A Career Dedicated to Giving Back Lives

One of Dr. Stephen D. Silberstein’s earliest childhood memories is that of his mother lying in bed with an ice pack on her head, enduring the agony of a migraine.

“We couldn’t do anything about it back then. I couldn’t find anyone to treat her,” says Silberstein, a neurologist and one of the world’s foremost experts on migraine headaches. “So maybe it was a sense of helping my mother that led to my choice of specialty.”

Silberstein is a professor of neurology at Thomas Jefferson University and director of the Jefferson Headache Center. His life’s work has been dedicated to easing the pain of people like his mother, and he’s been at it for more than 50 years.

Silberstein says his decision to become a doctor was made for him early in life. His uncle was a general practitioner, and he would spend days in the office seeing patients with him and filling pill bottles. “I don’t think I had a choice. There was no question that I would be a doctor like him. The question was: what kind of doctor would I be?”

The answer came in the form of a mentor—Dr. George Milton Shy, who served as chair of the Department of Neurology at the University of Pennsylvania from 1962 to 1967.

“He was smart; he was energetic; he cared,” Silberstein says. “When I met Milton Shy, I knew I was going to be a neurologist.”

Silberstein says he “always wondered how the brain and nervous system works, and studying neurology allowed me to answer those questions in part.” While he still doesn’t have all the answers he has sought, he has gotten many of them.

The questions he thought would never be answered were: When we think, where do we think? Where is the eye located when I’m talking to you and I have a sense of my personality? Where does that exist?

But now, he says, we’re beginning to get the answer to that fundamental question of the nature of human existence.

“We can now look at the brain in action using certain types of scans and see where the information is coming from and try to understand the interactions between the different parts of the brain,” he says.

That understanding has led to a greater grasp of how medicines work to influence the brain’s own mechanism for diseases such as schizophrenia, depression, and bipolar disorder—and, of course, migraine.

Silberstein explored the field of headache medicine long before it became popular. He was at the forefront of research that led to the use of triptan in the treatment of migraines in the early 1990s and the discovery that Botox not only treated wrinkles but alleviated the pain of migraines. From there, discovery “steamrolled,” leading to the use of calcitonin gene-related peptide, an antibody treatment that has revolutionized migraine prevention and care. And, he promises, there is more to come, as research into the field is expanding rapidly.

Silberstein is involved in multiple research projects and clinical trials and works with several pharmaceutical companies to bring new and better treatments to migraine sufferers. He has written— and continues to update—every guideline for the treatment of the condition and lectures on the topic all over the country and the world. He easily rattles off all the places he’s brought his expertise: “Brazil, Peru, Bolivia, Mexico, Colombia, Egypt, South America, South

Africa, England, France, Germany, Spain, Russia, Israel, Turkey, Japan, Thailand, Hong Kong, Singapore…” and the list goes on.

He is senior author of Wolff’s Headache and Other Facial Pain, the “bible of headache science,” as well as hundreds of other books and publications.

In 2016, Silberstein was awarded a Lifetime Achievement Award by the American Headache Society, for whom he has served as president, treasurer, and member of the board of directors. He was also co-director of the national and international Headache Guideline Project and was chair of the headache research group of the World Federation of Neurology.

Silberstein is also eager to pass the baton to the next generation of specialists. He has trained more headache doctors in the U.S. than any other neurologist; by his estimates, between 70 and 80 residents and fellows have been educated under his tutelage.

Philadelphia is Home

Silberstein is Philadelphia born and bred. He grew up in the city, went to Central High School, graduated from the University of Pennsylvania, received his medical degree from Penn, and completed his internship, medical residency, and neurology residency there.

He left Philadelphia briefly—to spend three years at the National Institutes of Health in the laboratory of Nobel Prize-winner Julius Axelrod, PhD, who received the award for research into the chemistry of nerve transmission. He also lived in London and Israel for several months. But for him, “Philadelphia is home.” He and his wife of 54 years, Marsha, raised their two sons there and currently reside just a short walk from Jefferson’s Center City campus.

Silberstein describes himself as a “physician first who’s interested in doing research to answer fundamental questions about getting my patients better and finding new drugs.”

He takes a hands-on approach to treating his patients, knowing that most have been seeking relief from pain for years.

“For many who come to see me, I’m the sixth or eighth doctor they’ve been to,” he says. “The first questions I ask are, ‘Why are you here? What do you want?’ And they want to understand what’s going on. I can’t guarantee I’ll get them better, but I promise them I won’t stop trying.”

He has followed some patients for 20 or 30 years, many of them telling him he “gave them their life back.” Silberstein understands his patients’ pain intimately—he is a lifelong migraine sufferer, too. When the first headache struck during medical school, he didn’t know what was happening, even though he watched his mother and grandmother experience the same symptoms.

“The throbbing, the headache, the nausea, the inability to think; I had no idea what it was,” he remembers. “In those days, it [migraine] was ignored, and that’s one of the reasons that drove me to take care of migraine patients.”

Silberstein started a headache center while working at Germantown Hospital in 1986. In 1997, he was invited to move it to Jefferson. The outpatient offices and clinical research laboratories are located on the Center City campus; the inpatient facility is at Methodist Hospital in South Philadelphia.

“We came with three doctors, four nurses, and one nurse practitioner,” he says. “We now have 10 physicians, two psychiatrists, six nurse practitioners, seven nurses, and a staff of about 30.”

Through philanthropy, Silberstein plans on growing the program even larger. His vision is to create the country’s first comprehensive headache institute at Jefferson.

Art and Medicine

When he isn’t performing research or patient care, Silberstein indulges in his favorite pastime—art. Specifically, photography. He attends exhibits and collects photos to adorn the walls of his home.

His interest in photography was sparked when he was working at the National Institutes of Health in the early 1970s. A friend introduced him to the Washington Print Club, and they would attend exhibits in their spare time. He discovered galleries and began buying photographs to hang in his apartment. Then he sought out new artists’ work and

bought a few more photographs— and a few more.

How many framed photographs does he own? “A lot!” he says. He carries photos of his prints on his phone—scores of them, including two of his favorites: a little boy in Paris carrying a bottle of wine down a cobblestone street and a self- portrait of a photographer taking a photo of his reflection in a mirror.

He says the photos speak to him—much like the way people speak to him. “Depending on the circumstance, they make me laugh; they make me think; they take me to another plane of existence.”

Even though he’s now 80, Silberstein isn’t slowing down. He continues to teach, treat patients, conduct research, and plan for a future of easing the pain for the more than 1 billion migraine sufferers in the world. He says it’s what he was always meant to do.

“Did you ever feel when you were growing up that you knew what you wanted to be and that you were going to devote your life to being it?” he asks. “That’s how I feel.”