Chapter 03:  Early Developments in the Department of Public Information and Education

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Chapter 03: Early Developments in the Department of Public Information and Education

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This chapter opens with the interviewer providing an overview of the three story threads told in Mr. Stuyck's interview: the story of his career, of the Public Affairs at MD Anderson, and a story of what public affairs encompasses.

Mr. Stuyck asserts that he had a direct effect on the broad scope of Public Affairs, citing the gradual absorption of Volunteer Services into the Department.

Mr. Stuyck next explains that he was able to secure a contract to set up the Cancer Information Service in 1974. This was the first NCI-funded initiative to create a public information call-in line, and it was controversial, as most professionals did not believe that laypersons could be sufficiently trained to provide medical information.

Mr. Stuyck explains how he became principle investigator, and what was involved in setting up the service on this grant, which has run for 30 years for a total of twenty-six million dollars. Mr. Stuyck then provides historical context. He notes that the CIS was part of a larger national effort to open up communication about cancer, to develop advocacy for many groups, and to increase the role patients could play in their health decisions. He also notes that the President Nixon signed the National Cancer Act in 1971 and that knowledge in the sciences was growing at a tremendous pace during this time. He also cites the culture of excellence that existed at MD Anderson in the seventies.

Mr. Stuyck gives several examples to demonstrate how far cancer treatment has come since the seventies: the first BCG (Bacillus Calmette-Guerin) trials that required patients to be scarified; "gruesome" chemotherapy treatments; and treatments that required extreme surgical damage to a patient. He also recalls the first outpatient clinic at MD Anderson, which was very primitive by today's standards.

Identifier

StuyckSC_01_20130611_C03

Publication Date

6-11-2013

Topics Covered

Building the Institution; Discovery, Creativity and Innovation; The Professional at Work; Growth and/or Change; Information for Patients and the Public; Education; MD Anderson Culture; Building/Transforming the Institution; The History of Health Care, Patient Care; Cultural/Social Influences; Understanding Cancer, the History of Science, Cancer Research; MD Anderson History

Transcript

Tacey Ann Rosolowski, PhD:

And I wonder. Is it okay if I go back and pick up a little bit—a little bit more detail about the kind of—?

Steve Stuyck, MPH :

Sure. Yeah. I’m one for kind of quickly going through—just go right ahead.

Tacey Ann Rosolowski, PhD:

Oh, and that’s fine. I mean as we talked about in the beginning, there are kind of three different stories going on here. And just for the record I’ll say this. For me, I actually had to do kind of a lot of reading about what Public Affairs is. I’d never really thought about that, and as I was doing background research it was very clear that Public Affairs—when you were hired for Public Information it was very different in terms of the components that were included in it and probably in its functions, too, than what it is today. And then, of course, there’s how you went and moved your way through that institutional transformation.

Steve Stuyck, MPH :

And sometimes I affected that transition. You know, I went to Dr. LeMaistre, for example, and said I think I would be a very strong manager of Volunteer Services. And they were floundering in that area where they were at the time, and here’s what I think I could do for them. And so I had my eye on some of these things, and I thought as I worked on it that we would bring together under one umbrella much of the institution’s expertise in dealing with our constituents—whether they be the lay public or patients or many in between—media, whatever it is—we would bring them all together in this, and we did a pretty good job of that. There were a few things that didn’t work out but—

Tacey Ann Rosolowski, PhD:

Now when was that change? When did that change take place?

Steve Stuyck, MPH :

It was gradual over a period of time.

Tacey Ann Rosolowski, PhD:

Oh, really? CLIP C: Discovery, Creativity and Innovation C: The Professional at Work B: Growth and/or Change B: Information for Patients and the Public B: Education B: MD Anderson Culture B: Building/Transforming the Institution D: The History of Health Care, Patient Care D: Cultural/Social Influences Developing the Cancer Information Service

Steve Stuyck, MPH :

The first—we started with the Public Information Office and then—and this was another thing. You know, Steve, how could you—how could this happen to you? There was a big contract with the NCI called the Cancer Information Service. And it had just been awarded for the first time in 1975.

Tacey Ann Rosolowski, PhD:

And what exactly was that?

Steve Stuyck, MPH :

It was the very first NCI-funded public education programs about cancer. There was a toll-free WATS line—an 800 number that served the state of Texas where people could call you with their questions about cancer, and there were some educational programs targeted for minority and underserved audiences. And this was brand new, and I cannot convey to you how controversial it was at the time.

Tacey Ann Rosolowski, PhD:

Why?

Steve Stuyck, MPH :

This was 1975 when most communication about cancer was between doctors and patients. And the notion that trained lay people could answer the phone and answer a technical question about cancer was preposterous to many people, especially to doctors. And one—and so I was—there was a time where I was the director of it briefly, and one MD Anderson doctor said to me, “I hope you screw up early before you do some real damage.” And another MD Anderson doctor said to me, “I understand you have the MD Anderson albatross hanging around your neck.”

Tacey Ann Rosolowski, PhD:

So this was controversial not only nationally but at MD Anderson.

Steve Stuyck, MPH :

Right. Nobody wanted to touch it. And I know that sounds so foolish nowadays. It’s so logical that education about cancer is so pervasive and people—there are so many things—but it was just a different era about things.

Tacey Ann Rosolowski, PhD:

Yeah. I’m remembering back to that time, and actually I can totally understand it.

Steve Stuyck, MPH :

It was like—

Tacey Ann Rosolowski, PhD:

Because doctors were still gods at that time.

Steve Stuyck, MPH :

The first inklings of it—Happy Rockefeller, Betty Ford, Rose Kushner—different things like that that were kind of starting to come on, but it was very pioneering and innovative. Hell, I’m thirty years old, and I’m thinking this sounds like a great idea to me. So I volunteered to Dr. Clark to become the principal investigator because he wanted nothing to do with it really. He said sure. Thirty years old with a bachelor’s degree at that time and they make me the principal investigator on the most—not the director but the PI on a very innovative and controversial contract thinking this would probably go nowhere at any time. And it worked out fine (laughs) and I worked really hard on it with Jo Ann Ward, whose name comes up often in my material—she still works here—and others. And we ran that contract for thirty years—and about twenty-five or twenty-six million dollars—and it was the first—I tell you this story because it was the first element beyond public information that we added to my milieu, which is public education. But we had no MD Anderson money, and public education was all this contract from the NCI. So that’s how it started.

Tacey Ann Rosolowski, PhD:

So how did the investigation work? What did you actually do to set it in place?

Steve Stuyck, MPH :

Just to set up the cancer information service?

Tacey Ann Rosolowski, PhD:

Uh-hunh (affirmative).

Steve Stuyck, MPH :

We did a lot. We had to get all the resources, find space, hire people—all that sort of thing. We had to set up the 800 number, develop training programs and quality assurance programs for the people who answered the phones, develop liaisons in the community with African American and Latino populations, create media materials and get them approved by doctors. We were taking—well, I wish I could remember how many calls. But near the end of it, it was 100,000 a year or so.

Tacey Ann Rosolowski, PhD:

Really? Wow. How long did it take for people to under—the public to understand that this resource was available and take advantage of it?

Steve Stuyck, MPH :

We got a lot of media attention at the beginning. It took a while, and we never thought that the CIS—the Cancer Information Service—was as appreciated or widely utilized as it should be. And that program morphed and evolved over the years for a time. We also served the state of Louisiana, and then for a time we also served the state of Oklahoma. This was a national network of about fifteen or so contracts all around the country.

Tacey Ann Rosolowski, PhD:

Wow, that’s amazing. And what impact did you feel that information service had?

Steve Stuyck, MPH :

I think we were part of a larger national and even international effort—that CIS helped open the doors for communication about cancer. But it was happening all along, everywhere. The advocacy movement that came along—breast cancer advocacy, prostate cancer, AIDS—those advocacy movements contributed to it. Baby boomers contributed to it because they wanted to play a greater role in decisions about their own health care than prior generations had. It was a national and worldwide movement—the educational movement in health care and disease prevention—and we were just part of it.

Tacey Ann Rosolowski, PhD:

You know, I was thinking as I was putting together my questions and approach that—I was thinking this was a period of time in which people’s understanding of cancer was completely changed.

Steve Stuyck, MPH :

Absolutely.

Tacey Ann Rosolowski, PhD:

And I was thinking, wow, how did that cultural fact fit in with Public Affairs? Or what was the relationship back and forth?

Steve Stuyck, MPH :

There were several things. First of all, MD Anderson—the National Cancer Act of 1971 was passed just before I arrived here. And with that came this great infusion of funds for research and other purposes and infrastructure, and we were riding on the coattails of that along with the advocacy movement and the burgeoning science about cancer. Cancer medicine used to be so easy to explain when I first got here. I can hardly keep up with it anymore—and can’t really. All these forces came together at once, and I was just riding on the coattails of all of that.

Tacey Ann Rosolowski, PhD:

Well, it’s interesting because when I talk to scientists who were trained during that period and starting in their careers—I mean they speak about this real excitement because scientifically it was an incredible time. But it sounds as though in your job—which was really on kind of that interface between the science, the clinical care, and the public that needed information—you were in that perfect storm, too. Clip D: The History of Health Care, Patient Care C: MD Anderson Past C: The MD Anderson Ethos B: MD Anderson Culture B: Building/Transforming the Institution B: Growth and/or Change C: Personal Reflections, Memories of MD Anderson How Far Cancer Treatment Has Come

Steve Stuyck, MPH :

Yes. I’ll tell you, when I arrived at MD Anderson, I thought MD Anderson was a great place. I had heard of it before. I knew about it.

Tacey Ann Rosolowski, PhD:

What did you know about it?

Steve Stuyck, MPH :

Well, I just knew it was a big cancer hospital in Houston, and we didn’t even live too far from here—just a couple of miles from here. I remember driving past it many times when I was a kid in the medical center. But I thought it was a great place but it was nothing—the size is one thing, but the excellence that exists here amazes me. And when I look back on MD Anderson in those days it was very, very primitive compared to what we have now.

Tacey Ann Rosolowski, PhD:

How would you characterize it?

Steve Stuyck, MPH :

I’ll tell you this. I remember when we began our first—one of our first immunotherapy trials of BCG—Bacillus Calmette-Guerin—the tuberculosis vaccine—and they called it scarification. They carved a tic-tac-toe pattern into a person’s arm and applied it topically. I have a friend whose wife is now deceased but he—not that long ago we were talking about it and all of those scarification grids—they didn’t go away. Patients had them up and down their arms and legs for the rest of their lives, and they didn’t work that well either. And that was immunotherapy when I first came here. I can remember our ambulatory treatment center, which was two rooms on either side of a hallway. I thought it was neat. You know, look at all these patients getting outpatient therapy. Two rooms on either side of the hallway—one was chairs and one was beds, and the beds were so close to each other and just protected by a little curtain, and you could hear patients being sick and smell smells and all that sort of thing. And it was gruesome to take chemotherapy, and yet we thought we were on the cutting edge. And we were, but things are so much better now than they were back then. I can remember seeing patients in the hallways with some incredible surgical damage that had been done to them that you just don’t see any more. You really don’t. It’s much more refined. So I think we’ve—it sounds so trite to say it, but we’ve come so far in the last thirty or forty years, and it made it great to work here when you can see that sort of thing happening. I have to remind myself sometimes to stop and think about what it was like when I first got here. I can remember the outpatient—the first outpatient clinic where we had—across one wall we had lockers like you have in a bus station where you could pay a quarter and lock your stuff up. And there were these long benches stretched out, and one of the things LeMaistre did was to enhance the ambiance of the place tremendously. But it was nothing more than a bus station look in our clinic right at the beginning. And you’d walk down this long hallway that ran east west on the first floor, and there’d just be hundreds of patients sitting in these chairs on either side of it. It’s so different now. I still think cancer is an incredible burden for many, many patients, but the changes have been phenomenal—just phenomenal.

Tacey Ann Rosolowski, PhD:

Uh-hunh (affirmative).

Steve Stuyck, MPH :

That got me off your subject, but it’s what interests me in talking about MD Anderson.

Tacey Ann Rosolowski, PhD:

No, no, no. Not at all. No, I think it’s really important, too, because you mentioned that you have to remind yourself and you worked here. I think a lot of people need to be reminded. I mean, there are people who have come in successive generations that they don’t—they don’t really appreciate how far cancer treatment and the situations in which patients receive treatment—how much they’ve changed. So it’s important to be reminded.

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Chapter 03:  Early Developments in the Department of Public Information and Education

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