Chapter 05: The New Division of Cancer Prevention and Department of Epidemiology
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Description
In this chapter, Dr. Spitz talks about the creation of the new Division of Cancer Prevention and Population Science under Dr. Charles LeMaistre and her role heading the new Department of Epidemiology. She notes that she suggested Dr. Bernard Levin [oral history interview] to head the Division. She also notes that MD Anderson had three population sciences programs at the time, which was “unheard of” in a cancer center.
Dr. Spitz then talks about why the Department of Epidemiology was formed at this time she then talks about her activities as Acting Chair and then Chair of the Department (1992 – 1995; 1995 – 2008). She lists her recruits and tells an anecdote about securing laboratory space for them.
Dr. Spitz notes that the Department was “my baby.” She talks about intentionally creating an environment to provide a good quality of life. She notes that many of the supports for staff and faculty that she instituted are no longer in existence.
Next, Dr. Spitz notes some particular achievements in the Department. Lung cancer research became a focus and the Department created a Lung Cancer Database that continues to serve as a great resource. She lists several activities that focus on lung cancer.
Dr. Spitz next explains why she stepped down as Chair in 2008.
Identifier
SpitzM_01_20161013_C05
Publication Date
10-13-2016
Publisher
The Historical Resources Center, Research Medical Library, The University of Texas Cancer Center
City
Houston, Texas
Interview Session
Margaret Spitz, MD, Oral History Interview, October 13, 2016
Keywords
Building the Institution; Leadership; On Leadership; Mentoring; On Mentoring; The Researcher; Research; The Professional at Work; MD Anderson Culture; Working Environment; MD Anderson Impact; MD Anderson Impact
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the InstitutionLeadership; On Leadership; Mentoring; On Mentoring; The Researcher; Research; The Professional at Work; MD Anderson Culture; Working Environment; MD Anderson Impact; MD Anderson Impact
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, PhD:
So tell me those stories that you wanted, the lab?
Margaret Spitz, MD:
Well, I don’t know the exact years, but the Division of Prevention was established in—you’ll know when, I think in—
T. A. Rosolowski, PhD:
I don’t have the date in my brain, but—
Margaret Spitz, MD:
And actually, Dr. LeMaistre spoke to me about heading the division, but I suggested that he recruit Bernard Levin [oral history interview]. And that was a wonderful [choice]—Bernard did a fabulous job. He was kind and generous, and supportive, mostly. And he created the Department of Behavioral Science. And Ellen Gritz [oral history interview] came as the first chair. Then there was the Department of Epidemiology, and I was acting chair for, I think, two years, before I became a chair. And then there was the Department of Clinical Cancer Prevention. And this was unique among cancer centers, you have to realize. And towards the end, he also established the Department of Health Disparities. Now there’s a fifth department, Health Services Research. And then I was obviously given some positions to recruit. And Melissa Bondy, whom you met, came. She was one of the first recruits. And then we brought in Chris Amos who was, at the time, at the National Cancer Institute. He was perhaps one of the best recruits I could possibly have brought in.
T. A. Rosolowski, PhD:
Why was that?
Margaret Spitz, MD:
Well, he was a brilliant scientist. He’s a statistical geneticist. He was the first one not only at MD Anderson, but in the State of Texas. So he developed—we gave him the freedom to develop his own section within epidemiology, which we called CGE, Computational Genetic Epidemiology. And he recruited his own faculty and staff. In fact, he was in such demand that not only did he do cancer, but he developed research programs on rheumatoid arthritis, on dermatologic diseases. He was in great demand. And then I recruited Michele Forman from the NCI, who was in nutritional epidemiology. We had really a fantastic department.
T. A. Rosolowski, PhD:
Now can I ask you, someplace in my background research I read that you are listed as founding chair.
Margaret Spitz, MD:
I was the first chair, yes.
T. A. Rosolowski, PhD:
Okay, you were the first chair.
Margaret Spitz, MD:
Absolutely. I was the first acting chair, and then founding chair.
T. A. Rosolowski, PhD:
And then the founding chair. So why was it actually formed as a department at that time?
Margaret Spitz, MD:
Well, because we already had a nucleus. It was clearly such an important topic. In fact, it became its own program within the Cancer Center, so that there were three programs, which is actually unheard of in Cancer Centers, three [population] science programs. There was Epidemiology, Behavioral Science and Clinical Cancer Prevention. And, in fact, epidemiology was twenty-seventh program out of twenty-seven programs. It’s probably changed now, but [it was so] when I was there.
T. A. Rosolowski, PhD:
So I hadn’t realized the degree to which all of this activity really was unique in the country.
Margaret Spitz, MD:
Oh, it certainly was. But I want to go back and talk about getting a lab for epidemiology.
T. A. Rosolowski, PhD:
Yeah. Absolutely.
Margaret Spitz, MD:
I recruited Qingyi Wei from—he was at Johns Hopkins. And he was truly a molecular epidemiologist. He did epidemiology studies, but he also—he worked in the lab, and he had assays to measure DNA repair capacity. And he agreed to come, but he said he needed his own lab. And how naïve I was, I can’t believe. I called up Fred Becker, who was then the—
T. A. Rosolowski, PhD:
VP of Research?
Margaret Spitz, MD:
VP of Research. And I said, “Dr. Becker, good morning.” I said, “I’m calling you because I need a laboratory for epidemiology. And he was a very dominant person, shall we say. And he said to me, “What? A laboratory for epidemiology? Never heard of it. You can’t have it.” And he put the phone down. And I was fortunate that Margaret Kripke [oral history interview] had been recruited at the time to the Smith Building. She and Josh Fidler [oral history interview], her husband. And she was given more lab space than she needed, and I can’t remember how it turned out, but I did approach her, and she offered lab space. And that was how our laboratory, our epidemiology laboratory started, on the good will of someone else.
T. A. Rosolowski, PhD:
That’s an amazing story.
Margaret Spitz, MD:
Oh, there are plenty of stories. And then eventually, after a lot of fighting and scars, to tell the tale, we did get our own lab. But it was moved more than once. We were in Naomi Street, we were in the Main Building, then eventually we ended up in the Mitchell Building. But we were never—if a department had to be moved, it was always thought this was the department that could move. And then they wanted to put us very far [out from the main campus]. And I tried to explain that our research, we contacted patients, we collected blood from patients, we got data from patients. And the blood had to be delivered to the lab. If all the time we were so far removed from our lab, this would never be successful. And it was very difficult. But I had some support of colleagues, and eventually we did get our own beautiful lab space.
T. A. Rosolowski, PhD:
And where was that located?
Margaret Spitz, MD:
In the Mitchell Building.
T. A. Rosolowski, PhD:
In the Mitchell Building. Okay.
Margaret Spitz, MD:
And that’s where I understand it still is.
T. A. Rosolowski, PhD:
Okay.
Margaret Spitz, MD:
But when they used to do reviews of lab space, which I think was a very good idea, and we always got an outstanding score, certainly when I was chair. I can’t say anything about now. I don’t know.
T. A. Rosolowski, PhD:
What did these reviews involve?
Margaret Spitz, MD:
Well, they used to review—they actually to decipher it to see how well you utilized the space. And then they reviewed each of the faculty, the grant dollars, the number of positions that they had, and dollars per square foot, and so on. And we always came out very well.
T. A. Rosolowski, PhD:
Which, of course, encouraged people to keep supporting [that dimension?] of it.
Margaret Spitz, MD:
That’s right, yes.
T. A. Rosolowski, PhD:
So you were [ ], acting chair and then chair until 2008. [ ].
Margaret Spitz, MD:
Yes, it was my baby. And I constantly thought about how can I improve and build the department. And I have to say this, you can only be a successful leader when you feel that your own career, you’ve done everything that you wanted to do. And now you’re thinking only of the good of the department and the good of others. And sad to say, this is not the case with all leaders. Certainly not at the time I was there, and probably currently, too. But we had a wonderfully happy, cohesive department. We developed a lot of very nice traditions. One was we had a lot of foreign students and foreign faculty in our department, so that every year in February, we used to have an international lunch. And everybody was asked to bring a dish from their home country and a flag, and we used to describe what the dish was. And we had this wonderful lunch. And then we used to select somebody to talk about their home country. And that was every single year. And I’m told now they no longer do it, and that saddens me.
T. A. Rosolowski, PhD:
I was going to ask if the inclusion of this international component went over into research, was the research globally focused as well?
Margaret Spitz, MD:
No, most of our research was local.
T. A. Rosolowski, PhD:
Okay.
Margaret Spitz, MD:
And then I did another wonderful tradition, and that was a 9-11 commemoration every year. It’s no longer done. And every year, we used to have a meeting, and we read the Gettysburg Address. And I chose that because it was relatively short. And we had it read by three people; one was an American citizen, one was a naturalized, and one was somebody on a foreign visa. And these three people would read the Gettysburg Address. And then some of us spoke about what our thoughts about 9-11, because we had a very diverse department. And we even had a map showing where all people came from. And then we used to also select somebody to tell us about their home country. So this was a wonderful tradition that we had. That, too, no longer is in existence.
T. A. Rosolowski, PhD:
What do you think is the impact of establishing those kinds of traditions in a department?
Margaret Spitz, MD:
I think it’s quality of life. I did a lot for improving quality of life. We had a care team. And this was a group of faculty and staff who were there only to be sure to make the lives of everybody better. And if there was somebody who was ill or needed help the care team was there. Somebody had a fire, they were there to help raise money. And they also organized—every year, we used to have a holiday party. And although I knew what I would have liked as a party, I didn’t interfere. I gave them a budget, and they decided where they wanted the party, what was the menu for the party, and what was the entertainment. And they were generally lovely parties. And I don’t know whether that’s still in existence. I’ve heard that the care team is no longer in existence, and all these things saddened me because I spent so much time building things up, and I don’t want them to be lost.
T. A. Rosolowski, PhD:
Right. I mean, I can imagine that it would do a lot for retention and attracting faculty to know that there was—
Margaret Spitz, MD:
All these—yeah, absolutely. You know, in fact I used to—I was a firm believer in feedback from the faculty and staff. And some of my colleagues told me I needed anti-depressant medication, because I was wanting to hear the bad news, and you know, to improve. And they thought I was crazy, you know.
T. A. Rosolowski, PhD:
But you took it really not as a downer, but as a—
Margaret Spitz, MD:
No, it’s to make myself better.
T. A. Rosolowski, PhD:
Inspiration.
Margaret Spitz, MD:
Yes. That’s right.
T. A. Rosolowski, PhD:
Yeah. I can understand that.
Margaret Spitz, MD:
And most of the faculty were really very happy.
T. A. Rosolowski, PhD:
Now, I mean, you’ve told some individual stories about what went on during your period of leadership during this time. But when you came in, did you have a vision of what you wanted to accomplish?
Margaret Spitz, MD:
I don’t think I did. I think it developed over time.
T. A. Rosolowski, PhD:
Interesting. And what were some of the milestones in the evolution of that?
Margaret Spitz, MD:
I think one was the lung cancer research, because I started a database of lung cancer cases. And these were African Americans, whites and Mexican Americans, and matched controls with samples. We collected well-annotated information. And I knew this would be a great resource. And in fact, we had post-docs who worked on it and eventually became faculty. And Chris Amos built on it, and he published in Nature, Genetics, one of the first genome-wide association studies of lung cancer.
T. A. Rosolowski, PhD:
Wow.
Margaret Spitz, MD:
And that really solidified his reputation. And many other faculty worked on lung cancer as well. And that was the dominant part of the department. But then Melissa Bondy, for example, built a fantastic program in brain tumors. She created a Brain Cancer International Consortium, first focusing on familial gliomas and then on sporadic gliomas as well. We developed programs in prostate cancer, and a wide variety of other cancers; bladder cancer, head and neck cancers, and so on. And we worked very closely with Waun Ki Hong [oral history interview], who was a great supporter. I helped him with his former smokers, he had a chemo prevention in former smokers. In fact, it was our observation that over 50 percent of lung cancers were occurring in former smokers, of whom about 30 percent had quit smoking maybe 30 years before their diagnosis. So we realized that we needed to focus on former smokers. Even if you were to stop everybody from smoking on day one, we’d still have an epidemic of lung cancer for a long time. So that was the—and then also, we were given money by the State tobacco settlement fund. And this was the vision of the institution, I believe it was already in John Mendelsohn’s time [oral history interview]. He gave substantial money to cancer prevention, and Bernard divided it out among the departments. And I decided that I didn’t want to fund merely incremental research. I wanted something transformative. So what I did was, instead of funding research, which I felt should be funded by people’s grants, I wanted to create research infrastructure. So we started a Mexican American cohort, which Melissa Bondy spearheaded. And that’s still in existence today.
T. A. Rosolowski, PhD:
What does that mean?
Margaret Spitz, MD:
Well, we enrolled Mexican American households using a variety of different techniques in the Houston Metropolitan area. And it’s a very important program, because they’re understudied.
T. A. Rosolowski, PhD:
Now are you studying this population from the perspective of only brain cancer? Or is this all—
Margaret Spitz, MD:
No, all cancers.
T. A. Rosolowski, PhD:
All cancers, okay.
Margaret Spitz, MD:
Yes. And I wrote a grant looking at initiation of smoking cessation in Mexican American youth, building on that cohort, which was a very successful study.
T. A. Rosolowski, PhD:
And that was established in the ’90s sometime?
Margaret Spitz, MD:
Yes. Maybe even later. We’d have to look that up. And the other—the rest of the money I used to create the patient history database, which is ongoing now. And that was, we wanted a set of core epidemiologic data on every new patient who walks into the institution. And this would include family history, smoking history, alcohol abuse, previous medications, and so on. And originally, it was a paper form. And then it became electronic. Now I’m told it’s part of the EPIC database. And this is an extremely valuable resource, because if you can link it with the tissue banks [ ], it enriches the tissue banks. And I’m hoping, although I don’t know, that this is widely advertised and used.
T. A. Rosolowski, PhD:
Yeah, it’s always key to make sure people know about these resources.
Margaret Spitz, MD:
And it probably should not belong in the Department of Epidemiology, but should be somewhere where it’s accessible to everybody. But I don’t know the status now. I can’t say.
T. A. Rosolowski, PhD:
Now when you—why did you step down as chair of the department?
Margaret Spitz, MD:
Two reasons, maybe more. One was, I had spent a year, I had been three times to Israel to visit my mother, who was in late stage Alzheimer’s. It was a very painful and difficult time. That was one reason. And on the plane coming home after her funeral, I thought there are more important things to life than just working nonstop. And number two, there were one or two very challenging faculty in the department, that I’m not going to go into any further, and that had made my life much more difficult. And I thought, number three, that it was time to turn the reins over to someone else who could take the vision and move along with it, and that I thought that I could carry on in a part-time capacity. I’d been longest in the division than anyone else. In those days, Bernard had left, and there was a new leader, Ernie Hawk. And I thought that I could provide the background and advice, and strategic direction for the division in a part-time capacity. And of course, there were financial reasons. I was on the old retirement plan, which was excellent. So those were the main reasons why I stepped down.
Recommended Citation
Rosolowksi, Tacey A. PhD and Spitz, Margaret R. MD, "Chapter 05: The New Division of Cancer Prevention and Department of Epidemiology" (2016). Interview Chapters. 1589.
https://openworks.mdanderson.org/mchv_interviewchapters/1589
Conditions Governing Access
Open
