Chapter 09: A Difficult Exit from MD Anderson
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Description
In this chapter, Dr. Komaki shares the story of how she came to retire from MD Anderson. She begins by explaining that Dr. Cox felt that attitudes toward him changed when he stepped down as Chair of Radiation Oncology and as Division Head. She reports that people began asking her why was not retiring and goes on to tell a series of stories about how she was treated in the Division under the new division head. She describes changes in division culture under the new division head. She then narrates a series of events that demonstrate that the department wished to push her out of her position. She describes her late husband’s reaction to her treatment in the division and her own feelings now that her husband has passed away and she has left the institution.
Identifier
KomakiR_02_20181128_C09
Publication Date
11-28-2018
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - Overview; Critical Perspectives; Critical Perspectives; Personal Background; Obstacles, Challenges; Understanding the Institution; MD Anderson Culture; Working Environment; Professional Path; Evolution of Career
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
T.A. Rosolowski, PhD
So this is at MD Anderson.
R. Komaki, MD
At MD Anderson. In 2013 when he [James Cox, MD] stepped down [from the Division Head and Chairman of Radiation Oncology at MDACC], everybody started [not being kind to me]. Their attitude really totally changed. [Some of them started to ask me,] “Why you are not retiring?”
T.A. Rosolowski, PhD
To you or to Dr. Cox?
R. Komaki, MD
To me.
T.A. Rosolowski, PhD
To you, wow.
R. Komaki, MD
Yeah, Jim Cox, he noticed too. When he stepped down, everything was kind of suboptimal, you know? His office was taken away and they didn’t give him very good service any more. But Barbara Lewis, she kept really doing everything for him and for me, and we really appreciated, but other people really changed. [They didn’t treat him right and I was not treated as the tenured respected professor academically and experienced clinician at MD Anderson for 29 years.]
T.A. Rosolowski, PhD
I’ve heard that story a number of times. That people feel that their transitions and their transition away from the institution is not handled well.
R. Komaki, MD
Right, no, [not at all. It was a nightmare. Their cruelty to me was indescribable. I cried everyday and said to my husband that I would rather die if they take me away from seeing and treating patients who I dearly love. My sadness made my husband so depressed that eventually killed him due to immune suppression.]
T.A. Rosolowski, PhD
Do you have any insight into why that might be. What it is about the institution culture that makes that difficult for people to handle?
R. Komaki, MD
[For the sake of MDACC, I would like to be honest here. To be the leader at MDACC or any place wherever we are, we need to treat people as human beings with respect. They should not torture employees mentally. If they would like to change the system, the leaders need to give good reasons why they are doing this. New comers have tendency to destroy previous system without any good reasons. Those people who cared patients and worked at MDACC for many years should be respected and continue to work at MDACC. New leaders should not fire them or should not demote them with deviated opinions given by people who just want to stay around without moving MDACC ahead.] [The way I was treated when a new division head and chair came,] I just couldn’t believe it. One day, this goes back a year ago, I was told --I had been at MD Anderson 29 years, and then I was told I’m not getting any resident and my physician assistant was fired. She was with me for a long time. Then, all my [patients’ Radiation Treatment] plans, I had to do by myself and my Radiation Therapy Treatment plans had to be checked by the section chief. I had been the section chief of Thoracic Radiation Oncology since I arrived in 1988. Then I gave that position, like after ten years, to Dr. Lao, and she became the Radiation Oncology clinical chief. [I nominated her, so the position of section chief of Thoracic Radiation Oncology came] back to me. So I was section chief of the Thoracic Radiation Oncology a really long time, 25 years or more. In any case, after my husband stepped down, the new division head and chairman came, and he told me [that I was not qualified as the chief section and he wanted to be the section chief of Thoracic Radiation Oncology in addition to being chairman and division head of Radiation Oncology] [ ] When I met with him in his office, and I brought my CV [which was very thick CV about 60 pages]. [He never wanted to see my CV]. He askedme what else do you want? I said I would like to continue to see the patients. I would like to teach our residents, I can contribute a lot to teach in a multidisciplinary clinic, and I have many protocols ongoing. I have had a few NCI grants, and I wanted to continue my protocols and grants. And then he said, “Well, next year, your tenured professorship will expire.” You know every five years we have to get a tenure renewal. “I don’t want to renew it.” So I said, “Well that’s fine, next year I will be 75 and I don’t want to continue next five years, so I don’t need to get the renewal of the tenured professorship.” He said he will be the section chief of Thoracic Radiation Oncology. So I said well, I don’t understand, you are divisional head, chairman of Radiation Oncology. Why do you want section chief, you have so much to do? But he didn’t like my point, he wanted to take everything. So I said okay if you want, that’s fine. Then he appointed somebody else, very, very junior attending, to be a section chief.
T.A. Rosolowski, PhD
Just to be clear, had you offered to step in as section chief at that point?
R. Komaki, MD
I was section chief.
T.A. Rosolowski, PhD
You were section chief, okay. I was confused, yeah.
R. Komaki, MD
So this guy, he wanted to take section chief under his name, and he knew I cannot argue just because he’s divisional head and the chairman of Radiation Oncology.
T.A. Rosolowski, PhD
Right, yeah.
R. Komaki, MD
I felt very strange, why do you want...? He was kind of threatened by me because his specialty is lung cancer, and I have been doing lung cancer so many years. Originally, when I came here in 1988, my predecessor, [Dr. Tom Barkley] who was section chief, he died and Lester Peters, he wanted me to do [ ] Thoracic Radiation Oncology, although around that time, I was very interested in GYN. But I said I’ll do it. I covered enough of those lung cancer patients. So I started to do all this thoracic radiation oncology and at the beginning, I was the only one attending to [Thoracic Radiation Oncology].
T.A. Rosolowski, PhD
Interesting.
R. Komaki, MD
I had to treat like 70 patients by myself around that time.
T.A. Rosolowski, PhD
So obviously, this interaction with this new division head was not very satisfying
R. Komaki, MD
No. My husband wanted me to retire, because his health was declining and he stepped down from divisional head. [He wanted me right next to him always especially after he retired.] The chairman, the people are not treating him right because this new division head and chairman trying to get all this—you know, [when Dr. Cox retired], everybody kept saying oh, Dr. Cox, Dr. Cox, I miss you and I want you to be with us, [and truly he was missed because of his kindness and causaulity.] [The new division head and chairman] didn’t want to hear it. My husband was just not treated right after this new divisional head and the new chairman of Radiation Oncology came. Many people left because of the way he started to treat who are really, really connected with –the radiation therapists and the dosimetrists and the physicists and the residents, they had a kind of whole family because of Jim Cox and myself. We treated them like a part of our family, extended family. [ ] Jim, he memorized every therapist’s name and the secretaries, clerks, just because he loved all those people. So he memorized everybody’s name and he ask everybody to just call me Jim. He called all those people by their first name and everybody just loved him so much, and that kind of relationship, this new division head hated.
T.A. Rosolowski, PhD
Interesting. Well I’m sure that that solidifying of all those personal connections and kind of feeling that people were really interacting, really helped with the multidisciplinary care as well.
R. Komaki, MD
Right, yeah. So what happened was when Jim stepped down, certain people decided to report or do something to new division head and chairman. Eventually, my patient plan had to be supervised by a young, non-experienced new section chief, and he never examined the patients, he did not know the patients. He, he changed my patients’ treatment plans around, even palliative [cases without seeing patients. He wanted to keep his position as the section chief and had to follow the orders from the member of evaluation of faculty in tenured position.] I had a patient with extensive small cell lung cancer metastasized in 20 different areas of bone mets, and I saw the patient and I said I cannot treat every spot in the bone. So the most painful area, I gave palliative treatment here and here. He started to change around my plans and I said, “Uou never examined the patient. [How can you change my plan for this patient without examining the patient?]” He never wanted to talk to me. Eventually, I said I am going to resign and I retired. So, what they started to do, there was clinical chief, like a QA, [Quality Assurance]. She was doing …and she and this junior attending and one more person, they wanted to meet with me once a month. Sometimes I was out of town. Also, Barbara, my secretary, [REDACTED] she took off while she was sick [REDACTED], and so the meeting was not on my schedule --when I’m going to meet with them. So I didn’t meet with them a couple times. Then every time I met with them, they said well, you have done this one good and this one, you need 15 percent improvement, this and that. I said, I really don’t understand what you are trying to do about my patients’ plans without examining patients. You really have to explain to me why you are doing this to me. The bottom line, I recognized they are trying to push me out from tenure position and section chief. So with my husband’s illness, I wanted to be with him all the time, so I said I am going to resign. The first thing, they told me I have to sign the form, what I did wrong. I said I did not do anything wrong, I have checked every patient, all the details, and this is so unethical, somebody who never examined the patient, changing my patient plans, unethical and this is not good for the patients. You know basically, this is illegal, to change Radiation Treatment Plans made by the American Board Certified, well-experienced Radiation Oncologist who examined the patient. I do not think this is the right thing to do. Then I was called by the new chairman, who just arrived. His position has been separated from the divisional head now. The new chairman showed up, didn’t know anything of what’s going on. So I sat down with him and my husband, he just dropped by my office and Barbara, said well, you have to meet with this new chairman.
T.A. Rosolowski, PhD
And who was this?
R. Komaki, MD
Who?
T.A. Rosolowski, PhD
The new chair’s name.
R. Komaki, MD
Albert Koong.
T.A. Rosolowski, PhD
Oh, okay.
R. Komaki, MD
Yeah. So he just arrived from Stanford and he was put there as a chairman [of Radiation Oncology] [ ]. And my husband, he said, Well, I would like to say hello to him. So I said come with me. That was Friday and then we went to his office, and the woman, maybe you should not put her name.
T.A. Rosolowski, PhD
That’s fine.
R. Komaki, MD
She was sitting there and she said, “Dr. Komaki, you have to sign this form.” So I said, “What kind of form?” She said, “You did not follow all the compliance about the QA, you had to meet with us once a month and do whatever we said.” I said that I did not do anything wrong, I am not going to [sign this form without knowing what I am signing]. I came here to meet with the new chairman and I wanted to introduce my husband to this new chairman. I explained to this new chairman what’s going on and I left, and actually, my husband was so upset, he said to this new chairman that, “You know this woman and this new section chief, they have been bullying Ritsuko.” There was no reason why they were forcing me to meet with them once a month for QA without telling me why I had to meet with them. Also they were forcing me [to sign the form without telling me what has been written on the paper] . So we left the new chairman’s office. That was Friday. On Monday, when I came to my office, Barbara was not there, she took off, she was getting treatment. There was another person who came to my office and she said “You have to meet with two lawyers of MD Anderso, and this woman, the QA [person from Radiation Oncology. I have all names who tortured me mentally and destroyed my heart and my husband heart which led him to his death. I do not want to disclose here today. But I never forget their cruelty in my life. I wanted to die with my husband. They just do not know how much I suffered and my patients suffered due to my sudden departure from MDACC. I miss my or our patients and residents so much that I pray for them every day as long as I live! I truly hope that they know how much I care for them.]
T.A. Rosolowski, PhD
And QA, I’m sorry that stands for?
R. Komaki, MD
Quality Assurance.
T.A. Rosolowski, PhD
Okay, that’s what I thought. I’m sorry I interrupted you. So she said you have to meet with two lawyers.
R. Komaki, MD
Yeah, and this QA person, at the conference room. So I said I don’t have any appointment with them. I went there and this QA person, she said, “Well, these lawyers, they have to talk to you,” and she left. Then those lawyers, they said, “You have to sign this form; otherwise, your medical license will be revoked from Texas.” Medical license? I said, “For what? I do not understand this, I did not do anything wrong, I never harmed any patients, and why are you doing this?” They said, “Okay, you have to read this and you have to sign this within one week and you have to leave from your office now and do not come back to MD Anderson, never.”
T.A. Rosolowski, PhD
My gosh.
R. Komaki, MD
I was escorted from my office, they said do not take anything from your office, so I had to carry my bag. I was still in white uniform because I had my clinic that day. I had a birthday gift for Thomas who [is Dr. Heath Skinner (one of my junior attending)’s] baby. So to the woman who escorted me to the garage ten, I said the last thing: “I would like to ask a favor, please give this gift to Dr. Heath Skinner, for Dr. Heath Skinner’s baby, Thomas. Please give this one to him.” And that was the last time I was at MD Anderson.
T.A. Rosolowski, PhD
Oh my God, what was the date?
R. Komaki, MD
I think it was...
T.A. Rosolowski, PhD
I’m so sorry.
R. Komaki, MD
I don’t know exactly. [August 7the, 2017. Monday.]
T.A. Rosolowski, PhD
That’s all right, we could—
R. Komaki, MD
August.
T.A. Rosolowski, PhD
That’s okay we could—
R. Komaki, MD
[ ] And I never went back and I never felt [like going back there because I was treated in such a cruel way.] I worked so hard at MD Anderson for patients, my residents and everybody, but that was my last day at MD Anderson Cancer Center.
T.A. Rosolowski, PhD
Why don’t we stop for today. Okay, I’m turning off the recorder at noon.
Recommended Citation
Komaki, Ritsuko MD and Rosolowski, Tacey A. PhD, "Chapter 09: A Difficult Exit from MD Anderson" (2018). Interview Chapters. 1290.
https://openworks.mdanderson.org/mchv_interviewchapters/1290
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