Chapter 09: Reflections on Dr. Clifton Mountain and Data Collection Roles at MD Anderson
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Description
Mrs. Hermes begins this chapter with memories of how much she enjoyed working for Dr. Mountain over the course of 25 years. He taught her how to think about data, she explains, and she was listed as an author on a number of publications on lung cancer [see examples below]. She explains that Dr. Mountain left MD Anderson in 1993, but she continued to work freelance for him. She recalls that he set up the first conference on mathematics at MD Anderson, early in his career sometime in the sixties.
Next she comments on how the unique openness of Houston culture fit well with the bold visions that both R. Lee Clark and Eleanor MacDonald held for oncology. She says that her most important work was on Dr. Mountain’s staging system for lung cancer and she explains why staging the disease presented challenges.
She confirms that she was always interested in the implications of basic research for clinical findings. She credits Eleanor MacDonald for helping her to develop her curiosity and questioning style.
Identifier
HermesKL_01_20180122_C09
Publication Date
1-22-2018
City
Houston, Texas
Interview Session
Topics Covered
View on Career and Accomplishments; Personal Background; Professional Path; Portrait; Overview; The Researcher; Research; Discovery and Success; Contributions; Career and Accomplishments
Transcript
T.A. Rosolowski, PhD:
I was just curious, because that’s always—how do they give credit to the people who have really done the actual research and crunched the numbers?
Kay Hermes, BS:
Well, you do the actual research, but for example, when I did—Dr. Mountain was a marvelous teacher, and he was an absolutely genius surgeon. He really taught me a way of thinking, I think, about a lot of the data. And he had a question, he always had a question, to look at in the data and what would it amount to. Because you see, it was important because you couldn’t get enough patients in any one area to get a really good report on, say stage one lung cancer. And then we did all the work on developing and refurbishing, you might say, renewing the staging system for lung cancer. That was based on, those recommendations were based on that pathology data from all the different institutions.
T.A. Rosolowski, PhD:
Very interesting.
Kay Hermes, BS:
Yeah. I think I did, let’s see, I did have my name on some book chapters that he wrote, I wrote for him, but I don’t remember what they were now.
T.A. Rosolowski, PhD:
How long did you work for him?
Kay Hermes, BS:
I worked for him twenty-five years.
T.A. Rosolowski, PhD:
Wow, okay.
Kay Hermes, BS:
And then when he retired and moved to California, I moved his whole little research office home to my house, and so I continued to work for him for a number of years. I don’t think I was making slides anymore, but we did the last manual for staging lung cancer and sold it to one of the drug companies for distribution, so that we got enough money to work for another few years.
T.A. Rosolowski, PhD:
So what year did he leave the institution?
Kay Hermes, BS:
Pardon me?
T.A. Rosolowski, PhD:
What year did he leave MD Anderson?
Kay Hermes, BS:
I’m trying to think. Everybody had to leave, I think, when they were sixty-five, and I suppose it would have been about 1993. I worked at Anderson, that’s—I worked there for twenty-five years.
T.A. Rosolowski, PhD:
And then you retired and worked freelance for him?
Kay Hermes, BS:
Yeah. I did a compilation of all his papers, a two-volume thing, and got that all together and got all the papers Xeroxed to the same size, and all the documents and everything from the beginning of his career, when he was at Boston Medical School and was doing—he actually formed the first—he was assistant surgeon when he came to MD Anderson, and he was appointed to run the first Conference of Mathematics in Medicine there at Anderson. He had worked on data systems, I don’t know if it was at Boston University, it probably was.
T.A. Rosolowski, PhD:
Now, do you have any idea when that first conference on mathematics took place? I mean ballpark.
Kay Hermes, BS:
I would place it, it was not when I was there. I would place it at his early career, so I would imagine, and I’m trying to think when he would have arrived on the scene as assistant surgeon at MD Anderson. I think it probably had to be somewhere in the early 1960s.
T.A. Rosolowski, PhD:
That’s pretty amazing, that that was done.
Kay Hermes, BS:
Yes. He always thought it was amazing that he was put in charge of it, as a new assistant surgeon, because he said in the Northeast, in Boston, such a job would never have been given to an assistant surgeon. He always remarked on the wonderful possibilities for young people in Houston, that it was just an open field, there were just endless possibilities, not only in medicine but other areas too, but especially in medicine. There were great possibilities when the Medical Center was being built and developed, and the Heart Institute.
T.A. Rosolowski, PhD:
It was a very special time.
Kay Hermes, BS:
It really was, it was, and he remarked on that often, that the openness of Houston, to new ideas, and the openness of Houston to promote visionary things was remarkable in this lifetime. He always said that he was greatly influenced by that.
T.A. Rosolowski, PhD:
When you were working at MD Anderson in the ‘50s, did you kind of know…? I mean, you were very young, just out of school, but did you have a sense that you were taking part in something special, or is that something that you know now that you look back?
Kay Hermes, BS:
It never dawned on me, and I’ll tell you why. It never dawned on me because I was very selfish in that I think most of my thinking was that I wanted to learn everything that Eleanor had to teach. I wanted to learn everything I could about all those records, I mean I was just, I was a real sponge, and I don’t think it ever occurred to me that this was even important, other than the fact that I had a job that I absolutely loved, working with wonderful people. It didn’t ever pay very much but that was all right, I got along all right. I don’t think that I ever had the sense that I was doing anything unique or wonderful or anything else.
T.A. Rosolowski, PhD:
And now that you look back what do you think?
Kay Hermes, BS:
Well, I think the same thing. I think I was so… I did very much appreciate Dr. Clark’s vision and Eleanor’s vision, the way the two people that I knew about, and I was close to Eleanor, not to Dr. Clark, but I was close to Eleanor and through her to him, I guess. No, looking back on it, I think in all the years I worked at Anderson, probably the most important thing I ever did was the staging system for lung cancer. I produced a book that had I- worked with a doctor in radiology, worked with a radiologist and got pictures of all the different subgroups and stages of lung cancer, and put all the data together in this little book. That was very useful. The staging of lung cancer was very important. Staging, per se, was very important, and I think in lung cancer it was probably one of the first finely developed systems. There was a system for staging sarcoma, there was always a system for staging cancer of the breast, but in lung cancer, the promotion of the idea of the pathology of the tumor and the anatomy of the tumor were very important because that’s all you had, until you had CTs and so on. We did a project with the Mayo Clinic, and this was—or maybe it was North American Lung Cancer Study Group. Anyway, I remember the person that handled the data for this project was at the Mayo Clinic, and I remember his presenting the data. This was on smokers, that was the population. I think the population, the definition of the population, was probably men over forty who smoked. This of course, was compared in all kinds of different ways with other studies and so on, and there was absolutely no positive information came out of it, and everyone was completely baffled, because clinically, everybody knew that more people that smoked were going to get cancer. But anyway, that project was a bust, I mean it didn’t turn out to be anything, but that’s what data does sometimes, it doesn’t tell you the answer you want to hear.
T.A. Rosolowski, PhD:
That’s interesting. Did anybody ever figure out why the data wasn’t yielding expected results?
Kay Hermes, BS:
Well, I think Dr. Mountain thought that they didn’t—I think he thought that they included people with small cell cancer in that database, and that would have skewed it. I really don’t have that firmly in mind. Everybody questions it, believe me. All the doctors said, oh no, that can’t be, all the doctors said, Oh no, that isn’t true, that isn’t true. Well, it was true.
T.A. Rosolowski, PhD:
Huh, very interesting.
Kay Hermes, BS:
It was interesting. The North American Lung Cancer Study Group did some interesting studies. The people in chemotherapy that were involved in the group treated a lot of patients, but there was nothing. You either had a complete resection, and Dr. Mountain was very instrumental in promoting the idea of mediastinoscopy. I think he actually introduced mediastinoscopy to that part of the world. He was very instrumental in identifying the influence of the extent of the cancer in terms of lymph node involvement, that the mediastinal lymph nodes, especially if they were bilateral, were really bad news, but you could remove the hilar lymph nodes along with the tumor and that wasn’t such bad news. That distinction was quite important and that was one of the reasons that we never could use that government database, because there was no separation of the lymph nodes. I don’t think there still is maybe.
T.A. Rosolowski, PhD:
Oh, that’s interesting.
Kay Hermes, BS:
It is. My niece, Dr. Giordano at Anderson, she’s in the breast service. No, she’s in charge of something else now, I don’t remember. Anyway, she did some interesting studies, data. One of which she published and talked a lot about was breast cancer in males. She, I think published some interesting work there, but of course she got a degree in public health, after actually she came to Anderson.
T.A. Rosolowski, PhD:
Yeah, often. What is her last name again?
Kay Hermes, BS:
Giordano, G-i-o-r-d-a-n-o.
T.A. Rosolowski, PhD:
Okay, great, and her first name?
Kay Hermes, BS:
Pardon me?
T.A. Rosolowski, PhD:
Her first name?
Kay Hermes, BS:
Sharon.
T.A. Rosolowski, PhD:
Well, you’ve had a very interesting career.
Kay Hermes, BS:
Well, I think I did have—was able to do something I loved and the overall result of everything I did, one thing I was always very interested in and I did work on a couple of book chapters with this in mind, and that was I was always really interested in the implications of basic research for clinical findings. I was always kind of searching in that direction and we did do a chapter in a book, The Biological Implications of Diagnosis, I guess, I can’t remember all of it now, it’s been a long time ago. But anyway, I was interested in that kind of work.
T.A. Rosolowski, PhD:
Why were you interested in that?
Kay Hermes, BS:
I think it just sparked my imagination, and you know, I really did have the bent, and I think I learned it from Eleanor, a questioning, kind of a curiosity, a questioning curiosity as to why. Like the smoking and lung cancer studies, I’d look at this and think well, what about all these people that never smoked that got lung cancer, especially women? Then I would look at other populations and think to myself well, we have all this information on diseased people, but we have very little solid database or population defined database, on people that don’t get heart attacks and lung cancer and diabetes and all the other things. We know everybody who gets it and their genetic workup, and what they ate and what they did, and so on, but we really don’t have… I guess one reason it came to my mind, I visited my sister one time in Minnesota, and she lived, I think in a house or apartment, with an older woman, she, and her family. I’m trying to remember how I knew this woman, but anyway, she was a chain smoker, she was coughing constantly, coughing up blood and so on, and she lived to be a very old lady. Of course, she had a lot of limitations in her life, but it didn’t kill her, and she didn’t get lung cancer.
T.A. Rosolowski, PhD:
How did that happen?
Kay Hermes, BS:
Yeah. Well, see I was always interested in that, and one reason I was, because I do remember Eleanor has a very interesting book chapter. If you look in her resume, there’s a very interesting book chapter, she wrote chapter one, and the big question she had at that time was that the data on smoking and lung cancer was very flawed. Now, it wasn’t that she had any feeling one way or the other. I think the accepted the science of the smoking project, but she always, I think questioned, through there were flaws in that data, and then I got to thinking about it and I thought you know, everybody that smokes doesn’t get lung cancer, and there are an awful lot of smokers in the world, since World War II especially. So, I always had, and still sometimes, I have that question, when I read different research reports and so on. So anyway, it was that curiosity I think.
T.A. Rosolowski, PhD:
Did you ever, in any of your projects, have direct contact with patients?
Kay Hermes, BS:
Very little.
T.A. Rosolowski, PhD:
Very little. Did you have a sense that the work you were doing was having an impact or going to have an impact on patients?
Kay Hermes, BS:
I thought the establishment of all those clinics for follow-up would have a major impact on patients’ lives. Yes, I did think that. I didn’t relate it so much to myself as to the work as a whole. When you’re young, when you’re in your twenties, you know the world is kind of your oyster, and I was exploring so many things, and coming from a little town in the Midwest, it was just marvelous, to be somewhere with a symphony, with a ballet, with wonderful theaters, and I’m sure I spent every cent of money I had in pursuing my cultural interests.
T.A. Rosolowski, PhD:
Yeah. Well, Houston is a place with a lot of opportunities in that way.
Kay Hermes, BS:
Oh, lovely, lovely.
T.A. Rosolowski, PhD:
For sure, for sure. Now, as you kind of think back, what’s your sort of overall impression of being part of this institution that’s grown so much? What are your reflections on MD Anderson and what’s happened to MD Anderson over that time that you were connected with it?
Kay Hermes, BS:
Well, when I think about it, and I think about starting out in reconverted Army barracks at the old estate, when I think about that, and then I think about the—it was sort of a gradual expansion. I think the biggest expansion probably took place when I wasn’t there, but thinking back on it, I always thought it was just marvelous, that that building was built and that you had—oh, I think the doctor that was the physicist, had invented the cobalt radiator.
T.A. Rosolowski, PhD:
Dr. Fletcher.
Kay Hermes, BS:
Yeah, Dr. Fletcher had invented the cobalt radiator, and I think overall, the growth of the institution, I think my overall thought is that it was just phenomenal, that it had to be, I used to think it had to be guided by a very special hand, to become what it has become. I’m not sure what it has become. See, I was not working there until after 1993, and a lot of new departments had been formed, a lot of technology. I think the leukemia studies, showing the multiplicity of chemotherapy for childhood leukemia was going to cure people, that I thought I was a phenomenal thing. To the extent, other than an emphasis on mammograms and an emphasis on what early detection there might be available in the time that I was there, I think the strides that have been made to the present date, the combination of research, technology, and clinical expertise, have really produced a marvelous institution. I don’t feel like I was really much a part of that. Overall, that’s what I think. I think of it growing from that—the growing pains from those first days, and there were so many funny things, you know? There was no air conditioning in those barracks’ buildings, and I was in a room with several women, and we had attic fans. Well, all these people were coding records, and the attic fans would blow the papers. Well, I remember this one lady, her name was Curin, and she was just tiny, and she would just march over to the widow, slam the windows down, and go back and sit down. Well, not too much time later—this struck me so funny; I never forgot it. Not too much time later, somebody else would very surreptitiously work their way around to the windows and open them because they were hot.
T.A. Rosolowski, PhD:
Well, it’s sort of amazing, to think that there was no air conditioning in Houston.
Kay Hermes, BS:
Oh, no, there wasn’t. Eleanor eventually bought air conditioners with her own money for those rooms.
T.A. Rosolowski, PhD:
Oh, gosh.
Kay Hermes, BS:
But oh it was, it was funny. Now I don’t know that there was no air conditioning in the clinic buildings. I don’t think there was.
T.A. Rosolowski, PhD:
Really? Wow.
Kay Hermes, BS:
Unless somebody had specific—I do remember another very lovely person that worked in the old MD Anderson. Her name was [Dovey Faulk?], and she was just a lovely woman. She was in Admitting. The story I remember about her, she would come to work in the morning and just be huffing and puffing and all out of breath, and somebody ask her, “Dovey, what have you been doing?” She said Well you know, I have to get my house in dying shape before I come to work. [laughs] I always—I don’t know why I remembered that, but it just stuck in my mind because she was a delightful person.
T.A. Rosolowski, PhD:
That’s funny.
Kay Hermes, BS:
It was funny. Anyway, I think that is overall, what I thought, and what I think about is that—and you know, we’re seeing similar things in all areas of our life today. When you think about the exploration in space and the progression of the exploration in space, and the vision of that, and I suppose the thing in medicine that is really more important than anything else, almost more important than the clinicians, is the technology. I mean the fact that you have MRI and CT scans, and that you have all these things available, and that you—well, you’re still not curing cancer and not curing all of breast cancer either, but your opportunity for treatment and cure is so much better, but many people, there’s really almost no treatment for them. It depends on the type. It goes back to the same thing, it’s the histology and the extent of disease, or the pathology at least. It wouldn’t be histology. It goes on with all of your things in your life. I saw the other night, about the technology being used to see what’s inside of the pyramids, for example. And then, another thing I think of, maybe kind of not on a parallel with MD Anderson, but somewhat the idea, the flu epidemic of 1914, I remember Eleanor saying that almost all of her friends that she was in high school with at that time, that their mothers had died with the flu, and that was in Boston. PBS had a very interesting documentary on the flu epidemic, and no one ever knew for sure why it stopped. The only thing they could think of is that the virus had affected all the people it could effect, and all the people that was left had developed some kind of immunity, so it petered out. But I had no idea so many—the number of people that died. I knew it was a serious thing, but I had no idea of the number of people that died. Now you think today, I don’t think we had those—we don’t have that strain of flu with that particular set of symptoms, but we have so many tools to treat. There are always new things coming along, there’s going to be new bugs from somewhere, or we are identifying new bugs from somewhere.
T.A. Rosolowski, PhD:
Absolutely, yeah.
Kay Hermes, BS:
And there will be researchers that can use all the tools at their command to do something about it.
T.A. Rosolowski, PhD:
Well, is there anything else that you—that we’ve missed, from your years when you were working at MD Anderson? Are there more memories that have been stimulated from that, projects you were interested in, or have we kind of…?
Kay Hermes, BS:
Well, I think we pretty much covered almost everything.
T.A. Rosolowski, PhD:
We covered it, yeah.
Kay Hermes, BS:
I like the fact that I did become, at the end of my working life, I did become - I do much more work in science writing. I had taken courses in it because I belong to the American Medical Writers Association, in fact I was president of it, in Houston. I took many wonderful courses in science writing. We had some really fine teachers.
T.A. Rosolowski, PhD:
You know, I was going to ask you. You had mentioned the different people who remarked on how Houston was very open and there were a lot of opportunities, and Dr. Mountain, who came down, was given the opportunity to jumpstart that conference, that was really innovative. Did you feel, I mean now that you look back on what your own experience was, do you feel that you were offered opportunities that were maybe unusual, because the institution was new and growing and kind of an open arena?
Kay Hermes, BS:
I think I had a very good opportunity to use all of the education in science. When I first started working, as a temporary typist, that was pretty downhome clerical, I mean it’s humbling and a good thing to do. You have to earn a living, so you do whatever. But I do think that the opportunity to study cancer records, I mean I coded hundreds and hundreds of cancer records. The opportunity to study cancer records, to learn about the disease, to learn about the treatment and the research, I think that was a very special opportunity. I didn’t think so at the time, I just did my job and loved it, I mean I knew I loved my job. Larry and I both talked about that a lot. Both of us worked at something that we really loved to do, and he did too, he loved his work.
T.A. Rosolowski, PhD:
You’re a very fortunate person. Not everybody can say that.
Kay Hermes, BS:
Yeah, that’s right. I suppose I got bored with it but not really. I really enjoyed it; I enjoyed it a lot. I always think about Eleanor, I think about her a lot. As a matter of fact, I just received, at Christmastime, a lovely gift of pears from her nephew, Joe [Castano?] in Danbury, Connecticut, is where he is, and her family. Her sister, of course died, Mary, she died of leukemia, was treated at Anderson. She was the head of statistics at Memorial for many years and then she came to Anderson, and she got cancer. Actually, I think she was treated for breast cancer, but she was one of those unfortunate people that developed leukemia following the treatment for breast cancer. My daughter in-law, the same thing happened to. But anyway, so Eleanor’s family, her older brother was in the priesthood, but they were all musical. George, her younger brother, no he was not younger than Eleanor. Yes, he was younger than Eleanor. Eleanor was the second child in that family. George was a very interesting person. He was part of Paul Whiteman’s original orchestra, and so Eleanor used to tell so much about all the different musicians coming to their house and music was such a big part of their lives. Of course, she was an excellent cello player. She played in different symphony orchestras in the Northeast, and when she came to Houston, she played in the orchestra at the University of Houston.
T.A. Rosolowski, PhD:
Well, is there anything else you would like to add at this point?
Kay Hermes, BS:
Well, no. I just hope I remembered enough things in my rambling review of the last sixty-eight years. There is a lot you don’t remember you know.
T.A. Rosolowski, PhD:
Yeah, of course. Well, I’m staggered at the detail that you remember, of the studies that you worked on.
Kay Hermes, BS:
I think it’s quite funny, the details I do remember, and probably the ones I forget, but somehow, some things stick in your mind, you know?
T.A. Rosolowski, PhD:
They do.
Kay Hermes, BS:
They really do. I think overall, the things that were—I was happy. I look back on it, I was very glad I could participate in the studies that I worked on. I was extremely happy to do the work on staging, that I think was probably the best work I did really, and I always considered it a real opportunity to be in a situation where I would study different aspects. Of course, the last part of my career was all lung cancer, it wasn’t anything else, and mostly surgical treatment of lung cancer. Oh, these terrible looking fingernails. This is my granddaughter’s (inaudible), and if I leave it on a week, I think I can take it off.
T.A. Rosolowski, PhD:
There you go. I noticed it earlier.
Kay Hermes, BS:
Oh, it’s just terrible.
T.A. Rosolowski, PhD:
That’s so funny.
Kay Hermes, BS:
It just shocks me every time I look down.
T.A. Rosolowski, PhD:
That’s so funny. Well, I was going to say, I thought you were pretty—
Kay Hermes, BS:
Oh, she was so proud of it, she just took such pains. She put a little design.
T.A. Rosolowski, PhD:
I know, I know. Well, I have to say, when I came, I thought wow, this is a pretty wild and crazy woman I’m going to talk to here with those nails. For the record, they’re aquamarine color, I mean they look pretty—
Kay Hermes, BS:
Yeah. Well, it’s really weird.
T.A. Rosolowski, PhD:
Well, since we’re talking about fingernails, maybe we should—
Kay Hermes, BS:
We’ve departed from our subject.
T.A. Rosolowski, PhD:
We’ve departed.
Kay Hermes, BS:
I don’t think I can think of anything else. I’m sorry that I can’t.
T.A. Rosolowski, PhD:
No, that’s quite all right.
Kay Hermes, BS:
I can’t put together any more details, it’s just overview of different periods of time and what I worked on and what I liked. I liked doing every bit of it a lot.
T.A. Rosolowski, PhD:
Well, I’d like to thank you for sharing your memories with me.
Kay Hermes, BS:
Okay.
T.A. Rosolowski, PhD:
And I’m saying for the record, I’m turning off the recorder at twenty minutes after one.
Kay Hermes, BS:
Okay.
Recommended Citation
Hermes, Kay L. and Rosolowski, Tacey A. PhD, "Chapter 09: Reflections on Dr. Clifton Mountain and Data Collection Roles at MD Anderson" (2018). Interview Chapters. 1039.
https://openworks.mdanderson.org/mchv_interviewchapters/1039
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