Chapter 17: The Beginning of the Division System, Closing Developmental Therapeutics (1983), and the Legacy of the Department

Title

Chapter 17: The Beginning of the Division System, Closing Developmental Therapeutics (1983), and the Legacy of the Department

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Description

In this chapter, Dr. Freireich talks about the beginning of the division system, the closing of the Department of Developmental Therapeutics in 1983, and the department’s legacy.

Identifier

FreireicEJ_03_20010806_C17

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; Education at MD Anderson; Growth and/or Change; Obstacles, Challenges; Institutional Politics; Controversy; Understanding the Institution; The Researcher; Overview; Definitions, Explanations, Translations; Discovery and Success; Critical Perspectives on MD Anderson; MD Anderson History; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Technology and R&D

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Emil J Freireich, MD

Now we're going to put Medicine and DT together. By this time, Cliff Howe had resigned. He actually was fired by Dr. Clark. The acting head of the Department of Medicine was Tom Haynie. Tom Haynie is a lovely guy. He came 2 or 3 years after I did, from Galveston. He is a very good guy, very academic. He was one of the few clinicians who wanted to be academic in the Department of Medicine. So he was ad interim chairman of the Department of Medicine. We had some meetings, and he and I saw completely eye to eye. We need to build up Medicine, put it together with DT, and have a joint training program. I got the first training grant at MD Anderson, and we had the first clinical oncology training program. It began in '65. So by the time Mickey came in '78, we had a very well-developed fellowship program. Medicine also developed a fellowship program, and they had also some fairly good fellows, but we had totally separate training programs. We combined the training programs. We combined our faculty. We reorganized it. We had meetings of the whole department. Everybody was happy. It was going along well.

We also had 2 searches when Dr. Clark was here. They both ended up with me. Now Dr. LeMaistre says, "Now we're going to have a third search." This search was really big. They had Roger Bulger, president of the Health Science Center, on the committee. They had the guy from Southwestern, a hematologist friend of mine who was dean at Southwestern, Dr. Charles Sprague, on the committee. It was really a big committee, very prestigious.

Lesley Brunet, MA

This was going to be a new Division of Medicine?

Emil J Freireich, MD

Right. We had Department of Medicine and Department of Developmental Therapeutics. We inverted the way medical schools do. Medical schools have a Department of Medicine and divisions that are subspecialty. But because we had 2 big departments, he said, "Let's use the title 'Division' to put them together." It was the first division.

Lesley Brunet, MA

And what was it going to be called?

Emil J Freireich, MD

It was going to be the Division of Medicine. That included all the medical specialties and everything. So we're going along fine. He appointed a new search committee. It had a lot of very prestigious people on it. The search committee was asked to make 3 recommendations without priority. The 3 people they picked were Joe Bertino, John Durant, and me. LeMaistre went after Joe Bertino. Joe Bertino came by, and he had a wonderful visit. Everybody was in favor of Joe Bertino, including me. Joe Bertino went back east, where he had a lot of connections. He had social problems. He came back at least 3 times. The search for Joe Bertino went on for over a year. Finally, Dr. LeMaistre decided that he really wasn't going to come. He was just constantly leaving the door open. So he moved on to Durant. John Durant walked in the front door, came to my office and said, "J, this job is ridiculous. Conrad decides everything. What the hell would I come here for?" He was at Fox Chase Cancer Center, in Philadelphia, as head of the center. It was out of the question. He wasn't here 5 minutes, and he knew that wasno job for him.

Two presidents and all the chairmen, and there was only one candidate left. What would you do if you were Mickey? It was a bad situation. If he appoints Freireich, everybody at MD Anderson is down his throat, except the people in Medicine. It was a tough decision. What would you do? Only Mickey could come up with this solution. The committee insisted that he interview Freireich. They said, "We gave you 3 names. You've rejected 2. You've got a third. You've got to interview." So Dr. LeMaistre called me. "Come to my office." I went to his office. This was one of Mickey's greatest performances. I wish I had a video camera. He's very elegant, and he always talks with a deep voice. He had a sunburn on the back of his head from sailing. He had someone who always did his hair, and he wore nice suits. He had a manservant who used to come and turn on the lights and the air conditioning before he went anywhere. This is King LeMaistre. "J, the search committee has recommended you for this job." He talked for 15 minutes, telling me things that I knew better than he.

Lesley Brunet, MA

He was telling you things about the situation.

Emil J Freireich, MD

Yes. "This is the job." So after about 15 minutes, I was getting a little bored by the performance. I said, "Dr. LeMaistre—" "Do you have any questions?" "I have only one question. Would you ever consider appointing me to this position?" Of course, he wasn't going to do it. So the next thing he did was he discharged the search committee, and he announced in public to the faculty that the reason he discharged the search committee was that there were leaks. They were supposed to be confidential, and there were leaks; therefore, this search committee was discharged. He appointed a new committee, appointed by only him, which were all slaves. There was only one person from DT on this committee. It was Jeane Hester. God bless her. She told me what happened. This committee was assembled and asked to review the credentials of one Irwin Krakoff.

Who is he? The prestigious search committee had at least 100 names recommended, and he was not in it. He was a hopelessly incompetent, no-good, worthless guy who ran the Rhode Island Cancer Center, and all of a sudden the committee was asked to review Krakoff and approve him. And they did, surprise of surprises. Krakoff was appointed in 1983.

Lesley Brunet, MA

Was he already here?

Emil J Freireich, MD

No. He was in Rhode Island. So in 1983, Irwin Krakoff is appointed head of the Division of Medicine. Four to six weeks after it was announced, he appeared at MD Anderson, and he called all the department chairmen to his office—Tom Haynie, Evan Hersh, and Gerald Bodey [oral history interview]. He announced that DT was being eliminated. It was the first time in the history of this institution, any academic institution, that the best department had just been eliminated. [LS1]Took it out of the bylaws, and it was just eliminated. DT was Balkanized, and I was given the responsibility to be head of the Department of Hematology. This is in 1983. The other 3 were department heads, he was head of the division, and that was it.

Lesley Brunet, MA

They dissolved the department. Is that what you're saying?

Emil J Freireich, MD

Yes, just eliminated it. It was Balkanized.

Lesley Brunet, MA

No wonder I couldn't find more records on DT.

Emil J Freireich, MD

It just vanished, vaporized.

Lesley Brunet, MA

Did they change it into other names?

Emil J Freireich, MD

Everybody was given different jobs. I could give you a list of things that DT contributed to MD Anderson. I told you we didn't have any platelet program. We established the platelet within the department and then farmed it to Pathology. I personally invented the blood-cell separator when I was at NCI. I told you I got fired. When I came here, Seymour Perry couldn't do anything with it. He was a total dolt, so the thing languished for a couple of years. Then IBM came to me and said, "This project's going to die unless you move it, Freireich." So they gave me a free machine and some money. We developed the blood-cell separator. It's now used the world over. That was all done in DT. Platelets were all done in DT. If it wasn't for DT, there wouldn't be platelets anywhere, because remember, NCI was a unique place. But to do it at MD Anderson, everybody copied it. We showed it could be done. We did the blood-cell separator. That established the proof of blood stem cells, the granulocyte transfusions, and all that stuff. We started the IV team. When I came here, doctors administered medications. If I ordered Cytoxan, they used to have 20 bottles of Cytoxan, because we'd give 2 grams, and they came in 200-milligram vials. The doctors had to go mix this stuff and administer it because the nurses couldn't do it. I said, "This is a terrible waste of professional time." So I hired research nurses, and now, of course, we have an IV team. The research nurses mixed the drugs. Then I made a deal with Mr. McKinley, who was then in the pharmacy. "Maybe the pharmacy ought to send the drugs up." And we established the unit-dose system, which is the way the place operates now. That was all done just for DT. Everybody else benefits from what we did.

When I did the blood-cell separator thing, we had to get our own space, so we created a pheresis center. In order to run it, we had to have nurses, because I didn't want doctors sitting by the bedside for 3 hours during these procedures. So I hired a nurse for DT, and we developed the research nurses, which now, of course, everybody has research nurses. When Joyce Alt came in, she immediately said obviously she should have done that. Renilda Hilkemeyer used to hate me. "Freireich, you can't do all this stuff." So we had our own nursing service, and now we have research nurses on every unit. We had a guy come to us with these catheters in order to figure out if we could use outpatient chemotherapy. We developed the outpatient pumps, the long lines, and the catheters in my department, with our own money and our own grant money. And then, of course, everybody else acquired it, and now we have an IV team, which is run by Surgery, to put in the catheters and long lines, so we can do outpatient chemotherapy.

The people I recruited are all giants in this institution. Even though DT was eliminated, our footprints remain. Evan Hersh became head of the Department of Bioimmunotherapy, which is now headed by Dr. Moshe Talpaz. Dr. Talpaz was one of the fellows in my training program. Razelle Kurzrock, who has won awards, was one of the DT fellows in Bioimmunotherapy. Dr. Rosenblum, who does the monoclonal antibody stuff, was a DT postdoc with Dr. Ti Li Loo. David Farquhar was a postdoc with Dr. Loo. Grady Saunders, who's still retired and still working every day in biochemistry, was in DT. Gerry Bodey, who started the infectious disease program, created the reverse isolation unit with our money on the twelfth floor. He's now retired, but is coming back, I think, part-time. He became Office of Protocol Research director. Gene McKelvey, who was the first or the second vice president for academic affairs, was a DT recruit and alumnus. Ti Li Loo, of course, did the pharmacology program. Robert Benjamin [oral history interview], who's head of sarcoma, was a DT fellow and trainee. Jaffer Ajani, who's still in GI, was a DT fellow and trainee. Yehuda Patt, who still does the liver program, was a DT fellow and trainee. Giora Mavligit, who does the melanoma service, was a DT trainee. I may not have remembered them all. Barthel Barlogie, who was very important, is now director of the myeloma program at the University of Arkansas. He's one of our distinguished alumni and was a DT trainee. Robert Livingston, who's head of Oncology at University of Washington in Seattle, was one of our DT fellows. And there was Jeane Hester and Ken McCredie. Jeane Hester developed the whole Pheresis Center. If you go down there and see that big Pheresis Center, that was all hand-built by us with our own money. When we were at our peak, before I got fired in 1983, Dr. Clark decided to expand our clinical research program, and we wrote a construction grant. The 2 floors that had been added to the entire building were built entirely by DT. We defended the grant. It was our research program. We built this whole thing. It was typical Dr. Clark stuff. It was supposed to be all DT, but when we finally finished it and occupied it, it got reduced substantially. He took away the seventh floor entirely. We were given the entire sixth floor. Then he negotiated with Pediatrics, and they got that little bit in the front there, and he gave the whole Gimbel Wing away. So we only got this piece of it. So that's why my office is here, because we built that, and I put myself in the middle. Dr. Hersh was here in immunology, this section, and Dr. Bodey was over on that wall with the infectious disease. This was all pharmacology and transplant. DT had a big impact on this place, and it will last forever. That's all written up in our book.

Lesley Brunet, MA

What you wrote on DT?

Emil J Freireich, MD

Yes. In 1983, it was gone. I was very upset about it. I went to Dr. LeMaistre.

Chapter 17: The Beginning of the Division System, Closing Developmental Therapeutics (1983), and the Legacy of the Department

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