Chapter 01: Recruitment to MD Anderson

Chapter 01: Recruitment to MD Anderson

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Identifier

GuttermanJ_02_20060329_C01

Publication Date

3-29-2006

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview's Subject Story - Joining MD Anderson/Coming to TexasJoining MD Anderson; Professional Path; Mentoring; On Mentoring; The Researcher; Definitions, Explanations, Translations

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

Lesley W. Brunet:

This is Lesley Williams Brunet about to record an oral history interview with Dr. Jordan Gutterman. The date is March 29th, 2006. This interview is being recorded in Dr. Gutterman's office at the SCR2 in Houston, Texas. This interview is being recorded for the MD Anderson Cancer Center oral history project.

Lesley W. Brunet:

Why don't we start by talking about when you arrived at MD Anderson? What year did you move down from NCI?

Jordan Gutterman, MD:

No, I never was at NCI.

Lesley W. Brunet:

Why did I think you were?

Jordan Gutterman, MD:

Yeah. I trained, I went to medical school at the Medical College of Virginia. And then did my five years of internship residency and fellowship at Duke. And this was during the Vietnam Era, I was in the Berry Plan. And I was lucky enough to spend my two years of military service as head of hematology at the Brooke Army Hospital in San Antonio. That's what got me to Texas.

Lesley W. Brunet:

Oh. That's right. That's your Texas connection.

Jordan Gutterman, MD:

Yeah. And I was very lucky. This was just fortuitous that they had put in as the oncologist, which was just emerging as a specialty, medical oncology. A doctor, physician from Bogota, from Columbia, Victorio Rodriguez, who had just finished his training here at MD Anderson -- particularly worked with Gerry Bodey on infectious diseases. And he was -- I just arrived at Brooke for two years as an oncologist. I'm not sure oncology was even recognized as a specialty, but that's what he was. He's not trained as a hematologist. But I was in charge of the whole operation, and they had a hematopathologist there. We had an incredible two years. And I was trained as a classic hematologist, and spent time in the laboratory. And I learned a lot of oncology from Victorio, because I didn't -- I had virtually no experience in solid tumors or modern day chemotherapy, particularly acute leukemia. And because of Victorio, he had gotten the MD Anderson, the developmental therapeutics people to act as consult -- to be consultants at Brooke. And periodically they would show up. This is how I met Freireich, and Evan Hersh, and Gerry Bodey, maybe one or two others. And I don't remember if Tom Frei came down, but I remember Freireich, and of course, once you meet Freireich, you don't forget Freireich, and Victorio always had plans to come back to MD Anderson. And over the course of two years of working with him, we became close friends, and it was natural for me to think about this. I thought about going back to Duke, but I came to MD Anderson with him and I was extremely impressed with the medical center and MD Anderson. I think back about those times, which is 35 years ago. This was 1969 to '71, when I was in San Antonio. And I remember driving to Houston thinking what an enormous city, compared to San Antonio. And the medical center, I'd never seen anything like it. And I said, this is the place to be. If I want to do cancer research, which is really what I was committed to. During my hematology, I gravitated to be interested in malignancies and so forth. And so, when I finished my military training in the summer of 1971, July, I came here for about -- from July and October of '71 -- initially, it's what they called -- they don't have the positions anymore -- a "faculty associate." And that was a very junior position. It was like, not a fellow anymore. And then immediately, I start working really hard, and I think they were willing to give me, I think an assistant professorship in October 24th, I think, 1971. So that's when I came here. And that's how I got here, through Victorio Rodriguez, who came back at the same time and stayed only about five years, and left, I think he just got fed up with the politics of the place, and went to San Antonio into private practice of oncology, where he still is today.

Lesley W. Brunet:

So when you first came, what did they have you do? Or what projects did you work on?

Jordan Gutterman, MD:

Yeah. I was assigned to -- initially I wanted to work with Victorio, because we were friends on infectious diseases, and Freireich said no, that's -- you need to work in immunology. And I'm still stuck with that title, people think I'm an immunologist. But we'll come back to that later. But that's OK. So he assigned me to work with Evan Hersh. Evan was head of a section of immunology and immunotherapy, I guess they called it. And so, Evan was very good. He set me up in a laboratory with a research technician, and I started two major projects. One was, in the laboratory, studying the immune response to acute leukemia, which resulted in some really interesting publications in the '72, '73, '74, early '70s. How the body responds to leukemia. We won't go into those results, but they were some really interesting papers. We even had one in Science.

Lesley W. Brunet:

Come back to that in maybe another interview.

Jordan Gutterman, MD:

And my clinical duties were split between two things. I worked in the outpatient clinics seeing melanoma patients. And started working with immunotherapy. When I was in the Army, in 1969, a paper -- and this is, eventually, what got me to interferons, so it's an important part of the story. In 1969, I read a paper by George Mathe, M-A-T-H-E, who was a former Gottleib winner, about the use of BCG and the treatment of kids with childhood -- you know, children with ALL. And so, when I came to MD Anderson, Evan asked me what I wanted to work on, and he, too, was interested in this whole thing, but he himself didn't want to really initiate it. So I started a program using BCG immunotherapy. Immediately when I came here, using melanoma, but not acute leukemia as a model initially, and then also we worked in AML, which I'll come back to.

Lesley W. Brunet:

For people who don't know what BCG is, can you explain exactly what it is?

Jordan Gutterman, MD:

Yeah. BCG, I think it stands for Bacillus Calmette --C-A-L-M-E-T-T-E -- dash Guérin, G-U-E-R-I-N. Because I'm not in the field for over 30 years, I don't know if it was one man or two men who -- it's a TB vaccine. It's a live TB vaccine. So it's Bacillus Calmette-Guérin. It's an attenuated Mycobacterium, or TB vac that's used to vaccinate against tuberculosis. And I haven't really kept up whether it's in use at all -- it is an approved drug, actually, today, for bladder cancer, actually. But it was kind of the exciting thing. I mean, there was, of course when I came, surgery and radiotherapy, obviously, had been well established, and chemotherapy was now solid rock, you know. In large part because of Frei and Freireich and all that work that came out of the NCI, first in leukemia, then in Hodgkin's which -- and I learned all that stuff when I was in -- particularly when I was in the Army. Although, when I was in Duke in training, we were -- I was aware of Frei and Freireich and leukemia, because we began to use some of the same drugs they were using at the NCI in Hodgkin's disease as well as in myeloma. At Duke. So, I came and set up a BCG program. Initially in malignant melanoma. And shortly thereafter, also in patients with acute myeloid and acute lymphocytic leukemia. That was the major focus. And eventually, as well as in lymphomas. So from 1971 through my own direct participation, '76, '77, I was in charge and collaborated as well with multiple studies at BCG as immunotherapy, which we can come back to. And as well as studying the immune response to acute leukemia. So it was really all immunological. And then because of the melanoma studies of BCG with -- alone in early disease, and with chemotherapy in late disease, I had a pretty heavy, heavy duty clinical load of patients in the outpatient. And in addition, there were only two of us rounding on the acute leukemia service, which could never happen today. You know, it was still busy, but it was Ken McCredie and myself. Rounding, alternating, attending on the acute leukemia service. I was one...

Lesley W. Brunet:

And how large was that, how many?

Jordan Gutterman, MD:

We only averaged about, most of those patients were either down in 2 West or, but I think we averaged about 15 to 18 patients. But we had really good fellows. We didn't have -- there was -- I mean, I was at Duke when the positions assistant program started, so I was quite aware of it. But we didn't have PAs at the time, although I hired the first PA at MD Anderson, I'll come back to that. And nurse practitioners were just a, you know, vision in somebody's head probably, or nobody's head at that time. But we had fellows. So the fellows were the nurses, the PAs, as well as the fellows. But we had some really outstanding fellows at the time who went on to careers, like [Jean Hiss?] at MD Anderson, or Robert Livingston at University of Washington, and a whole variety of others. So, I was pretty busy.

Lesley W. Brunet:

Sounds like it. So, you were doing BCG until about '76, '77?

Jordan Gutterman, MD:

Yeah. Well, that story changed where I began to change directions. You know, at some point, we'll start talking about -- when I went to a meeting on interferon in late March, ironically, 31 years ago, probably today or tomorrow, I think it started the 31st of March of 1975. I'll come back to that, or how I got there. But that was a pivotal, rather serendipitous meeting, where I began to think -- and I'll tell -- I'll explain the science of why I began to think that the use of BCG, although a good start, and taught me a lot, and I still think to this day, probably benefited some patients with acute myeloid leukemia -- I have little doubt about that, and absolutely, certain lymphoma patients. That is, boosting the immune system. I didn't think, because it was a live vaccine and a lot of variability in making it, and there wasn't -- there were no -- there were organizations making it. There was not a drug, as I saw it. And for various reasons, which I'll get into, I thought interferon would be the real first step of establishing something that would affect the immune system as well as other aspects of cancer, and we'll come back to all that. So I worked on that from 1971 'til around '77. Six years. And then I shifted directions completely.

Lesley W. Brunet:

You said you went to a meeting in -- was it '75?

Jordan Gutterman, MD:

Yeah.

Lesley W. Brunet:

What was that meeting? I had this on here.

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Chapter 01: Recruitment to MD Anderson

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