Chapter 02: Choosing to Specialize in Cancer Research and Treatment

Chapter 02: Choosing to Specialize in Cancer Research and Treatment

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After explaining why his internship at Lebanon Hospital in New York was disappointing, Dr. Hong describes his move to the Veterans Affairs Hospital in Boston, Massachusetts. He talks about cross-cultural adjustments. He also explains that he saw many cancer patients in Boston and decided to work on smoking related cancer. He was, at the time, thinking about cancer treatment from a new perspective (which would create an entirely new field), as he was not approaching head and neck cancer as a surgeon. He describes his next move to Memorial Sloan-Kettering in New York, where he was part of a top fellowship program and met “good people,” among them Dr. Irwin Krakoff, who would later come to MD Anderson and serve a role in recruiting Dr. Hong for that institution. Dr. Hong next traces his move back to Boston, where he joined the faculty of the Veterans Affairs Hospital as an assistant professor (1975-1984). Dr. Hong was the only medical oncologist on staff, and he describes how he was able to prove himself able to build a medical oncology program. Dr. Hong also states that he was “lucky” because the drug Cisplatin had become available, and he was able to obtain and test the drug on head and neck patients –he was one of the first individuals to treat head and neck patients with chemotherapy and the first to demonstrate its effectiveness in preserving the larynx. He explains that the human motive of preserving patients’ ability to speak and swallow motivated him. Dr. Hong tells a story about his connection to George H.W. Bush.

Identifier

HongWK_01_20130916_C02

Publication Date

9-16-2013

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Professional Path; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; The Researcher; Evolution of Career; Experiences re: Gender, Race, Ethnicity; Patients; Patient, Treatment, Survivors

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 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:

Okay, we were talking about your internship program at Bronx-Lebanon Hospital. And you were explaining how you came to be at a community hospital. What did you learn from that experience at a community hospital?

Waun Ki Hong, MD:

Not a whole lot. And I was very disappointed. They used to house their interns like labor—and it was incredibly long hours of work. So they hired me as an intern, because they needed somebody. There was very minimal teaching. I was disappointed from that internship.

Tacey Ann Rosolowski, PhD:

How was that?

Waun Ki Hong, MD:

Then I was lucky to get a very decent residency program in Boston.

Tacey Ann Rosolowski, PhD:

Because you were in New York for one year, ’70 to ’71. And so how did you make that move to the Boston Veterans Affairs Medical Center?

Waun Ki Hong, MD:

There was a lot of teaching there. Again, I tried to get a residency position, but I was never to get it. And somebody was supposed to come to the Boston VA as a resident and changed their mind and dropped out.

Tacey Ann Rosolowski, PhD:

Lucky for you.

Waun Ki Hong, MD:

So I didn’t have a job or position until April. They contacted me and said, “Are you still interested?” So I had no choice but to say, “Yes.”

Tacey Ann Rosolowski, PhD:

Now before you tell me about that, tell me how the adjustment went coming to the US. You mentioned there were language issues. How was that whole cross-cultural adjustment?

Waun Ki Hong, MD:

It was—you can imagine—there are obvious language barriers and cultural barriers. My son was born right after that year so—you know—

Tacey Ann Rosolowski, PhD:

New family. Waun Ki Hong, PhD And then it’s very tough to adjust to a new environment.

Tacey Ann Rosolowski, PhD:

Did you feel as though—just to say it honestly—did you feel discriminated against in any way?

Waun Ki Hong, MD:

No, I didn’t feel they were discriminating. Obviously, it was hugely challenging to adjust to a different culture. And obviously, I was not able to communicate smoothly. I didn’t feel that they were. They treated me reasonably well. I never felt they were, because I had always my own pride. I don’t speak as well as you do, but my brain can be as smart as you are.

Tacey Ann Rosolowski, PhD:

Absolutely.

Waun Ki Hong, MD:

And then I was fairly confident in that.

Tacey Ann Rosolowski, PhD:

So in terms of moving to the medical residency at Boston Veterans, tell me about that experience there. It sounds like it was a whole lot better.

Waun Ki Hong, MD:

Yes, it was a hundred percent improvement and more teaching and opportunities. It was also a teaching hospital, so there are medical students from Boston University and Tufts University. And I was very independent and more autonomous. I was expected to manage the patients. So I was very happy. Lo and behold, I was able to really quickly establish my own identity. It was interesting, you saw doctors from foreign countries that came, and some of them were really smart. The guy that used to work in my department, we worked side-by-side, and he turns out a very famous guy. He’s on CNN constantly, Deepak Chopra. He and I, we did residency together. He and I constantly hang around together. It turns out to be such a great experience.

Tacey Ann Rosolowski, PhD:

Now, you mentioned Boston as the place where you decided to focus on cancer studies. Did that happen during this period?

Waun Ki Hong, MD:

Yeah, that’s a good point, because at Veterans Hospital there were tons of cancer patients suffering from smoking-related cancer, head and neck cancer and lung cancer. That really inspired me to think about something and medical oncology as a subspecialty. I did a very good residency training, so I was able to get a very good recommendation letter. I was enrolled into fellowship at Memorial Sloan-Kettering in 1973.

Tacey Ann Rosolowski, PhD:

Now I was going to ask you, too, because as I’ve spoken to people about this particular period of time and they’ve emphasized over and over that there wasn’t a whole lot of treatment available for cancer. So approaching head and neck cancer from the position, not as a surgeon, but as someone from medicine, you were thinking about it quite differently. Tell me about that. What were you thinking about at that time?

Waun Ki Hong, MD:

Well, at the time I was just thinking about it as a new field. There were more opportunities than you can imagine. It was a tremendous time. And then at that time, a diagnosis of cancer was the same as a death sentence of cancer. So I think, again, I like a challenge. And I decided to pursue it with medical oncology training.

Tacey Ann Rosolowski, PhD:

And that was 1973 to 1975 at Memorial Sloan-Kettering. So tell me about what you did there and who you worked with.

Waun Ki Hong, MD:

It was a fellowship, so just general training, not specific or subspecialized. But I met very good people. At the time, the Chief of Medical Oncology was Dr. Irwin Krakoff. He was the first head of Cancer Medicine. And then he left Memorial Sloan-Kettering and became director at Vermont. He was in a comprehensive cancer center. Then he came to MD Anderson in 1983 as head of medicine. So he was the one who recruited me to come to MD Anderson in 1984, so I think that he was the most influential person in my career.

Tacey Ann Rosolowski, PhD:

At the time when you were at Memorial Sloan-Kettering, how did Dr. Krakoff help shape your education to get—because you mentioned earlier that you’re eccentric. And it sounds like your experience in Boston—you were enjoying the autonomy and thinking outside the box. So how did that start to show itself, and how did he help it along?

Waun Ki Hong, MD:

I got to this fellowship, and I was only foreigner then, and it was the big fellowship program at the time. It was the top fellowship program in the country. So I must have said that I was very mediocre, and then I tried to just learn as much as I could. I wrote just a couple of research projects that I never finished. And so it was a two-year fellowship that I completed, and then I tried to get the job in Boston, because I wanted to come back to Boston. And then nobody from Sloan-Kettering offered a job to me to stay there. The only job that was available in Boston was at the VA Hospital as a medical oncologist.

Tacey Ann Rosolowski, PhD:

Okay, I’m confused here because I have—let’s see—from your CV that in 1975 you were at Boston University School of Medicine.

Waun Ki Hong, MD:

That’s the same, Boston Veterans and Boston University.

Tacey Ann Rosolowski, PhD:

Okay. Got it. All right. Now, in that position, how did your career develop?

Waun Ki Hong, MD:

That’s a very good question. In 1975, after I finished the fellowship, I started with tons of cancer patients. And I was the only one trained formerly in medical oncology. Then I had some sense of responsibility taking care of cancer patients, because the VA hospital had tons of cancer patients. And I was alone, so I was the Indian and nobody was above me, so I was the Indian and the Chief. So I started a program really from scratch, from nothing. Then in 1984, nine years I spent at the Boston VA Hospital, and I manufactured a thirteen-person team of medical oncologists. And it was considered one of the better clinical oncology programs in the world. So I think there is something—I tested myself. I can be good enough to build some program. In my own experience, I think that’s really a core experience. I feel like I proved to somebody that I can do it. And there I was very lucky, too, because there was a new drug called cisplatin that was available. And I was one of the only investigators. I was able to obtain the drug and then test it in the head and neck cancer patients. It does not come from my idea.

Tacey Ann Rosolowski, PhD:

Right place at the right time.

Waun Ki Hong, MD:

I happened to be in the right place and seeing the right patients, and I was able to obtain the drugs. And then I developed a small study in head and neck cancer patients. As you mentioned earlier, there is a predominant preoccupation with surgery, nothing but surgery and radiation. So I probably was one of the only people to give the treatment of chemotherapy and then see a response. And then if there is substantial response after chemotherapy—and then comes out the idea. We were not sure at the time. We used to do surgery anyway, regardless. So even though I was very young, removing the human voice box from laryngeal cancer is—I felt—is such radical overtreatment, especially losing the voice box and losing communication skills. That is devastating for quality of life. That really motivated me to do the studies all on preservation. So that’s what started—you can see on the back—Cancer Therapeutics. That’s what the story—this guy, a gentleman, was doing an autobiography. That gentleman is Babe Ruth. Babe Ruth, you know the baseball player? He was giving his autobiography to the baseball player—see that here under my picture?

Tacey Ann Rosolowski, PhD:

Yes, I can.

Waun Ki Hong, MD:

That is George Bush the senior, when he was captain of the baseball team in 1948, and the story is of Cancer Therapeutics. Can we have a cure for Babe? Babe Ruth received the treatment regimen I developed of chemotherapy and radiation.

Tacey Ann Rosolowski, PhD:

Would you mind if next time I take a picture of that?

Waun Ki Hong, MD:

You bet.

Tacey Ann Rosolowski, PhD:

That’d be great, because then I can put it right in your interview.

Waun Ki Hong, MD:

I have it in some file too. And I can send it to you in a PDF.

Tacey Ann Rosolowski, PhD:

That would be terrific.

Waun Ki Hong, MD:

That’s the story. And Andy von Eschenbach used to be here. He was the NCA Director and [also FDA Commissioner]. He was very close with George Bush the senior. So he took me—Andy was sitting over there. I explained to Andy, and then he took me to George Bush’s office. Then he created the photograph, and then he signed. The picture was taken in 1948.

Tacey Ann Rosolowski, PhD:

That’s a great story.

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Chapter 02: Choosing to Specialize in Cancer Research and Treatment

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