The lesser-known vision and legacy of Dr. Richard Goldbloom: Advancing research in a clinical department

Andrew C. Issekutz MD, Harold W. Cook PhD, Scott Halperin MD, David Byers PhD, Thomas B. Issekutz MD, Elizabeth Winsor PhD, and Robert Bortolussi MD

We recently mourned the passing of Dr. Richard B. Goldbloom (1924-2021) in Halifax, Nova Scotia.  Dr. Goldbloom was a truly remarkable person. As a compassionate paediatrician, educator and Chief of Pediatrics and Director of Research (1967-1985), he was instrumental in bringing world-class clinical care to the IWK Hospital for Children (now the IWK Health Centre).  He was also a wonderful father, patron of the arts and civic organizations, and philanthropist who could lead with charm and by personal example when communicating with donors.

Dr. Goldbloom’s peers and admirers have described many attributes and accomplishments. However, there is a side to Dr. Goldbloom that is less known: his vision over 50 years ago to weave research and the pursuit of scientific discovery into the fabric of a clinical department. As physicians and scientists recruited to Dalhousie University’s Department of Pediatrics by Dr. Goldbloom in the 1970s and 1980s, and who pursued our careers here, we want to highlight some of his accomplishments and their impact.

When Dr. Goldbloom became Head of Pediatrics in the original Halifax Children's Hospital in 1967, the department was small and his first objective was to recruit subspecialty clinicians to cover essential clinical services and provide accredited training to residents. 

By 1970 and when the new Izaak Walton Killam (IWK) Hospital for Children opened, he actively pursued his vision about the importance of research in a clinical department. By working with the university and basic science department heads, often capitalizing on opportunities from federal government or disease-specific granting agencies, Dr. Goldbloom expanded the recently created clinical genetics service by recruiting a clinician neuroscientist (Matthew W. Spence), a PhD biochemist (HC), as well as a PhD geneticist (EW) in the 1970s. This group became nationally and internationally recognized for their research in genetics and metabolism, and served the clinical needs of patients and families affected by genetic and metabolic disorders. Recruiting scientists into a clinical department (especially a small one) was remarkable at the time, and was exceptional outside of the two or three major centres in Canada. The success of this initiative led Dr. Goldbloom to recruit a third PhD scientist (DB) to this group in the early 1980s.    

Soon after, recruitment of four more clinician scientists was intended to form a critical mass of researchers in infectious diseases (RB and SH) and in immunology (ACI and TBI).  These recruitments addressed important clinical needs, established competitive research programs and provided research training to residents, graduate students and postdoctoral fellows. All these scientists established independent research funding and, in most cases, independent salary awards from research granting agencies. 

As the Director of Research, Dr. Goldbloom also encouraged the IWK Foundation to designate 20% of its funding to the IWK for research. He promoted the initiation of the highly successful annual telethon.  These initiatives were key to making the IWK more competitive in research with other children's hospitals, which were rapidly developing in-house research funding programs. Dr. Goldbloom leveraged all available opportunities to facilitate the success of all researchers at the IWK as well as promoting the patient care, teaching and research mission in his department. The strong economic headwinds of the 1970s (double-digit unemployment and hyperinflation) did not dampen Dr. Goldbloom's optimism and drive to make progress on all fronts. 

Dr. Goldbloom was correct in his foresight that genetics and biochemistry, and infectious diseases and immunology would be at the forefront of medical advances by the 21st century. Our careers were established under his leadership and have since flourished, with some of our discoveries—and thus Dr. Goldbloom's vision—having wide impact.

Some of the impactful discoveries in immunology are: the identification that TNF alpha is a key cytokine in joint destruction, which underpins the current TNF alpha-blocking therapies so effective in juvenile and adult rheumatoid arthritis; discovery that the alpha-4 integrin leukocyte adhesion molecule is key for lymphocyte migration into the central nervous system and also to the intestinal mucosa. Using alpha-4 blocking treatments in preclinical disease models predicted that alpha-4 blockade would be therapeutic in multiple sclerosis and Crohn's diseases, which has been confirmed in the clinic with biological therapies.  

Studies by infectious disease researchers helped understanding of the unique maturational deficiencies in the defences against infections in newborns and premature babies. This has led to improved care for newborns at risk of infection. The initiation of research to improve vaccines for pertussis was the start of the subsequent evolution into today's Canadian Center for Vaccinology, based at Dalhousie. This centre now plays a leading role in the evaluation of many new vaccines, including ones protecting against COVID-19.

Genetics, biochemistry and related molecular biology have moved to the forefront of medical advances, whether it is diagnosing inherited diseases, applications in cancer biology and diagnosis, newborn screening for genetic conditions or virus mutations and viral evolution such as with SARS-CoV2.  Dr. Goldbloom’s foresight was likely ahead of many of us.  The discoveries by the geneticists and biochemists Dr. Goldbloom recruited have added to our knowledge of the biochemical and molecular basis of several inherited diseases, including some prominent in the Maritime provinces. Often this was linked to a better understanding of the development and functions of the brain, the nervous system and of various types of nerve cells in normal and diseased states. Other studies of the proteins involved in fatty acid synthesis in bacteria has led to developing novel antibiotics.

Dr. Goldbloom’s commitment to research had real economic benefits by way of the many millions of dollars received by researchers from national and international research funding agencies during their careers.  More than 60 percent of these funds were used to employ personnel and fund trainees in research. Most of these former trainees are now MSc, PhD and MD scientists in Halifax and elsewhere in Canada and beyond. Many came from other countries to be mentored here and some of them made Canada their permanent home and are making important contributions scientifically, academically and clinically. Those who returned home are doing the same there. This kind of local, national and global impact was very much in Dr. Goldbloom’s vision of expanding academic activity and clinical service to communities near and far.

Dr. Goldbloom’s vision for the needs of children in the Maritimes was not limited to long-term advances in research.  Paediatric subspecialization was relatively new when Dr. Goldbloom took over in 1967.  During his 18 years as department head he recruited many subspecialists who had state-of-the-art training, and he staffed every major subspecialty to deliver excellent tertiary care to children in the Atlantic provinces. He encouraged all clinicians to ask research questions related to their practice and their patients’ challenges.  Many of these clinicians, including Alec Allan (neonatology) and Peter and Carol Camfield (neurology) made major research contributions while providing excellent clinical care. 

In honour of Dr. Goldbloom's many contributions, a sizeable addition to the IWK 15 years ago was fittingly named the Dr. Richard B. Goldbloom Research and Clinical Care Pavillion. (Picture here, Dr. Richard Goldbloom and his wife, Ruth, on the opening of IWK’s research and clinical care pavilion named in his honour)

For each of us, Dr. Goldbloom was an inspiration by his vision and optimism, leadership and administrative skill, kindness and charm, compassionate and exemplary clinical care, teaching, and research. While few will match his many attributes, Dr. Goldbloom did set a remarkable example for us and for future academicians, clinicians and department heads.

The authors are physicians and scientists recruited by Dr. Goldbloom, and are currently at or recently retired from Dalhousie University’s Department of Pediatrics.

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