Neurologist Karen Furie has devoted her career to understanding and preventing stroke.
Karen Furie has always been a reader. As the daughter of a nurse and a dentist growing up in Queens, NY, she would marvel at the medical textbooks she pulled off her parents’ shelves, particularly the parts about tropical diseases and brain parasites.
And it was her love of literature that drew her to apply to the Program in Liberal Medical Education at Brown while attending Stuyvesant High School, a science- and math-focused magnet school.
“I always had a passion for literature and English, and coming to Brown enabled me to be an English major while fulfilling all the premedical requirements,” says Furie, MPH ’87 MD’90 RES’94 F’95, P’19MD’23, now the Samuel I. Kennison, MD, and Bertha S. Kennison Professor of Clinical Neuroscience and chair of the Department of Neurology at Alpert Medical School.
Today if you sit next to Furie on a train or a plane, you might catch her in one of her guilty literary pleasures: reading mystery novels (her current favorites are by Deborah Crombie and Louise Penny). “I read them like popcorn,” she says. “That’s the way I relax and unwind.” But even her favorite pastime is intimately connected to her true passion: neurology.
“When I think of neurology, I see all the patients and the problems as mysteries to be worked through,” she says. As a neurologist and researcher, Furie has spent her career unwinding the mysteries of one of the most common and debilitating neurological afflictions: stroke.
Stoked by Stroke
Furie’s fascination with stroke was ignited by the first person to hold her current position, J. Donald Easton, MD, Brown’s inaugural chair of neurology. “He was a stroke neurologist before there even was such a thing,” Furie says. She was especially inspired by Easton’s ability to balance seeing patients with research into how best to prevent and treat stroke. “It was so exciting,” she says, “trying to answer all of the many questions that were still unresolved.”
She left a similarly strong impression on Easton. “It was obvious that she was really smart, driven, and going to be a future success,” he says.
In medical school, Furie took an elective at Massachusetts General Hospital with J. Philip Kistler, MD, director of the MGH Stroke Service. “He was an amazing mentor,” she says. “He is an incredibly dedicated clinician and he had a roll-up-your-sleeves-and-do-the-work attitude toward things.”
During her elective, Furie and Kistler determined that the drug warfarin (Coumadin) can help prevent stroke in patients with atrial fibrillation. Their finding is now so fundamental that it’s taken for granted as the course of treatment. “He had recruited patients from hospitals all around Boston and he would get in his truck with a little portable centrifuge,” Furie says. “We’d go to people’s kitchens—quite literally—and draw their blood and spin it.”
When it was time for Furie to pursue her residency, Easton encouraged her to consider Brown’s program, which was then only four years old. “She was, of course, top of her class, and that was an attraction to having her join us, but it became pretty obvious that she was a risk taker and had great self-confidence,” says Easton, who’s now a professor emeritus of neurology. “She just jumped right in and decided she was going to thrive here. And she sure did.”
After completing her fellowship at Rhode Island Hospital and earning a Master of Public Health from Harvard, Furie joined the faculty at MGH’s Stroke Service. Besides treating stroke patients there and at Spaulding Rehabilitation Hospital, Furie joined Kistler on another clinical trial—this time looking at clotting propensity and blood markers for cryptogenic stroke (stroke of unknown cause).
Furie wrote a career development grant from this work, seeking to identify genes that put people at risk for developing thrombosis, or blood vessel clotting, which can lead to stroke. In addition to identifying potential risk genes, she created a unique database of well-characterized stroke patients that included a blood biobank, genetics bank, and clinical database complete with imaging data. It’s a major part of Furie’s MGH legacy: “There are still papers being written on that database,” she says.
Stroke Around the World
Furie has had a hand in dozens of clinical studies related to preventing and treating stroke. “She’s really moving along in the field, nationally and internationally, because she’s recognized to be intelligent, knowledgeable, and very easy to work with,” Easton says.
In February, Furie and others published in the New England Journal of Medicine the results of a decade-long international study on the effects of the diabetes drug pioglitazone on stroke survivors with insulin resistance. “You can reduce the risk of heart attack and recurrent stroke by 24 percent,” she says. “That’s pretty dramatic.”
As the primary neurologist for the study, Furie traveled extensively, to the UK, Germany, Israel, and Australia. She also got to explore her childhood interest in tropical medicine when she went to Brazil to study Chagas disease, a parasitic infection that can cause inflammation of the heart and brain.
“Neurology, and stroke in particular, is a major problem globally,” she says. “We’re fortunate in the US to have so many resources at hand, but when you travel to other places in the world, you realize how much there is to be done.”
As the head of Alpert Medical School’s neurology department since 2012, Furie is traveling a lot less these days. But she couldn’t be happier.
“When the opportunity came up, I got emails from multiple people who knew me from my time at Brown saying, ‘Oh, this was the job you always wanted,’ and it’s true,” she says. “It felt so right—that desire to come back to this environment and the culture of Brown.”
“This community nurtured us for a dozen years,” adds Furie, who met her husband, neurosurgeon Marc Friedberg ’87 PhD’91 MD’93, P’19MD’23, as an undergraduate. “There was this sense of coming home.” Brown feels even more like home these days, since one of their two sons, Adam Friedberg ’19 MD’23, enrolled as a PLME.
In four short years at the helm, Furie has implemented some big changes in the department, including a required neurology clerkship for all medical students, an increase in the number of residency spots in neurology from 15 to 18, and the requirement of a clinical research project as part of resident training.
Furie marvels at just how different training for these residents is now, thanks to advances like the invention of the stent retriever, a mesh tube that can remove large clots from blood vessels in the brain. The device has changed clinical outcomes for some of the most poorly off stroke patients.
“They would often be left unable to move one side of their body, unable to speak, unable to swallow, unable to return home to any type of an independent lifestyle,” Furie says. Now these patients can go home “virtually normal” in a matter of days. “It’s really been a transformation of our whole field,” she says.
But there’s still much to be done. “We really still don’t understand completely how the brain recovers from injury and how we can augment that,” Furie says. “That’s the question that patients who are left with any deficits want to know: how can I improve my language function? How do I help get my weak arms strong again?” She has been working to get FDA approval to test a new drug that may preserve brain tissue that’s injured by the lack of blood flow during an acute stroke.
Developing treatments for brain recovery—whether pharmaceuticals, stem cell therapy, or brain stimulation—will require coordinated efforts between basic and clinical researchers. Furie says this is something that Brown is uniquely situated to foster, with collaborations between the Brown Institute for Brain Science, the VA Center of Excellence for Neurorestoration and Neurotechnology in Providence, and the Norman Prince Neurosciences Institute at Rhode Island Hospital, of which she is coclinical director. “That’s the real joy of Brown: thinking outside the box and forming unconventional partnerships to solve problems,” she says.
Meanwhile the already blossoming neurology department will continue to grow under her watch. “We’ve gained about six new positions and we’ll probably add that many again in the coming year. Lots of good things are happening in neurology,” she says.
Despite the administrative demands, Furie still makes time for her patients. “Karen Furie is everything you’d like your doctor to be like—smart, knowledgeable, nice, concerned about you,” Easton says. “As busy as she is and as involved in as many things as she is, she’s still able to stop when she’s at the bedside and talk to the patient and put those other things out of her mind. She’s a winner.”