Chapter 06: Key In-House Publications
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Description
Here Mr. Pagel talks about several key activities in the Department. First he notes the move, in the 198s, to a new building and then the shift from an MBI computer to Mac personal computers. He then talks about the key publications the Department produces. The Year Book of Cancer ’56 – ‘88), provided a collection of abstracts of cancer research and was, effectively, a database before the days of electronic databasing. Mr. Pagel himself started the Cancer Care Series, created as a holistic picture of MD Anderson research treating particular care sites. In 1990, Mr. Pagel began talking to clinical leaders about the series, and realized he needed a champion. Dr. Ralph Freedman emerged, offering the idea that the project could be funded by the Alumni Association. Scientific Publications has published “Breast Cancer,” “Gastrointestinal Cancer,” Gynecologic Cancer,” “Lung Cancer,” “Pediatric Oncology,” and “Tumors of the Brain and Spine.” Each is a comprehensive work, heavily edited, he points out, as it is designed to inform non-academic physicians about the latest research. Also planned are volumes on bone sarcoma, head and neck, emergency oncology medicine, and survivorship. Mr. Pagel questions how effectively these books are being marketed. Next he talks about the OncoLog newsletter, first published in ’56. It is now offered in print and as an online publication for non-academic physicians, in both English and Spanish.
Identifier
PagelW_01_20120801_C06
Publication Date
8-1-2012
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Walter Pagel, ELS (D), Oral History Interview, August 01, 2012
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the InstitutionInstitutional Processes Definitions, Explanations, Translations Building/Transforming the Institution Professional Practice The Professional at Work Discovery and Success 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
Tacey Ann Rosolowski, PhD:
Now, you had mentioned some other issues that you—or some other initiatives that you took on when you were director. I think we’ve talked about the first four of them. You also mentioned that you were the first department to move in to—I’m sorry. Mr.
Walter Pagel, ELS (D):
Go ahead.
Tacey Ann Rosolowski, PhD:
No. (laughs) Mr.
Walter Pagel, ELS (D):
I’m just laughing because I had nothing to do with that.
Tacey Ann Rosolowski, PhD:
You didn’t? Well, why don’t you finish my sentence, because I am ashamed to say I can’t read my own handwriting in the note I took. Oh! The former Prudential building. Mr.
Walter Pagel, ELS (D):
In 1971. MD Anderson bought the former Prudential building in 1971. We were handed offices specially designed for us, opposite the research medical library, way over on the first floor of the old building. But the Office of Clinic Administration wanted our offices. And there is no service department that can succeed in fighting off the Office of Clinic Administration. So we ended up over here—over there, at that building that no longer exists, in ’72, actually. And what happens when you’re the first people to be sent away from the central? What do you think? You think, oh, God. They think that they don’t need it. Too far away. Nobody will come to you. So it was distressing at first, but we got over it.
Tacey Ann Rosolowski, PhD:
And so how did you deal with the space issue? Mr.
Walter Pagel, ELS (D):
That problem, through the mail. In those days it was mail.
Tacey Ann Rosolowski, PhD:
Oh, okay. So that wasn’t that big a deal, then. Mr.
Walter Pagel, ELS (D):
No, it really wasn’t.
Tacey Ann Rosolowski, PhD:
Oh. What about this interesting first—of the first institution to put a publication on Gopher services? Tell me about that. Mr.
Walter Pagel, ELS (D):
Well, it is a research report. I don’t know about the first institution, but that’s the first place, I think, that any MD Anderson publication went up on the World Wide Web. I’m guessing. I don’t know that for a fact, but I think it is. The other kinds of software that you use to go up on the World Wide Web didn’t exist. It was a Gopher thing.
Tacey Ann Rosolowski, PhD:
So when was this? Mr.
Walter Pagel, ELS (D):
(whistles) I’m thinking early ‘80s. It was a server managed by the University of Minnesota, which is why it was called the Gopher Server. What replaced it? I don’t guess it was called the World Wide Web, then. Maybe it was just called the Internet.
Tacey Ann Rosolowski, PhD:
So tell me about the decision to do that. Mr.
Walter Pagel, ELS (D):
I don’t remember. I suppose—I mean, you can imagine what it might be to think you’ve got a catalog of the research activities at MD Anderson and not everybody who wants to know is going to have that catalog when they want to know. So the whole reason for the existence of the Internet, really—or, not the reason for it, but the best use, as far as I’m concerned, is how can you know what you want to know from disparate sources when you want know, and not when you don’t want to know. So there’s no sense sending the research report to a thousand people, hoping one of them will want to look. Though we did do that. There’s another thousand people who will never get it who might want to know, who’s working in this area or that area.
Tacey Ann Rosolowski, PhD:
So that’s really early, though. Mr.
Walter Pagel, ELS (D):
It is.
Tacey Ann Rosolowski, PhD:
I mean, that’s cool. (laughs) Mr.
Walter Pagel, ELS (D):
Yeah. Well, you know what, we—wouldn’t publishers do that? Wouldn’t publishers think about media in which to publish? Wouldn’t they think about the best way to get a product into the hands of who they think are their customers?
Tacey Ann Rosolowski, PhD:
Well, I’m just curious about what the conversations were. I mean, here you’re— Mr.
Walter Pagel, ELS (D):
I’m thinking that’s what they are. What are we going to do this thing? I mean, a great big old fat book that we can’t send around. It costs us this many dollars, every one of them. There are students who want to know whether they want to come here. How do they find out what we’re doing? Et cetera, et cetera. I think that way that it’s kind of evolved for everyone. That we early just means that we were a group—I think it just means that we were a group involved in publishing, and we thought about how you publish. I would say, personally, my point of view is that there have been 2 groups at this institution who think about what they’re doing, the best way to do what they’re doing, what is important to MD Anderson, and what is not important. What should you not be doing? I’m not sure this is useful at all. But I thought that Scientific Publications and the Department of Biomathematics, in the old days, had people who thought about what it was they were doing in a broader sense than just the limited question right in front of them. They thought about efficient ways of doing things. They thought about their audience and what they really wanted to know. They understood the relationship between what they were doing and what other people needed to know or needed to do, or whatever. And I thought biomath, because of the kinds of people that were in it, were bringing up that, and I thought we were bringing that because we had those kinds of people too.
Tacey Ann Rosolowski, PhD:
Who were some of the people at Biomath that were kind of leading that philosophical approach to what they did? Mr.
Walter Pagel, ELS (D):
I don’t know that it’s philosophical. I do think it was the people that they hired. And probably the way they thought about things and talked about things. So Stuart Zimmerman that was in the chair, and there’s an interview somewhere with him. Almost surely is the one who shaped that sort of thing. And I know very well a man named Howard Thames, who also thinks that way. And I could go all the way down into the lowest—they’re not low, but the most junior, or even the technicians in that department. I could tell you that they think in that way. David Gutierrez would be an obvious person, but you don’t know him and will have no reason to interview him, but he’s—well, what is he? I don’t know exactly what he is. But he’s not on the faculty. He’s a person who helps other biostatisticians and biomathematicians get their jobs done.
Tacey Ann Rosolowski, PhD:
So this kind of long-range thinking and broad-context thinking was a very important cornerstone to Scientific Publications and how you saw yourself getting your work done here? Attention to audience when it came to actually processing a manuscript at an editorial level, and then thinking about those institutional and national and even international arenas in which this material needed to be received in order to solidify the careers of individuals and raise the reputation of the institution. I mean, this was sort of— Mr.
Walter Pagel, ELS (D):
It sounds great.
Tacey Ann Rosolowski, PhD:
It does? Mr.
Walter Pagel, ELS (D):
I’m for it. (laughs)
Tacey Ann Rosolowski, PhD:
No? Mr.
Walter Pagel, ELS (D):
It’s not no, and it could be yes.
Tacey Ann Rosolowski, PhD:
It could be yes? No, but I mean, I’m just curious. I’m imagining the ‘80s—I was aware of computers in the ‘80s. I used a mainframe computer in the ‘80s. Did I know about the World Wide Web? No. I remember learning about a modem. So here, you know, I wasn’t at a place—in a career where I had to think about those issues. But here it is in the ‘80s, and you people are here doing this work, and you’re running into each other in the hall and talking about what you do and this issue of the Web comes up. And so I’m wondering, what’s the strategizing? What is the, “Huh, how can we use this creatively?” I mean, that’s just a creative thing going on in the culture. Suddenly this new accessibility is present. So I think it’s neat that you jumped on it. And I’m just wondering how did you go about doing it? I mean, what was the process of getting something ready to put on the Web? Did it cost money? Who funded it? Who had to get behind it? Mr.
Walter Pagel, ELS (D):
I don’t remember, but I know somebody who does, if you really want to know.
Tacey Ann Rosolowski, PhD:
Who is that? Mr.
Walter Pagel, ELS (D):
Melissa.
Tacey Ann Rosolowski, PhD:
Oh! Huh. Mr.
Walter Pagel, ELS (D):
So basically, I don’t think it was Melissa who had the idea, but somebody in the department had the idea. And enough other people liked the idea and recognized the idea as good, and our relationship with biomathematics was close in many ways. Melissa has close relations to some of those people; I had close relations with them. Other people on the staff knew them and worked with them. It didn’t feel like a stretch. It just felt like something that needed to be done. When somebody had the idea, it was recognized as a good one right away, as I recall. Probably don’t recall very well, but that’s what I think happened. It just happened. We didn’t sit down and say, “How can we publish this?” Somebody said, “You know what, there’s this thing now that the University of Minnesota has called the Gopher server, and you can put things on the Internet with that. And you don’t have to be at the University of Minnesota. You can do it from here.” And that’s it. Okay, let’s do it.
Tacey Ann Rosolowski, PhD:
Let’s do it. Were there other things that happened like that? Kind of not top-down, but the bottom-up kind of ideas that helped this department get material out more creatively, more efficiently? Mr.
Walter Pagel, ELS (D):
I don’t actually know. We were allowed by the financial people to have a big word processing system called the NBI. This was before the ubiquitous personal computer. And it was invented, basically, for law firms so they can retrieve information and glue it together easily. More easily than they had been doing. And it was adopted for desktop work of sorts. It had no application as far as editing went, at the time, but it did as far as communication goes. So anyway, it became clear at some point that it was time to think about personal computers for the department. I’m thinking this might be the way to what you said. And so I said, “Well, let’s put together a group, three or four editors, and ask them to determine whether we should be a Macintosh office or a PC office.” So is that an example of what you’re talking about? And they did. They said—well, after quite a bit of studying, they decided we should be a Macintosh office. And that’s pretty obvious for a publishing group in those days. But I worked at it—I don’t know why I’m saying this. I’m not sure it does address the issue you just said. I’d say the education program is a bit like that. Because it was built by everybody. There were three or four people at the top who said, “Here are the problems,” but the solutions were all invented by small groups who did the research and proposed solutions.
Tacey Ann Rosolowski, PhD:
Uh-hunh (affirmative). And all in house, as you said. It came out of our hides; it was not a special thing. Right. Mr.
Walter Pagel, ELS (D):
We did work with a consultant in adult education to be sure that we knew how to teach adults; we more or less knew. And the same consultant helped us with multicultural communication, because we felt we needed to improve our ability in those areas. And then we have sent people to what amount to presentation workshops in Dallas, by a group that does mainly stuff for sales people. Sort of increase the dynamism of the teachers. So I don’t say we did it all ourselves. There were things we didn’t know how to do. We didn’t know what was important about adult—this was the accelerated learning program at the U of H then, too.
Tacey Ann Rosolowski, PhD:
Oh, interesting. Well, the portrait I’m getting of the department is one that allows a lot of room for creativity. That people can come up with an idea, and it’s like, “Oh, okay. Huh. Yeah.” Am I wrong? Mr.
Walter Pagel, ELS (D):
I don’t think about it. (laughs)
Tacey Ann Rosolowski, PhD:
You don’t think about it? All right. (laughs) Mr.
Walter Pagel, ELS (D):
Sure.
Tacey Ann Rosolowski, PhD:
We haven’t really talked about the various publications that the department produces, and there is a whole list of them going back to—well, is there one that you’d like to tell me about before the others? Some of them were established very early. Mr.
Walter Pagel, ELS (D):
Well, I think the one that might be most interesting—it’s not in existence anymore, but one’s The Year Book of Cancer, which was basically an invention of Dr. Clark’s. I’m sure, though, he took the model from books done in other areas by Year Book Medical Publishing. People posed this model to them, this book series to them, but he proposed to run it the way he wanted it run. Instead of out of their offices it was run out of our office. And it was done for—what? Forty years or something. Many, many years.
Tacey Ann Rosolowski, PhD:
Yeah. 1956 to 1988. Mr.
Walter Pagel, ELS (D):
Well, that’s thirty-two. But anyway. It’s a collection of abstracts written by the authors of the original papers, selected by an editorial board, collection of abstracts about cancer that the editorial board felt that people needed to know. This was in the days before databases and so on. These books were, in essence, printed databases, I guess you could say. So a little bit of basic science in there. And you can see one if you’d like. But I’m very proud of the Cancer Care Series, because I did that. It would not exist except for me. And that is one accomplishment I would say is mine.
Tacey Ann Rosolowski, PhD:
I don’t even have that on my list. So tell me about the Cancer Care Series. When was that started? Mr.
Walter Pagel, ELS (D):
In 2000, basically. I started work on it in 1990. It took me ten years to get the right people interested.
Tacey Ann Rosolowski, PhD:
And what’s its purpose? Mr.
Walter Pagel, ELS (D):
Its purpose is to tell how we treat cancer at various sites. Here’s the model. This was in Advanced Patient Care at MD Anderson Hospital and Tumor Institute, which is our old name.
Tacey Ann Rosolowski, PhD:
Yeah. R. Lee Clark and Clifton Howell. Wow. It’s a heavy book. Mr.
Walter Pagel, ELS (D):
That book is from 1976, so we’re now talking, well, at least fourteen years later, and by the time the series that I’m talking about got started, it was twenty-four years later. So in the meantime, there had been nothing systematic written about what MD Anderson’s standards of care are. Everything that you know, that you could know about how MD Anderson treated cancer appeared in journal articles, which meant it was always about the latest improvements. The latest changes in care and changes in diagnosis, changes in treatment, changes in aftercare. So assembling that into some sort of holistic picture of what we do—I can’t imagine how you would do it. That book did it. But I’ll tell you, Dr. Clark was—and the era of Dr. Clark was different times. So he could stand up and say, “I want this book, and you will do it.” And they did. Some people more reluctantly than others, but in the end, this book was published in ’76. And this department edited the book. I don’t know what else they did on it, because it happened while I was gone. I’ve talked to clinic leaders, beginning in 1990, about a replacement for that book. I got a lot of encouragement, but I couldn’t find a champion anywhere. And it needed a champion in order to succeed. And how did I finally succeed? I noticed that the Anderson associates, which was what the Alumni Association was called at the time, was doing a series of medical meetings regarding standards of care at MD Anderson under Ralph Freedman, who was the chairman at the time. And I went and talked to him a little bit about it. And I said, “How could we fit this idea into what you’re doing?” And he jumped on it as something that could be a project of the Alumni Association. And I recognized, maybe before I had talked to him or maybe afterwards, that there was no way we could ever get everyone at MD Anderson to do this at once. So it had to be a series of books, and here’s one of them, One on One with Cancer. And there have been seven books in the series so far, two of them, Breast Cancer, have been first and second editions. So we heavily intervened as editors in this book series, because the book is intended for nonacademic physicians, but physicians here are often ignorant of how to write for people who aren’t academic physicians. So we have to do a lot of editorial work in order to make it work. The editors work pretty hard, too, because unlike many academic books, it is not a collection of your best friend’s chapters. It is a collection of chapters that begin in one place—that do not overlap and do not under lap, if that makes any sense. But actually is comprehensive. Well, we think comprehensively on the subject.
Tacey Ann Rosolowski, PhD:
So to whom is this distributed? Mr.
Walter Pagel, ELS (D):
Well, it’s sold by a publisher, and that is Springer. My goal was to get it to nonacademic physicians. I don’t think they do a very good job of that, for one very particular reason. I don’t think there’s an association of nonacademic physicians, so you can’t buy a mailing list. All I can do is offer it and hope they notice that it is in the offering. And it’s online and can be bought through Amazon. But I don’t know that they do a good job on marketing it to the people we think are the primary audience.
Tacey Ann Rosolowski, PhD:
What’s the issue that you have in progress now? Mr.
Walter Pagel, ELS (D):
There are three in progress now. There’s—one is at the publisher, on bone sarcoma. One we hope—much delayed, on head and neck cancer will be going to the publisher shortly. Two are in development. One on emergency medicine, emergency oncology medicine, whatever—I’m not sure exactly how to title it—and one on survivorship.
Tacey Ann Rosolowski, PhD:
Wow. Mr.
Walter Pagel, ELS (D):
Then there’s been a Lung Cancer, two Breast Cancers, a first and second edition of breast, Gynecologic Cancer, Pediatric Oncology. What am I missing? Oh. GI Oncology.
Tacey Ann Rosolowski, PhD:
OGI? Mr.
Walter Pagel, ELS (D):
No. Not OGI. Oh. O-H, comma, GI.
Tacey Ann Rosolowski, PhD:
1:42.59.0 Oh, GI! Oh, okay. (laughs) Mr.
Walter Pagel, ELS (D):
And Tumors of the Brain and Spine. So that reminds me, what you just said, of one of my favorite proofreading errors I found in a book one time. Why do they miss one? It was a table, and it was supposed to say “adenocarcinoma” in this particular place, but it said “had no carcinoma.” (both laughing)
Tacey Ann Rosolowski, PhD:
Yeah. The slip between the written and the spoken. That’s so funny. What about neuro-oncology? Or, I’m sorry, OncoLog is what I was going to ask about. Mr.
Walter Pagel, ELS (D):
That’s a newsletter. That was started in the ‘50s. Evolved over time. I guess I should be proud of that, too, because in the mid ‘90s, when MD Anderson had its economic crisis, we were losing a couple of staff. I didn’t think it was right to continue to do this newsletter without explicit support from the institution, which, again, we were basically doing out of our hide. People didn’t three or four issues a year, then another time. Sometimes it was really good, but sometimes it was nothing. And so, basically, I put together a proposal after talking to a lot of different people in marketing and among the physicians, and so on. Either pay for this twelve times a year with a real designer and an editor in charge, or let’s just kick it out. Let’s get rid of it. If we don’t want it, let’s get rid of it. Let’s not pretend that we have a physicians’ newsletter. Let’s have one or not have one. And they did fund it.
Tacey Ann Rosolowski, PhD:
And just for the record, can you tell me what the mission of this publication is, OncoLog? Mr.
Walter Pagel, ELS (D):
To tell physicians in private practice—well, it’s got two missions. It’s got an overt mission, which is to tell them what’s going on in cancer care at MD Anderson. And its covert mission is to increase referrals from physicians. Or make it easy for them to support their patients who want to refer themselves to MD Anderson.
Tacey Ann Rosolowski, PhD:
And this is in both—still, both in print form and online? Or only online now? Mr.
Walter Pagel, ELS (D):
Yes. Print and online, and also in Spanish translation online.
Tacey Ann Rosolowski, PhD:
And how is it distributed? I mean, well, I’m wondering about the online one. Do people sign up to get it, or is it at a central place? Mr.
Walter Pagel, ELS (D):
Well, it can be transmitted by email. Is that what you mean? I forgot what the delivery is called. Push-serve or something. Or it’s just online where you can come get it.
Tacey Ann Rosolowski, PhD:
I imagine you would have a thing where people could sign up to get the newsletter, and it pumps out— Mr.
Walter Pagel, ELS (D):
We do.
Tacey Ann Rosolowski, PhD:
Yeah. Right. Mr.
Walter Pagel, ELS (D):
And I don’t know how many people are on that list, to tell you the truth. Thirty thousand for the print, but it’s not because they ask to be on the list. We put them on the list.
Tacey Ann Rosolowski, PhD:
Oh, yeah. There you go. There you go. So in the ‘90s, when this got funded, what was the budget for it? And how did you—why do you think the administration decided to fund it? I think I know the answer to that, but— Mr.
Walter Pagel, ELS (D):
Because they had no other form of communication with physicians who didn’t work in academia.
Tacey Ann Rosolowski, PhD:
Yeah. Yeah. Mr.
Walter Pagel, ELS (D):
Because it was—it looked like it could be good.
Tacey Ann Rosolowski, PhD:
And that was also the whole moment when the shift, the change in legislation to allow physician referrals was taking place, too. So it was a natural marketing tool at the same time. Mr.
Walter Pagel, ELS (D):
Well, not to allow physician referral, but to allow self-referral.
Tacey Ann Rosolowski, PhD:
To allow self-referral. That’s what I meant. Yeah. Right. Mr.
Walter Pagel, ELS (D):
So, yes. A lot of patients accessed it online. We don’t send it to patients, but they access it. And I’m sure because of the level we write it at, which is for physicians in private practice, that many, many, many sophisticated patients find it to be useful. I said “I’m sure.” I should know, shouldn’t I?
Tacey Ann Rosolowski, PhD:
It seems like it’s part of your verbal style. We’re almost at four o’clock. And I do have some extra questions to ask. Can we schedule another talk? For like an hour or something like that? Mr.
Walter Pagel, ELS (D):
We can. Sure.
Tacey Ann Rosolowski, PhD:
Okay. That sounds good. So is there anything else that you’d like to add today, before I shut off the recorder? Mr.
Walter Pagel, ELS (D):
No. I’m here at your command. I’ll answer your questions. If I think of something in the meantime that I think you’ll want to know, I’ll be ready to tell you the next time around.
Tacey Ann Rosolowski, PhD:
That’d be great. Mr.
Walter Pagel, ELS (D):
But I don’t feel—the reason I never thought that I would be useful as an interviewee, is I’ve never been part of the upper structure. I don’t know amazing stories about people like Stu Zimmerman knows, or like Steve Stuyck knows. Those people.
Tacey Ann Rosolowski, PhD:
Well, I mean— Mr.
Walter Pagel, ELS (D):
I know stories about—I know secondhand stories about people, but—
Tacey Ann Rosolowski, PhD:
Well, but this isn’t—this project was never conceived only as an effort to collect amazing stories about people. I think it’s also a story about the institution as a person, and to me, this is an extremely interesting place where really important stuff happens. I mean, Scientific Publications. This is the place where stuff turns in to really solid user-friendly information that goes out to the world. And so finding out how that happens and why it happens the way it does and who are the people that work. That, to me, is really important. So to me it was not at all surprising when you popped up on my list of people to come and speak to. Mr.
Walter Pagel, ELS (D):
Well, thank you.
Tacey Ann Rosolowski, PhD:
Well, I thank you very much. Mr.
Walter Pagel, ELS (D):
Thank you, from the department.
Tacey Ann Rosolowski, PhD:
Yes. Absolutely. I thank you very much for your time today, and I look forward to talking to you again. Mr.
Walter Pagel, ELS (D):
Thanks.
Tacey Ann Rosolowski, PhD:
So I’m turning off the recorder at 4 pm. (End of Audio Session 1)
Recommended Citation
Pagel, Walter ELS and Rosolowski, Tacey A. PhD, "Chapter 06: Key In-House Publications" (2012). Interview Chapters. 1275.
https://openworks.mdanderson.org/mchv_interviewchapters/1275
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