Chapter 03: The Decision to Bring Sex Therapy to Oncology
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Description
Dr. Schover begins this chapter with stories about her first job, as an instructor in the Department of Psychiatry, Sleep Disorders and Research Center at the Baylor College of Medicine in Houston (3/1981-1/1982). She describes a study she conducted, looking at erections in aging men. She discusses an ethical issue that arose during a research study at Baylor and explains how her time there taught her about physiology and disillusionment.
Next, she explains how in 1982 she made the decision to take a position (Assistant Professor in Urology; Assistant Clinical Psychologist in Psychology, 2/1982-6/1986) at MD Anderson based on an interview with Andrew von Eschenbach, MD. She explains her strategies of transitioning to a focus on oncology, knowing little about the field. She also talks about how she presented herself and her clinical services to patients, as discussing sexuality was quite new in patients’ experience of treatment at the institution.
Identifier
SchoverL_01_20180918_C03
Publication Date
9-18-2018
City
Houston, Texas
Interview Session
T.A. Rosolowski, PhD, Oral History Interview, September 18, 2018
Topics Covered
The Interview Subject's Story - Professional Path; Joining MD Anderson; The Researcher; Professional Path; Evolution of Career; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Cultural/Social Influences; Mentoring; On Mentoring; MD Anderson Culture; Overview; Definitions, Explanations, Translations; Ethics; Professional Practice; The Professional at Work
Transcript
T.A. Rosolowski, PhD:
That’s absolutely right. What were some of the—I mean, I’m not asking you to tell tales, but kind of what were the ups and downs during that time? What were some things that made you think oh my God, what have I gotten into, or that really spurred you on?
Leslie Schover, PhD:
Well, probably my first job was one of them, which was I spent a little less than a year at Baylor College of Medicine, before I ended up at MD Anderson, and the head of the—I was in the Sleep Lab, because they had a grant that was looking at erections and aging in men, and I was supposed to be recruiting subjects for that and running the grant. Really, what was going on was during those years, there were three urologists that were there and one of them, [F.] Brantley Scott, had invented the inflatable penile prosthesis, and at that time there weren’t other medical treatments that were successful for erectile dysfunction, so they had a surgery mill going and they had three urologists. They had men coming from all over the world and they would come already scheduled for their surgery and go through this psychological and medical evaluation so that insurance would pay for it, and part of that was a sleep study which was supposed to show that they didn’t get firm erections during their sleep. Occasionally, maybe 10 percent of the men really didn’t need the surgery, but boy, getting them off the surgery train was not so easy. I was kind of appalled by the whole thing, having come out of this, “we are the psychologists looking at the true outcome of sex therapy” kind of thing. And here I was in the real world and there were some suspicions that they occasionally were faking data in this Sleep Lab and publishing things that may not have been true; nothing that I was involved with but you know, I was learning a lot. I learned a lot about the physiology of sex that I had not understood before. But at the same time, I was very disillusioned and upset at what I thought was going on there. I used to have to do these structured interviews. And this is really funny, they made me ask all the patients, What are your hobbies? And of course most of the patients came from Texas and I told all my friends, after being there for several months, there are two kinds of men in Texas; there are those who fish and hunt, and those who hunt and fish. [laughs] And then they made me ask, when was your first sexual experience, and I had at least three men from West Texas say, “Well, ma’am, with a person?” [laughs] So it was an education.
T.A. Rosolowski, PhD:
A very new window into life.
Leslie Schover, PhD:
What happened was, I was starting to get really fed up and thinking I’ve got to get out of here, and somebody told Andy von Eschenbach, who was at that time kind of a young to mid-career urologist at MD Anderson, that—he was looking for a psychologist to come and help him do research and clinical work on sexuality in urologic cancer patients. Someone knew that I was there in town and I had an interview with him. And he offered me this job, which was almost double my salary and I thought ooh, cancer, I don’t know anything about cancer. Sounds kind of grim but I’ll give it a try and get out of here. So, that started my original five years at MD Anderson.
T.A. Rosolowski, PhD:
So that was in 1982, you came.
Leslie Schover, PhD:
Yeah, early 1982, I think.
T.A. Rosolowski, PhD:
So tell me about kind of your first impressions of the institution and then how you started to adjust to working with cancer, which is a whole other arena.
Leslie Schover, PhD:
Yeah. Well for one thing, because I felt so ignorant about cancer --I was in my early thirties and I was single, so I could do whatever I wanted with my schedule. I’ve always been a morning person anyway, so because it was a surgical department, they had meetings at 7:00 a.m. every day. So I would come and eat breakfast at the cafeteria with the urology guys, and then I would attend whether it was a mortality and morbidity, or resident/fellow teaching conference. And that was --that and reading were how I learned to understand what was going on with the urologic cancers. Later on, during those years, I also ended up working a lot with gynecology and with the breast clinics as well, but I knew nothing about cancer. It was before the era where—now there are health psychology programs. There was no such thing when I went through graduate school, so that was very new to me. I had to learn a new way of doing things too. You know, when I was at Stony Brook, we would show educational films to patients and one of them was a film about how to do the Masters and Johnson sensate focus, touching exercises, where you know, one partner touches the other and they take turns, and they’re in the nude. They actually had an educational film, where there was actually some nudity and touching, but it wasn’t like pornography or something. So, when I saw this couple with bladder cancer pretty early on, in the first couple of months I was there and I said, “There’s this film I would like to show you but I have to warn you that there’s some nudity and stuff and do you think that would bother you?” They said no and I sat with them during the film and afterwards, I asked them if they had any emotional reaction or what their impressions were and they were just deadpan, “No everything is fine.” The minute we finished the session, they ran to one of the enterostomal therapists and said, “That woman showed us pornography!” So, I decided no more of those films at MD Anderson, this is not the right setting for them or the right part of the country. I also learned that—you know, they weren’t charging for my services, so I was doing things like I was seeing all the radical cystectomy patients or all the prostatectomy patients, and I learned very quickly that if I went in and I said, “Hi, I’m the psychologist in urology and I came to talk to you about your surgery,” they would go, “What? I didn’t ask to see any psychologist, I’m not crazy.” So I developed this kind of little routine, and at that time people were still in the hospital for three days before these major surgeries, so there was lots of time to get to know them. So I’d trot on over there and I’d go, “Hi, I’m Dr. Schover and I’m one of the team in urology, and I happen to be a psychologist but first of all let me say that nobody sent me to you because they thought you were crazy. I see everybody that’s going to have this operation and the reason for that is here at MD Anderson, we don’t want you to feel like a number. We want to know you as a real person, and that’s my job, is to find out more about you and how you’re feeling about your cancer and this surgery, and oh by the way, one of the things I might talk to you about is how this surgery might affect your sex life later on.” And you know, no one would say no, because who wants to be a number? [laughs] So I discovered this was a great way of introducing myself and everybody would talk to me.
Recommended Citation
Schover, Leslie PhD and Rosolowski, Tacey A. PhD, "Chapter 03: The Decision to Bring Sex Therapy to Oncology" (2018). Interview Chapters. 1494.
https://openworks.mdanderson.org/mchv_interviewchapters/1494
Conditions Governing Access
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