Chapter 04: An Evolving Field; Dealing with Patients; Leadership Advice
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Description
In this chapter, Dr. Leeds recalls finding out about an opening for a neuroradiologist at MD Anderson and explains the process he went through to decide to take the position. As his wife, Betty, preferred not to leave New York City, they set up a long-distance marriage.
Next, Dr. Leeds also notes that he wanted to give up chairmanship of neuroradiology at Beth Israel Medical Center and believed that focusing on brain tumor radiology offered a good opportunity for him. He notes that he came to MD Anderson as Head of the Section of Neuroradiology.
Identifier
LeedsNE_01_20170530_C04
Publication Date
5-30-2017
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - Overview; Overview; The History of Health Care, Patient Care; Mentoring; On Mentoring; Definitions, Explanations, Translations; Professional Values, Ethics, Purpose; Career and Accomplishments; Offering Care, Compassion, Help; Patients; Patients, Treatment, Survivors; Leadership; On Leadership
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
T.A. Rosolowski, Ph.D.:
I was curious when you said that the surgeons were going ahead and injecting the air themselves. Is that what you...? Am I interpreting that correctly?
Norman Leeds, MD:
When I got there, they did all these things. T.A. Rosolowski, Ph.D. So, I mean, was that—
Norman Leeds, MD:
[ ] Ma’am, you have to understand, we had to fight a battle. They didn’t want to give [up procedures to the neuroradiologist]. T.A. Rosolowski, Ph.D. That’s what I was getting to.
Norman Leeds, MD:
Well, I—when I started doing angiograms at Columbia, one, they got paid for it. You know, money is also—you know, if you get money, you like things, right? They didn’t want to give me those, but a couple of them were very helpful and said, “No, no, no, we need the neuroradiologist.” So I was the fellow. And I pointed out to them, “You don’t have to be here and hang around. I do—I know what I’m doing it for, and I’ll answer your question.” T.A. Rosolowski, Ph.D. So that was—that was what I was trying to get to. You know, this being a new field, it was kind of like you had to assert what is my territory, what is my value here.
Norman Leeds, MD:
I had—exactly. Well, I made that—when I went to Montefiore, when I came to Montefiore to run the program, I did the same thing in Los Angeles. I did the studies. I took over all the studies from them. But when I got to Montefiore—you know, at Los Angeles County they weren’t getting paid, so (laughs) no one objected to my doing angiograms. Do you follow what I mean? T.A. Rosolowski, Ph.D. Mm-hmm, absolutely.
Norman Leeds, MD:
They didn’t object. When I got to—when I went to, let’s say, Philadelphia, there was not a problem. At the graduate hospital they were happy to have me do the studies. They didn’t have to be there. The chair of Neurosurgery at the University of Pennsylvania was the chair, and he was happy that I did them and explained it to him. T.A. Rosolowski, Ph.D. How long did it take in the field before people accepted—
Norman Leeds, MD:
It took a while. It was not... They didn’t want to give it up, because it’s money in the bank. T.A. Rosolowski, Ph.D. So it wasn’t purely an intellectual issue, “I don’t know quite—we know just as much as you do.” It was a financial issue throughout.
Norman Leeds, MD:
When we started, it was a financial issue. The surgeons wanted to do it. They didn’t want us to do it, not because they didn’t... Well, they did think they were better. They believed that. But one of them, who was the best neurosurgeon around, said, “Let Leeds do it.” So it took me... I missed my first five angiograms [and then I succeeded]. T.A. Rosolowski, Ph.D. Oh, really?
Norman Leeds, MD:
I didn’t stick the [carotid artery]. You know, it took a while, and then I did it. Then I was very good. But, you know, again, I remember doing a baby, a little baby, at Children’s, and I spent the morning. And I had a rule: three tries and you’re out. I did not stick people incessantly. So I did three tries. If did not get in., I said to them, “Not a problem.” I didn’t realize... I said, “We’ll do it tomorrow.” So they brought the child back tomorrow, and it went in in one stick. Why you don’t get in? I have to tell you—you don’t know. Either you’re not ready, the patient’s... Whatever it is... You know, that’s why I believe in the three stick. I never went over three sticks. If I did three sticks in a carotid and didn’t get in, I stopped. I explained to the patient. If there were plenty of people to do it, I would tell the patient, you know, “Someone else is going to try.” “Why did you?” “Because I’m very good at it, but I can’t—I wouldn’t write you a guarantee that I’m going to hit the artery.” I mean, I’m going to hit it before anybody else now, but I can’t tell when I’m going to miss. Like that one I missed on the three sticks came—little baby—came back the next day and I went right in. So, you know, is there a reason? No. I don’t know what it is, but it happens to you. And once you know that, I don’t feel guilty. I don’t want to punish the patient. If I can’t get in in three, I’m not sticking anymore, because I’m not happy, and I’m not comfortable, and I shouldn’t stick anymore. So I stopped. T.A. Rosolowski, Ph.D. Interesting, interesting. So you have no kind of suspicion about what’s different from one day to the next.
Norman Leeds, MD:
I don’t. I do everything the... No, ma’am. I follow the same... It’s like reading them: I don’t make many mistakes, but I’m sure I made some. But I’m as good as anybody, and better than most. So I have a great deal of confidence in myself now. But no, missing is not—you know, I have done [over ten thousand angiograms]. T.A. Rosolowski, Ph.D. Yeah, I mean, it’s a biological system. (laughs)
Norman Leeds, MD:
Well, no, I learned a lesson. My wife had the baby. The worst thing was the resident’s IV. When I saw my wife’s arm with all these black and blue, I said, “Sweetheart, how did you let them do that?” I was really angry at her. It was a female resident, and I think she was just trying to prove she could... There’s a time to stop. I said, “After...” I said, “You do not allow them to make more than three sticks. And it doesn’t—it’s not—and you can tell them it’s your husband’s rule, and he’s a... You can blame me, dear.” I was really angry. I didn’t say anything, but I was angry. I mean, doctors should know that. If you can’t get in, it’s not because you’re bad; it’s just not your day that day, whatever it is. Either you’re thinking about an argument you had with your wife, or you’re thinking about a party or you... You know, whatever the distract—there’s always a distract... You know, we’re normal human beings. Things happen, and you have to understand none of us—and I know more than most—are perfect. And I’m as good as it gets, but you’ve got to know when to stop. It’s like when somebody makes a mistake, you have to be careful what you say to them to—you know, in training them, because it can have a terrible impact [on the trainee]. [ ] T.A. Rosolowski, Ph.D. Tell me about that. Yeah, tell me more about that.
Norman Leeds, MD:
Well, you know, if you start hollering or complaining, or... You’re badgering someone. I mean, people don’t like making mistakes, particularly people below you, and so you have to be very cautious in how you train them, because most people feel badly when they can’t [perform]. That’s the other thing that I think makes you miss, because you become more [anxious]. You know, it’s normal: you get more anxious. If you get more anxious, you’re not quite as good. And I think, well, you know, it took me a while. I’m not a child, and I know I’ve learned, and I continue to learn. Do I make mistakes? Absolutely, but I try to correct them. I don’t try to keep—do the same things. I do try to correct my errors. And I think when someone does something, it may be better to talk to them later. [ ] T.A. Rosolowski, Ph.D. When they have a little distance on it.
Norman Leeds, MD:
Yeah, give everybody a chance to cool down, because, you know, it’s all psychological. And you’re angry because [you] missed. They’re—they have anxiety, and that’s why they did these things. And some are just stupid. [ ] But the way to correct it is if you are overzealous in correction, it’s worse. So I try to correct things later, OK, without, [upsetting the person you’re training]. Because everybody’s unhappy when they make mistakes. All of us. I’m unhappy, and they’re unhappy. And I think—that’s why I said three sticks, because I find after that, you know, you’re so anxious, because you don’t want to fail, that I... That’s why I learned bring them back the next day. It’s not fair to the patient. T.A. Rosolowski, Ph.D. Sounds like a good rule, yeah, yeah.
Recommended Citation
Leeds, Norman MD and Rosolowski, Tacey A. PhD, "Chapter 04: An Evolving Field; Dealing with Patients; Leadership Advice" (2017). Interview Chapters. 1304.
https://openworks.mdanderson.org/mchv_interviewchapters/1304
Conditions Governing Access
Open
