Chapter 05: Service, Stewardship and Safety Through Committee Work

Authors

• Albert E. Gunn JD, MD, The University of Texas MD Anderson Cancer Center
• Allison Sáenz PhD

Files

Description

In this chapter, Dr. Gunn describes his committee assignments at MD Anderson, many of which oversaw patients’ rights and wellbeing. He served on a research committee that approved all research conducted at MD Anderson and later the Institutional Review Board (IRB), which was responsible for protecting patients’ rights at the institution. One of the committees, the Surveillance Committee, could not approve of psychological research because it lacked a mental health professional. Dr. Gunn filled that role based on his experience teaching a course on philosophical psychology. He also remarks on his work with a committee on protecting human subjects, where he served as the first chair. He notes that the goal of the committee was to protect human subjects while also helping them avoid viewing themselves merely as part of a research project.

He concludes the chapter by briefly discussing his role as Dean of Admissions for the School of Public Health, the working relationship between Drs. Hickey and Clark, and an overview of the history of psychological services at the Rehabilitation Center.

Identifier

GunnAE_20240627_C05

Publication Date

7-27-2024

City

Houston, Texas

Interview Session

Albert E. Gunn, MD, Oral History Interview, July 27, 2024

Topic Covered

Professional Path; Professional Path; Career and Accomplishments; Contributions; The Educator; Institutional ProcessesEthics; Offering Care, Compassion, Help; Patients; Patients, Treatment, Survivors; Dedication to MD Anderson, to Patients, to Faculty/Staff

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

Albert E. Gunn, MD:

Getting back to MD Anderson, these committees that I served on, because the rehab center, declared a residential care facility included the research committee, which was very, very interesting. All the research done at MD Anderson had to be approved by that committee, and it was composed of members of the staff. Now, interestingly enough, before this committee came about, they didn’t have a real system for it, and doctors used to send in grants on their own signature and get—to have them funded. And then the institution was landed with the responsibility of having to meet what the government expected them to do. And this was not a system that was working out well, and the same with space, that they had to control space. That was getting to be—quite a premier or a very hard-to-find item. People needed space for their research, for all of them, the offices, for everything, and allocation of space became very important. But anyway, we went through all the research projects, and it was a similar system where I would review a research project, say, in Developmental Therapeutics or some other department and give my best opinion of. And I was not a specialist in these areas, but gave my best opinion as to how valid I thought the research was. And each member did that, and they went around the table, and they approved or disapproved it based on these reports. Now, because of the increased interest in human rights, they needed an institutional review board to make sure that patients were not put at risk through research or for anything like that, and Dr. van Eys was appointed the first chairman of it. Now, one of the great people at MD Anderson was a faculty member, Jim Bowen. Jim Bowen was—many different jobs, but he—I think he was ultimately the executive vice president and dean. He was one of the great people I thought at MD Anderson. But Jim Bowen, [honcho?], this surveillance committee appointed Dr. van Eys to it, and they appointed me to it. And one of the problems the surveillance committee had was it couldn’t approve psychological research because it didn’t have a research scientist on it like a psychiatrist or a psychologist. And Dr. Bowen, I said, passing one day, “Well, I was a graduate assistant as part of my law school scholarship, and I used to teach philosophy, and one of the courses I taught was philosophical psychology.” And he said, “You taught philosophical psychology?” and I said, “Yeah.” He said, “Fine, you’re going to be the psychologist on the committee,” and so they applied to the NIH that I was a behavioral scientist. And they removed the limitation on the committee, and they could approve behavioral research projects, too, as well. So, kind of—I remember I said, “Jim, you said I was an eminent behavioral scientist,” he said, “I said imminent, not eminent.” That’s what I mean about the humor back and forth at MD Anderson. People could talk to each other, and really hit it off, and admit problems, and try to work on them together, and not get ownership or go in too much of a hissy fit over things. But anyway, the surveillance committee took off, and we began. It had public members, it had members from the faculty, very qualified people. I was very—it was very educational for me, I was glad to be on it, I was glad to associate with the people they had on it, and I thought it did a wonderful job. It got off on the right foot and got going. Another committee I was involved with at MD Anderson was later created, was [protective?] human subjects. And this was created to try to look at projects to make sure that—or research to make sure that the human subjects that would be involved with them, their rights were properly guarded and taken care of. The surveillance committee does a similar thing, but this one’s to be more targeted, and I got to be the first chairman of that. It was a—I think one of the first issues that we faced was what should you call what we do at MD Anderson? Is it research, or is it patient care? And it was a thorny issue because there was a desire not to tell patients they were part of a research project because I don’t want to be a guinea pig, well, they thought would be their reaction, they wouldn’t participate. So they wanted to use euphemisms, and we were faced with that issue. We never came down a hard on one way or another because it was a very difficult decision to make, and my term ended, and we never did. I had hoped we would come to a decision on it, but it never took place. That they were not—they—I didn’t want to call them experimental subjects, but I did want to be sure to place the patient on notice that this was not just ordinary patient care, but this was something special and different, and that they were, in a certain sense, a subject. Somebody always used to say, why are they subjects, who are they subject to? You say the subject, when you talk about research, the subject will, and so on. But, yeah, that was a very interesting committee too. Getting back to my experience, Dr., I guess, [Jim Thomas?] was the vice chairman of internal medicine at the medical school, and he was the one who asked me to be the director of the course in physical diagnosis. And in the course of that, I began involvement with the medical school. I was a course director, and I had to interface with the dean and with the faculty curriculum committee, and I got to knew a—know a lot of the people. And so I went on a trip up to Austin to meet with—something to do with the board of regents, I forgot the exact meeting, but we were meeting with representatives of the administration. And Dr. Tuttle and I, I was representing MD Anderson, and Dr. Tuttle, the dean of the medical school—the McGovern Medical School as it’s now known—was up there and he and I got chatting together, and he got a kick out of some of the stories I was telling about New York. And I—one of the famous remarks I had heard that you can always tell a New Yorker but you can’t tell them much, and he took a—he got a big kick out of that one. And so we flew back on the plane together and enjoyed each other company. And so time passed, and I didn’t think any more about it. I thought he was a good guy, I liked meeting him, and he was doing a good job as dean, he was the founding dean. Well, he wasn’t the—he was the second dean, that’s Cheves Smythe. But anyway, got a phone call in the rehab center. I had an office in—we had a basement section called the medical suite where they had offices for the psychologists. And I should talk about the psychologists out there and the various other people involved in rehab, vocational rehab. Dr. Villanueva had an office, and I had an office, so was—and then we had secretarial help in the rehab center. But anyway, yeah, I took the phone call, it was Dr. Tuttle. He said, “This is Bob Tuttle,” and I said, “Hi, Dr. Tuttle,” and so he said, “Good,” he said, “Dr. Hickley and I have been talking, and we want you to go out (inaudible) over here and be the dean of admissions.” I said, “What is this?” He said, “Yeah, well, George Blumenschein said you expressed interest in that kind of thing once, and,"" he said, ‘I thought you’d be a good one to be that.’” And he says, “So I called Dr. Hickey, and we agreed that you could do it 49 percent time,” and that’s how I got involved with the medical school. Dr. Hickey, and he had the rage for me to go over there and take over the course, and I’d be 51 percent time at MD Anderson and continue on the rehab center and 49 percent at the medical school as the dean of admissions, then assistant dean of admissions, and later, I was promoted to associate dean of admissions. So that was how I got involved with it. It was serendipitously, just getting people, and Dr. Hickey said, “So you’re going to be a dean, are you?” Dr. Hickey was a very interesting person. He was the director of MD Anderson Hospital, and I think he also was the executive vice president, I’m not sure, but he was like after Dr. Clark, the operational man. Dr. Clark was president, and Dr. Hickey had assistant and associate directors. I’m not sure he was totally comfortable with the organizational system, but he was very decisive, and he’d been chairman of surgery in Wisconsin, and that’s where Dr. Clark first heard tell of him, and then he left the chairman of surgery up there—he had a five-year term as I recall—and Dr. Clark invited him to become the director at MD Anderson. And I think he thought—yeah, as I was saying, he’d take some of the administrative responsibility and handle it. And Dr. Hickey was a very decisive person. He was an administrator at heart, and he could make decisions, make strong decisions and so forth. I had occasion to see some of them in action, and once he made that decision, he stuck with it. And he and Dr. Clark had a comfortable working relationship together, but they tended to be two power centers, in some ways, of a—I have nothing but high regard for Dr. Hickey, and he was always very supportive of me, and so I should mention him. I wanted to talk about psychological services. When I first came to the rehab center, we had a psychologist, Dr. Richard Benton, and he was—and he taught psychology, I believe, at University of Houston–Clear Lake. And he was a clinical psychologist, and he left, I forgot why, and Dr. Hickey, through a patient, discovered Dr. [Norman Lawson?]. And Dr. Lawson was known to Dr. Wainerdi later who was the president or chairman of the Texas Medical Center, Richard Wainerdi. And we knew him well at MD Anderson because he had worked on some projects with Dr. Hickey, and he knew him well. And Dr. Wainerdi, I believe, called Dr. Lawson to Dr. Hickey’s attention. And Dr. Hickey interviewed him and hired him as a psychologist to take Dr. Benton’s place. And Norman Lawson was a psychologist, and he worked a lot with the rehab center patients. He was very helpful to a lot of them who had problems adjusting to the cancer diagnosis. He spent a lot of time with them. He had somebody working with them, [Roe Eden?], she was a student at your alma mater, UH. She got—getting a PhD there in psychology. And they worked very hard to try to meet the psychological problems that the residents at the rehab center were having with their cancer and its diagnosis and the treatments. It very often—and he brought them to his office and talked to them. And we had two social workers on top of him. Later one was [Rusty Kies?], a very experienced—she’d been an assistant director of social worker—work and a close associate of the founder of the social service department. I forgot her name, [Edna Walker?], I think, and she was a very capable person. So we had a strong psychological services program at the rehab center with Dr. Lawson and with the social service and with (inaudible). They all give the patients a very good screening, and they were able to meet their problems that they were running into. So it did measure up there, and that’s another area that I thought it achieved its purpose. Let's see, where are we going next? In—

Recommended Citation

Gunn, Albert E. JD, MD and Sáenz, Allison PhD, "Chapter 05: Service, Stewardship and Safety Through Committee Work" (2024). Interview Chapters. 1610.
https://openworks.mdanderson.org/mchv_interviewchapters/1610

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