Chapter 04: Building the Department of Pathology: Clinical Service, Research, Education

Title

Chapter 04: Building the Department of Pathology: Clinical Service, Research, Education

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Description

In this chapter, Dr. Becker discusses building up the Department of Pathology and its focus on research.

Identifier

BeckerFF_01_20080619_C04

Publication Date

6-19-2008

Publisher

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

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the InstitutionBuilding the Institution; Research; Definitions, Explanations, Translations; Discovery, Creativity and Innovation; Discovery and Success; On Research and Researchers; Professional Practice; The Professional at Work; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Technology and R&D; Patients; Patients, Treatment, Survivors

Transcript

Lesley Williams Brunet:

I want to come back to -- later your -- how you picked your field and everything.

Frederick F. Becker, MD:

Well that's -- have to buy my autobiography. In any case, I made it clear to everyone that I would not do a thing in research -- recruit or anything -- till I was sure that the --what we used call service pathology-- the actual anatomic pathology, was at my standard. When they heard that, they looked at me rather grievously because here they were a whole bunch of world renowned pathologists. But I pointed out to them that none of them had any backup. That they had plowed a long -- one was in breast cancer, one was hematopathology-- and that was ridiculous for where this place was. They sort of tearfully said to me, "You mean you're going to get us help?" I said, "You bet your boots!" I also took a rotation in the pathology -- surgical pathology. I did autopsies. Shortly thereafter, their desire to challenge me pathology-wise ended, and we enlarged the pathology department, we increased service to the surgeons, we changed the milieu of how reference cases were done. Meaning, pathology slides would come in from around the state mostly, and we would read them and give them a diagnosis. In fact, that leads to another story because I propose that we put a charge on that, which had been done gratis because we were state pathologists. I thought this was insane because it took time and effort, and sometimes we had to re-cut them, and nobody was paying us for it. These people in pathology were making a fortune.

Lesley Williams Brunet:

Do you think that was just a holdover from the really early days? Trying to win people over?

Frederick F. Becker, MD:

Yeah, yeah, yeah. I haven't gotten to that yet. There was a lot of "You scratch my back, I'll scratch yours." The first call I got -- the first call I got as chairman of pathology here was Ducks Unlimited. Do you know what Ducks Unlimited is?

Lesley Williams Brunet:

Yes, yes I do.

Frederick F. Becker, MD:

I said to my officer manager, "From whom?" Ducks Unlimited. Because my predecessor had been a renowned hunter. Member -- founding member -- of Ducks Unlimited. They assumed that I had been recruited on that basis.

Lesley Williams Brunet:

(overlapping dialogue; inaudible)

Frederick F. Becker, MD:

So that was a little -- that was amusing to me. Not that I wouldn't eat a duck on a moment's notice. Actually when we instituted a minute reference charge, one of the leading private pathologists in Texas flew in his Cessna here to personally protest to me that I was a state employee, that it cost him money to send the slides here for (inaudible), and that often we disagreed with the diagnosis of the pathologist elsewhere -- occasionally let's call it -- and that why would he want me -- why would he want to pay me to be proven wrong? I answered that by saying, “To prevent someone dying from the wrong diagnosis.” At which point he looked at me and realized that it was no scratching of one's back. Sometime later he offered me a position in his practice, but that's --

Lesley Williams Brunet:

Now this was Russell? (overlapping dialogue; inaudible)

Frederick F. Becker, MD:

No, no. No, no. A private practitioner who had a Cessna to fly here to protest a charge.

Lesley Williams Brunet:

Must have been pretty bumpy, wasn't it?

Frederick F. Becker, MD:

No, I'm not talking about (inaudible). So we mend again in pathology to recruit some outstanding young people -- people who had already had pathology training but also had outstanding research training. We began to add them to the faculty. I was completely in accord with the distinguished pathologists here that these people had to prove themselves qualified, because the type of pathology done here was almost unheard of in general pathology training. The reason for that is --

Lesley Williams Brunet:

(inaudible)

Frederick F. Becker, MD:

– that, in general pathology in a general hospital, cancer was often the minority of specimens one saw. While here, we didn't see tonsils, and herniorrhaphies, and gall bladders. So these people had every right to want new pathologists to prove their skills and so forth. People here could see a hundred specimens of a rare tumor that in another general hospital would never be seen. So we made demands that anybody hired here had to in effect undergo a kind of fellowship training. As a matter of fact, that was the instigation of the fellowship program here. We then began to recruit pathologists who wanted to get specialized treatment in cancer, and now it's one of the largest and most successful programs in the world. At the same time, some of these new and relatively younger pathologists also were given laboratories, support --which was somewhat of a new concept here-- and began their research as well. And a number of … It's the end of the world outside, don't turn around. You won't believe it right now. It's gone. The building's gone. I want everybody to know that I love my wife, and if this going to be the end of the world --

Lesley Williams Brunet:

How can you see out there?

Frederick F. Becker, MD:

-- somebody might give her the tape. In any case, it worked beautifully. The pathologists who were here became extraordinarily receptive and supportive. They loved the idea of training fellows, they were very receptive of the idea that no one would do pathology here on a clinical basis till they had the say that these people were effective. And we had a wonderful department with wonderful people of great skill, and they were part of the growth process. At that time -- now jumping ahead again -- suddenly and amazingly to most of us who knew him, it was announced that Dr. Clark was retiring. It didn't seem possible. He seemed eternal. He was the blood, the heart, the pulse of this place, and a pleasure to deal with. A pleasure. We were all proud to work for him. And my wife and I had bought a ticky-tacky house because we had almost no money. My wife is one of those people who says hello to a geranium, and it grows six inches. I'm one of those people who says hello, it turns brown and dies. She had begun to convert our beautiful backyard into a prize winner. Our daughter, who was a baby at the time, was accepted into preschool into Kinkaid, which itself was a bit of a miracle because Kinkaid was one of the enormously social prominent schools -- legacy schools -- and we were told flat out by everybody that our daughter would never get in it. But they underestimate themselves here sometimes. The head master was a man named John Cooper, and he was extraordinary. He was the founder of the Gilbert and Sullivan Society of Houston. To give you an idea of his stature when he retired from Kinkaid, he moved to the woodlands where one of the best schools up there is the John Cooper School. When he met us, he said, "Let me tell you something. You are exactly the parents we want here. Your daughter is going to have to take some tests and so forth, but we want to change the image of this school. We want to make it diverse. We want people from elsewhere. So anytime you bring someone here who has children, please give us a shot at them." My daughter took a -- I think she was two and a half or something -- had to sit and take a test, and she talked to a psychologist or something. And while they were talking she looked outside where there were a bunch of children playing. She said, "Is this going to be over soon? I'd like to go out and play with the children." And the psychologist said, "You're accepted." OK.

Lesley Williams Brunet:

I picked (inaudible).

Frederick F. Becker, MD:

OK. And we became very loyal to Kinkaid. Later on I was elected the first Damen Wells Fellow of Kinkaid and gave science lectures and tried to help them with the curriculum.

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Chapter 04: Building the Department of Pathology: Clinical Service, Research, Education

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