, until 2015, when he left to chair the Neurology Department at the University of Kentucky College of Medicine. In this week’s Alumni Spotlight interview, Goldstein talks to us about his current work, his three decades at Duke, how our ability to treat stroke has changed since he became a doctor, and adjusting to living in Lexington, Kentucky. He also offers words of wisdom for neurologists in training.

What are your current responsibilities as Chair of UK Healthcare’s Neurology Department and Co-director of the Kentucky Neuroscience Institute? What does your typical day look like?

As Chair of the Department of Neurology, I am responsible for all neurology-related clinical care, promoting the department’s clinical and translational research, overseeing its educational programs for medical students at UK and our other campuses, our adult and child neurology residences, and our postgraduate fellowships in addition to a service activities. As Co-director of the Kentucky Neuroscience Institute, I am helping to support all of the neuroscience-related clinical-translational research across nine Colleges .

How and when did you first get interested in neurology? What interests you most about stroke and cerebrovascular disease?

My interest in neurology began in high school where I did research in learning and memory as part of an Advanced Placement Biology course. I decided to focus on cerebrovascular disease during my residency when I recognized its public health impact and the opportunity to conduct research that could lead to therapies or approaches that could positively affect people's’ lives.

You completed your fellowship in stroke here at Duke three decades ago. What’s one memory that stands out from that time?

When I was recruited to Duke by Jim Davis, my mentor, he promised me that the weather was perfect all year long and that the swimming pools are open even in February- caveat emptor. My first fellowship year was spent in Bob Lefkowitz’s laboratory. I spent many weeks running columns to purify the alpha1-adrenergic receptor. It was a great experience, but did make me want to pursue research that was more immediately applicable to stroke.

What has been the biggest change to how we understand or treat stroke since you started studying the condition? What changes do you see coming over the next decade?

When I started, we were doing only initial studies of intravenous thrombolytic therapy. The advent of IV-tPA led to a complete revolution in stroke care, including the development of Stroke Centers and the use of tele-stroke. We are now also incorporating the benefits of being able to offer endovascular clot retrieval to patients who previously would have been devastated by their strokes. Advances in stroke prevention contributed to a more than 30% reduction in stroke-related death in the country over the last decade, but we are now seeing a reversal in those gains, in part possibly related to socioeconomic factors. We will need to focus on regaining this lost ground, expanding the effectiveness of mechanical thrombectomy, and exploring the potential of regenerative medicine.

What advice or words of wisdom do you have for early-career neurologists or medical students interested in studying stroke?

Find a mentor to help explore clinical and research opportunities and to help guide you as you launch your career.

What other passions or hobbies do you have outside of the Department?

I am addicted to my 2001 BMW Z3- but now in Kentucky there is also bourbon and thoroughbred horses. Lexington has an outstanding philharmonic orchestra, two chamber music festivals, great Broadway shows (similar to DPAC), and there is always NCAA basketball (UK has a different blue team).


Goldstein trades his white coat for more casual attire at a Kentucky Derby party from earlier this year.