Chapter 03: From Burn Surgery to Cancer Surgery
Files
Loading...
Description
In this Chapter, Dr. Pollock narrates his shift in focus from burn patients and plastic surgery to cancer surgery. He begins, however, by underscoring that the connections he made with patients reinforced his belief that he had made the right decision in going to medical school. (He tells a funny and touching anecdote about treating the mother of boxer Leon Spinks.) During his residency at the University of Chicago, he did not care for the competitive atmosphere of the program.
[The recorder is paused.]
Dr. Pollock also describes being called to treat two badly burned little girls, a case that taught him he would not be able to endure a specialty where he had to treat burned children without sacrificing a part of himself. He transferred to Rush-Presbyterian-St. Luke’s Medical Center in Chicago, where some surgeons were interested in surgical oncology. He began to see that surgical oncology was about working with other specialties and establishing connections with patients.
Identifier
PollokRE_01_20121008-C03
Publication Date
10-8-2012
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Raphael Pollock, MD, Oral History Interview, October 08, 2012
Topics Covered
The University of Texas MD Anderson Cancer Center - Educational Path Character, Values, Beliefs, Talents Personal Background Professional Path Inspirations to Practice Science/Medicine Influences from People and Life Experiences Evolution of Career Professional Practice The Professional at Work Formative Experiences Patients Human Stories Offering Care, Compassion, Help
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:
So this was your third-year rotation. Tell me about what happened after that in your education.
Raphael Pollock, MD:
Well, on the basis of that experience, I took as many rotations as I could that year at the St Louis City Hospital. I had almost all of my junior year was spent there on the different services, and it was phenomenal. When I was on OB, I got to deliver fifty babies. When I was on internal medicine, I had the opportunity to acquire the full gamut of skills. I did chest tube insertions, liver biopsy, central line placements. Things that most junior students get to observe I got to do. Again, it was these really interesting sort of patient contacts that triggered a sense that I was tracking in the right direction, that I was finding my true calling in life, if you will—without sounding smarmy—and it really validated my decision not to pursue a profession as a historian. I could see that I was really—this was very much in my face. Another funny story—this was again 1975. There was a very famous boxer in St. Louis, a man named Leon Spinks, who that year won the St. Louis Golden Gloves Championship, and that led to 1976; he was the gold medal heavyweight boxing champ for the US Olympic team. Well, one night they brought Mrs. Spinks in. They lived in a housing project right across the street from St Louis City Hospital. They brought her into the emergency room. She was a very bad diabetic. She was blind, and she’d already had 2 above-knee amputations. She had a condition called diabetic ketoacidosis, meaning that her diabetes was out of control. Her blood sugars were dangerously elevated. We had to re-regulate her insulin. Well, that all sounds well and good. She came up the floor. It was just a rotational basis. It was my rotation—or I was in the rotation. She became my patient. What we first had to do is a test called a glucose tolerance test, which consists of giving a patient a sugar load and then every hour for six hours taking a blood sample to see what the sugar is and titrating the insulin does accordingly. Well, unfortunately Mrs. Spinks had no peripheral bloods vessels. The only blood vessels that she had were her femoral arteries in her groin. So we started the glucose tolerance test, and I did a needle aspiration of her femoral groin, which is not a pleasant experience for patients. There is pain associated with that. And she being blind, I told her this was going to hurt, but she didn’t know where I was, what I was doing. I tried to explain it as best I could. When I actually inserted the needle through her skin, she screamed in mortal agony, and it was all I could do to get that sample and get that needle out of her as quickly as possible. The next stick was at 5:00. I came back and did that. At 6:00 I came back and her twelve sons were all there, including Leon. And Leon’s arms were bigger than my legs. I mean, he could have picked me up and thrown me out the window. I came in and I just said, “Fellas, I’m going to need to work with your mom for a second.” I pulled the drapes, and I leaned over and said, “Mrs. Spinks, your sons are out there. If you scream the way you did the last two hours, they’re going to throw me out the window, and if they throw me out the window there’s not going to be anyone to take care of you, so I really hope that you won’t scream, because I have to stick the needle in again.” And she just smiled up at me with her—blind, but she smiled. She was quiet as a church mouse, and everything worked out just fine. But it was those human contacts that spoke to my inner self that became— I just knew, can I have something in my life that will enable me to continue to have this opportunity to directly connect with people across all racial and ethnic boundaries and barriers that might exist? I can just help them. And that was just a very, very powerful motivation and remains, I think, at the core of who I am and what I want to do.
Tacey Ann Rosolowski, PhD:
How did that evolve when you went on to become—your internships and residencies? What were those decisions like?
Raphael Pollock, MD:
I started my residency at the University of Chicago, which had, at the time, the very best burn surgery program in the city of Chicago. I found, as I was going through my residency, that there were some things that I didn’t appreciate. It was a very contentious and competitive environment, first of all. It was what’s called a pyramid program. These no longer exist, but they admitted— They had sixteen interns, and they graduated four chief residents, so every year they fired people. It made for an extremely competitive situation. So there was that aspect. And at the time, their surgical volumes were actually pretty weak, so I was concerned about how well I was being trained in a practical sense as a resident. During the residency—actually, turn the recorder off.
Tacey Ann Rosolowski, PhD:
Certainly.
Tacey Ann Rosolowski, PhD:
All right. We’re recording again. I’m just going to note the time is 10:47. We’ve had the recorder off for a few moments. So you were going to go back and give me another dimension.
Raphael Pollock, MD:
Part of what happened is that I had the opportunity as a second-year resident to actually run the burn unit for a four-month period of time. Among many formative experiences that that led to—one thing that did happen that was really determining for me—this was like from September through December. So about two weeks before Christmas that year, Tuesday or Wednesday morning, the squawk box that was connected to the fire department said, “We’re bringing in some burnt children.” And it was two little twin girls. It was just a classic burn story. They had rayon nightgowns. They lived in a trailer. The nightgowns got caught in the space heater, and pretty much their entire front of their bodies were destroyed by the fire. I recognized that if I were to go forward in burn surgery that I would have a steady responsibility of taking care of burnt children and that I really didn’t have the emotions to deal with that. I thought it would be too erosive of me and my personhood. It was too distressing, too life determining for people who had that happen to them for me to be able to see how I can help put things back together again. I didn’t think I was able to do that. And that was about the time that I transferred to Rush from the University of Chicago. Rush was not a strong burn program, but it was a very strong general surgery and surgical oncology program.
Tacey Ann Rosolowski, PhD:
So this is Rush—?
Raphael Pollock, MD:
Rush-Presbyterian-St. Luke’s Medical Center. I began my time at Rush really not knowing exactly where I was going to go with my career. I thought, well, I will finish my training as a general surgeon and then find a medical school or a VA hospital or a city hospital somewhere that wants someone who can perform general surgery effectively and go do that for a period of time and hopefully coalesce clinical skills and probably go into private practice somewhere. That seemed like the logical pathway. But there were several people at Rush Medical College who were very interested in surgical oncology, although this was before the time when there were many training opportunities in surgical oncology. The man who had been chief of surgery there was a fellow named Ted Beattie, who had left two years before I arrived to become chief of surgery at Sloan-Kettering. There were strong connectivities on that level, and it also had the reputation in Chicago as being perhaps, at that time, the strongest cancer surgery environment. There was very good medical oncology, very good radiation oncology. It was a major focus of what was done. The man who ran the cancer tumor board was also the chairman of the surgery department who was actually a forerunner head and neck surgeon. His name was Harry Southwick, and he had been the person who had offered me the residency slot. He saw that I was interested in cancer, so he started taking me with to the tumor board meetings. I’d never thought about cancer as something for myself as an outlet, but through this initial exposure I got to see how in cancer it wasn’t just surgery; it was surgery working with the other modalities. It also spoke to me because I could see that you’d have to develop a long-term relationship with a patient, so that part of me that wanted give of myself, that wanted to use my personality, my positive energy as part of the therapeutic process, it seemed like it would be a good fit. I got more and more interested—less and less interested in burns and more and more interested in that. And it also answered the dilemma of what I’m going to actually do, because, having made that decision that would ultimately lead to doing a fellowship in surgical oncology, which in that time meant either going to Sloan-Kettering or potentially going to MD Anderson. So what happened is that Rush had traditionally sent one resident a year to Sloan-Kettering. They hadn’t sent anyone to MD Anderson. But I applied to both institutions. MD Anderson accepted me for fellowship here. Part of the reason that I was accepted was that there was a sarcoma—well, a general surgical oncologist here at the time named Marvin Romsdahl, who was very close to Dr. Southwick. They had all trained at the University of Illinois, which was also part of the Westside Medical Center. Rush-Presbyterian-St. Luke’s had been one of the Illinois teaching hospitals before Rush Medical College had been created, so there were these antecedent relationships. So I was accepted, and I liked the Anderson fellowship better than the Memorial fellowship because the Anderson fellowship included rotations in medical oncology, radiation oncology, endoscopy, as well as the possibility of some time in the research lab. Whereas the Sloan-Kettering fellowship, at that time, was twenty-four straight months of surgery, including surgery on services which while useful in a surgical education perspective, such as gyn onc, urology, and thoracic surgery, were probably not going to be very useful given that those were separate specialized areas in their own right. And I thought that it would be much more important to have a broader exposure.
Tacey Ann Rosolowski, PhD:
So you came to start your fellowship in 1982.
Recommended Citation
Pollock, Raphael E. MD and Rosolowski, Tacey A. PhD, "Chapter 03: From Burn Surgery to Cancer Surgery" (2012). Interview Chapters. 1315.
https://openworks.mdanderson.org/mchv_interviewchapters/1315
Conditions Governing Access
Open
