Body
Richard Harvey, MD, is retiring after more than 30 years with Shirley Ryan 星空传媒视频. He is the David W. Trott Clinical Chair of The John and Kathy Schreiber Brain Innovation Center at Shirley Ryan 星空传媒视频, as well as the Wesley and Suzanne Dixon Stroke Chair for Stroke Rehabilitation 星空传媒视频.
Dr. Harvey joined Shirley Ryan 星空传媒视频 (formerly known as the Rehabilitation Institute of Chicago) as a stroke rehabilitation medicine fellow in 1992. When that fellowship ended, Dr. Harvey continued as a research fellow, focusing on medical complications occurring after stroke. After that, he joined the organization on a permanent basis in 1994.
Over the next three decades, Dr. Harvey built a reputation as a tireless and innovative clinician, leading researcher and beloved teacher of rehabilitation residents. His research included studies on neuromodulation for post-stroke arm recovery, dysphagia, pain management after stroke, and the treatment of limb spasticity. The medical residents he taught voted him Teacher of the Year in 2010 and 2016, and Mentor of the Year in 2006, and he authored definitive textbooks and clinical guidelines on stroke rehabilitation.
To honor his lasting contributions to stroke care and rehabilitation, the Academy — Shirley Ryan 星空传媒视频’s educational arm — recently renamed its annual stroke course in his honor: the Dr. Richard L. Harvey Annual Stroke Course.
Read below as Dr. Harvey reflects on his career.
What drew you to a career in stroke rehabilitation medicine?
Body
In medical school, there comes a time when you have to decide your career path. For me, it came down to being either an internal medicine physician or neurologist. When I did a rotation in physical medicine and rehabilitation, I realized it was sort of like the combination of both those specialties.
After residency, I discovered that Northwestern had a stroke rehabilitation fellowship, and I applied. Once I started studying stroke rehabilitation, I thought, “I'm going to be the best stroke rehabilitation doctor I can possibly be, because my mother always taught me, whatever you do, be the best at it that you can be.” I have never regretted picking this as my specialty.
How have medical treatments for patients with stroke changed over the course of your career?
Body
In inpatient rehabilitation, the biggest change I have witnessed is that our patients’ average length of stay has shortened, and the complexity of our patients has increased. When I started, our patients were largely already medically stable. Now, I'm basically an expert in managing diabetes and high blood pressure because most of my patients have one or both of those conditions. Over the years, how we treat patients has changed, with interventions like GLP-1s and monoclonal antibodies. Interestingly, I have learned about so many of these new treatments from my residents.
What’s your best advice for young doctors?
Body
I tell younger physicians who want an academic career to get involved in national organizations. This is an excellent way to make connections throughout the country with people who have similar interests. It can propel your career and build not only your own reputation, but also the reputation of the institution you work for.
For example, in the 1990s, I was at the American Heart Association’s conference and visiting the exhibition hall. There was a company there that made a brain stimulator used to map the cortex of the brain, which they were marketing to neurosurgeons to use during surgery. I just casually said they should see if the tool was useful for stroke recovery. They said they would look into it. They did, and they asked me to be involved in the study.
I developed the protocol and led a national,12-hospital study as a principal investigator. Unfortunately, that study was not positive — I did not become famous — but I did get a couple of publications in major journals. It also led to my meeting more people in the stroke world. I eventually became chair of the American Heart Association’s Stroke Rehabilitation and Recovery Committee, putting me in a position where we made major decisions about stroke science and developed scientific statements published by the American Heart Association.
That simple conversation in the exhibition hall turned into a very fruitful, 20-year relationship.
What part of your career are you most proud of?
Body
Years ago, I was doing consultations at Northwestern when a patient came in who had locked-in syndrome. This condition is caused by a stroke on both sides of the brainstem. It causes paralysis in the face, arms, legs and throat. All patients can do is move their eyes. After he was admitted, the patient started making improvements fairly quickly in the hospital, so we brought him over to our hospital. His rehabilitation went so well, and he eventually walked out of the hospital. I thought, “I want to do that more often!”
I proposed developing a program for locked-in syndrome, telling our leaders, “Care for these patients is probably going to cost us more than we get from their insurance.” But, they approved the program. They said, “If we can develop a program for locked-in syndrome, it shows the world that we are a level above everybody else, and that alone is worth it.”
In our program, the first thing we do when patients arrive is make them feel comfortable and give them hope. We have our therapists see them on the very first day they’re admitted, which is not typical for other patient populations. We do this to assess how they communicate, and to determine if they can use a call light. You cannot believe how comforting this is to a patient with locked-in syndrome — that people on the floor know how they say yes and no, and that people will check on them.
Not everybody does as well as that first patient because it’s a very complicated condition. But, over the past 20 years, I have enjoyed caring for more than 100 patients with locked-in syndrome — I probably have more experience with locked-in syndrome rehabilitation than anyone in the world.
