Gerald Malcolm Stern

Gerald Malcolm Stern (Avatar)

1930-2018

Vol XII

Web

Gerald Malcolm Stern

Gerald Malcolm Stern

1930-2018

Vol XII

Web

b.9 October 1930 d.9 September 2018

MB BS Lond(1954) MRCP(1958) MD(1965) FRCP(1970)

Gerald Stern was a consultant neurologist at University College Hospital, London and a leading authority on Parkinson’s disease. He was born and raised in Bethnal Green in London’s East End, where his Orthodox Jewish parents, Aaron Nathan Stern and Rebecca Stern née Marks, owned a cigarette shop. During the Second World War he was evacuated to the Cambridgeshire countryside and received no formal education between the ages of eight and 12. After his bar mitzvah, his father encouraged him to consider medicine as a career. He tried for all 12 London medical schools, but was invited for interview to only one, the London Hospital, a stone’s throw away from his grandparents’ delicatessen shop in Whitechapel.

As a medical student at ‘the London’ he was greatly impressed by a lecture given by Russell Brain [Munk’s Roll, Vol.VI, p.60] and aspired to become a neurologist. After junior hospital jobs at his alma mater working for Brain, the cardiologist William Evans [Munk’s Roll, Vol.VIII, p.146] and the neuropathologist Dorothy Russell [Munk’s Roll, Vol.VII, p.510], his training was interrupted in 1956 by two years spent in the Royal Naval Volunteer Reserve. In later years he would recall how sailing around the world had opened his eyes to other worlds outside his own narrow confines.

When his naval service was over, he returned to London to begin his neurological training working again for his ‘master’ Lord Brain at the Maida Vale Hospital for Nervous Diseases. Brain helped him gain a scholarship to carry out research with Fred Mettler in his laboratory of experimental neurology at Columbia University, New York, where he worked on lesioning the substantia nigra and the subthalamic nucleus in primates. During this period he also attended the grand rounds led by Houston Merritt at the Neurological Institute and travelled to Boston to attend teaching rounds with Raymond Adams, Derek Denny-Brown [Munk’s Roll, Vol.VII, p.146] and Miller Fisher.

On his return to England, he was appointed first assistant to Henry Miller [Munk’s Roll, Vol.VII, p.396] at the Royal Victoria Infirmary in Newcastle upon Tyne. Miller was in many respects the antithesis of Lord Brain, but became a second important influence. His funny one liners and sharp wittedness appealed to Gerald and, as with the economy of words taught to him by Brain, he built these aspects of Miller’s methods into his own approach. During his time in the North East of England his conviction that important lessons are always learned from one’s patients was reinforced. In 1960, as a reward for ‘services rendered’, Miller arranged for him to go to work at L’Hôpital Pitié Salpêtrière with Raymond Garcin [Munk’s Roll, Vol.VI, p.189], where he wrote up his thesis based on the experiments he had conducted with Mettler, and presented a paper in French on equine Parkinsonism due to star thistle poisoning to the Société Française de Neurologie.

While in Paris he applied successfully for a part-time consultant post at St Pancras Hospital and returned to London in 1964. There he was strongly encouraged to continue clinical research by Max Rosenheim [Munk’s Roll, Vol.VI, p.394], professor of medicine at University College Hospital, and decided to focus primarily on Parkinson’s disease. He was one of the first physicians in the United Kingdom to evaluate the effects of L-DOPA after its miraculous effects had been reported by George Cotzias in 1967. In the late 1960s he helped to set up the Parkinson’s Disease Society with Mali Jenkins, the sister of one of his patients. Over the next 25 years he initiated important clinical pharmacological studies that led to the introduction of several new treatments for Parkinson’s disease into clinical practice, including selegiline, the first oral dopamine receptor agonists and the apomorphine infusion pump. He also founded the United Kingdom Parkinson’s Disease Research Group, a group of curious consultant neurologists and geriatricians which carried out pragmatic clinical trials independently of pharmaceutical sponsorship. One of these showed that there was no reduction in mortality or long-term benefit with respect to functional improvement in starting treatment with an oral dopamine agonist or a selective monoamine oxidase type B inhibitor over L-DOPA monotherapy.

At University College Hospital, where he spent the early part of his career before the closure of the Cruciform building on Gower Street and the transfer of neurology services to the Middlesex Hospital, Mortimer Street, he was kept busy as the only consultant neurologist on site with ward rounds and referrals, teaching the undergraduates and outpatient clinics. Two grateful patients gave him unsolicited benefactions, which allowed him to appoint clinical research fellows working for higher degrees and publish important research in high impact journals without ever having an academic appointment.

From the middle of the 1970s through to his retirement from the National Health Service in 1995, he was considered the pre-eminent clinical opinion on Parkinson’s disease and related disorders in England and as a consequence he had a large private practice. He was a good listener, had excellent clinical judgement and most important of all loved his fellow man. His silvery tongue and powers of oratory meant that he was also in great demand in the law courts as an expert witness. He served as president of the Association of British Neurologists and was chairman of both the medical advisory panel of the Parkinson’s Disease Society and of the Guarantors of Brain.

By the 1908s he had a global reputation and was much in demand as a guest speaker at international symposia on Parkinson’s disease. He had an enduring passion for art, literature, history and philosophy, perceiving value in the fusing together of the arts and sciences, which was reflected in the content of many of his mesmeric lectures. In his 80th year he delivered the Stanley Fahn lecture at the International Parkinson and Movement Disorders Society meeting in Buenos Aires with the title ‘The fox, the hedgehog, the MDS and the world’s best known neurologist?’

His quiet dignity, qualities of inclusivity, generosity and humour and a powerful intellect worn lightly endeared him to overseas colleagues and led to many requests for second opinions on patients that included notable dignitaries, tycoons, artists, fellow physicians and politicians. Such was his reputation that he was also asked by the Vatican to provide a medical opinion and then look after Pope John Paul II after he had been diagnosed with Parkinson’s disease. His most important legacy, however, will be the countless students and neurologists he encouraged, mentored, and entertained over the years. He was survived by his widow Jennifer (née Pritchard), their children, Melanie, Robert and Edward, and six grandchildren.

Andrew Lees

[2010 Stanley Fahn Lecturer: Gerald Stern. International Parkinson and Movement Disorder Society 15 September 2017 www.youtube.com/watch?v=q0_MZWVK3mE – accessed 28 February 2019; BMJ 2018 363 4440 www.bmj.com/content/363/bmj.k4440 – accessed 28 February 2019; Movement Disorders 2018 Dec;33(12):1831-1833 https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.27560 – accessed 28 February 2019]