Chapter 14: The Research Environment in Developmental Therapeutics

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Chapter 14: The Research Environment in Developmental Therapeutics

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In this chapter, Dr. Benjamin explains the climate for research that Dr. Emil J Freireich [Oral History Interview] created in the Department of Developmental Therapeutics. He begins by explaining the approval process for conducting research studies "a much simpler process than today's. He notes that all patients were provided with care, irregardless of ability to pay, and that this obligation was written into the institution's bylaws. Next he explains how the clinical and research territories were divided among faculty members. Dr. Benjamin then describes the "noon meetings" held in DT to review cases and determine treatments. He describes the "no holds barred discussions" and recalls how Dr. Freireich handled these meetings. He recalls that there was "remarkable cohesion" in the department, despite the antagonism that could break out.

Identifier

BenjaminR_02_20150116_C14

Publication Date

1-16-2015

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - An Institutional Unit; Institutional Processes; Institutional Mission and Values; Building/Transforming the Institution; Research, Care, and Education

Transcript

Robert Benjamin, MD:

+As I said, I wasn’t there when it first started, so it’s a little hard to tell, but by the time I got here, Developmental Therapeutics was well enough established as a department to be able to exist within itself. The whole idea was to do studies, and doing studies was easy. You simply wrote a protocol and had it blessed by the Surveillance Committee, which was the predecessor of the IRB, to say, yes, this is a reasonable experiment to be done on people, and then you did it. It was a much simpler time to be able to carry out therapeutic research. I don’t think that there were any greater risks to patients. There was never a question of was the insurance company going to pay for it, and there was never a question of a patient not being able to get in because he couldn’t pay, because when MD Anderson was established, one of the ground rules was that we would provide care to any Texan with cancer, regardless of his ability to pay. That was written into the bylaws of the institution.

Tacey Ann Rosolowski, PhD:

I didn’t know that. No one’s ever mentioned that before.

Robert Benjamin, MD:

So we had indigent patients as well as full-paying patients, and everybody got treated the same way. Testing was a lot cheaper and a lot less effective than it is now, but at least within the constraints of what was available, we did everything we could. And I guess everyone had some area that he concentrated on in terms of research, but the only division in terms of taking care of patients was whether they had solid tumors or leukemia, and so all solid tumors, including lymphoma, were taken care of by those of us who dealt with solid tumors, and leukemia was specialized to the leukemia service. And every day we had a noon meeting that we all attended, and it was different things on different days, and I don’t remember what they were. Dr. Freireich might. He basically ran all of those meetings.

Tacey Ann Rosolowski, PhD:

So there was a topic for discussion or some kind of activity planned?

Robert Benjamin, MD:

Yeah. So there was one day when we discussed patient problems, and various people from the inpatient services would say, “We have this patient with whatever problem, and we’re not sure what to do. Does anybody have any good ideas?” And we would all put in our good ideas, and sometimes they would be followed and taken up, and sometimes they actually worked, and then we’d develop some program around that. But there was a tremendous amount of dialogue back and forth where people expressed their opinions in a more or less no-holds-barred type of discussion.

Tacey Ann Rosolowski, PhD:

There’s some pretty vivid memories, from the look on your face. (laughs)

Robert Benjamin, MD:

Well, Dr. Freireich, in his youth, was a force to reckon with, and most of the time he would be highly critical of whoever came up to talk, often in a very unpleasant way, to the point where those who were easily cowed would be sometimes reduced to tears. Usually if you knew what you were doing and you stood up for what you thought and said, “This is why I said this and this is why I said that,” you would be able to convince him.Often at the end of the hour, you thought, “Gee, I’ve done a terrible job,” and a couple hours later, after telling you how terrible you were and insulting your parentage and things like that, he would call you up on the phone and say, “Hey, you know, you gave a really good talk at noon, and I just wanted you to know that I liked that.”

Tacey Ann Rosolowski, PhD:

Was that your experience from time to time?

Robert Benjamin, MD:

Oh, yeah.

Tacey Ann Rosolowski, PhD:

Oh, gosh. So it sounds like you were able to stand up well for your ideas.

Robert Benjamin, MD:

Yeah. So you learn to defend yourself under fire.

Tacey Ann Rosolowski, PhD:

So it was kind of a mentoring against the wall. (laughs)

Robert Benjamin, MD:

Absolutely. It was actually terrific. But despite some of the outward antagonism within the group, there was actually remarkable cohesiveness and remarkable, as I said, optimism that we were going to make things better, and we would always be trying to figure out ways of pushing the envelope and getting better results.

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Chapter 14: The Research Environment in Developmental Therapeutics

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