Chapter 10: A Look Back at Institutional Change and a Legacy Left
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Description
Dr. Spitz first talks about big changes she saw at MD Anderson during her career and then reviews her contributions to the Department of Epidemiology.
She first talks about the impact of the requirement under Dr. Mendelsohn’s presidency that faculty supply 30% of their salaries from grants. She talks about the effect of rapid growth on the culture of the institution.
Dr. Spitz then turns to a discussion of the culture of the Department, noting her efforts to create a collegial environment with good quality of life.
At the end of the interview, she talks about the sub-area she created, integrative epidemiology that leverages the strengths of multiple sciences.
Identifier
SpitzM_02_20161101_C10
Publication Date
11-1-2016
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, November 01, 2016
Keywords
View on Career and Accomplishments; Growth and/or Change; MD Anderson Culture; Working Environment; Discovery and Success; On Research and Researchers; Understanding Cancer, the History of Science, Cancer Research
Topics Covered
The Interview Subject's Story - View on Career and Accomplishments; Growth and/or Change; MD Anderson Culture; Working Environment; Discovery and Success; On Research and Researchers; Understanding Cancer, the History of Science, Cancer Research
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:
Are there any other observations you have of how things have changed?
Margaret Spitz, MD:
Well, you know, I haven’t been at MD Anderson for quite some time. And certainly I left before Dr. DePinho [oral history interview] took over. So I cannot comment on anything since he’s—but I felt that Dr. Mendelsohn was supportive of women and women’s issues. He always treated women with respect.
T. A. Rosolowski, PhD:
What are some other changes that you’ve seen, you saw at MD Anderson? I’m kind of looking at over the long-term. What were big periods of institutional change that you recall? And what happened at those moments?
Margaret Spitz, MD:
Well, I remember one was MD Anderson originally had no requirements that there be faculty salaries on grants. And Dr. Mendelsohn put in place a very reasonable 30 percent of one’s salary should be on grants. I mean, Harvard at that time was probably 80 percent on grant. I think it’s now 90 percent. And some of the faculty were in an uproar about it. But in fact, I think it was probably a very wise decision. We needed to become much more like other cancer centers.
T. A. Rosolowski, PhD:
Why is that important?
Margaret Spitz, MD:
Well, it’s unheard of that there shouldn’t be a requirement for faculty to have some of their salary on grants. Every cancer center does it. Every academic institution does it. Actually, it must make people envious of MD Anderson if they don’t do it. I think the thought is, well, they’re obviously so rich, they don’t need the money. So I think it was a very wise decision. That was one major change. And then, of course, I think—you know, I think to ask about the climate at MD Anderson and the political changes, and the changes in referral of patients and so on, self-referral versus referral by physicians, there are people much better able to discuss that than me. Those didn’t impact me directly, and therefore, I can’t really comment on those, although they had major impacts on MD Anderson. I think MD Anderson grew very quickly. There were so many buildings built and changes made, that inevitably the culture of the institution changed. Originally it was a much smaller institution, and you knew many of the people, the junior and the senior, and you knew the administrators. And it was a much more personal relationship. Now it’s so much bigger, and it’s far less personal.
T. A. Rosolowski, PhD:
Did you find that that growth and that kind of weakening of personal relationships changed the way you had to do your own work?
Margaret Spitz, MD:
Yes, I’m sure it did.
T. A. Rosolowski, PhD:
How—can you think of some ways?
T. A. Rosolowski, PhD:
You didn’t—there were more layers, you couldn’t go directly to the person involved. You had to—there was much more bureaucracy, which is never efficient. But of course our own division grew rapidly, and we got our own building. And those were very trying times, when we had to plan the building, we had to plan the layout of our department. We had to plan on how we would situate the faculty, what sort of offices, and how the support staff would be situated, what would be the culture of the department.
T. A. Rosolowski, PhD:
Tell me about those decisions.
Margaret Spitz, MD:
Well, many of them were made for us. For example, in the old days, there was great variation in department chair office size. And of course we moved around the Houston main building so much that I went from a tiny office, and at one stage they had no room for us, so we were placed in Dr. LeMaistre’s old suite. And I had this enormous office with a private bathroom. And then at other times, I had a tiny office. But when we moved to the new building, there was strict criteria in place so that department chairs had an office configuration. The deputy department chair had a configuration. The faculty had specific office sizes. And not everybody was happy with those decision, but they were not my decisions. They were made by the institution.
T. A. Rosolowski, PhD:
What about the decisions you referred to regarding culture? What was some of the issues you had to go through?
Margaret Spitz, MD:
Well, I was a firm believer that it was not only the scientific culture, but the quality of life in the department. So, for example, I formed a care team, which were representatives of the faculty and the administrative staff and support staff, and program directors, and so on. And these people would—they had Jolly Trolley, for example. They’d hand out snacks and treats at certain times. They would organize the holiday party every year. They would organize special events, and recognize birthdays and special events in the people’s lives. And I think that sort of quality of life is important. For example, after 9-11, every year we had a 9-11 commemoration event. Obviously it wasn’t a party, but what we did was, we used to recite the Gettysburg Address. I don’t know if I told you about that last time.
T. A. Rosolowski, PhD:
I think you may have mentioned that last time.
Margaret Spitz, MD:
Yes.
T. A. Rosolowski, PhD:
Yeah.
Margaret Spitz, MD:
And unfortunately, it’s no longer done, and I think that’s sad.
T. A. Rosolowski, PhD:
I think the recognition that they’re actually human beings rather than functions in a department.
Margaret Spitz, MD:
Yes. And we used to recognize all of the post-docs when they completed their program, or when the pre-docs completed their doctoral degrees, we tried to honor and recognize all these people. And then, of course, if there were tragedies, like somebody had a fire or a flood in their home, we tried to organize and help each person.
T. A. Rosolowski, PhD:
What are some things that you hope, and when you left in 2010, what are some things that you hoped would be carried on?
Margaret Spitz, MD:
Oh, I hoped the department would go from strength to strength and continue to be a first-rate department that was highly regarded throughout the epidemiology community. That was my hope, because it’s like my baby or my grandbaby. I started it from nothing, and I worked very hard to achieve it.
T. A. Rosolowski, PhD:
Yeah. I had just one additional question, which was about the field of integrative epidemiology. And you talked a good deal about that last time. But I wondered if you could tell me kind of, what do you think is the power of bringing all the sciences together, and kind of in the long-term?
Margaret Spitz, MD:
Well, I think this is the way epidemiology is moving. You know, when I started in the 1980s, our instruments of use were a pen and paper. That was all we had, and we could question patients and look at correlations between lifestyle and risk of cancer outcome. And all we had for genetic susceptibility to disease was family history. We’ve come a tremendous way now. We have these high throughput technologies. We have very advanced biostatistical and bioinformatical approaches to analyze these high dimensional data. We have brand new disciplines like System Biology, Functional Genomics, Microbiomics. And I think we have to educate epidemiologists to enter this new era of team science and multi-disciplinary research. Obviously , no one person can understand all these new technologies. But they need to understand and develop a common language so that they can interact with scientists and other disciplines, and they can become members of the team and conduct transdisciplinary research. When we started with technology, we had PCR. And we could look at a specific polymorphism in a specific gene, in maybe 100 or 200 subjects, that was all we could do. And these studies were underpowered. And we selected candidate genes with very little knowledge of their functional relevance, and we found some significant results. I suppose you could consider it beginner’s luck. But a few of these studies were replicated. We had no idea of the functional relevance of the genes that we identified. And we entered an era of—I think it was almost despair, where epidemiologists were considered to be promoting false hypotheses, they were over-exaggerating results. We’d found everything that we could possibly find, and we needed to leave all this work to lab scientists. That was the prevailing feeling. But fortunately, that didn’t last too long.
T. A. Rosolowski, PhD:
Wow. You hadn’t mentioned that at that time. I mean, was that a period where it was difficult to attract people to the field, even?
Margaret Spitz, MD:
No, not so much. But it was a difficult time to get recognition for epidemiology, because people were writing editorials criticizing epidemiology.
T. A. Rosolowski, PhD:
Oh, well. So what made you keep the faith during that time?
Margaret Spitz, MD:
Well, I had no choice. I had no other training.
T. A. Rosolowski, PhD:
Right. Right.
Margaret Spitz, MD:
And I think we overcame those hurdles. We overcame—I think they called it the “lost decade.” And I think epidemiology now is going from strength to strength. And if I were a young person starting out now, I’d be thrilled to be studying epidemiology. I think the prospects are golden.
T. A. Rosolowski, PhD:
Is there anything else that you would like to add this morning?
Margaret Spitz, MD:
No. I think I’ve said more than enough. Probably regret 50 percent of what I’ve said. (laughter)
T. A. Rosolowski, PhD:
Oh, I hope not! Well, I wanted to thank you for taking the time this morning.
Margaret Spitz, MD:
It’s my pleasure.
T. A. Rosolowski, PhD:
If there’s nothing else you’d like to add?
Margaret Spitz, MD:
Well, MD Anderson was such a nurturing, caring, warm environment when I started. And when I look back, I realize, and I’ve visited many other cancer centers, and I’m at a different cancer center now. I think MD Anderson is unique in the resources it has in the caring clinicians, in the collaborative scientists. And I hope this won’t change. Perhaps it has. Many people—I read a lot, and I hear a lot. I have no way of knowing whether it’s true or not, but MD Anderson, in my day, certainly was a caring environment where money was not the bottom line. Caring for the patient was the bottom line. And the clinicians were truly exceptional. And they were very helpful in terms of generating research for us. They were wonderful collaborators as well.
T. A. Rosolowski, PhD:
Well, thank you for that.
Margaret Spitz, MD:
Sure.
T. A. Rosolowski, PhD:
And I’m turning off the recorder at about 10 minutes after 10.
Recommended Citation
Spitz, Margaret R. MD and Rosolowksi, Tacey A. PhD, "Chapter 10: A Look Back at Institutional Change and a Legacy Left" (2016). Interview Chapters. 1594.
https://openworks.mdanderson.org/mchv_interviewchapters/1594
Conditions Governing Access
Open
