Chapter 22: An Endowment for Education, More Research, and a Think Tank

Chapter 22: An Endowment for Education, More Research, and a Think Tank

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Description

During this chapter, Dr. Hill talks about the endowment he made (1998) to MD Anderson for education in Pain Management that would show the complexity of pain associated with cancer. He talks about current plans to discuss toxicities from cancer treatment, “the backdoor of treating symptoms from cancer treatment,” and hopes that the money will be used to support a “think tank” about symptom relief tied to individualized therapy.

Identifier

HillCS_04_20120228_C022

Publication Date

2-28-2012

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Post-Retirement Activities; Contributions; Activities Outside Institution; Career and Accomplishments; Post Retirement Activities; Professional Values, Ethics, Purpose; Character, Values, Beliefs, Talents; Philanthropy, Fundraising, Donations, Volunteers; Donations, Gifts, Contributions

Transcript

Tacey Ann Rosolowski, PhD:

Dr. Hill, I wanted to ask you about the endowment that you made for the lectures, the educational pain management, because that’s kind of one of the big legacies that you’ve left, among other things, is this endowment. I was wondering if you could talk a bit about that. That was in 1998, the endowment to MD Anderson for education on pain management.

C. Stratton Hill, MD:

Just recently, this guy named [Richard] Holz, who is in the development department for planned giving at Anderson, I’m sure he was wanting to see if I had any more money to give to that endowment. When he called me I said, “I’m absolutely thrilled that you have called because I’ve been wondering about what to do about this endowment because I’m just a little bit concerned about what might happen to this because of the uncertainty or the fluidity of pain at the moment.” And when I was there, although I was working mostly in pain, I realized that there were other distressing symptoms that needed to be looked at. We actually changed the name of the service to the pain and symptom management.

Tacey Ann Rosolowski, PhD:

What were some of the other symptoms?

C. Stratton Hill, MD:

Shortness of breath, fatigue. We didn’t do too much with the diarrhea because that’s generally the bailiwick of the gastroenterologist, but we did have a significant number of people that had radiation-induced urgency, which is a terrible, distressing symptom. It makes you feel like you are about to have a bowel movement all the time. It’s sort of a pushing-down feeling. What it amounts to is, with the old type of radiation, you had a lot of damage to surrounding tissue. So if you had, say, carcinoma of the prostate, you might have radiation and end up with this feeling that you had to go to the bathroom all the time, that you had to have a bowel movement. Well, that doesn’t get relieved with morphine or pain medication. At that time what we did was we started treating that with steroid enemas, and I believe that there was a company that finally made enemas with steroids in them. They had to be dispensed on a prescription, but that would cut down on the inflammatory reaction. So I realized that there are far more symptoms than just pain that were distressing that had to do with either the tumor or its treatment. I realized that we needed to look at those things from a purely scientific point of view. It’s just “Oh, you’ve got cancer. You had radiation. What do you expect? You’re tired all the time. That’s what it does to you.” Well, if that’s the case, what caused it? When we started out, we thought we were really going to make a push to get a significant amount of money, but not to just give a lecture in pain because there are too many variables. There are too many people who are advocates for a certain type of treatment or something like that, who are advocates against a certain type of treatment and so forth, so let’s set up a colloquium, if you want to call it that, so that you’d have opposing views for a couple of days, and then you’d have that published. We tried that, and we realized that it took an awful lot of money for that. It would take millions of dollars. We’d have to pay for people to come, to stay here for two or three days, to get them to do a manuscript, and to print it and so forth, so it ended up then that we’ll start with a lecture, and of course, we wanted to get leading people. Kathy Foley was the first one. I’m pretty sure she was the first one. Everybody knew her, all over the world, so she gave the first lecture. I think Russ Portenoy was next, and then Dan Carr. He was one, and I’m not sure that we— And then after that, things began to change in terms of the pendulum swinging over to the regulatory and law enforcement agencies clamping down on doctors. I don’t think we had anybody that got into that. Those three people were in the science of pain. I kept doing programs for the Texas Pain Society, and we kept bringing people in because that was the thing that was spooking the doctors, sanctions by regulatory agencies and so forth. Since it has swung way over to most of us all being anesthesiologists and they’re interested in interventions and procedures because that’s where the money is, it’s become almost an exclusive bailiwick of anesthesiology. You’ve got anesthesiologists that will treat— Would you like another Coke?

Tacey Ann Rosolowski, PhD:

No, I’m good. Thanks.

C. Stratton Hill, MD:

That will use drugs and so forth, but most of them can’t do anything more for you. When the procedure is not working, and especially when the procedure is not working and payment for the procedure has stopped, then they really can’t do anything for you. That’s been the problem, and then you’ve gotten into the problem with the pill mills, where it’s taken on a sinister image, and so Charlie and I have been thinking, what should we do?

Tacey Ann Rosolowski, PhD:

Is this Charles Holtz?

C. Stratton Hill, MD:

No, Charles Cleeland. He spells that with a C. And so we’re going to have— Last year we had one on—and I’ve forgotten the name of it, but it had to do with encouraging research for other distressing symptoms. This year it’s going to be on toxicities from cancer treatment, which is sort of the back door of treating symptoms of cancer treatment. That’s coming up in April, and I don’t think he’s gotten the faculty for that firmed up yet. I think he’s got some people on it, but that’ll be a couple of days, I think, at the ZaZa Hotel. That’s what it’s evolved into. Now, what I have— When Mr.—I forget what his first name is—Mr. Holtz came, I indicated how this had developed. When we’re all gone, what’s going to happen to that money, and where is it located? Administratively, does Anderson have its hands on it, or is this part of the general university fund, and it’s just put in there, and you get your percentage of whatever interest it is depending on your percentage of the thing or what-not? We had a hiatus in there where we didn’t do anything, and I think that the university from Austin got on us and said, “Hey, if you don’t want this money, other people do. We can use this money.” That’s when we had the thing last year. Mr. Holtz did send me something back that they had in their file, which even makes it more problematic because it wasn’t signed by me. It was signed by Mike Best, who was the business manager at that time, and it was not the final product. Then the lady that works for me came yesterday, and I said, “I need to find that stuff that relates to that endowment,” and she came up with a signed document that’s got my signature and somebody from Anderson’s signature. I really haven’t had the chance to look at it to see where it says the money is— If we can’t do it in the university, then it goes to another place. I know that other place is not viable anymore either. This may just kind of bounce around and nobody knows about it until somebody up there in Austin says, “Hey, there’s some money over there that’s not being used,” and they call up somebody down here and say, “You’ve got some money. Who should get it?” and the guy or whoever is in charge thinks, “Oh, that’d be nice for so and so.”

Tacey Ann Rosolowski, PhD:

In the ideal world, what would you like to see that money used for?

C. Stratton Hill, MD:

I would like to see it used as a think tank, support for innovative symptom relief. You’ve got the tailored therapy money, which Dr. Mendelsohn is going to be using, and the sheik gave the money for the building. The Bush family has been supporting that for years. Every time they would sponsor somebody being here, there would be at least $10 million raised, so there are millions of dollars in that that has to do with focused therapy. I’d like to see think tanks for how to deal with things like this. The Baker Institute over there at Rice is sort of the—or let’s say the Hoover Institute or the Cato Institute. Those are all political. I don’t know about the Hoover. The Heritage Society—no, not Heritage. But those are all national, and they are funds that are used for think tanks for different things. That’s what I would like to see, because I don’t know that you’re going to— Almost everybody likes the biomedical model, the Cartesian, and of course, there’s a lot to that. But I think until we can get our hands and arms around some of these concepts that we need to know where to focus things. There was a neurophysiologist at the University of London named Pat—oh, let’s see; I’ll think of it in a minute—Pat Wall, and he says the body has an amazing capacity to create pathological pain pathways. See, you can do things like— And Ronald Melzack at McGill in Montreal, he and I are good buddies, and we’ve talked about phantom pain a lot. He’s looked up people who have had phantom pain who have been in automobile accidents and had back injuries and investigated whether or not there was any connection from a severed spinal cord, some places where they had to take sections of the spinal cord out, and that means they take the sympathetic chain. There are just no connections whatsoever, and yet people still have phantom pain. And of course, he talks about these images that are created and mechanisms in the brain that are set up and that they don’t need a stimulus. They just occur. So things like that. We haven’t arrived there yet, so have people think things like that. Basically, what you’d have to do, I think, is have somebody to come up with some thought that you think is absolutely stupid and crazy and that they’ve done some work and say, “Gee, let’s give that a shot.” And it may turn out that that’s the way it’s going to happen somehow. You’ve got to do that.

Tacey Ann Rosolowski, PhD:

That would be a great legacy. Well, I don’t have any other questions. Is there anything else you would like to add at this point?

C. Stratton Hill, MD:

Let’s see if I can think of anything. I’m trying to think of unusual things that have happened. Well, there was a murder at Anderson.

Tacey Ann Rosolowski, PhD:

I think James Olson wrote about that in his book.

C. Stratton Hill, MD:

I don’t think we want to go there again, and there’s nothing to go there for. I mean, nobody knows what happened. And I told you about Eleanor MacDonald, that her adopted daughter just vanished.

Tacey Ann Rosolowski, PhD:

Yeah, pretty amazing stories, and the Marshall Islands.

C. Stratton Hill, MD:

Oh, the Marshall Islands, yeah.

Tacey Ann Rosolowski, PhD:

Well, it’s always possible, if you think of something down the line that’s really significant, you can give me a call.

C. Stratton Hill, MD:

There have been characters at Anderson that are just—stories that are really—unusual people that have nothing to do with Anderson, but I think Anderson is a place that attracts minds that cause the individual to have different behavior, you might say.

Tacey Ann Rosolowski, PhD:

Eccentric, perhaps.

C. Stratton Hill, MD:

Yeah. I mean, we had one guy that I knew real well, and I don’t know where his money came from, but he was a pathologist. He quit and went to live in California. I had an exhibit at the American Medical Association that was meeting in San Francisco. He lived there, so he came by. I recognized him at the exhibit, so we visited, and he said, “Let’s have dinner,” or something. We had dinner, and he took us to his house, and his house was just strewn through with all kinds of things. He had mail all over the floor and all over everything. And I noticed that some of them, they were obviously checks that he hadn’t even opened, and he told me that— I don’t know how we got to talking about it. He was talking about one of his children going to Reed College. I think it’s in Oregon. He said that Sunday he’d go up and visit his son, and he knew that he lived off campus at a house. He said he went there, and his son said, “Dad, we don’t have another bed here. We’ve got a bed, but all it’s got is just springs. They’re not box springs. They’re just springs.” And he said, “That’s the only bed we’ve got.” This guy said, “That’s okay. I’ll sleep on that.” He went to bed, and I guess he went to sleep, but he woke up, and he was freezing. His son had a bunch of cats, so he goes and rounds up all those cats and puts the cats on him to keep him warm.

Tacey Ann Rosolowski, PhD:

That’s quite a character.

C. Stratton Hill, MD:

He said that he would take us to the airport. Well, when he arrived at the hotel I thought my wife was going to go out the back door because he had on a black French cap, a purple suit with a big red tie, and some weird colored shoes. He drove a Citroen of the vintage when the Citroen looked the weirdest it’s ever looked, and we went to the airport in that car. I hope nobody saw us that knew us.

Tacey Ann Rosolowski, PhD:

Well, I think MD Anderson is a place—well, great minds have sometimes interesting characters.

C. Stratton Hill, MD:

He was a smart guy.

Tacey Ann Rosolowski, PhD:

Well, thank you so much.

C. Stratton Hill, MD:

Thank you.

Tacey Ann Rosolowski, PhD:

I really enjoyed talking to you.

C. Stratton Hill, MD:

I hope that this all comes out. Do you want me to just kind of either fill in the names or correct spelling? Do you want me to add any text to anything?

Tacey Ann Rosolowski, PhD:

Since we’re talking business, why don’t I just turn off the recorder? It’s 3:30, and I’m terminating the interview now. (end of audio session 4)

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Chapter 22: An Endowment for Education, More Research, and a Think Tank

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