Chapter 04: Strengthening Medical Oncology at MD Anderson with the Aid of NCI Researchers in the Department of Biostatistics

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Chapter 04: Strengthening Medical Oncology at MD Anderson with the Aid of NCI Researchers in the Department of Biostatistics

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Dr. Gehan recollects Dr. R. Lee Clark’s approach to funding, recruitment, and management and the attraction of MD Anderson/Houston to Dr. “Tom” Frei III, his wife Elizabeth “Liz” (nee Smith), as well as himself. Dr. Olson mentions from Kenneth Endicott (NCI Director) to Dr. R. Lee Clark (President, MD Anderson) lamenting the move of Dr’s Frei III and Freireich to MD Anderson. When Dr. Gehan started at MD Anderson in 1967, Dr. Lee D. Cady Jr. was the Head of the Department of Biomathematics. Dr. Gehan talks about the impact of the arrival of Dr’s Frei III and Freireich on MD Anderson Research. Dr. Gehan cites the cooperative group collaboration model of NCI/NIH Clinical Chairman Dr. C. Gordon Zubrod and biostatistician Marvin A. Schneiderman on the first randomized trials in acute leukemia and solid tumors. He recalls the members of the administration and the research team at MD Anderson before the arrival of Dr’s Frei III and Freireich: Dr. H. Grant Taylor, Chairman of the Southwest Oncology Group (Southwest Oncology Group), epidemiologist Eleanor Josephine McDonald (known for creating the National Cancer Registry) statistician Kenneth M. Griffith, Dr. Roy C. Heflebower, Joe E. Boyd and Dr. Stuart O. Zimmerman, Chairman of the Biomathematics Department. He also mentions other MD Anderson administrators and researchers: Terry L. Smith, Dr. Peter F. Thall, Dr. J. Jack Lee, President Dr. Charles A. LeMaistre, Dr. Frederick F. Becker and President Dr. John Mendelsohn. Finally, he talks about the Department of Biostatistics, how it differs from Biomathematics, and the effort to strengthen medical oncology at MD Anderson.

Identifier

GehanE_01_20030328_C04

Publication Date

3-28-2003

Publisher

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

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - An Institutional Unit; Building/Transforming the Institution; Professional Path; Giving Recognition; On Research and Researchers

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

Edmund A. Gehan, PhD:

It was around 1966 that Frei moved here. Have you ever heard this story of how he moved here?

James S. Olson, PhD:

All I have is a letter from Kenneth Endicott I came across to Dr. Clark about 1965-66, when Frei and Freireich had made the decision to come and Endicott was just absolutely heartbroken about it. He was happy for Dr. Clark in a way, but he just thought it was a real blow to him and the program.

Lesley W. Brunet:

But Frei came down in 1964.

Edmund A. Gehan, PhD:

Who?

Lesley W. Brunet:

Frei came down in 1964.

Edmund A. Gehan, PhD:

1964?

Edmund A. Gehan, PhD:

Late in the year.

Edmund A. Gehan, PhD:

Well, it was around 1964-65. But do you know why he came? Where was Houston in 1964? Well, I can tell a very brief story, which I mentioned. I first came to Houston in the late fifties, early sixties. It was probably in the 1961-62 time. I was sort of a member of an NCI group visiting Dr. Clark. Dr. Clark had applied for some money for a project that I don’t remember, but he took the following tack. There was a committee of seven or eight people, and head of that particular biometric section was actually in some ways was still the best job that I have had in terms of administratively. But Dr. Clark spoke to the group and said, “We know we are well behind down here. We are trying to catch up with you there at NIH. We need some more excellence in our research people and better capabilities than we have. If you give us this money, that will help us along the road.” Well, he got that money. That was a very successful approach to dealing with people. And I later followed Frei and Freireich [here]. I have asked Tom and you should ask him, too. “Why did you ever move here?” He is from St. Louis and he was doing well in Washington. He had a very senior position. The answer is a personal matter. Tom has five kids. He has four girls and a boy. We do, too. We have four girls and a boy. Tom’s wife was Liz Frei, a wonderful woman. Liz had a sister, Lil, who had seven or eight kids and was married to a postman, who died at age 39 or 40, something like that. Tom is the only potential source of income for these, so Tom is responsible for thirteen kids. Some of them were old enough to take care [of themselves]. It might have been eleven or twelve, I don’t know, but he basically moved here because he couldn’t afford to support that size family on a government salary, and so that’s why he came. I am quite sure of that.

Lesley W. Brunet:

Yes, that is true.

Edmund A. Gehan, PhD:

When I first came here for an interview, I guess I’ll never forget this part either. Tom says, “Why don’t you come for dinner?” You know it was part of the recruitment. “Oh, OK.” But he didn’t have a car, so Liz was going to come and pick him up. So Liz came. [I thought] Who is taking care of these twelve or thirteen kids? (Laughter) Well, you get to the house. Liz took care of all that. Tom is oblivious to things. It was like a picnic table. And the dinner was kind of thrown together. I guess one of the things about Tom is that his professional life is tremendously well organized, but his home life is chaos—absolute chaos. J can expand on that. I came here in 1967. It started out that Lee Cady was head of the Department of Biomathematics, although he was an M.D. I guess one of the others have probably told you stories about this, too. In the final stages of the negotiations with Clark, I get to see Dr. Clark. I had already got a good background. I had already been to London and I had a number of published papers, and so on, so I had a pretty good background in statistics. Lee Cady, as I said, was an M.D., but he was a Professor of Biomathematics. So we came down [after] talking to Dr. Clark. “What level of appointment do you think you should have?” I said, “Well, if Lee Cady is a Professor, I should be a Professor, too.” Done. That’s taken care of. [There were] no committees, nothing. Then we came to discussing salary. I was making about $14,000 with the government. I was a GS14, which is actually a reasonably high level. It was something like $15,000 that he was going to offer me, something like that. I said, “Well, I was really hoping to get something more, maybe $16,000,” a thousand or two more than he said. (Sound of a hand hitting the table) Done. (Laughter) I mean, Dr. Clark was autocratic, but he was a good autocrat, and in the end that is kind of the reason that we came here. I would regard the letter that you had from Endicott that they really brought M. D. Anderson into the modern era. There were a number of good old boys here, and they certainly were good old boys.

Lesley W. Brunet:

I’d like to hear about that.

Edmund A. Gehan, PhD:

I was one of the younger people. Somebody could say, “What were the research accomplishments at M. D. Anderson prior to their coming?” They were the headquarters of the Southwest Oncology Group under Dr. Grant Taylor, who was the chairman.

James S. Olson, PhD:

There is controversy about that though, isn’t there? A problem with Taylor?

Edmund A. Gehan, PhD:

No, not at the beginning. The mid-fifties are when these cooperative groups got started. Gordon Zubrod went around the country with Marvin Schneiderman, the statistician, so right from the start there was always a clinical chairman and a statistician. Houston, even though it wasn’t such a great place, was a major spot here. I guess Clark assigned Grant Taylor to the chairmanship of the Southwest Group. A woman named Eleanor Macdonald, who Clark had run into, was at the Connecticut Tumor Registry. She was more epidemiologist and a tumor registry person than a statistician. And then a fellow named Ken Griffith was the statistician. That started in 1957-1958, around there. There was a Dr. [Roy C.] Heflebower. Joe Boyd was on the business side. Others could tell you, Clark certainly was loyal to the people closely around him. But I wasn’t a part of that mix.

James S. Olson, PhD:

That is kind of interesting because he had that team he started off with, and as the place really grew, he had to start marginalizing some of those people. He was loyal to them, but some of them were kind of out of touch with what had happened in the disciplines so you start seeing them getting pushed to the side a little bit.

Edmund A. Gehan, PhD:

Yes, a little bit. I guess one personal part of this, as I said, I became a professor in biomathematics, but within six months of coming here, Lee Cady left and went to California. OK. Who is going to be head of biomathematics now? I have a reasonably good background. I am not picked. Stu [Stuart] Zimmerman is picked. Where is Stu Zimmerman? Stu Zimmerman is actually more in the Dental School. He is an associate professor and he doesn’t have a primary appointment here, but he gets one. To this day, I think that Clark didn’t want to give too much power to Frei and Freireich. Frei is the head of Developmental Therapeutics. I think, and we’ll never exactly know, by any objective standard I was far ahead of Zimmerman, who wasn’t really in biostatistics anyway, he was in biomathematics. Part of the crosses I have had to bear is that Stu Zimmerman became chairman in 1967, and I was very disappointed in not being chosen. Stu did not step down as chair until, what, last year?

Lesley W. Brunet:

Yes.

Edmund A. Gehan, PhD:

I think he was the longest serving chair in that particular department. I don’t know whether you have spent time with him, but you should go through some of the same things [with him]. He was not particularly supportive of me. I guess, in part, I’m sure he perhaps detected some resentment on my part, but he kept a fairly tight lid on me and the [other] people. One other small story is I said we have five kids, and a number of them are in the Houston area, so I had this opportunity to go to Georgetown to be head of a small group. My wife really didn’t want to leave. I did go to see Dr. LeMaistre and I did go to see Dr. Fred Becker. Becker and Zimmerman got along very well, and Becker was head of research. One of the things I went to Becker about was biostatistics has been a part of biomathematics for a long time. I think it’s time that it could be a separate group. Becker said, “Well it may become a separate group some day, but it won’t happen for you.” It has happened since. For two years they tried to find a replacement for me. They found Don [Donald A.] Berry, who was a terrific biostatistician, and now there is a Department of Biostatistics, but biostatistics is four or five times the size. Biostatistics, when I was here, was a section in the Department of Biomathematics. Now it is its own department. You’ll have to look it up on the web site. It is four or five times what it was. Biomathematics has gone down to this. They recently had a site visit. What are we going to do with Biomathematics?

James S. Olson, PhD:

Is that a trend?

Edmund A. Gehan, PhD:

I would just say that I have heard Mendelsohn say this, which I agree with, “Biomathematics is a luxury; biostatistics is a necessity.” You’re not going to solve cancer with mathematics. It’s much more statistical modeling and computer modeling, not strictly mathematical modeling. Is that a trend? Yes. I guess the trend since my coming into the field is much more in the direction of computer modeling and computer-intensive methods. I guess one of the things I had to deal with, towards the end, people wanted more expansion in the area of biostatistics. OK, we’re going to set up a new section. I was head of the section of biometrics. We’re going to form a new section, I think it’s section of clinical biostatistics. So if we’re going to form this new section, we’re going to have to find a new head. However, all of the people in biometrics will be invited to be part. So, in other words (tape ends)… Tape 2, Side A

Lesley W. Brunet:

Is that what you mean when you say Zimmerman was not supportive?

Edmund A. Gehan, PhD:

Things started a lot before that. I really want to be positive, but I can’t be positive about Zimmerman. Get him here and say, “OK, what were the things that happened in your tenure as head of the department from 1967 to 2001, or whatever it was, something like that.” There are still some good people. Terry Smith is someone I’ve mentioned to you, Peter Thall is excellent, and [J.] Jack Lee [Ph.D.] are three people that I recruited to come here that are still key parts of that group. We have had other people that were there. I guess I would like to say that Zimmerman was not at all helpful to me over the years, but I wasn’t working with him. I was in his department, and so on, but he didn’t mentor my work or the people’s work under me. I may not have gotten the recognition here that I might have otherwise, or at least had more control of things. Everything I wanted to do had to go through his office. I am not a negative person; I don’t think [I am]. What were the main influences here? I would say for me it would be providing the analytical support to the Frei/Freireich team. They build up people in clinical pharmacology, immunology. I mean they broaded out the whole the medical oncology work.

James S. Olson, PhD:

By design?

Edmund A. Gehan, PhD:

Oh, yes. Oh, yes. I think some of it was an analogy to what was at NIH, and that you had a lot of capabilities there and they weren’t here. Now how they actually got the money to do all this, that I don’t know. You’d have to ask Freireich more about that. "

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Chapter 04: Strengthening Medical Oncology at MD Anderson with the Aid of NCI Researchers in the Department of Biostatistics

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