Chapter 15: Developmental Therapeutics, the Division of Medicine, and Dr. Clark’s Final Years as President

Title

Chapter 15: Developmental Therapeutics, the Division of Medicine, and Dr. Clark’s Final Years as President

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Description

In this chapter, Dr. Freireich continues talking about the Department of Developmental Therapeutics at MD Anderson, the Division of Medicine, the medical school in Houston, and Dr. R. Lee Cark’s final years.

Identifier

FreireicEJ_02_20010730_C15

Publication Date

7-30-2001

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

Building the Institution; The Professional at Work; Understanding the Institution; MD Anderson Culture; Working Environment; Leadership; Obstacles, Challenges; Institutional Politics; Controversy; Critical Perspectives on MD Anderson; MD Anderson History; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Patients, Treatment, Survivors; Ethics

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 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

Emil J Freireich, MD

We came in '65, and we got to '72, when Dr. Frei leaves. At the time Dr. Frei decides to go, he was still very bitter about Dr. Clark. I think in his old age it had moderated. I was less so because Dr. Clark didn't promise me anything. Frei promised me everything, and the fact that he couldn't deliver wasn't his fault, so I didn't bother with anybody. We just did our thing. By 1972, when Dr. Frei left, DT was the largest administrative unit at MD Anderson. We had the largest clinic and most outpatient business of any department, including Surgery. We had the biggest referral base. We had the most dollar income from patient care. We had the most dollar income from grants and contracts. When Frei resigned, it was bad news.

Lesley Brunet, MA

He takes the grants?

Emil J Freireich, MD

No, he can't do that, but the last time he resigned, I got fired, remember?

Lesley Brunet, MA

Oh, that's right.

Emil J Freireich, MD

Remember, everybody hates DT, except Dr. Clark. "Okay, Freireich. I don't know what we're going to do about this DT thing, but I'm going to make you ad interim chairman, and I'll try to work out a solution."

Lesley Brunet, MA

How did you feel about that?

Emil J Freireich, MD

I said, "Dr. Clark, I've been here 7 years. I've built you the best clinical research unit in the country. If you don't want to make me head, I'm leaving." He said, "Okay. You're head." So DT survived Frei's leaving intact.

Emil J Freireich, MD

I became head of DT, and the department boomed. We just kept getting better and better and better.

Lesley Brunet, MA

You got a big award in '72, also.

Emil J Freireich, MD

We get awards every year. We just got new training grants. We just kept getting bigger and bigger and better and better, and we kept recruiting more faculty. Dr. Frei tried to get me to go to Boston, but that didn't work, so I stayed here. The next big event that occurred was in 1983, when they hired [Irwin] Krakoff. The hiring of Krakoff was a catastrophe for me, for DT, and for the institution, because he was a very destructive person. He was not intelligent, and he was arbitrary, capricious, and crude. Everybody has some high principle that guides them, but this was a man who had "nuttin'." I never heard him say anything like he wanted to cure cancer or help people or build a hospital. Part of that perception, of course, is the fact that he and I were designed to be protagonists, by LeMaistre [oral history interview], not by Krakoff.

Rulon Rawson was head of Medicine at Memorial Sloan-Kettering. After Dr. Copeland, Dr. Clark recruited the surgeon who's with the American Cancer Society, Arthur Holleb, to be director of Education. Then he left to go to the Cancer Society, and Dr. Clark hired Rulon Rawson. Rulon Rawson retired from Memorial, and he brought him here. He's a very accomplished physician-scientist, a wonderful person, and a very highly principled guy. Dr. Clark hired him as director of Education, and Dr. Rawson hired Blumenschein. Rawson immediately identified us as important. Dr. Rawson and I became very close friends and associates. He was from Memorial, he liked DT, and he knew Medicine was a service department. He was a medical oncologist, and he was excited by our research, so we became strong allies.

George Blumenschein was hired from Northwestern to be director of Education. He and I had a couple of confrontations, but eventually we became very close friends and colleagues. But he, by design, was not in DT. He was in Medicine, because he wanted to treat breast cancer, and Nylene Eckels had created a major breast cancer program in Medicine. Nylene Eckels was an intern of mine when I was a resident in Chicago, so I knew her for 50 years. She was like Sinkovics, very backward. We had to fight with Nylene Eckels to get anything done in breast cancer.

Rawson was able to maneuver Blumenschein into the breast clinic, so we could do DT in breast, in Medicine. Of course, Rulon Rawson and I and everybody, including Dr. Clark, wanted Medicine and DT to come together. It didn't make any sense for patients with breast cancer to get inferior treatment in Medicine to the excellent treatment they were getting in DT. So that was the Blumenschein function. [Aman] Buzdar [oral history interview] came along. We never made that interaction with Hematology, because Shullenberger stayed active, and Lillian Fuller in Radiotherapy and Jim Butler in Pathology kind of kept lymphoma in Hematology with Shullenberger and Alexanian.

So the next big event is when Blumenschein comes in; he's director of Medical Education. Rawson is there, and he says, "Dr. Clark, we have to bring Medicine up to snuff, like it was at Memorial. You've got DT, which is an outstanding leadership group of scientists, and you've got Medicine; it's a bunch of service people. We've got to bring them up."

Dr. Howe and I had a meeting in Dr. Clark's office, and Dr. Howe said, "DT is a pain, and they're doing all this stuff. They're experimenting on people; they're torturing people. They're ruining the environment. They're doing all these experiments. It's terrible stuff." Dr. Clark said, "Dr. Howe, you have to compete with them. I'm not going to rule in your favor." They couldn't compete. So Rawson and Blumenschein decided that they would put Medicine and DT into one. They appointed a search committee, and the search committee consisted of 4 outside people; I don't recall their names. This must have been about 1975. They did a national search, they interviewed people, and they made a recommendation to Dr. Clark that Dr. Freireich be head of the combined Department of Medicine. Cliff Howe, Shullenberger, Alexanian, Sinkovics, Jess Gamble, Bill Nelson, everybody in Medicine said, "No way. Freireich is terrible." Clark couldn't do it, so he just did nothing. We stayed separated. About 3 years later, they decided, "This time we've really got to do it." They appointed another search committee. They had all the chairmen of the in-house departments, and they had 4 outside Cancer Center directors. It was a big committee. They did another national search over 2 years.

Lesley Brunet, MA

This was when Clark was still here?

Emil J Freireich, MD

Clark's still here, but then there was a problem. Then comes '78, the holocaust. You know what happened in '78?

Lesley Brunet, MA

I know LeMaistre came in.

Emil J Freireich, MD

Dr. Clark was fired.

Lesley Brunet, MA

From what I've seen of the records, even earlier, in like '74 and '75, people are already getting nervous about him retiring.

Emil J Freireich, MD

It was his age. Dr. Clark wasn't going to retire. It's just like giving up your children. Everybody wanted him to retire. The legislature, every dean—they all wanted him to retire. But remember, his ambition was to have a health science center at Houston. What year did the medical school start?

Lesley Brunet, MA

It started in '71.

Emil J Freireich, MD

That's when Dr. Clark lost the game, because the legislature made a health science center, and they took the medical school away from Clark and appointed a dean.

Lesley Brunet, MA

Did he think that he was going to control the medical school?

Emil J Freireich, MD

Yes. He had already controlled it. The coordinating board had agreed. He had the graduate school. He had the public health school. He had the dental school. He had MD Anderson. Each had a dean, and he was chair of the deans. The legislature had approved a medical school, and then it went to San Antonio. When it came up again in '71, apparently he made enough enemies that he didn't get it. He was crushed. They hired a new president in Houston.

Lesley Brunet, MA

They hired a new president of the health science center?

Emil J Freireich, MD

Yes.

Lesley Brunet, MA

Plus he had the head of the medical schools.

Emil J Freireich, MD

He was the guy from the space program.

Lesley Brunet, MA

South Carolina.

Emil J Freireich, MD

It was a total catastrophe.

Lesley Brunet, MA

The one from South Carolina was a total catastrophe?

Emil J Freireich, MD

That comes later. First it was the guy from the space program. He was the dean of the medical school.

Lesley Brunet, MA

He must not have been there very long.

Emil J Freireich, MD

Robert Moreton was a good friend of mine and Dr. Clark's closest confidant. I asked Bob Moreton once, "How did Dr. Clark ever lose that battle?" He said, "Nobody knows. There were some forces that they couldn't identify." Dr. Clark was so popular with the legislature. I think it was his age. He was born in '06, so he was 65 or 66.

Lesley Brunet, MA

Plus, to get the medical school in Houston, they had to come to all kinds of agreements with Baylor, so it gets very complicated.

Emil J Freireich, MD

That's correct. So he lost the medical school, and that was the beginning of the end of Dr. Clark. What happened subsequently is the medical school was a catastrophe. We were a powerhouse. Their first dean was Cheves Smythe. The first president was this guy from the space program, whose name I can't remember. He was a catastrophe. They fired him.

Lesley Brunet, MA

I want to say Sprague, but that's later, isn't it? Did Sprague come in later?

Emil J Freireich, MD

Yes, he came later. He was the doctor for the space program. They fired him. Cheves Smythe hired Walter Kirkendahl, and then they fired Cheves Smythe, and 90 percent of the faculty was MD Anderson. I ran Oncology. I loved Walter Kirkendahl. He and I were buddies. We had a service over there. We were getting along fine with the medical school. Then when the president was fired, they needed a new president. They couldn't recruit anyone because the school was in such a hubbub, so they asked Truman Blocker, who was president in Galveston, to come in as ad interim president. Truman Blocker came in as interim president, called a meeting of the faculty, including us, and he announced that his intention was to have MD Anderson become a part of the Health Science Center. It made perfect sense.

The medical school had Hermann Hospital, but there was nothing they could do with Hermann Hospital; it was a total catastrophe. It's not a city-county, it was a private hospital. They had their own board and their own chairman. That marriage was a marriage of hatred. There are only 2 institutions that get patient care support in the whole UT system, Galveston and MD Anderson. We got bed support from the legislature. We got a beautiful hospital. This should be the teaching hospital for the medical school. Truman Blocker took one look and said, "It's obvious." Dr. Clark said, "Wait a minute. If we become a teaching hospital, then the Cancer Center is gone. I am opposed to it." We went to the legislature. He used all his political muscle.

Lesley Brunet, MA

Was Blocker actually saying "change Anderson"?

Emil J Freireich, MD

Make it public. Dr. Clark and the legislature came to a truce, and I'm sure that this is correct, because he announced it at a public meeting at MD Anderson. Dr. Clark called a staff meeting, and he said, "Dear faculty, I have resigned as president of MD Anderson Cancer Center. The agreement was that both Dr. Blocker and I would resign at the same time because we could not coordinate our views, and the Coordinating Board and the Board of Regents had no way to resolve our conflicts. We had polar opinions. What the Regents have decided to do is to form 2 search committees for the president of the Health Science Center and the president of MD Anderson. Both committees are going to be chaired by none other than the chancellor of the University of Texas System."

Lesley Brunet, MA

That was LeMaistre.

Emil J Freireich, MD

Charles A. LeMaistre, Jr.

(End of session two)

Emil J Freireich, MD

Interview Session Three: 6 August 2001

Chapter 15: Developmental Therapeutics, the Division of Medicine, and Dr. Clark’s Final Years as President

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