A Harvard-Trained Cuban-American Doctor on the Battlefield of Covid-19 in Miami

Leaving behind 35 years at Harvard, Robert Sackstein packed his bags in 2019 and headed to his hometown of Miami, soon to find himself on the new battlefield of Covid-19.  The world-renowned physician, educator and researcher became the first Cuban-born dean of a U.S. medical school when he accepted the position at Florida International University (FIU).

His priorities were clear.  FIU would provide healthcare to underserved households in Miami-Dade County, like his own as a child, where more than 70% of the residents are Latino.  Dr. Sackstein would lead, by personal example, a medical school with more students that share his Latino heritage than any other school in the United States.  “It can’t get any better than this,” Dr. Sackstein said in an August 2019 interview.

Born in Cuba in 1956, Dr. Sackstein in front of his Miami home in July 2020. The beret belonged to his father, head of the American Legion in Cuba until the family fled to Miami in 1960. Courtesy of family.

A year later, Miami has become the Covid-19 epicenter, forcing Dr. Sackstein to find new ways to meet his objectives. Additionally, he has to manage Covid-19 related challenges, including budget cuts caused by the damage inflicted by the virus on Florida’s economy.  Dr. Sackstein has not taken a day off since March 11, when Covid-19 was declared a pandemic.

“Covid has consumed Robert’s life every day,” said Beth, Robert’s wife of 35 years.  “We have not had an uninterrupted conversation in four months due to one emergency after another.  While physically home, he is not at home.”

Dr. Sackstein’ presence at FIU is paying dividends.  Notably, despite a nationwide COVID-19 ban on patient contact, FIU never stopped providing basic and preventative healthcare to otherwise underserved Miami-Dade County residents.  Under its NeighborhoodHELP program, founded in 2010, students would normally visit residents in their homes.  Dr. Sackstein pivoted, leveraging “telemedicine,” which enables patient-student interactions online, to enhance the program when needed most.  As of July 30, only one of more than 4,500 residents receiving care from Dr. Sackstein and his students has died from Covid-19, according to the dean, representing one-third of the death rate across Miami-Dade County.

The expanded use of telemedicine also provided FIU students with patient access, a critical element to medical education.  Dr. Sackstein enabled this option at a time when medical students at other schools were being sidelined completely.

By putting himself on the frontline in the fight against Covid-19, including as a volunteer at testing sites, Dr. Sackstein delivered on his promise to provide a model of strength and determination for his students.

Dr. Sackstein (left) – frontline at Florida COVID-19 site in July. Courtesy of family.

Dr. Sackstein’s “fight not flight” leadership style finds its roots in his upbringing.  His mother Rosalina, a Cuban concert pianist, had to start as a cashier upon settling in Miami before fighting, over years, to become a well-known music teacher at the University of Miami.  Rosalina’s surname?  “Guerrero,” the Spanish word for warrior. His father Harold fought in many famous battles during World War II, earning a Purple Heart.

Robert remembers the first time he was ready to fight like his parents, when in 1962 he wanted to return to Cuba to confront Castro.  At the time he was also getting into fist fights on his unpaved street with neighborhood racists who saw Cuban immigrants as stealing local jobs.  Dr. Sackstein has had his fists up since he was six years old.

Six-year-old Robert in Miami in front of the family car in 1962, insisting he return to Cuba to fight Castro. Robert also expressed early feelings about American life on the back of the Polaroid. Courtesy of family.

Reflecting further on childhood lessons, Dr. Sackstein said “Covid-19 reminds me of my father’s story of D-Day, which didn’t end the war.  My father and other soldiers were on a constant push through Europe for months after D-Day before the war ended.  That is how I have felt every day since March. This is my war.”

“De tal palo tal astilla,” is a Spanish saying, literally meaning “a splinter like this must come from a stick like this,” equivalent to the English expression, “Like father, like son.

To navigate successfully through the turbulent and relentless Covid-19 waves, the new dean also relied on lessons learned during his long tenure at Harvard, where he received his undergraduate, M.D. and Ph.D. degrees.  During his total of more than 35 years at Harvard, Dr. Sackstein became a world leader in the study of glycobiology, which studies the role of sugars in biological processes, earning many awards and significant NIH grant funding, and held dual professorships at Harvard Medical School, where is an Emeritus Professor.  Maybe a coincidence, but HMS is another medical school that has fully embraced telemedicine during the pandemic.

Even with victories, few in war go unscathed.  Dr. Sackstein’s basic research in glycobiology, which he initially continued at FIU, has taken a back seat during Covid-19. While important, Dr. Sackstein confirmed his community and students come first.

FIU’s students have not been spared either.  Historical data show that a majority of students suffer from a mental disorder during medical school.  COVID-19 is making things worse.  Dr. Sackstein is concerned about this fall-out, which may be unavoidable.

Despite the hardships, Dr. Sackstein provided a quick and stern “No” when asked if he would change anything about his return home.  Medical students worldwide, including at FIU, have reported a similar resolve:  they too are eager to play a role on the frontline against the pandemic.

Dr. Sackstein has become the stick, his students the splinters.  De tal palo tal astilla.