Dr. Silke Appel-Cresswell is a 2024 recipient of the UBC Medical Alumni Association Honorary Medical Alumni Award.
Dr. Silke Appel-Cresswell (she/her) is a movement disorder neurologist trained in Germany, London, UK and Vancouver, Canada. She is an Associate Professor for Medicine/Neurology at the University of British Columbia where she holds the Marg Meikle Professorship for Research in Parkinson’s disease and directs the Pacific Parkinson’s Research Centre. Her research focuses on the role of the microbiome and nutrition in Parkinson’s disease and related brain disorders, lifestyle interventions as well as non-motor symptoms of Parkinson’s. In addition to Parkinson’s disease, dystonia is a particular interest of her work, especially ultrasound guidance for injection treatment with botulinum toxin. When not working, she enjoys the outdoors in BC, skis, hikes, bikes, gardens and cooks.
She is the founding director of the BC Brain Wellness Program and has previously served as the president of the Canadian Movement Disorder Society and the Director of the Canadian Residents Course for Movement Disorders. She is the recipient of a 2022/2023 UBC Killam Teaching Award.
What drew you to UBC and the UBC Faculty of Medicine?
Coming to UBC was a combination of the attraction of an internationally leading Parkinson’s research program at UBC led by Dr Jon Stoessl at the time and his kindness of taking me on as a fellow, the pull of family and the natural beauty of BC. When moving from London, UK, to Vancouver, I instantly fell in love with the city and that feeling has endured every since.
What has been your career journey?
My career journey has been somewhat unusual – I grew up in Germany, mostly dedicated to athletics and thanks to a full scholarship I was able to attend an American independent boarding school, The Hotchkiss School, in Connecticut for grade 11. This is where I learned English (my first foreign language was Latin in grade 5 which did not take me that far). Immersion into the English language as well as the experience of being abroad laid the foundation for my future choices. My initial university studies in macroeconomics and international relations were geared towards joining the diplomatic service or an international NGO with the hope to contribute to international connections and to better understand what makes societies work and how to change them for the better. Soon I found myself too far removed from the needs of individuals, though and I changed to study medicine.
In medical school I was very fortunate to have been supported by a full scholarship from the Studienstiftung des Deutschen Volkes (the German Academic Scholarship Foundation) which allowed me to travel internationally for electives and extended internships. I spent time in hospitals in New Orleans (neurology and pediatric neurology), London, UK (neurology) and Durban, South Africa (surgery). At the end of Medical School, I was considering neurology (plus psychiatry) or pediatrics as my career choices, neurology won as I found it challenging to emotionally deal with severe illnesses in children and Oliver Sacks’ books had sparked my curiosity about the brain and how it shapes how we experience the world and make decisions. I did my neurology residency at a teaching hospital of the University of Heidelberg but eventually the travelling bug caught up with me again and in 2001, I took my CV with me to London, went to Dr Andrew Lees’ office at Queen Square and asked if they had a fellowship position in movement disorders. Fortunately, they did and in 2002 I started my first fellowship in movement disorders with Dr Lees where I was part of the team that worked on the then newly discovered impulse control disorders that can arise from dopaminergic medications in Parkinson and profoundly influence decision making in affected individuals. In order to qualify as a neurologist in Germany, I also had to do at least one year of psychiatry so I embarked on four years of psychiatry training during which I had two children and took time off for parental leave. This was followed by locum time as a neurology consultant in London.
In 2006/2007 the opportunity came up to move to Canada, my German qualification as a neurologist was not recognized in Canada but I could fortunately do another movement disorder fellowship at UBC. With the help of a lot of fundraising by the Pacific Parkinson’s Research Institute (PPRI) through the Porridge for Parkinson’s event by Marg Meikle and her family, the “Porridge Professorship”, later renamed the “Marg Meikle Professorship for Parkinson’s Research” was established which I have held since 2010. The position has allowed me to focus on movement disorders clinically and with the support from many colleagues and crucially PPRI to build my research program. My path has been anything but straight forward but it all makes sense now. I am incredibly grateful for the opportunity provided by UBC and the many colleagues and mentors who have helped to overcome the many hurdles along the way.
What UBC Faculty of Medicine initiatives or projects have you been involved in that you are particularly proud of?
The BC Brain Wellness Program is very close to my heart – Dr. Jack Taunton and I founded it in 2017, it launched with a fabulous team in 2019 to bring lifestyle interventions such as exercise, arts-based practices and more recently nutrition to people living with chronic brain conditions, their care partners and healthy agers. The program is now in its 5th year and has reached several thousand British Columbians with free mostly online and some in-person programs while also supporting the education on brain conditions in several allied health specialties, and providing volunteering and research opportunities for many students from across campus. We are grateful to all our donors, the VGH and UBC Hospital Foundation and to the Faculty of Medicine Development Office for all their crucial support including for featuring the BC Brain Wellness Program at UBC Giving Day.
The biggest part of my research program now is the focus on the role of diet and of the gut microbiome in Parkinson’s. This has been a highly collaborative, interdisciplinary endeavor. Visionary funding from PPRI again made the first several projects possible and allowed us to contribute significantly to the field internationally, we are now running several clinical trials and cohort studies, bringing together a large team of researchers and clinicians, supported by and in close collaboration with the Faculty of Medicine.
I am grateful to be a member of both the Djavad Mowafaghian Centre for Brain Health as well as the Edwin S. Leong Centre for Healthy Aging – both have been most supportive and I truly enjoy the many opportunities to collaborate and create new initiatives. Both are creative spaces where good ideas are supported and I feel there is freedom to explore them.
Could you share a specific moment or experience that reaffirmed your commitment to your role as a clinician, teacher, mentor, or administrator within the UBC Faculty of Medicine?
Recently, one of my children has had significant medical challenges and my colleagues stepped up to help immediately. I have been enormously grateful to all of them for their kindness and wisdom. Moreover, it strengthened my feelings of empathy for my patients and deeply reaffirmed for me the importance of kindness in medicine, the importance of accessibility to medical care, the importance of research to move the needle in the conditions that we don’t have causative treatments for and the importance to teach and mentor the next generation. It affirmed for me that I am in the place I need to be in, even if it is not always easy to strike balance.
What does receiving the Honorary Medical Alumni Award mean to you?
I feel very honored and admittedly very surprised, I certainly did not see this coming! The award is very reassuring that my work and that of my team has meaningful impact which in turn is highly motivating. It makes me feel included in a very special community which is particularly meaningful for someone like me who is coming from the outside on so many levels but has made Vancouver and UBC their home.
How has your identity affected your perspective on the field of medicine and future pursuits?
My identity as a woman and mother has highlighted the challenges of having a family while also pursuing a career as a clinician scientist, it is an ongoing search for balance but also a most rewarding one and one where my female mentors have been very helpful. While I have several suggestions for change at the systems level, I also particularly enjoy mentoring young women embarking on the same career path.
Having worked in medicine in several different places around the world, I particularly appreciate the opportunities we have in British Columbia to create new projects, our universal health care insurance and the well-organized, high-quality medical training in BC.
What is one thing you hope to accomplish in the next 10 years?
In the next ten years, I am hoping to establish personalized prevention (primary and secondary) and fostering of resilience as an important pillar in the management of neurodegenerative disorders and other brain diseases. Research will focus on lifestyle interventions such as nutrition, exercise, stress-reduction, social connectedness and microbiome-related mechanisms to develop and implement effective therapies to improve quality of life, function, and delay/slow down progression of those diseases.
What does a healthy society mean to you?
A healthy society actively fosters emotional, social, physical, cognitive and spiritual health across all ages; it is designed to create community, is inclusive of all and recognizes each individual as a precious member with their own unique talents and ways to contribute; access to prevention and health care is universal regardless of socio-economic considerations.
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