Prominently placed on Dr. Robbie Goldstein’s desk is a red-framed plaque he received his third day on the job as Massachusetts’ new public health commissioner.
“Hard things are hard,” it says.
The motto is a reminder from his mentor and former boss at the Centers for Disease Control and Prevention, Dr. Rochelle Walensky. She had a similar plaque on her desk at Massachusetts General Hospital, where the two first met a decade ago when Goldstein was honing his skills as an infectious disease specialist and Walensky was chief of the department.
“As I faced barriers and adversity, she would remind me, ‘Hard things are hard, but we do hard things,’” he said.
Goldstein arrived as commissioner last month at a challenging time, when staff is worn down from three years of a pandemic, misinformation about science has flourished, and trust in public health has seriously eroded. In his first press conference last week, Goldstein pledged to build back the department and the public’s trust — and be prepared for whatever health emergencies lie ahead.
Friends and former colleagues say he is well matched for the challenge. Lanky, and with a boyish grin, but with gray creeping in at his temples, Goldstein, 39, is described as a high-octane, even-keeled, and collaborative force of nature.
“It has been awe-inspiring to see his incredible talents at work daily to advance the health and well-being of others,” Walensky wrote in an e-mail.
Walensky recruited Goldstein to the CDC just weeks after she started, during the height of the pandemic in early 2021. He served the past two years as her senior adviser, translating science into policies and recommendations on COVID-19 and other pressing public health issues, such as gun violence prevention.
Looking back, Goldstein said he learned some vital lessons while at the CDC, especially about changes in guidance that caused considerable public confusion.
In May 2021, the CDC announced that anyone who was fully vaccinated could participate in indoor and outdoor activities without wearing a mask or physically distancing.
At that time, the available science suggested that fully vaccinated people were unlikely to transmit the virus. But after a July 2021 COVID outbreak in Provincetown, in which three-quarters of those initially infected had been fully vaccinated, scientists realized that vaccinated people who become infected can carry as much of the virus as unvaccinated people. The CDC then reversed its guidance and said even those who had been vaccinated should continue to wear masks indoors in public settings.
“We should have been more clear about the decision around masking and that it was a decision based on the available science, at the time,” Goldstein said.
“We should have articulated that science continues to change and that our guidance may need to change,” he said. “I hope that we can be transparent at [the Massachusetts health department] and share clearly what we know, when we know it, and what we don’t know so that our guidance can be interpreted correctly.”
The drinking-from-a-firehose pace Goldstein faced at the CDC helped prepare him, he said, for his new post in Massachusetts, where he typically works 11-hour days. The agency, which counts 3,200 employees, touches nearly every facet of life, from inspections of food facilities, housing, and beaches to licensing hospitals and health care centers.
At Mass. General, Goldstein was known for a remarkable bedside manner and detailed notes in patients’ files, said Dr. Chana Sacks, who met Goldstein when he was in his first year of residency. She was in her second year.
“You are meeting people on the worst day of their lives, often sick and scared, and Robbie’s ability to connect with people stood out from the beginning,” said Sacks, now codirector of Mass. General’s Gun Violence Prevention Center.
While most doctors stand while talking to patients in a hospital room, Robbie sat down by a patient’s side, Sacks said, fostering an instant bond.
Sacks and Goldstein have remained close, and in his rare free time, he loves cooking for friends and hosting dinners with his husband, Ryan Stanton, an interior designer. The couple married in 2008.
Said Sacks: Goldstein makes a killer fish stew and a scrumptious flourless chocolate cake.
Cooking and baking, along with running, are his favorite safety valves in a hectic life. Goldstein generally hits the road five or six days a week, usually running four to five miles a day at about a 7:40 pace.
“I am a very task-oriented person,” Goldstein said. “I like a list and checking the boxes. So cooking and baking in particular help me relieve that stress.”
At DPH, Goldstein’s list of priorities includes breaking down entrenched silos within the agency’s 18 bureaus and offices, while also building back trust within the department and with the public.
His blueprint involves behind-the-scenes advances such as improving the department’s often clunky data collection systems, as well as public-facing changes.
“It matters when we answer the phone, and we are friendly, and we say, ‘Hello,’ and we have the answers,” Goldstein said.
“I want to make sure that the people of Massachusetts see us, trust us, and know that we are sharing information with them for their good and for their health,” he added.
Goldstein also lists equity as a priority, which he describes as improved access, including transportation, for those who most need state services, such as nutrition programs for low-income women with young children, substance use disorder treatment, HIV testing and prevention, and vaccination programs for adults and children.
But sitting in his sparsely decorated office in downtown Boston three weeks into his new position, Goldstein said he was still studying his new landscape, and that it was too early for him to share specifics on changes or new initiatives he may launch to address the many inequities he sees.
Goldstein’s sense of mission, he said, was implanted early on: His father was a dentist in upstate New York, and his mother was the practice’s front desk manager. Goldstein spent countless hours there doing his homework after school and helping his father during emergency calls on weekends, making sure he had the supplies he needed.
“They were taking care of neighbors, friends, family,” Goldstein said. “They taught me that idea of you take care of the people around you. You think about your community, you invest in your community, you do all the good that you can do for the people in your community.”
That inspired his decision to attend medical school. From Tufts University School of Medicine, he went on to residency at Mass. General, where he was drawn to patients vulnerable to infectious diseases, specifically HIV.
“We know that the people who are vulnerable to infectious diseases are vulnerable to chronic diseases and vulnerable to so much more in our society,” Goldstein said. “And it really moved me down a path to think about public health.”
By the time he finished his fellowship in 2018, he had started the hospital’s groundbreaking Transgender Health Program, among the first in the county to offer primary care, pediatrics, surgery, mental health, and other services to gender diverse populations.
He said he intends to ensure the health department issues guidance and “leans in” to its mental health and substance use disorder services to support that care, noting that LGBTQ youth are disproportionately affected by these issues.
Even in times of high stress, Goldstein is known for his calm, reassuring way of reaching out, colleagues say. In July 2021, when July Fourth gatherings in Provincetown triggered a large COVID outbreak, Senator Julian Cyr, a Cape Cod native who represents Provincetown, said he received a text from Goldstein asking simply, “How can I help?”
“Sometimes when people end up in extraordinary positions, they have a bit of an approach of, ‘You come to me, I am the important, powerful person,’” Cyr said. “Robbie is the opposite, which is pretty rare.”
Despite the sense of calm Goldstein often projects, he recently acknowledged that by his third day on the job last month, he was feeling a bit overwhelmed as he walked home from work. Then he spotted a package in his mailbox.
He opened it up and there was the red-framed plaque with a note from Walensky, in what Goldstein describes as her “terrible” handwriting.
“She was just reminding me,” he said, “that we do hard things.”