Chapter 15: The MD Anderson Children’s Cancer Hospital; Creating a Successful Training Program
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Description
Dr. Kleinerman begins this chapter by discussing her working relationship with Dr. John Mendelsohn, MD [Oral History Interview], who supported her efforts to develop pediatric care. She notes that Dr. Mendelsohn formed an Advance Team composed of Board of Visitors members to advise Dr. Kleinerman on strategy to develop Pediatrics. Their main advice: “You need a separate name,” and in 2005 Pediatrics received their designation of the Children’s Cancer Hospital. She describes initiatives arising from this.
Next, Dr. Kleinerman explains that at the same time, she was building the faculty. She acknowledges that faculty were leaving because of conflict with her new focus on innovative research and research productivity. She notes that she recruited about 75% of the current faculty and describes the active networking required to identify good candidates.
Dr. Kleinerman next sketches her vision for the future of the Division then talks in more detail about the successful Fellowship program that she initiated twelve years ago.
Identifier
KleinermanES_03_20140604_C15
Publication Date
6-4-2014
City
Houston, Texas
Interview Session
Eugenie Kleinerman, MD, Oral History Interview, June 04, 2014
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the InstitutionThe Leader Beyond the Institution Leadership Collaborations Critical Perspectives on MD Anderson Education
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:
I wanted to ask you about some admin issues, because you mentioned a little earlier that it was kind of difficult getting executive leadership to understand that Pediatrics had really special needs. Now, when you took over, obviously the search for the new division head started in 1999, and that was just three years after John Mendelsohn came in. So what was that? That was a new environment, administrative environment that was part of—in which the division shift took shape. So tell me about that. Tell me about communicating with executive leadership at that phase and also, I mean, how developing Pediatrics also fit in with the plans to greatly enlarge the institution.
Eugenie Kleinerman, MD:
So, yes. So, John, when he first came in, he did meet with all the divisions, and he came with a yellow pad and a pen, and he really listened. He didn’t do a lot of talking. He listened. What are the issues? So I said to the faculty, “You need to—.” You know, I brought them all together, and he sat there with a pen, and he did have a very—I felt very comfortable about telling him—now, my husband also was, I think—yes, he was vice president for research administration, so he also had a relationship with John, so that socially there were opportunities for me to have one-on-ones with John. And John would listen and, of course, he came from Memorial Sloan Kettering that had a very strong pediatric program, and I think he understood the issues of critical care. He was the one who let me develop critical care. He understood that, and so he was very supportive and listened, but I think the real—and I told him—I mean, he allowed me to have a cocktail party in his house and invite all of the local pediatricians. I said, “You know, John, they don’t know that pediatrics exists at MD Anderson. I’ve got to get out with the private pediatricians. Do you know a way?” And I don’t know whose idea it was, I don’t even remember, but I said, “If we send an invitation out from you to have a cocktail party in your house, the pediatricians are going to come.” And he said, “Okay.” So we hosted a cocktail party in his house, and we had a lot of pediatricians, and he stood by. He let me take the show, but he stood there and clearly demonstrated his support. And the response was, “Gee, we didn’t know you had all this at MD Anderson.” So I think that really validated what I was telling him. The other thing is that he allowed me to—okay. So the first thing, we have our Board of Visitors. He formed the advance team, which was younger people in the community that probably were going to be future members of the Board of Visitors, and these were people with children. So he and the Development Office said, “Why won’t we assign the advance team to work with Genie on developing pediatrics in terms of a reputation.”
Tacey Ann Rosolowski, PhD:
Interesting. Yeah.
Eugenie Kleinerman, MD:
And it was that team that really amplified my voice and cornered him at cocktail parties and said, “You know, you have a wonderful faculty and you have wonderful resources. Nobody knows it’s here, because when you say ‘MD Anderson,’ there’s no indication there’s children. We need to have a name.”
Tacey Ann Rosolowski, PhD:
Who were these individuals on that advance team?
Eugenie Kleinerman, MD:
So Beth Lee was one. Angela Schroder. I’m blocking on—
Tacey Ann Rosolowski, PhD:
That’s okay. I was just curious some of the folks. And did those people end up being on the Board of Visitors?
Eugenie Kleinerman, MD:
I think some of them are, yes. Some of them are. So what they said is, “You need to have a separate name.” So it was really their instigation and their pushing that was the birth of the Children’s Cancer Hospital, and in 2005, Dr. Mendelsohn went down to the Board of Regents and got us the designation of the Children’s Cancer Hospital.
Tacey Ann Rosolowski, PhD:
Why did they say that? What was their reasoning that you needed a different name?
Eugenie Kleinerman, MD:
Because when you say “MD Anderson,” people thought it was an adult facility. We did focus groups, and they say, “You say ‘MD Anderson,’ we think, you know, it’s a cancer place. It’s big, it’s cold. I want soft and fluffy. When you say ‘Texas Children’s,’ you think about playrooms and happy types of things and social workers and everything that we need that is in a children’s hospital.” We perceived that, okay, so there’s this one ward that you have children, but there’s no playroom, there’s no child-life workers, there’s no camps, there’s no fieldtrips, there’s nothing. So we wanted to send a message that at MD Anderson there was a very special place that was a hospital within a hospital, where we had everything that a family could need and everything that was focused on the child and family, and they felt that having that designation made a statement that MD Anderson felt it was really important to treat children and that they were willing to put resources into it. Then from there, he let me have an advisory board made up of members of the big Board of Visitors, and the big Board of Visitors was the ones that said, “Okay, you’ve got a great name, you’ve got great faculty, you’ve got [unclear]—you know, all of this. You need to have a physical plant.” And so they were the ones that really—I don’t want to say pushed, but pushed him to approve the renovation of what we now have as our new unit. So it all began with him.
Tacey Ann Rosolowski, PhD:
So tell me about planning this, because the new inpatient—okay. Wait a minute. I’m trying to get the—so in 2005 you were approved to have the new identity for the pediatric—
Eugenie Kleinerman, MD:
Correct.
Tacey Ann Rosolowski, PhD:
—the Children’s Cancer Hospital—
Eugenie Kleinerman, MD:
Correct. Correct.
Tacey Ann Rosolowski, PhD:
—the hospital within a hospital.
Eugenie Kleinerman, MD:
Correct.
Tacey Ann Rosolowski, PhD:
And that involved a lot of renovating, creating that space.
Eugenie Kleinerman, MD:
No.
Tacey Ann Rosolowski, PhD:
Oh, it did not.
Eugenie Kleinerman, MD:
There was no—it was just a name.
Tacey Ann Rosolowski, PhD:
It was just a name.
Eugenie Kleinerman, MD:
It was just a name.
Tacey Ann Rosolowski, PhD:
So it was not until 2013, okay, that it actually—
Eugenie Kleinerman, MD:
Correct.
Tacey Ann Rosolowski, PhD:
So what did happen, in practical terms in 2005 when you got that designation? I mean, were there some reorganizations or—
Eugenie Kleinerman, MD:
Okay. So we had the name. He allowed us to hire a firm so we could come up with a logo. So, again, we did focus groups on logos. Where are you going to put the Children’s Cancer Hospital? We clearly want it linked to MD Anderson, but we want to make sure—so we did a lot of work on that. At the same time, I still was building the faculty, recruiting people that shared my vision. I have to tell you, in the beginning a lot of people left, and there were times when I thought, “I don’t know who’s going to see the patients.”
Tacey Ann Rosolowski, PhD:
So why were people leaving?
Eugenie Kleinerman, MD:
They didn’t like me, I think. I don’t think they liked my vision. My vision was we’re not going to just be a department that does national cooperative group trials, COG trials. I want innovative research. People in the lab are going to have to demonstrate that they are productive. So there were a lot of people who didn’t share my vision, didn’t like me, and left. But that allowed me to recruit a very talented group of young physicians, and that’s what I did. Rather than—what I said is, “Okay, I’m losing a professor. Let me hire two assistant professors.” And I really went out. I pretty much—well, maybe 75 percent of the faculty now I recruited. I ate a lot of dinners out, spent a lot of time. My lab work suffered because I was out looking for these people, sending out announcements, talking to my colleagues, “Who do you have that’s young and upcoming?” and whatever, and recruiting people. So I was recruiting, trying to get out in the community. Joined the Houston Pediatrics Society, went to the dinners, to the monthly dinners, so the private pediatricians got to know who I am. Went to some ERs, again, trying to reach out to the community in MD Anderson. My predecessor kept the division like this: insular.
Tacey Ann Rosolowski, PhD:
And who was your predecessor?
Eugenie Kleinerman, MD:
Archie Bleyer.
Tacey Ann Rosolowski, PhD:
I’m sorry, the last name?
Eugenie Kleinerman, MD:
Bleyer. He at the time became the principal investigator for the COG or the CCSG, and so he was spending his time away. And decisions at MD Anderson are made by committee, and if you don’t sit there, decisions are going to be made and you’re going to be left out, not because anybody’s trying to get you or mean; they just don’t think about children. So that’s one thing I tell my faculty. We have to be on every committee. It’s important. Everybody’s got to step up to the plate to do that. So I try to get my faculty involved in lots of committee work, so that the other physicians at MD Anderson started to know who we were. They didn’t know who we were. They knew a name, but there was no—it was really funny, even though I was in the lab, because of my interactions and lecturing, things like that, every time Pediatrics came up, I was always the one that was called because they knew me.
Tacey Ann Rosolowski, PhD:
Right. They didn’t know anyone else.
Eugenie Kleinerman, MD:
They didn’t know anybody else.
Tacey Ann Rosolowski, PhD:
Yeah. Interesting. Interesting. So now that 75 percent—I mean, you’ve obviously made your mark on this division. I mean, you’ve hired these people.
Eugenie Kleinerman, MD:
I like to think so. I like to think so, yes.
Tacey Ann Rosolowski, PhD:
Well, with all of these hires, the very least—
Eugenie Kleinerman, MD:
It’s not the same place.
Tacey Ann Rosolowski, PhD:
Yeah, it’s not the same place. So what’s the reaction time in terms of getting things done? I mean, these are people who share your vision, one assumes, and it’s got a very different character. So what’s it like to put—has the vision changed? Is there a new vision now that is shared by these individuals?
Eugenie Kleinerman, MD:
Is there a new vision? I don’t think so. I think our vision has always been to create the next generation of therapies for children with cancer, to train the next generation of pediatric oncology leaders both in clinical research and in basic research, to create a—I guess one of the new ones is family-centered care. We only took that on about five years ago. Let’s start thinking about treatment from the family perspective and let’s start thinking about clinical research and clinical trials from the family perspective and informed consent from the family perspective. So I think that’s a new aspect. When I first came, I created a research training program for the clinical fellows. The American Academy of Pediatrics requires three years of fellowship; one is clinical, two are supposed to be research. When I came on, the few fellows, they were doing chart review. To me, that’s not research. So my vision—and I think now it’s still shared—what we need to do is train these clinical oncologists to understand what basic science is so that when they go out, they can read a basic science article and can know is this really a translatable hypothesis, how to set up a clinical trial, so they’ve really had work in the laboratory. Well, when you have somebody who has never been in the lab and you say, “You’ve got to do two years of laboratory research,” they’re going to say, “Oh, my god. No way I’m coming here,” because they finished their residency and the fellowship. They feel at the top of the game clinically, and you’re going to throw them into the lab? They’re going to feel like the stupidest person there, stupider than the technicians. So what I created—and, again, this is based on my experience at Duke. Remember we talked about the Virology Training Program?
Tacey Ann Rosolowski, PhD:
Mm-hmm, mm-hmm.
Eugenie Kleinerman, MD:
So I created a twelve-week research training program for the clinical fellows, and I hired an assistant professor, and for those twelve weeks, that’s her job, and we created a course. We’d take them through and we’d teach them how to do tissue culture, how to extract proteins, western, look at the microscope, do animal work, and so they finish that twelve weeks and because they’ve had basically one-on-two or one-on-three teaching, they feel comfortable, then they can choose their lab. And I would say almost all of them have had a successful lab experience. I don’t expect them to publish in Nature and Cell or Cancer Research. Somebody, one of the fellows in my lab, published in an infectious disease journal. And it’s been a meaningful experience. So again, I think that’s one. Now, because it’s out of my lab and I pay for it, it may disappear when I’m not here anymore, but, anyway, I think it has left a mark in the individuals during the past twelve years that have trained here.
Tacey Ann Rosolowski, PhD:
Wow. So twelve years it’s been in existence.
Eugenie Kleinerman, MD:
Uh-huh. Oh, that was one of the first things I did.
Tacey Ann Rosolowski, PhD:
Wow. That’s interesting. Well, we’re at eleven-thirty right now, and I know that you’ve got a busy day, so why don’t we close off the interview today—
Eugenie Kleinerman, MD:
Okay.
Tacey Ann Rosolowski, PhD:
—with the fellowship program. We do have another session scheduled so we—
Eugenie Kleinerman, MD:
Oh, good. Okay.
Tacey Ann Rosolowski, PhD:
—can tie up any loose ends at that time.
Eugenie Kleinerman, MD:
Okay.
Tacey Ann Rosolowski, PhD:
Well, thank you very much, Dr. Kleinerman, for your time today.
Eugenie Kleinerman, MD:
Thank you very much. Thank you.
Tacey Ann Rosolowski, PhD:
And I’m turning off the recorder at eleven-thirty. (End of Audio Session Three)
Recommended Citation
Kleinerman, Eugenie S. MD and Rosolowski, Tacey A. PhD, "Chapter 15: The MD Anderson Children’s Cancer Hospital; Creating a Successful Training Program" (2014). Interview Chapters. 1411.
https://openworks.mdanderson.org/mchv_interviewchapters/1411
Conditions Governing Access
Open
