Chapter 06: Institution Building at UCSD and Memorial Sloan Kettering
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Description
In this Chapter, Dr. Mendelsohn discusses the two major roles in institution building that prepared him to assume leadership of MD Anderson. First, in 1970, he was invited to start a new medical school at the University of California-San Diego. It began, he recalls, with twenty people, two rooms, and a “teeny clinic.” He talks about the challenges of creating a school from scratch, but notes that it was a “dream school” where the students wanted to combine science and medicine. He also discusses why it was important for the Medical School to add a cancer center and explains why he was asked to create the center –an initiative that gave him his first experience running a capital campaign. He lists the administrative lessons UCSD taught him, then briefly describes his experience working under Paul Marks at Memorial Sloan Kettering, where he was hired to expand the Department of Medicine and integrate laboratory science into the clinical departments.
Identifier
MendelsohnJ_01_20120926_C06
Publication Date
9-26-2012
City
Houston, Texas
Interview Session
John Mendelsohn, MD, Oral History Interview, September 26, 2012
Topics Covered
The Interview Subject's Story - The AdministratorProfessional Path The Administrator Evolution of Career Professional Practice The Professional at Work
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
Tacey Ann Rosolowski, PhD:
You went to University of California San Diego in 1970, and you were invited to go there, to expand their program.
John Mendelsohn, MD:
I was invited to go to help start a new medical school.
Tacey Ann Rosolowski, PhD:
From scratch.
John Mendelsohn, MD:
Yes. When I arrived, the entire Department of Medicine was 20 people. That’s cardiology, pulmonary, GI, renal, hematology, oncology, dermatology. The whole department could meet at a home. The Department of Medicine in most medical schools today is 400 people. The fun was starting a new medical school, being 1 of 2 people in hematology and oncology. The other person was a wonderful man named Mickey Goulian and we started that program. We had 2 rooms in a little teeny clinic. I started my lab. I started practicing. It was small scale, so you could do all 3 for a little while. UC San Diego was one of these phenomenal schools. They had the Scripps Oceanographic Institute for many years, but the university was started in the 1960s. Thirty years later, it was one of the 10 best universities in the whole country. It was not a hardship to come live in La Jolla. We raised our kids there. Today it’s a hardship because it’s so crowded, but when we were living there, it was idyllic. They built an incredible university and an incredible medical school, and I had the fun of doing that.
Tacey Ann Rosolowski, PhD:
Tell me a bit about the challenges of doing that, having 20 people in a room.
John Mendelsohn, MD:
It’s incredible challenges, because you’re in charge of teaching everything. You have to teach people the introduction to clinical medicine. I ran that course. You have to teach them the practice of medicine. I had to lecture on some of the basic science courses too. We had really bright kids. It was a dream school. The really smart people that wanted to do science and medicine applied there because right from the beginning this was very strong in science. In medicine, most of the heads of different programs were leaders in their field, the science of their field, the science of cardiology, the science of hematology, the science of lung disease. It was a very exciting period. They needed a cancer center director, and they brought out some very distinguished people to look at the job. I was on the search committee. Again, this is luck. This is timing. You can’t plan. We were too small to get the really top people to come. They were in big programs like Sloan-Kettering.
Tacey Ann Rosolowski, PhD:
Why was it felt that the cancer center was needed then? What was going on?
John Mendelsohn, MD:
In those days, heart disease and cancer accounted for probably 40% of hospital admissions. If you’re going to be a major medical school, you had to have a strong program in heart and cancer. Dr. Braunwald was the head of the department. He had invited me to go back to Harvard with him in 1972 and was probably the most well-known heart researcher in the country. He’d been at the National Institutes of Health and had run a huge program there. The UCSD Department of Medicine had 2 people in every area except heart. They had 4 people in heart on their faculty of 20. It was pretty clear that we better build a cancer program, too. Some very prominent people were invited who were running large programs. I just think they were attracted to the ambience and the science, but the clinical programs needed a lot of work. I remember I was told that one of the people invited to look was an oncologist named Tom Frei who had been at MD Anderson and then went to the Dana-Farber. I’m told that he suggested to the dean this young guy, Mendelsohn, has a lot of energy. He gets it. Why don’t you let him do this and run with it and see what happens? I was invited to take this on. Now, I was a tenth as distinguished of any of them. This was when I was still doing hematology. I had not even gotten into this target therapy niche, but they must have seen in me someone that liked working with people and empathized and liked to organize, so they gave me this opportunity, and we created the UCSD Cancer Center.
Tacey Ann Rosolowski, PhD:
Where do you start doing that?
John Mendelsohn, MD:
There were only 3 or 4 of us on the team, so you get to do everything. We had to start a training program. We had to expand the research program. We had to put up a building so we could put the research program in it. We had to expand the clinical program. In a period of 4 or 5 years, UCSD’s first capital campaign was for the cancer center.
Tacey Ann Rosolowski, PhD:
Had you ever had experience running a capital campaign?
John Mendelsohn, MD:
No, I learned a lot that I used here.
Tacey Ann Rosolowski, PhD:
What did you learn?
John Mendelsohn, MD:
I learned how you organize and work with the community, and what it takes and the vision and the hard work and the excitement, and what you can do with money. In those days, it was $3 or $4 million, which would be equivalent probably today to $30 or $40 million, maybe a little less. You had to have the university behind you, and you had to have the faculty behind you. We started Friends of the Cancer Center. There were no other friends groups at UCSD. It was a brand-new place. I remember when the chancellor, who was a friend of mine, said, “John, I’m going to borrow all the people on your friends group. I’m forming a UCSD friends group. I want to raise money for the whole place, and these people are good at it.” Of course, I was honored but not thrilled. That was probably one of the reasons I finally agreed to go to Sloan-Kettering when I got that offer, because I felt we had plateaued. Building the clinical program was really fun. The UCSD hospital was the county hospital, and the 11th floor had been made over for private patients, for the whole medical school. Within a few years, half the patients on that floor were our cancer patients, partly because we were known in the community. We had community people on our board, and the county hospitals were where all the poor people went. We had to convince the people of means that had insurance that, by the way, there’s something going on down there that’s really good. You’ll get good care. It’s not a dirty place. It’s a nice place.
Tacey Ann Rosolowski, PhD:
Was there something about the way you communicated with folks or who you reached out to?
John Mendelsohn, MD:
I hired some really good doctors, some of whom were not on the tenure track. In order to be on the tenure track at UCSD, you had to run a lab in those days. I had to convince people to come and be great clinical scientists but not get tenure track positions. The first tenure track position at UCSD for a non-lab person at the medical school went to my successor when I left. He was one of the top physician doctors and clinical trials persons in the country. I had figured out what we needed. I needed 1 person in pharmacology, I needed 1 person in immunology, and I needed 1 person in clinical research. I had 3 positions to recruit. That was a big deal. I did national searches, and one of them came from Harvard, and 2 came from Stanford. The 4 of us got together, and we divvied up the work and just built. The community came through. The hospital was excited. They wanted private paying patients. So again, things fell into place.
Tacey Ann Rosolowski, PhD:
Were these people you recruited also big-picture thinkers, so you could share visions?
John Mendelsohn, MD:
Yes.
Tacey Ann Rosolowski, PhD:
That was important?
John Mendelsohn, MD:
Yes. One of the people I recruited started the first biotech company in San Diego called Hybritech. That was a big deal because a lot of the faculty were very upset that a faculty member would actually be starting a company. It’s very common today. I had to fight the faculty senate about that.
Tacey Ann Rosolowski, PhD:
What were their reservations about that?
John Mendelsohn, MD:
Academic medicine is not for profit.
Tacey Ann Rosolowski, PhD:
Sort of a pure, don’t-be-sullied-by-money thing?
John Mendelsohn, MD:
Yes. You shouldn’t be out trying to make money, but it’s an issue that came up recently at MD Anderson. If you’re going to do science just to advance knowledge, you’re only halfway there, in my opinion. The other half is to take that knowledge and do something useful for people, especially if you do it in the medical field. I believed that back then, and we won that battle. This recruit was a visionary. Hybritech spawned the biotech community in San Diego, which is one of their major economic drivers today.
Tacey Ann Rosolowski, PhD:
What is his name?
John Mendelsohn, MD:
The 1st recruit was Ivor Royston. The 2nd was Stephen Howell, who is a brilliant pharmacologist and is still in his early 70s doing exciting research. The 3rd was Mark Green, who is a fabulous clinician and clinical investigator. They all had aspirations to do something important. They all were willing to leave meccas and come to this little nascent cancer center with me and Dr. Goulian, who was the senior person, a hematologist, and a great molecular biologist but not a cancer person. They joined this vision.
Tacey Ann Rosolowski, PhD:
They created something that was theirs, but a shared theirs.
John Mendelsohn, MD:
Yes. I did that at Sloan-Kettering, and I did that here, actually. I moved to places that wanted to expand in what I was good at and gave me the resources to recruit and grow, and we built teams. I learned how to do that at UCSD.
Tacey Ann Rosolowski, PhD:
Are there certain lessons you learned that stuck with you?
John Mendelsohn, MD:
You’d better love it, and you have to make a decision in your mind that you may be hurting your scientific career, because there’s only 24 hours in a day. You’ve got to sleep at least 6 of them, and it takes a village. You need community support, you need the support of the faculty and the administration, and you need the scientists on board. That’s all obvious, but having done that now 3 times, it’s natural for me. Yet when I meet new faculty leaders, I can see they sometimes don’t have a clue how to conceptualize that. So I had the privilege of doing it in a small place, and from the ground up, creating a new cancer center. Then when I went to Sloan-Kettering, I had the privilege of working in a leadership role there as the head of medicine, at the biggest and then number 1 cancer center and see how they did it. So I was well trained with experience when I came here.
Tacey Ann Rosolowski, PhD:
Tell me about the experience at Sloan-Kettering. How did that give you a different perspective from the one that you got at UCSD?
John Mendelsohn, MD:
Sloan-Kettering was the largest then, the number 1 cancer center in the country, with a huge faculty, a huge research establishment, a huge facility. You weren’t on a little sailboat anymore. You were on a battleship. I watched the men run the battleship, learned a lot of things to do and some things not to do.
Tacey Ann Rosolowski, PhD:
Who was that?
John Mendelsohn, MD:
Paul Marks, the CEO, who was a scientist clinician, mostly a scientist. He was very plugged into the community. I watched how he raised money. I watched how he made plans.
Tacey Ann Rosolowski, PhD:
What were the dos and don’ts that you gathered from him?
John Mendelsohn, MD:
Most of it was do’s, but I just have a little more of a kinder, gentler approach, and at that time, more of a commitment to taking that 2nd step in science.
Tacey Ann Rosolowski, PhD:
To bring it to the patient.
John Mendelsohn, MD:
Yes. He certainly was balanced, but his main love was gaining new knowledge. As he got older, I watched. He got more interested in translating the science to the patient and actually ended up in his own lab developing a drug that’s now used for some patients. How do you manage this complex matrix and try to keep everybody happy? Keep your board happy, keep your chairs happy? How do you make the decision of who’s got to go? I learned a lot watching him. I had the fun of being chairman of medicine at what was arguably the strongest cancer center. I think MD Anderson’s is now probably stronger, but I didn’t believe it back then. I was trying to develop there what we do here so well, integrate laboratory science into the clinical departments, and we didn’t get as far there as I’d hoped. There was more of an emphasis on basic science rather than applied science.
Tacey Ann Rosolowski, PhD:
Did people have a prejudice against the whole clinical-versus-basic-science thing?
John Mendelsohn, MD:
There was more of a division between laboratory science and clinical medicine at Memorial Sloan-Kettering than there was here.
Tacey Ann Rosolowski, PhD:
Tell me about coming to MD Anderson, because I read that you were pretty happy in your job at Sloan-Kettering. You hadn’t really intended to leave.
John Mendelsohn, MD:
I was happy at UCSD. We paid an extra $10,000, had an ocean view for our home. Our kids were brought up in an idyllic environment. I thought I’d plateaued in what I could accomplish there.
Tacey Ann Rosolowski, PhD:
What about at Sloan-Kettering? Where did you feel that you were in your career path at that moment?
John Mendelsohn, MD:
I’d been Chairman of Medicine for 11 years. I could continue to do that, and I was enjoying that, but the opportunity to be the head of a whole cancer center must have crossed my mind. I wasn’t looking for a job. I got a letter from the search committee here. Would I be a candidate? I remember talking to my wife. When we left an East Coast environment and moved to La Jolla, we were told we were crazy. “This is Southern California you’re going to, John. This is Nutsville.” I remember when I left La Jolla to go work in Manhattan, I was told I was really crazy. “Everybody would give their right arm to have your home and be working at UCSD, and you’re going to go live in Manhattan? It’s a zoo up there.” Well, we loved it. When I thought about coming to Houston from Manhattan, I was really told I was crazy.
Recommended Citation
Mendelsohn, John MD and Rosolowski, Tacey A. PhD, "Chapter 06: Institution Building at UCSD and Memorial Sloan Kettering" (2012). Interview Chapters. 1422.
https://openworks.mdanderson.org/mchv_interviewchapters/1422
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