- Email: [email protected]
Eduardo Tolosa: from Spain to the USA and back again
In Context
Profile Eduardo Tolosa: from Spain to the USA and back again
For the American Academy of Neurology website see http:// www.aan.com/
For The Movement Disorder Society website see http:// www.movementdisorders.org/
124
In 1980, Eduardo Tolosa returned to his home town of Barcelona after 10 years living and working in the USA. He has remained in the Catalan capital ever since, and in that time he has seen the practice of neurology advance rapidly in Spain. “When I arrived, neurology was very much still linked to internal medicine and that was an impediment for growth. Now, neurology is like any other specialty and is very competitive in Spain. There are many neurologists and it has changed so much for the better”, he enthuses. Tolosa says that Spanish neurology has followed the US model and has become very disease oriented, with study groups for each neurological subspecialty. The downside, he says, is that departmental cohesion can be difficult to maintain because everyone is studying different pathologies. “But I think the young neurologists get good training programmes that are very similar to the US approach”, he says. Tolosa himself benefited from spending his formative years in the USA. His father, a neurosurgeon, arranged for him to work with a family friend in the neuropathology department at Hartford Hospital in Connecticut during the summer holidays of his medical degree, which he obtained from the University of Barcelona in 1967. Tolosa returned to Hartford for his advanced medical training before a residency programme at the Department of Neurology, University of Minnesota Medical School, Minneapolis. “Living and working in the USA was exciting; it was a phenomenal time of my life”, he recalls. “Everything was new and different and exciting. It was a fantastic time professionally and personally.” AB Baker, one of the founders of the American Academy of Neurology, ran the residency programme at the University of Minnesota, which Tolosa says was very well structured. “AB Baker had a strong personality and was very much involved in the training of residents”, says Tolosa. “Every Saturday morning for 4 years I had to meet with him, so he had a strong personal influence on me.” When he finished the residency programme, Tolosa stayed at the University of Minnesota for a research fellowship in movement disorders under the guidance of William Martin. “That was my first experience of getting involved with patients with Parkinson’s disease”, says Tolosa. “William Martin was a very bright and very dedicated individual who taught me the essentials of clinical research in Parkinson’s disease. At that time, people were not formally trained in movement disorders—I trained myself—but in clinical research, in clinical pharmacology, William Martin had a very important influence on me.” In 1974, Tolosa moved to the Brookhaven National Laboratory in New York, where George Cotzias had recently made the seminal discovery that oral levodopa had a dramatic and sustained beneficial effect on parkinsonian symptoms. Tolosa stayed for a year before returning to
Minnesota as an assistant professor of neurology, helping to set up the Parkinson’s unit there. In 1980, Tolosa returned to Barcelona to be director of the Instituto Neurologico Municipal, and 2 years later he moved to the University of Barcelona. “I was chief of the neurology department until about a year and a half ago. I did this for 20 years. I started almost from scratch here at the university hospital—there were just three of us at the beginning and no inpatient ward”, he says. During his 20 years in charge, Tolosa expanded the department considerably and divided it into specialty units. He also started a brain bank, the first such tissue bank in Spain. “That has been very rewarding”, he says. But he also says that he is enjoying his new-found freedom: “It’s wonderful because I am now devoted to Parkinson’s disease full time. I still have teaching and other responsibilities but I find it a good step forward.” Tolosa’s research now focuses on the early phases of Parkinson’s disease. “We are studying what the initial symptoms of Parkinson’s are before the motor phase”, he explains. “Looking at this phase of the disease can tell us where exactly it starts or how it evolves, and I think it will give us important clues about the cause of Parkinson’s disease”, he says. But this project is only one of the many that Tolosa has been involved with. “When I trained I did not become superspecialised”, he says. “People now become more and more specialised. You find movement-disorder specialists who have developed their entire career around dystonia, imaging, or genetics. Like other people of my age, I work in several areas in movement disorders.” But Tolosa says that the current trend to specialise early in a career is an unfortunate necessity. “You have to become specialised really to be competitive. If you are involved in drug trials, for example, you have to become a real expert on designing trials and how to handle them, and then build a team around that.” Tolosa himself is well known for his work on clinical trials and has been directly involved in the development of many treatment approaches that are used in movement disorders. “I have seen dramatic changes in the field, like the introduction of botulinum toxin or deep brain stimulation, so for me it has really been an exciting time to be involved in the development of these new treatments”, he says. Tolosa is also proud of his role in founding of The Movement Disorder Society and in the launch of the journal Movement Disorders in 1986. “I was lucky and privileged to contribute to the society and to the journal, which have been instrumental in the development of the field of movement disorders”, he says.
James Butcher [email protected]
http://neurology.thelancet.com Vol 7 February 2008
Profile Eduardo Tolosa: from Spain to the USA and back again
For the American Academy of Neurology website see http:// www.aan.com/
For The Movement Disorder Society website see http:// www.movementdisorders.org/
124
In 1980, Eduardo Tolosa returned to his home town of Barcelona after 10 years living and working in the USA. He has remained in the Catalan capital ever since, and in that time he has seen the practice of neurology advance rapidly in Spain. “When I arrived, neurology was very much still linked to internal medicine and that was an impediment for growth. Now, neurology is like any other specialty and is very competitive in Spain. There are many neurologists and it has changed so much for the better”, he enthuses. Tolosa says that Spanish neurology has followed the US model and has become very disease oriented, with study groups for each neurological subspecialty. The downside, he says, is that departmental cohesion can be difficult to maintain because everyone is studying different pathologies. “But I think the young neurologists get good training programmes that are very similar to the US approach”, he says. Tolosa himself benefited from spending his formative years in the USA. His father, a neurosurgeon, arranged for him to work with a family friend in the neuropathology department at Hartford Hospital in Connecticut during the summer holidays of his medical degree, which he obtained from the University of Barcelona in 1967. Tolosa returned to Hartford for his advanced medical training before a residency programme at the Department of Neurology, University of Minnesota Medical School, Minneapolis. “Living and working in the USA was exciting; it was a phenomenal time of my life”, he recalls. “Everything was new and different and exciting. It was a fantastic time professionally and personally.” AB Baker, one of the founders of the American Academy of Neurology, ran the residency programme at the University of Minnesota, which Tolosa says was very well structured. “AB Baker had a strong personality and was very much involved in the training of residents”, says Tolosa. “Every Saturday morning for 4 years I had to meet with him, so he had a strong personal influence on me.” When he finished the residency programme, Tolosa stayed at the University of Minnesota for a research fellowship in movement disorders under the guidance of William Martin. “That was my first experience of getting involved with patients with Parkinson’s disease”, says Tolosa. “William Martin was a very bright and very dedicated individual who taught me the essentials of clinical research in Parkinson’s disease. At that time, people were not formally trained in movement disorders—I trained myself—but in clinical research, in clinical pharmacology, William Martin had a very important influence on me.” In 1974, Tolosa moved to the Brookhaven National Laboratory in New York, where George Cotzias had recently made the seminal discovery that oral levodopa had a dramatic and sustained beneficial effect on parkinsonian symptoms. Tolosa stayed for a year before returning to
Minnesota as an assistant professor of neurology, helping to set up the Parkinson’s unit there. In 1980, Tolosa returned to Barcelona to be director of the Instituto Neurologico Municipal, and 2 years later he moved to the University of Barcelona. “I was chief of the neurology department until about a year and a half ago. I did this for 20 years. I started almost from scratch here at the university hospital—there were just three of us at the beginning and no inpatient ward”, he says. During his 20 years in charge, Tolosa expanded the department considerably and divided it into specialty units. He also started a brain bank, the first such tissue bank in Spain. “That has been very rewarding”, he says. But he also says that he is enjoying his new-found freedom: “It’s wonderful because I am now devoted to Parkinson’s disease full time. I still have teaching and other responsibilities but I find it a good step forward.” Tolosa’s research now focuses on the early phases of Parkinson’s disease. “We are studying what the initial symptoms of Parkinson’s are before the motor phase”, he explains. “Looking at this phase of the disease can tell us where exactly it starts or how it evolves, and I think it will give us important clues about the cause of Parkinson’s disease”, he says. But this project is only one of the many that Tolosa has been involved with. “When I trained I did not become superspecialised”, he says. “People now become more and more specialised. You find movement-disorder specialists who have developed their entire career around dystonia, imaging, or genetics. Like other people of my age, I work in several areas in movement disorders.” But Tolosa says that the current trend to specialise early in a career is an unfortunate necessity. “You have to become specialised really to be competitive. If you are involved in drug trials, for example, you have to become a real expert on designing trials and how to handle them, and then build a team around that.” Tolosa himself is well known for his work on clinical trials and has been directly involved in the development of many treatment approaches that are used in movement disorders. “I have seen dramatic changes in the field, like the introduction of botulinum toxin or deep brain stimulation, so for me it has really been an exciting time to be involved in the development of these new treatments”, he says. Tolosa is also proud of his role in founding of The Movement Disorder Society and in the launch of the journal Movement Disorders in 1986. “I was lucky and privileged to contribute to the society and to the journal, which have been instrumental in the development of the field of movement disorders”, he says.
James Butcher [email protected]
http://neurology.thelancet.com Vol 7 February 2008