Dr. David Rosenstreich, chief of the department of medicine’s division of allergy & immunology, has seen a lot in his decades-long career at Montefiore Einstein. In fact, when he first arrived in 1980, there was no allergy division within the department of medicine.
He was born in the Morrisania section of the Bronx – and has the accent to prove it – in the shadow of Yankee Stadium at a time when Jackie Robinson broke the color barrier in Major League Baseball. He went to the Bronx High School of Science and planned to become a chemist and majored in chemistry at City College. But his first advanced physics course changed his mind (something about a railroad track, a big stake in the ground, bouncing flat cars, Sir Isaac Newton, and deriving your own equations). So, he pursued a career in medicine and attended the NYU School of Medicine.
Dr. Rosenstreich did his internal medicine residency at Jacobi until public service requirements during the Vietnam War sent him to the National Institutes of Health (NIH) in a three-year-program at the National Institute of Allergy and Infectious Diseases (NIAID) primarily working in an immunology lab. It was the first time that he and his Brooklyn-born wife left New York (to live in Virginia), an adjustment in and of itself.
He wasn’t sure what specialty to pursue but had a budding interest in the study of allergies. Once a week he volunteered at the allergy clinic at the NIH. Dr. Rosenstreich also had more informal clinical training in allergies. In those days, every laboratory had its own experimental animal quarters right next to their labs. With animal dander everywhere, it became evident that a large number of personnel were allergic. Therefore, he received a lot of experience caring for colleagues with allergies and found that he liked it a lot. That’s when he decided to become an allergist.
His three-year stint at the NIH lasted for nine years. By then, he was running his own immunology lab. But Dr. Rosenstreich and his wife were eager to return to New York, so during a sabbatical year from the NIH, he accepted a visiting professorship position at The Rockefeller University. They never returned to Virginia.
A Return to the Bronx
Dr. Rosenstreich landed back in the Bronx, only a few miles away from where he was born, when Dr. Barry Bloom, then chair of the department of microbiology at Einstein, offered him a position as a basic scientist. He also received a primary appointment in the department of medicine and did translational research in his immunology lab.
While there was already an allergy division within the department of pediatrics, there wasn’t a dedicated allergy division to treat adults, which is when Dr. Rosenstreich offered to start and lead an allergy & immunology division – a division with only one member (now a division of 10 full-time faculty members, one allergy immunology fellow, and three full-time study coordinators that maintain very busy ambulatory practices at four outpatient sites).
“It wasn’t all that difficult to get institutional approval in those days,” said Dr. Rosenstreich. “They said ‘fine, as long as you are not asking for money, you can be the head of allergy & immunology.’”
Good decision since he built the division into one of the largest in the country.
The Margaret Mead of Medicine
Dr. Rosenstreich is a veritable medical anthropologist. When asked what some of the major advances he has seen since he began his career, he enthusiastically replied – everything!
“We are talking over 50 years. Every antibiotic, every x-ray procedure, essentially anything we take for granted in medicine today is an advance. I remember when amoxicillin was introduced, when the first ACE inhibitors came to market, when inhaled medicines for asthma were introduced. I remember the first CAT scan and the first MRI, and when there was someone at Jacobi working on something called ultrasound that no one ever heard of,” Dr. Rosenstreich recalled. “When I trained at Bellevue as a medical student, there was an oncologist who only had one drug to offer a patient and now we have so many effective treatments that save lives. And of course, advances in medications to treat and prevent HIV and the quick development of COVID vaccines is a major advance.”
Another advance is the focus on diversity, equity, and inclusion. Within the department of medicine, Dr. Rosenstreich is an active member of its diversity council, responsible for promoting, advising, and monitoring programs to enhance diversity throughout the department’s 14 divisions.
Asthma and Allergies on the Rise
Though there are better treatments for asthma than 50 years ago, its incidence, especially in communities of color, is still a major problem. The incidence of asthma is increasing every year and, overall, there is a steep rise in allergies, food allergies among them.
Worldwide, there is an epidemic of allergic disease, even among adults who had not suffered from allergies as children.
“We have some thoughts on why this may be occurring,” said Dr. Rosenstreich. In Western civilizations, a modern lifestyle of cleanliness (e.g., use of antibacterial soaps, not being exposed to a lot of dirt), not having childhood infections that build up your immune system that can suppress allergies, artificial colorings, and preservatives in food, all play a role.” He gives the example of additives used to stop bread from turning moldy that interfere with the bacteria in the gut (microbiome), adding, “In the past, before these anti-mold compounds were added, people would be ingesting mold microorganisms, which likely stimulated the immune system to suppress allergic reactions. We don’t have that protection anymore.”
When asked what he is most proud of, Dr. Rosenstreich didn’t hesitate. It was building the allergy & immunology division from the bottom up and hiring the best people to make it into what it is today, adding that the support of the institution and the department of medicine allowed the division to thrive.
Dr. Rosenstreich will be stepping down as division chief at the end of September but still plans to assist in the division in a consulting capacity. There is an “itch clinic” to help get off the ground, after all, and a chance to mentor. But mostly he is looking forward to spending more time with his family, particularly with his children and grandchildren who live in Switzerland. And tending to his garden – in the Bronx and beyond.
Posted on: Thursday, July 13, 2023