Chapter 11: Funding Innovative Clinical Research: Some Institutional Obstacles

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Chapter 11: Funding Innovative Clinical Research: Some Institutional Obstacles

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Description

In this chapter Dr. Gutterman comments on the reaction of MD Anderson "and then president Dr. Charles LeMaistre-- to the private funding of his interferon research." He also underscores how unique MD Anderson is, with all of its many resources, intellectual, creative, financial, etc. He also comments on his role as Chair of the Department of Clinical Immunology and Biological Therapy, noting candidly that he was not passionate about administration and unable to manage the Department adequately.

Identifier

GuttermanJ_03_20120419_C11

Publication Date

4-19-2012

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Giving to/Fundraising at MD Anderson; The Researcher; MD Anderson History; Discovery and Success; Critical Perspectives on MD Anderson; Critical Perspectives; Obstacles, Challenges; Institutional Politics; Controversy; MD Anderson Culture; The Administrator; Leadership; Personal Background; Character, Values, Beliefs, Talents; On Research and Researchers; Understanding the Institution; On Pharmaceutical Companies and Industry; 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

Tacey Ann Rosolowski, PhD:

This is Tacey Ann Rosolowski. I am, today, interviewing our third session with Dr. Jordan Gutterman. The date is April 19, and the time is approximately 3:15. So we’re off pause. We’re recording.

Jordan Gutterman, MD:

Okay.  

Tacey Ann Rosolowski, PhD:

So I just wanted to kind of put a little framework. We were talking before the official start of the interview that you wanted to reflect a bit on some of the administrative, departmental, institutional issues in which you were working over the—basically under four presidents now. So I just wanted to give a frame for that conversation.

Jordan Gutterman, MD:

Yeah. Well, when I came here it was 1971, and I think I discussed kind of what attracted me here being [Emil] Freireich and a couple of other people from MD Anderson. [R. Lee] Clark had been here for many years. As I said, he was extremely supportive. He selected me, along with Dr. Freireich, to meet with Mary Lasker when she came in 1974, which was a key event medically and scientifically in my life. You know, it’s just amazing the world that she opened up. And I’m not so sure we’ve talked in much detail about the world she opened up outside of MD Anderson, but at some point we might fill in the blanks on that. Not only in science and medicine, but kind of watching how she operated both within the government and the private sector and so forth, how she brought people together. As I said the other day, she had the greatest gift you can give a person as another person, and she was just a master at that. And so she came down here, and I discussed that. Then I’ve also discussed previously, I think, also with Lesley as well as probably some with yourself, that—I’m not—I haven’t done this with you, but I remember I went to this interferon meeting in 1975 where everybody thought that cloning genes and making recombinant molecules, biologics—many people said would never happen in our lifetime. I don’t think Mary Lasker believed that. And I think I’ve discussed it previously, so I’m not going to go into it. I’ll just mention it. In August of 1977—I always like to leave Houston in August. It’s so intensely hot. I remember that summer saying, “How can anybody tolerate it?” I didn’t think I would stay here that long, but—I mean, the first year I was here, way back in ’71, ‘72. But in ‘77 we had a newborn—a young boy—a little boy that wasn’t even one yet, so we couldn’t travel. Mary Lasker called me, and her secretary—it would have been Albert Lasker’s secretary—Jane had developed recurrent breast cancer. She said, “Jordan,”—and she sometimes swore—“God dammit, we’ve got to do something about this disease. Will you go to Sweden if I get you—and Finland—if I give you a million dollars?” But I think I’ve told that story, so I’m not going to repeat it. I think we’ve talked about all the preparations and the excitement about getting the interferon. It was called leukocyte interferon at the time. Finally it arrived, and we got FDA—Food and Drug Administration—approval to start the clinical studies in February 13, I think it was, 1978, with the schoolteacher. I won’t repeat that either. Around that time, Dr. Clark had decided to retire, and his replacement, Dr. Charles—known as Mickey—LeMaistre came in as the new president. It’s interesting; the inflection point is when we started those first patients. I think Clark was still in charge, but around that time—we could check the dates—LeMaistre came in as the first president. And I remember Mary Lasker returning here with Ann Landers, or Eppie Lederer—her real name—to Houston to visit [Michael] DeBakey. She came over, and I gave a short summary of where we were. We had already started the clinical studies. Mary and I had done a lot of stuff already. We had gone to drug companies, and I won’t repeat all that because I think that has been discussed. So it’s interesting that the year of LeMaistre’s arrival was the year of all this intense activity and excitement and publicity. And not all of it was well received. Mary said she wasn’t going to give a penny to an institute. Nothing about MD Anderson, it’s just that she didn’t want overhead. She wanted every penny to go to making the drug. And she’s not the only one in my life that has had that—it was said to me many times. So she sent the money directly to the Finnish Red Cross to make the interferon, which I think has been documented. But it’s interesting—this did not help me very much, which I agree with her. And I’m a bit of a rebel because I don’t—you know—we were bringing—once the publicity started, patients were coming here, and the institute was generating income from a lot of the patients, I think. All of the publicity—I mean—this was many, many years ago now. But there was not complete support for this, as I said, in various areas of the institute.

Tacey Ann Rosolowski, PhD:

Why?

Jordan Gutterman, MD:

Good question. It’s probably multi-factorial. I think, first of all, people in general don’t like other people to get credit or publicity perhaps. There may have been some concern about the credibility of all this. This was pretty bold. I think that’s one of the lessons for students and others—there are different types of people. I want to do really, really bold and important things in life. For me, to do incremental things or do whatever everybody else does, to me, would be very boring. That’s not what makes me—that’s not who Jordan Gutterman is. And we can discuss that in terms of my own self-awareness and image of what I want to do. So you are going to rub—I mean—anybody who has done—I’m not saying I’ve done great things, but I’m just saying anybody who changes the paradigm, opens up new areas, gets people to think, perhaps, differently is going to rub people the wrong way sometimes. You can’t avoid it. You can’t be popular. And you have to develop, and I did. I mean, I came from a small, little town, and I still am a very shy person in many ways, but I can open up. I must have developed a very hardcore shell about this, and not a shell that it didn’t affect me. It affected me deeply, but there were a lot of barbs and criticisms and pressures, including at the very highest level of the institute. I think I discussed in ‘84 when we made the big break—announced the big break in hairy cell leukemia publicly with The New England Journal paper. One of my colleagues accused me of making up the data with my other—one of my other colleagues—the person that worked with me, Dr. [Jorge] Quesada, who was very, very brave and courageous and honorable. And—you know—I think people believed it at the very top. I was asked to not go on McNeil/Lehrer. They had to clarify everything. So that was tough. I told you; we talked about “victory gin” and all that stuff back in 1984. The fifth of January, 1984—now, that is still a really interesting time. I always look at events. But I think for students and people, one day when they read this or hear this, I think that if your nature is to do major things, you are going to have to struggle. Nothing is easy. Once I heard a little parable—that you don’t climb a mountain on the smooth side. You have to climb it on the rough side. And so those steps are—it’s a struggle. I could understand, perhaps, in retrospect, as I’m a little older, why the higher levels might be nervous about all this PR and all this type of stuff. So, I think it’s multi-factorial. I’m not saying it’s all jealousy. I’m just saying that, in general, the establishments like to maintain order and control, and bureaucracies do that certainly. And this place has gotten bigger and bigger and bigger, and it gets more ingrained. I still maintain—and we’ll talk about this in a minute—that this institute is still a place, for various reasons including resources, if you are creative, you can still do things here in medicine and cancer research, for sure, that you almost can never do any place else. You probably could, but this is a place—the environment here—the place is very, very important. That’s where I choose to do the work. I’ve grown to love what you can do in Houston and Texas even more when I tell you the next story in just a second. So after the approval of interferon, I mentioned I started a department, and we did a lot—we published a lot of papers. We ran a lot of trials. But they weren’t that satisfying and fulfilling. They weren’t really getting at the deeper roots. Now a lot of big breaks and understanding are beginning to take hold in terms of our understanding of cancer. In the early eighties—the discovery was made in the late seventies. The concept of the oncogene was finally recognized by a Lasker award for Mike Bishop and Harold Varmas, both of whom I got to know very well now on the Lasker jury. They eventually won a Nobel Prize, I think in ‘89. And I mentioned we weren’t doing much work on those things, but it wasn’t just oncogenes or a bit later suppressor genes. It was the whole result of understanding many of the complexities of cancer which are still not completely understood by any stretch of the imagination. I mentioned in the early nineties I learned a lot about the business end of drug development, and that was very educational. I think, as I said earlier—before in the tapes—I brought a lot of that knowledge, began to work with the pharmacists and reimbursements, and so there are many aspects of making new drugs in terms of an institute, of the economy of the institute, with the progress of the institute, and so forth.

Tacey Ann Rosolowski, PhD:

Was there a similar discomfort at the administrative level for the negotiations that you were undertaking with drug companies?

Jordan Gutterman, MD:

Oh yeah. Well, you have very—you know—very strict conflict. You’ve got to be very careful. In the end, you have to police it. I think that there was initially—when I first started working with Roche and Schering, not with Dr. Clark, but just in general. I think looking—scientists working with—collaborating—in fact, I wrote a piece in the nineties, as I began to wind down this department, about the war of the parts against the whole, how private sector—like in this case the pharmaceutical industry, the emerging biotech industry, the third sector that is the philanthropy and the foundations, and the government all seem to be at war with each other. And I just never see it. I mean, I never published that article. I still have it. It was about drug discovery—that you have to have all elements because there’s part—we should not be dealing with pharma. We can’t do really what pharmaceutical companies can do or even biotech companies. There is a thrust now in the government to make new translational research and drug discovery. There is a thrust here now at MD Anderson. I think you can do elements of it. I’m doing it, but I always reach out to these other elements. I mean, the Lasker Foundation, and I haven’t talked much yet about the Clayton Foundation. I will. Without their support, much of this could never—or maybe none of it could ever have been done. I’ll come back to a very key decision they made. That’s the third sector they call the philanthropy—the foundations. That’s one of the great attractions of Houston are these medical research foundations that are amazing. Big resources, very philanthropic, very few cities—I don’t think any other city could equal that. So that makes MD Anderson a unique, special place to be in this wonderful medical center.

Chapter 11: Funding Innovative Clinical Research: Some Institutional Obstacles

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