Chapter 01: A Large Eastern European Family, a Scholarship, and A Scientist’s View of Spirituality
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Description
In this chapter, Dr. Tweardy talks about his family and early education and sketches the roots of his own spiritual beliefs.
He begins by sketching the immigrant roots of his family in the area formerly known as Slovenia in Eastern Europe. He talks about the origin of his name and the pride of place he grew up with in Pennsylvania in his large family. He also discusses being raised as a Byzantine Catholic, and his own relationship with faith, which transformed over his life into a spiritual sense connected to science.
Next, Dr. Tweardy explains how he was able to get a scholarship from U.S. Steel, where his father was employed, to transfer to South Kent High School. This gave him access to a very good secondary education.
He explains that he and his six siblings formed three subgroups, with he and his brother Jim and sister Susan being the spiritual ones in the family. He explains the influence of his mother, who had great emotional intelligence and who taught him that instances of deprivation could be seen in a spiritual light.
Identifier
TweardyDJ_01_20190122_C01
Publication Date
1-22-2019
City
Houston, Texas
Interview Session
David J. Tweardy, MD, Oral History Interview, January 22, 2019
Topics Covered
The Interview Subject's Story - Personal Background; Personal Background; Character, Values, Beliefs, Talents; Influences from People and Life Experiences; Faith
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. A. Rosolowski, PhD:
Okay, we are recording, our counter is moving, and today is January 23rd, 2019. The time is almost 25 minutes after 2:00, and I’m in the office of Dr. David J. Tweardy—am I pronouncing your name correct? Okay, cool—for our first interview session, and I want to thank you very much for making the time in your busy schedule.
David Tweardy, MD:
Oh, my pleasure, really. I’m looking forward to this.
Tacey. A. Rosolowski, PhD:
Because you came to MD Anderson in 2014, correct?
David Tweardy, MD:
That’s correct.
Tacey. A. Rosolowski, PhD:
—to head the Division of Internal Medicine.
David Tweardy, MD:
Correct.
Tacey. A. Rosolowski, PhD:
All right. And I also want to mention you’re a full professor in the Department of Infectious Diseases, Infection Control, and Employee Health. Is that the full name of it?
David Tweardy, MD:
Yes, it’s a big—
Tacey. A. Rosolowski, PhD:
It is!
David Tweardy, MD:
Longest name in the institution.
Tacey. A. Rosolowski, PhD:
Is it really?
David Tweardy, MD:
Yes.
Tacey. A. Rosolowski, PhD:
Oh my god. And that’s in the Division of Internal Medicine. And I also found you were serving as Department Chair at interim for the Department of Cardiology? Is that correct?
David Tweardy, MD:
Yes.
Tacey. A. Rosolowski, PhD:
Okay, cool.
David Tweardy, MD:
It’s my second stint as an interim Chair here.
Tacey. A. Rosolowski, PhD:
Yeah, I noticed from your record. I mean, that’ll be interesting to talk about. There’s a whole thing about serving as interim, isn’t there?
David Tweardy, MD:
Yeah.
Tacey. A. Rosolowski, PhD:
Yeah. Yeah, yeah, it’s a very neat thing. And there are a number of other things, but I’m sure we will get to that. Also, just to flesh out the identifier, this interview’s being conducted for the Making Cancer History Voices Oral History Project, run by the Historical Resources Center at the Research Medical Library at MD Anderson Cancer Center in Houston, Texas. And, well, I think we’re kind of ready to roll, if you are.
David Tweardy, MD:
I’m ready.
Tacey. A. Rosolowski, PhD:
All right, excellent. So let me just start in the traditional oral history place, which is: tell me where you were born, and when, and tell me a little about your family.
David Tweardy, MD:
Ah. Yes, I was born in February 12th, 1952 in Charleroi, Pennsylvania. It turns out—I really list Monessen, because it’s right across the river, and Charleroi had the hospital.
Tacey. A. Rosolowski, PhD:
What is the town across the river? L—?
David Tweardy, MD:
Monessen. So it’s really one of those situations, where do you list as your place of birth; do you list where you actually were born, or where your family lived? And so, because this is an oral history, I’m trying to be very exact. So I grew up—and so I was born in Charleroi, which, as somebody of French descent, it was named after the French. It was—both small towns were along the Monongahela River, in southwest Pennsylvania. The Monongahela River flows north. It’s sort of where the waters of the western edge of the Appalachians, the Alleghenies, collects and flows in to meet the Allegheny River to form the Ohio at Three Rivers, which is Pittsburgh.
Tacey. A. Rosolowski, PhD:
That sounds like something you heard a lot as a child, a narrative of the rivers. (laughs)
David Tweardy, MD:
Yes. Oh, yes! For instance, what is the—what river flows north besides the Nile? And, of course, all the third-graders would say, “The Monongahela!”
Tacey. A. Rosolowski, PhD:
There we go. I could see that on tests and quizzes and—yeah, yeah.
David Tweardy, MD:
Oh, yeah. In fact, we—just like Texas—I mean, I think Pennsylvania has a long history with pride of place. We did history of the State of Pennsylvania third grade, and that’s where you learn those kind of things, but—
Tacey. A. Rosolowski, PhD:
Yeah. I am familiar with that, being from New York State, as well.
David Tweardy, MD:
Oh, yeah. New York State thinks very highly of itself. The Commonwealths hold themselves a little bit above the rest of the states. Of course, the Republics hold themselves even higher, and that’s really Texas and California. For nine days, I think, California was its own republic. So I grew up there, I—large family. My grandparents, actually from both sides, my mother’s parents as well as my father’s parents, came from Eastern Europe, a small town in what is ethnically called Ruthenia, but is actually an area now in the Ukraine. At the time it was part of Slovakia, or Czechoslovakia, but those borders, as you know, have been somewhat fluid.
Tacey. A. Rosolowski, PhD:
Now, your name, did that get altered at Ellis Island?
David Tweardy, MD:
Actually, it’s a very good question. So the answer is no, but somewhere between Ellis—well, here’s what I’ll say: I ended up—in 2000, I guess—yeah, two years ago, two and a half years ago, we went to visit New York, my sons and I. Two of my sons were living there. And while we were there, we decided to finally, now that Ellis Island renovation has been completed, to go to Ellis Island. And so I was able to find the ship manifest, the boat that my great-great-grandfather George took when he came across from --at that time it was a German port. I’ve forgotten the—it was one of the standard German ports that people embarked to come to America from, and his name was written in the manifest as George Tvardi, T-V-A-R-D-I.
Tacey. A. Rosolowski, PhD:
So that’s the company later on.
David Tweardy, MD:
That’s correct.
Tacey. A. Rosolowski, PhD:
Oh, okay.
David Tweardy, MD:
So there’s a little connection there, and, in fact—
Tacey. A. Rosolowski, PhD:
Yeah, there is. Tvardi.
David Tweardy, MD:
—when we were thinking about what to call the company, and I told Ron DePinho’s brother, who was doing our—and still, actually, doing—all our graphics, the story. Coming from New York and knowing his own family story, he thought that was such a compelling story. And I felt proud of that, so I decided that I would go with that, and actually I’m quite pleased with the result. The logo’s quite nice, and the whole thing worked out. But that’s correct. So Tvardi, which is the original family name on my grandfather’s side, then was somehow, from the time of him boarding ship in Germany to arriving in Monessen, Pennsylvania, was morphed to Tweardy. And my guess is it was just—Tvardi is—that “tv”—
Tacey. A. Rosolowski, PhD:
Yeah, hard.
David Tweardy, MD:
—is just such an unusual combination, if you’re Scotch Irish or whatever. So I think just “tw” was a little easier—“tweak,” other words that are occasionally seen in this country with a “tw” combination—so it morphed. And the Twardi just became a “di.” There are a few people who came—I think must be some distant relatives who you’ll see spellings of T-W-O-R-D-Y, T-W-A-R-D-Y, T-W-E-R-D-Y, but that’s what happened. It morphed over the course of travel.
Tacey. A. Rosolowski, PhD:
Yeah, yeah, and that was so common with those unfamiliar names.
David Tweardy, MD:
Absolutely. That’s right. In fact, I assumed, because the story’s so often retold, is when my grandfather said his name to the official who was recording—I went up to those—if you’ve ever been to Ellis Island, there’s the second floor where everybody went up the stairs and went through all of the lines, and when he gave his name to the individual, the official who was writing the name, I suspect it was transcribed there in a way that he heard it. Anyway, so that’s—
Tacey. A. Rosolowski, PhD:
It wouldn’t be surprising at all—
David Tweardy, MD:
Yeah, exactly.
Tacey. A. Rosolowski, PhD:
—assimilating it to, yeah, more Anglo kind of—
David Tweardy, MD:
More Anglo, yeah, terminology, right.
Tacey. A. Rosolowski, PhD:
—yeah, yep, phonetics. So tell me more about your family. You said you had a large family.
David Tweardy, MD:
Yes, large family. The Ruthenians, religiously and ethnically, are Byzantine Catholics, which is a branch of the Catholic faith that’s distinct but unified with the Roman Catholics, but it’s kind of a different branch. The creation of the Byzantine Catholic Church had to do with the splitting of Europe during the ninth and tenth century. And as was the order of the day, so to speak, you looked to marry into your religion, so both my parents were the son and the daughter of Byzantine Catholic families. And they, as many families back then, my mother and my dad, we had kids, and we had a total of seven children in our family. I was the fifth of a family of seven. There were five boys and two girls. I was the fifth boy. And I always tell the story that when you’re—at your christening, all of your family and friends bring sort of gifts. And I can tell you that the gift number dwindled by the time I was born, (laughter) not that I knew this, but my mother told me. Then, of course, my sister was born, and it went back up—
Tacey. A. Rosolowski, PhD:
Oh, that’s so funny.
David Tweardy, MD:
—because—and they were all very kind of—
Tacey. A. Rosolowski, PhD:
Boys were old news. (laughter)
David Tweardy, MD:
Boys were old news. I mean, come on. Just give us a daughter, or a niece or whatever. But—
Tacey. A. Rosolowski, PhD:
Now, so you were raised in the faith.
David Tweardy, MD:
Yes, I was raised in the faith. In fact, I was an altar boy. I tell the story that I said the high mass. The high mass, if you know anything about the Catholic Church back 50 or 60 years ago, each of the Roman and the Byzantine had a high mass, which is usually the middle of the Sunday day, usually ten o’clock, so that the older people could come, because they’re the ones that really would appreciate the high mass. Then the Roman Catholic Church, it was an exchange between the priests and the parishioners in Latin, and in the Byzantine Catholic Church it was Old Slavonic, which was what the Bible was translated into when Cyril and Methodius tried to convert that part of Europe. And so (laughs) the Old Slavonic language is not spoken; it’s kind of like Latin. It’s like the Latin equivalent for Western Europe countries, because nobody—people stopped speaking it, but they kind of remembered it. Old Slavonic was that way, too --and so I went and I served at the altar for so many high masses that I could sing—it was a sung mass, too—I could sing the entire mass, only knowing maybe four words. (laughs) But it was really quite beautiful. So I was an active altar boy in the church.
Tacey. A. Rosolowski, PhD:
Is faith still important to you?
David Tweardy, MD:
That’s a very good question, and what I tell people now is I lost the gift of faith, and I do believe it’s a gift. And perhaps I’ve just transplanted, if you will, that faith into science. That’s kind of what I, in retrospect, like to think.
Tacey. A. Rosolowski, PhD:
Is there kind of a spiritual sense connected with science?
David Tweardy, MD:
Absolutely. I think that the— In fact, the way I now would express that is after I grew up in Western Pennsylvania, of course, with seven kids we all had jobs, and my first paying job was, as a third-grader, eight years old, the paper route was handed down to me, my brother and myself. My brother was just older than me. And so for the next—from third to tenth grade I was a paperboy. And what happened was in the enlightenment—I think there was an enlightenment that went on in this country with the Civil Rights era, women’s movement—
Tacey. A. Rosolowski, PhD:
The ’60s, yeah, ’70s, yeah.
David Tweardy, MD:
—and the ’60s. And one of the enlightenments that happened is, actually, to refer to the Fall River story, is there was a—many of the paper mills in the country, and clearly the one that supplied the print, the paper from the paper I took, newspaper I took, were in Maine: the Great Northern Paper Company was located in Maine. I think --for sure-- I think it was the motto for John Irving’s most recent book. Any event, the owner of that mill decided to open a scholarship program to prep schools in New England, about five—actually started with one and it expanded to about six, that the news carriers for those organizations that used his paper would be eligible for. And so I applied, and the year that I was eligible—I was in ninth grade—or, no, tenth grade—so for my eleventh and twelfth grade I actually won a scholarship to a small school in Western Connecticut called South Kent.
Tacey. A. Rosolowski, PhD:
Wow. Now, this was high school?
David Tweardy, MD:
This is high school. And getting back now to the long, long arc, perhaps, to a story—to the answer to your question, am I still spiritual—
Tacey. A. Rosolowski, PhD:
I trusted you. (laughs)
David Tweardy, MD:
Yes, that’s right. This is, you said, nine hours. (laughter) Plenty of time. So as I transferred my faith, if you will, from religion, Catholicism, to science, I think I was able to realize that maybe in clearly—because I was asked to come back to South Kent and give a presentation. They were having—it was probably about 20 years ago. They had a really, really good science program, and they wanted people to come back and talk about things that were scientifically-oriented, and wanted to— I think they thought—they knew I was active in science. So I gave a talk that I really wrapped around a patient that we saw, because you’re trying to appeal to—this was an all-boys school. So you’re trying to appeal to the tastes of teenage kids. So I brought, actually, a jar that had in it a tapeworm, a fish tapeworm. And actually, the fish tapeworm was from the patient my wife had seen in the emergency room in Pittsburgh. And so it was a great show-and-tell. But I wrote an article for that, and it was around what was the appeal to science. And to get back to the faith issue, I titled it “Knowing God’s Secrets.” And that is the thing that still, frankly, has throughout my career—there’s nothing quite in the experiences I have across my administrative, clinical research experiences in everyday life that affects me more and gives me more joy than learning something new for the first time that’s never been learned before. And the way I best expressed that was, these are God’s secrets. There’s only one entity that knows these, and then you discover it, and now you know. You’re in on the secret. And so I think I still maintain a faith-based aspect to what I do, yeah.
Tacey. A. Rosolowski, PhD:
Absolutely. And that’s not uncommon, actually, among scientists to feel that way. And I wanted to say, something I didn’t mention before we turned on the recorder, which is if you’d like to provide me with a copy of that or anything else to append to your interview, feel free.
David Tweardy, MD:
I wonder if I still—yeah, I think I—actually, I think I did save—it’s probably on my home computer, because this was when I was at Baylor—sort of a little file folder that I have, the article and all that. Yeah, I’d be happy to send it.
Tacey. A. Rosolowski, PhD:
Yeah, I mean, if you feel that would be an enhancement.
David Tweardy, MD:
I think it’s—I think that’s—the feeling that I expressed at that moment, I think, has stayed with me, and I think it still rings true, so I think that [would be good?].
Tacey. A. Rosolowski, PhD:
Yeah, I think that’s wonderful. I think that’s wonderful. I mean, I think it’s really—those are important things, I think, because there’s a common assumption that people of science have no sense of spirituality at all, and that’s very wrong.
David Tweardy, MD:
Oh, that’s—yeah. I mean, certainly, you’re right. If you look at a—point that to an example of somebody who does not fall into that (inaudible), I mean, it is—in fact, it’s really interesting. And I’ll just do a little sidebar, if you will, on families, large families. I’ve become, I think, a self-proclaimed expert on large families, coming from one. I think what you learn is that families are actually consisting of multiple families; that is, the siblings. They break out into groups. And the really interesting thing is my family of seven, my siblings, a family of seven, broke out into three groups. There was the first three, my oldest three brothers, John, Bill, and Tom; then it was the next three, which was Jim, myself, and my sister Susan; and then there was my sister Lynn, who was born eight years later, and you know the story there. I mean, it often does happen. But those were three separate families, almost. The reason I bring it up is that the three of us—my brother Jim, myself, and my sister Susan—we were probably—we were clearly the spiritual ones. In fact, two of them became ministers, one a Presbyterian and the other most recently was ordained an Episcopalian minister.
Tacey. A. Rosolowski, PhD:
Wow.
David Tweardy, MD:
Yeah.
Tacey. A. Rosolowski, PhD:
Now, that’s very interesting.
David Tweardy, MD:
Yeah, and I didn’t go with religion, but I went clearly into the science—
Tacey. A. Rosolowski, PhD:
Now, was—
David Tweardy, MD:
—with the same kind of, I think, religiosity, maybe, if that’s a—
Tacey. A. Rosolowski, PhD:
Now, was there something about the way you guys bonded, think—
David Tweardy, MD:
Yeah.
Tacey. A. Rosolowski, PhD:
Tell me a bit about that, I mean, that little cohort.
David Tweardy, MD:
Yeah, that’s a really good question. It’s one I’ve kind of been pondering for a while. And so I think one of the things that—my dad and my mom, they loved each other, and they were just, I think, one of the most effective dyads in terms of team leaders that I’ve seen.
Tacey. A. Rosolowski, PhD:
Their names? Your dad’s?
David Tweardy, MD:
Yeah, John and Helen.
Tacey. A. Rosolowski, PhD:
And your mom’s maiden name?
David Tweardy, MD:
Kotch, K-O-T-C-H. And if you wanted to know the way her name was, it was Tkatch, and, of course, as you know—
Tacey. A. Rosolowski, PhD:
It got modified.
David Tweardy, MD:
—that T-K-A-T-C-H, oh, that’s impossible, so they just got rid of the T and made it Kotch. And so they were very hardworking, and my dad was fortunate to—he was an electrician in the steel mills, and he was—and this was the early works of U.S. Steel. And because of the fact that that was a leading steel producer, and the unionization movement was taking place, my dad was able to be paid a reasonable salary for what he did. And, consequently, we were all able to have food on the table, clothes, and we never felt like we were poor, except for one year, when the U.S. Steel strike of 1967, I think. That was—I didn’t remember sensing things were—my mother was a little tense, (laughs) but other than that… But to my theory of why the three of us --nevertheless, even with what I think was a reasonably happy childhood, with all the things I could have wanted, or pretty much, I think that my oldest three brothers, they probably developed higher expectations because of my dad being successful, and resources were a little more abundant when they were young. And, of course, then we came along, (laughs) and things changed. So, interestingly enough, they’re more materialistic. They look at life more from the kind of capitalistic type of— I mean, the oldest owned his own—essentially was a metallurgic engineer, bought a couple companies with a classmate of his, and became a semi-captain of industry, okay. That’s the second. The oldest, I should say, became a financial planner. He went into education, computer education, and then, I think, moved into financial planning. The second was the captain of industry. Now, Tom was already on the transition, so it’s maybe not fair to break him off, because he went into education, stayed in education, I think just retired about two years ago. But he was kind of a tweener, in some respect, because Jim, myself, and Susan, we really had got completely—we went really a different direction. I think we were just more spiritual. And the—I mean, it’s—and, again, it’s probably overemphasizing differences, because there’s so much similarities. But if you try to answer the question why did, out of these three, were there two ministers and one scientist—
Tacey. A. Rosolowski, PhD:
Yeah, that’s evidence. (laughs)
David Tweardy, MD:
—yeah, how do you explain it? And it’s just—and because we moved—our emphasis moved from material more to the less material, the more spiritual. I think that’s the best explanation I can come up with for that. But it is an interesting one, and—yeah.
Tacey. A. Rosolowski, PhD:
It is. Well, and it’s kind of setting value systems really early, and—
David Tweardy, MD:
That’s correct.
Tacey. A. Rosolowski, PhD:
—not that yours is better than your older brothers’ or your youngest sister, but a different emphasis—
David Tweardy, MD:
Yes.
Tacey. A. Rosolowski, PhD:
—a different focus, and a different way of constructing identity, and those things are all important.
David Tweardy, MD:
Yeah, and I think my mother was instrumental in that.
Tacey. A. Rosolowski, PhD:
How so?
David Tweardy, MD:
Because I think my mother had this amazing—I mean, my mother was, I think, the most emotionally intelligent person I ever met. I mean, she was able to do something which I think is a real feat: she was able to have seven children and have everybody think that they were her favorite.
Tacey. A. Rosolowski, PhD:
Wow. (laughs)
David Tweardy, MD:
I mean—yeah, I mean, you can imagine that. How hard is that?
Tacey. A. Rosolowski, PhD:
Yeah, seriously.
David Tweardy, MD:
And I really do—I mean, it would be interesting to get all my brothers and sisters here, but she did that. I think—because there was never any sense that we were less esteemed in the eyes of my mother. My dad was more the disciplinarian, and your esteem is a function of whether you were behaving or misbehaving, but my mother just was kind of a constant in that regard. And because she had an ability to make anything that was maybe—for instance, we weren’t able to have everything we wanted, in a way, but she made it work. She made it work, and she made it not feel like we were really in any great want. And part of it was that—this is, frankly, my respect for the Catholic Church: in times that are clearly tumultuous for that organization, but the Church is—you can see how it’s structured to reinforce spirituality over the corporal, because, frankly, it’s supporting individuals who don’t have as much as they would like to have, and it, in turn, makes that a virtue. And I think my mother was incredibly good at doing that. Perhaps because we were—the three of us—Jim, myself, and Susan—were more maybe experiencing that a little more, we received that in our thinking around anything. The downside, we tended to look at the spiritual reinforcement of some deprivation, rather than the actual physical aspects of the deprivation. So I think she was really a masterful person in those two ways: able to spin things in a way that was very positive and spiritual, through a spiritual sort of sense, and then the other is the just emotionally able to have all of us feel that we were really very important to her.
Tacey. A. Rosolowski, PhD:
Is there anything else you learned from your mom, just watching her operate?
David Tweardy, MD:
Oh, I learned to cook from my mother. (laughter) Really, I love to cook, and I—as the fifth boy, all the outdoor jobs got taken. (laughter)
Tacey. A. Rosolowski, PhD:
Right, there we go.
David Tweardy, MD:
So I needed to help out, and, of course, the jobs that were available were more the indoor jobs, and so I was doing the dishes, I was doing—and I watched my mom cook. I—
Tacey. A. Rosolowski, PhD:
That sort of gender stuff going on, I mean, did that have an impact on you?
David Tweardy, MD:
Well, it’s funny. It’s really interesting. I think you’re right: it is gendered. But—
Tacey. A. Rosolowski, PhD:
Well, I don’t want to put words in your mouth, but I was like, wow, that’s kind of amazing.
David Tweardy, MD:
No—yeah, but I think there is a biological basis for some of these things, as you know. I mean, if you’re older—I mean, it could be a girl or a boy, woman or man, but if you’re older you’re just going to be a little physically stronger. You’re going to be able to handle some of the physically more demanding things. And so I think it wasn’t gender; I think it was just age. When we --notice that I said I was the fifth. I said I was the fifth boy, but I was also the fifth child. And frankly, maybe, it would have made a difference if several of my older brothers were girls. I might not have had as much of an opportunity—I might have been kicked out to do the outdoor jobs. But, bottom line, the circumstances were such that I had the opportunity to—I mean, I helped my dad a lot, too. So both of them taught me a great deal. I learned to cook, and just sort of shortcuts. My mother was an incredible efficiency expert. She had to be, I think. But cooking and baking were her just amazing skills, and so I learned that from her, and, just like I say, efficiencies on how to do those things, yeah.
Tacey. A. Rosolowski, PhD:
Yeah. Well, it’s always interesting to see families as a kind of pressure cooker for these things, because I’m already looking ahead to roles that you take on later, and there’s a service motive, and there’s being an administrator, thinking about how to run operations, and all those things. And you get thrown into these situations when you’re a kid, and looking at problems from a particular perspective seem to come second nature.
David Tweardy, MD:
Well, I actually couldn’t agree more. I mean, there’s that old line from 30 years back, everything important I learned in kindergarten. (laughter) I’m a strong proponent of the fact pretty much everything you learn about interpersonal relationships and how to work with people, you don’t have to stop learning them as you grow up and in your family, but you learn a whole lot. I think that has helped me immensely in terms of how I deal with pa—individuals. And, frankly, I slipped “patients,” in there, but it’s the same thing. I mean, your interpersonal relationships are so influenced by how your interpersonal relationships were when you were growing up, and so—but I, again, I was very fortunate in my parents. They were really very supportive, and made all the difference to us.
Recommended Citation
Tweardy, David J. MD and Rosolowski, Tacey A. PhD, "Chapter 01: A Large Eastern European Family, a Scholarship, and A Scientist’s View of Spirituality" (2019). Interview Chapters. 1383.
https://openworks.mdanderson.org/mchv_interviewchapters/1383
Conditions Governing Access
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