
Chapter 05: A Faculty Associate: Research and Clinical Responsibilities
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Description
In this chapter, Dr. Keating explains how fellows became involved in research projects and notes that he took on leukemia research about nine months after arriving at MD Anderson, when he also became a Faculty Associate. He explains the responsibility for patients that this new status allowed, allowing for more continuity of care. He describes his fellowship as a “baptism of immersion.” He notes that he read Cancer Medicine to fill in his knowledge gaps.
Identifier
KeatingM_01_20140513_C05
Publication Date
5-13-2014
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - The Researcher; The Researcher; The Clinician; Understanding Cancer, the History of Science, Cancer Research; Research, Care, and Education; Discovery, Creativity and Innovation
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
Michael Keating, MD:
The other fabulous thing about Freireich’s department was that the fellows were given responsibility in their second year to have a project, and that often entailed being the person in charge of development of a new drug, and they got to talk to people around the country in the NCI, and they, in their second year, were becoming responsible for a project.
Tacey Ann Rosolowski, PhD:
So you were here for two years or—
Michael Keating, MD:
Three years, because after I’d done three months in the clinic and then three months on solid tumors, I then went to leukemia and did three months there, and they decided that I was pretty good at leukemia, so that they would keep me there for a full six months. Then they decided, “Well, we need a slave to look after the Inpatient Service,” so they said, “okay, so we’ll make you a faculty associate,” which meant an increase in salary, which brought joy to my wife’s heart, and she could actually afford to do a few things rather than Hamburger Helper and that sort of stuff. And it was then that I became more and more interested in the acute leukemias in particular, because that was where most of the research was being done at that time.
Tacey Ann Rosolowski, PhD:
Now, you said that at that point you were actually responsible for patients. So prior to that, you had just a research, primarily a research—
Michael Keating, MD:
No, no, actually you—
Tacey Ann Rosolowski, PhD:
How did that work?
Michael Keating, MD:
When you’re a fellow, you didn’t have the ultimate responsibility, but every patient that you saw in the clinic and new patients that you saw in the Inpatient Service, if they were direct admissions, they’re your patients until they died or you died, so that from the very first time that you came in, you had a continuity of care. And that created a number of challenges, because as the year went on, you inherited more and more patients, and so that not only did you have to look after the Inpatient Service, but you had to go down to the clinic pretty much every day to see the patients that you had that were coming into the clinic.
Tacey Ann Rosolowski, PhD:
So how many patients were you handling at the time?
Michael Keating, MD:
Probably when I finished on the Leukemia Inpatient Service, I think we had something like twenty patients each. Dr. Hortobagyi was on the Inpatient Leukemia Service with me at the same time, so that we had those twenty inpatients and we didn’t have any mid-levels and we didn’t have any pharmacy people. We had to do the whole thing. I think that was when I got used to the idea of coming into work early so that I’d arrive at six o’clock, and the only other people that were in there at six o’clock were usually the Urology Clinic, because Doug Johnson used to have morning rounds in the cafeteria, which opened at six o’clock, and he would purchase breakfast for his fellows. He ran his organization like a military operation. He is a superb guy. But everything got done. There was a great sense of structure and responsibility. So I would come in and go from six until eight before anyone ever got under way so that I’d have everything ready for rounds, and we’d be finished. Then we’d go down to then clinic in the afternoon, then we’d come back and mop up any unresolved issues, etc. It was a baptism of emotion, because you ended up at the end of the year having seen everything, because there’s such a volume that assaulted you. There was a textbook called Cancer Medicine, and I didn’t know very much about solid tumors or the biology of cancer, so it was about, I think, two thousand pages, so I decided that I would read enough in those two thousand so that at the end of it I would have finished reading the book. So I learned a lot about the pharmacology and the immunology, etc. But at the end of it, when you go to a journal and start looking at Cancer, which was the big journal—this was before the Journal of Clinical Oncology, etc., and Blood wasn’t handling leukemias at that time, so you’d be reading through and say, “Oh, that’s just like the patient that I saw on such-and-such and such-and-such,” and you’d seen it all, so that it became easier to read the journals because, again, from my point of view, it was linking back to some person. And I said, well, we didn’t know how to do that then, so we’ll do better next time.
Recommended Citation
Keating, Michael MD and Rosolowski, Tacey A. PhD, "Chapter 05: A Faculty Associate: Research and Clinical Responsibilities" (2014). Interview Chapters. 1173.
https://openworks.mdanderson.org/mchv_interviewchapters/1173
Conditions Governing Access
Open
