Chapter 16: Charles LeMaistre, the New President, Initiates Reorganization, with Impact on Developmental Therapeutics

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Chapter 16: Charles LeMaistre, the New President, Initiates Reorganization, with Impact on Developmental Therapeutics

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In this chapter, Dr. Freireich talks about the new president of MD Anderson, Dr. Charles LeMaistre; reorganization initiatives of the new president; and how Dr. LeMasitre’s changes affected the Department of Developmental Therapeutics.

Identifier

FreireicEJ_03_20010806_C16

Publication Date

8-6-2001

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

Building the Institution; Leadership; Portraits; The Professional at Work; Growth and/or Change; Obstacles, Challenges; Institutional Politics; Controversy

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 were in 1978. Dr. Charles LeMaistre arrives.

Lesley Brunet, MA

He was the head of the search committees?

Emil J Freireich, MD

Correct.

Lesley Brunet, MA

How was that possible?

Emil J Freireich, MD

You'll get the real story from Dr. LeMaistre, but probably you'd get the real story from the guy who was chairman of the Board of Regents, who they named the center after, Frank Erwin. He was the big builder.

Lesley Brunet, MA

He's dead, of course.

Emil J Freireich, MD

Is he?

Lesley Brunet, MA

Oh, yes.

Emil J Freireich, MD

What happened? Did he shoot himself or something?

Lesley Brunet, MA

No.

Emil J Freireich, MD

Disease?

Lesley Brunet, MA

I forget, but I worked for the Johnson Foundation then, so I had to stand by his coffin.

Emil J Freireich, MD

Oh, my goodness.

Lesley Brunet, MA

It was an interesting experience.

Emil J Freireich, MD

Mickey [aka Charles A. LeMaistre, MD] was Frank Erwin's guy. Then there was the DWI against Erwin, and he resigned as chairman of the board. Now the board had either a new chairman or no chairman. It was obvious that Frank Erwin was running the university, so they needed someone to run the university. Remember, this is my perception. Mickey will give you a really gorgeous analysis. So they appointed the business guy, Don Walker, as chancellor. They negotiated with Dr. LeMaistre first, but the university doesn't like scandal, so they had to get rid of LeMaistre. But they didn't want to do it publicly, so they said to him, "Since Dr. Clark and Truman Blocker have resigned at the same time, we're going to form 2 search committees to replace them, and we'll ask you to head these 2 search committees."

Lesley Brunet, MA

Dr. Clark resigned before they headed up the search committee?

Emil J Freireich, MD

Correct. Dr. Clark announced to the faculty that because Truman Blocker wanted to absorb MD Anderson, he went to the wall, the confrontation occurred, and they both agreed to resign simultaneously.

Lesley Brunet, MA

But was he still acting president until someone else came in?

Emil J Freireich, MD

Yes, he was acting president, and so was Truman Blocker. Then they asked Mickey to run these 2 searches. Of course, the idea was that he could choose which of the 2 presidencies he wanted, based on what he learned about these 2 institutions. That was probably implied. It may never have been spoken, but it was my perception of what was going on. So here's Dr. LeMaistre chairing these 2 sessions. He's still chancellor of the University of Texas system, and the search goes on. I was a candidate. Someone nominated me. I wrote a really strong support of my own candidacy for the position, but I was never interviewed. They never took it seriously.

Lesley Brunet, MA

Who nominated you?

Emil J Freireich, MD

I have no idea. The letters came from the search committee and said, "You've been nominated. Please give us all your stuff." So I gave them all the stuff, but I was never considered seriously. But I was a candidate, so Dr. LeMaistre had to look at my curriculum vitae. So he knew who I was before he came here. I was the only one at MD Anderson, to my knowledge,who who was nominated. No, I think Dr. Hickey was nominated.

Lesley Brunet, MA

There were 3 big candidates.

Emil J Freireich, MD

Oh, yes, from the outside. So the searches proceeded. I didn't keep up with the medical school search, but they ended up with a guy who became president of the AAMC. He was pretty good. Our search came down to 3 big candidates, one of whom was Vincent T. DeVita. I was his host when he came because he was one of my fellows when I was at NCI. He'd told me this really looked great. I forgot who the other 2 were. But suddenly it was announced that Dr. LeMaistre had chosen himself, or to put it in university language, the committee insisted that he take the position because they didn't have a better choice.

Of course, the reason he picked MD Anderson is because Dr. Clark had built an ironclad position for himself. The Physicians Referral Service was fully funded, and very well-funded indeed. The institution was booming, and it was a perfect time for someone who wanted to just coast along to take over MD Anderson. The medical school was struggling. They had to hire deans and presidents and everything else. That was no job for Mickey, so he took this one.

Lesley Brunet, MA

Did it have to do with this creation of the executive vice presidents, who seemed to take over more of a load for the president in the '70s?

Emil J Freireich, MD

At MD Anderson?

Lesley Brunet, MA

Yes.

Emil J Freireich, MD

We didn't have any such person that I know of.

Lesley Brunet, MA

Frederick Becker [oral history interview] came in the late '70s.

Emil J Freireich, MD

Oh, yes, but Becker was Chairman of Pathology when he was recruited, and he was a hopeless failure and soon stepped aside. All that was created under Mickey. Dr. Clark ran the place and picked all the people, and when he gave them authority, they had it. He didn't have any deputy that I know of. Dr. Hickey was there, but Dr. Hickey was kind of an adviser. Dr. Hickey was really the person who ran the day-to-day operation around here. But I don't know of any other executive position at the time. So Dr. LeMaistre is announced as the new president, and soon after he resigns as chancellor of the University of Texas. The papers say he wants to come back to medicine. We all think that's a great idea.

Lesley Brunet, MA

You're being facetious?

Emil J Freireich, MD

No, we really did. You have to meet Dr. LeMaistre. He's a movie star. I mean, this man comes out from Heaven. Everyone who meets him is impressed by him.

Lesley Brunet, MA

So you were all looking forward to him coming.

Emil J Freireich, MD

Dr. Clark ran it with an iron hand. We had lots of frustrations, so Dr. LeMaistre sounded wonderful. Everybody was enthusiastic. As you know, I was running the most important part of this institution at the time. He was supposed to be a pulmonary specialist, so we thought we'd get him interested in medicine, and we invited him to see a patient on leukemia service. We took him on rounds, but it only took 5 minutes to realize that he knew nothing about medicine. So in 5 minutes we discovered that medicine was not his forte, and he didn't come to MD Anderson to return to medicine.

I thought his first moves were just wonderful. The guy had a lot of class. Dr. Clark was a good old Texan. It's as if Mickey was from the movies, and he made these speeches. "We're going to reorganize the place. We're going to decentralize authority."

Lesley Brunet, MA

There was a big push on that.

Emil J Freireich, MD

It's just going to be wonderful. I was chairman of the executive committee at the time, which was the medical staff executive committee, and we had the 5 departments. He came to the executive committee, and he said, "Dr. Clark ran this place with an iron hand, but I am using modern administrative techniques. We are going to decentralize the presidential authority, and the first step is, we're going to pick a vice president for clinical affairs and a vice president for research." I think those are the only 2 positions he created.

Lesley Brunet, MA

Education came in later.

Emil J Freireich, MD

Yes, it came later. By some mechanism that I don't know, maybe the executive committee of the science faculty, Becker was appointed vice president for research, which everybody was happy with. And the executive committee of the medical staff had to pick a vice president. We had about 6 nominees, and we had some very emotional meetings. Remember, DT is too powerful now. So this is an opportunity for the other chairmen to get some handle on it.

There was a guy named Fred Conrad. Dr. Clark hired Fred Conrad. He was an air force general, and they used to hunt bears in Alaska together, so he liked him. He came into the Division of Medicine under Clifford Howe, and he was just a doctor, no training, no expertise. But someone on the executive committee got the brilliant idea that Fred Conrad was well organized and decisive; he ought to be the vice president. Of course, I said, "We need someone who's academic, who cares about clinical research." But everybody hated clinical research, except DT.So to make a long story short, there were 7 people on the committee, and the vote was 6 to 1 in favor of Conrad, and I was the 1. Of course, Conrad knew about that. So Conrad became vice president, and Fred Becker became the vice president for research.

Lesley Brunet, MA

Where was Hickey? Hickey was out?

Emil J Freireich, MD

Hickey was special adviser to the president or something of that kind. He had no authority. He was immediately castrated. This was not looking good, so I went to Dr. LeMaistre. This is the world's greatest person. If you talk to him, he sounds like a semi-intellectual. He knows all the right sentences and paragraphs. He's really amazing. When you consider that between the ears there's only air, he is just amazing. Did you see that movie Being There? The guy was really retarded, but he just knew how to say sentences. This was Mickey. What a slick guy. I went to Dr. LeMaistre, and I thought, "Here's the really intelligent person who understands it." I said, "Dr. LeMaistre, you have a vice president for patient care who's a clinic doctor, doesn't know anything about research. You have a vice president for research who's okay. He does research, but he only cares about laboratory people. What you need is a vice president for clinical research." Dr. Hickey was present during all this. Dr. Hickey didn't like this kind of stuff. He was between Mickey and me for all the time he was here. He tried so hard to be helpful. In dealing with Dr. LeMaistre, you soon learned that everyone who came to him left his office feeling that he had accomplished his mission—everyone. Dr. LeMaistre said, "That's a great idea." So Dr. Hickey prepared a job description for this vice president for academic clinical research, and they offered me the position.

Lesley Brunet, MA

This is instead of Conrad or in addition?

Emil J Freireich, MD

It was in addition. We're going to have 3 vice presidents: one who ran the clinic, one who ran the laboratories, and one who ran clinical research. The department had its own beds. We had a Clinical Research Center. We had built the eleventh and twelfth floors on the Lutheran Pavilion. We had our own operation at Center Pavilion Hospital. The Clinical Research Center was a whole institute within MD Anderson. The responsibilities of this vice president were laid out that he would handle all of the DT part of it, the clinical research, and the office of research. It's all in the job description that was 2 pages long. So I read it carefully, edited a few ifs, ands, and buts. Dr. Hickey wrote it; I accepted it formally.

Then Dr. Hickey, Dr. LeMaistre, and I had a meeting. Dr. LeMaistre said, "This is really wonderful. We're distributing authority from the president, and it's an excellent idea. But what concerns me is the borders between the vice president for clinical research, the vice president for research, and the vice president for the clinics." He said, "I think what you ought to do, Freireich, is you meet with Conrad and Becker, and just be sure you define the borders, and then—"

Lesley Brunet, MA

I saw that letter, actually, and I have a note on it.

Emil J Freireich, MD

Do you? Where did you get it?

Lesley Brunet, MA

It's in the President's Office Records.

Emil J Freireich, MD

Good.

Lesley Brunet, MA

"To ensure clear lines and delineation of authority where possible and definition of deliberately"—it's really wordy—"overlapping areas."

Emil J Freireich, MD

I went to Dr. Conrad. Dr. Conrad said, "There's no such thing as clinical research. If it's clinical, I'm in charge of it. No need for that job." I said, "Well, let's go meet with Dr. LeMaistre, because we have a difference of opinion." We arranged a meeting with Dr. LeMaistre. This is where I suddenly realized what we were dealing with. Dr. Conrad speaks, I speak, and Dr. LeMaistre makes a 10-minute speech. Remember, Dr. Conrad thinks he won. Dr. Freireich thinks he won. We leave the room.

Lesley Brunet, MA

What happened?

Emil J Freireich, MD

"Well, Fred, I won." "No. You don't understand LeMaistre. You don't pay any attention to him. You lost." This is the secret of Dr. LeMaistre. He never, ever, acquired responsibility for any decision. That's why he lasted 18 years. That's why he lasted 10 years as chancellor of the university, because everybody he talked to, he agreed with. There were no controversies in his mind. It's not anything deliberate. It was part of his personality. He just wanted so desperately to help people. Everybody around him immediately realized that whatever he said made no difference. So everybody who had responsibility simply used it. And since Conrad was in charge, he said, "It doesn't make any difference what Mickey said. I'm in charge." I understood LeMaistre, so I went to Becker. I didn't understand Becker. I understood Conrad, because, remember, I voted against him. I knew he was a straight hospital guy. He thought research was trivial. He was a carbon copy of Shullenberger. They just work until they retire. Conrad ran a hospital. He just wanted to retire, and when he got 20 years, he came here. He just wanted another 20 years to retire. He wanted to become Air Force Surgeon General, and he lost that job, so he quit the air force and came here. He just comes to work every day. Conrad was the hardest-working person I've ever seen. He was here every morning at 6:00. He drove a fast car from Conroe. We began to compete. I always used to be the first one here. I had a practice of being the first one here and the last one out. If I was going to build a department, I had to be a leader. So I came to the parking lot one day; there was a car there. It annoyed me a little bit. After 3 or 4 days, I found out this was Conrad's car. So I came a half hour earlier. That lasted about a week, and then I came, and his car was there. So I came a half hour earlier, and there was his car. You couldn't beat Conrad. He was indefatigable. So I finally gave up on that. He was here at 6:00 a.m. He checked every clinic. This guy ran it like you run your kitchen. He's a military guy. He was really terrific at what he did. Mickey was terrific at what he did. That's the secret of surviving in the UT system. Never make a decision, but appear decisive. When we met with Mickey, I was certain he agreed with me, but it didn't matter, because he wasn't going to act on it, anyway.

Lesley Brunet, MA

He didn't ever follow up with delineating responsibility?

Emil J Freireich, MD

He never followed up anything. Then I went to Becker. Now, Becker's a different breed of cat than Conrad. Becker really is academic. He wanted to have all Nobel laureates here. He recruited Isaiah J. Fidler [oral history interview] and Eric Olson and a lot of very good people. Becker and I sat down. Becker said, "Yes, I understand, J." Becker really appreciated DT. He appreciated what we did. He understood clinical research. He knew the difference between clinical research and just patient care. He said, "No problem." So then we had the follow-up meeting with Dr. LeMaistre, Dr. Hickey, and me. How did it come out? Conrad still disagrees. How about Becker? Well, Becker disagrees, too. When I met with him, he thought it was perfectly okay. We understood the difference. He said, "But he has a letter here." That's typical Becker. Becker is a swine, in the real sense. He's the inverse of Mickey. He's not well-intentioned. He's very self-serving. He's very arrogant, and he's very malevolent. When he talked to me, he led me to believe he agreed with me, and then he sat down and wrote a memo to LeMaistre saying he totally disagreed. So he had Becker's letter. He had Conrad's opinion. He said, "I'm afraid this isn't going to work." That was the end of me. What's the next thing? Well, the next thing is, "I'll tell you what. Since you can't be vice president for patient care, what we ought to do now is combine Medicine and DT, because we can't have 2 departments of medicine, one good and one second-class. You have to bring DT and Medicine together." There was another deal. The deal was that he would make me VP for clinical research if I gave up the possibility of being chairman of DT. I said, "No way, because DT is what I do. The only reason I want to be vice president for clinical research is to be sure DT prospers."

Chapter 16: Charles LeMaistre, the New President, Initiates Reorganization, with Impact on Developmental Therapeutics

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