Chapter 02: A Conversation with Dr. R. Lee Clark

Chapter 02: A Conversation with Dr. R. Lee Clark

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Dr. Jones tells about a conversation he had with the first president of MD Anderson, Dr. R. Lee Clark, in the faculty restaurant of the Mayfair Hotel on the MD Anderson campus. He explains that Dr. Clark lived on the top floor of the hotel and had "his own table" at the restaurant. Dr. Jones was accidentally seated at that table, and Dr. Clark joined him. Dr. Jones recalls asking Dr. Clark how he came up with the idea for MD Anderson. Paraphrasing in his own terms, Dr. Jones says Dr. Clark was as concerned as he was about "linking discovery and delivery." He also recalls Dr. Clark speaking about decisions he would have made differently: relations with the UT System; dual appointments for faculty; the tenure system. Dr. Jones offers his own, negative view of the term tenure system.

Identifier

JonesLA_01_20140115_C02

Publication Date

1-15-2014

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 - Key MD Anderson Figures; Portraits; Understanding the Institution; The History of Health Care, Patient Care

Transcript

Tacey Ann Rosolowski, PhD:

So bringing this kind of perspective and this groundbreaking work to MD Anderson, what was it-I mean, I'm trying to get in the head of Mickey LeMaistre and some of the others who were interested in expanding the collaborative work and research base. What were they hoping to achieve that you could achieve by your presence here?

Lovell A. Jones, PhD:

Well, I think it was to develop a research emphasis in surgery that-and you can see it today in [unclear] and their research that has blossomed in Gyn Onc. I mean, they have a major research program going on that didn't exist in Gyn when I came. And before I moved out, there was the development of a whole research floor that was targeted towards Gyn Onc, not just myself but Ralph Freedman and several young investigators that they brought in, some who are still here and are now senior investigators.

Tacey Ann Rosolowski, PhD:

Now, I just need to be educated here. I mean, how was it that your research was going to enhance surgery?

Lovell A. Jones, PhD:

Well, I think it was to say that, you know, the research that was being done in surgery, not saying that there wasn't research being done, but it was confined to the Department of Surgery. There was a surgical research laboratory, which there were basic scientists in that laboratory, but the other departments, Urology, Gynecology, Thoracic Surgery, didn't have any research going on in terms of basic. I mean, there was clinical protocol stuff going on, but none of that in terms of basic behavioral sciences or any joint-say like the joint work that's going on with Lesley Shoger [phonetic], that was nonexistent at that time. And I think that the original idea was to develop this department in terms of molecular endocrinology that would have this transdepartmental research going on in Gynecology, Urology primarily, but looking at other areas. In fact, the researchers that were being recruited were researchers who would have a joint appointment in Biochemistry, because that was the closest area. Darrell Ward [phonetic], who was the chair of Biochemistry at the time, was an endocrinologist, and so that department had a lot of endocrinologists in it, but they didn't have any real relationship with any of the clinical departments. So it was to, first, develop this model of joint relationships and collaborations with the basic sciences, but also to develop a program that would be supported by the clinicians. And, in fact, I joked at times and said although I didn't have a specific line item for a long time before we developed the Experimental Gynecology Endocrinology Laboratory, I could go to the department chair and say, "I need this rotor," or I needed this or I needed that, and demonstrate how it was related to the ongoing clinical things that were happening, but also it provided, as the training of physicians was moving and these accreditation boards were moving to research, departments needed-and I think Gyn Onc, or Gyn at the time, was ahead, and I would say it wasn't because Gyn Onc wanted it, but there were people, including Mickey LeMaistre, that saw that for them to be accredited, they were going to have to have these programs and have places for their fellows to train. So I had a number of fellows who actually came down and spent some time doing research in my lab as part of their training. So I think that was-and you now see it. I mean, Medicine had been doing it for a while. That was the Division of Medicine. But the other divisions, no, at least from what I observed when I first came. Now it's throughout the institution.

Tacey Ann Rosolowski, PhD:

How long did it take really for it to catch on as a model?

Lovell A. Jones, PhD:

About ten years.

Tacey Ann Rosolowski, PhD:

Yeah. People keep talking about the decade marker.

Lovell A. Jones, PhD:

Right. About ten years.

Tacey Ann Rosolowski, PhD:

And what do you think happened over the course of time, that time?

Lovell A. Jones, PhD:

Change in leadership.

Tacey Ann Rosolowski, PhD:

Ah, okay.

Lovell A. Jones, PhD:

It went from Dr.-although, as I say, I think Dr. [unclear] supported it, but that wasn't his era. He was a clinician. He came from private practice, in terms of being [unclear]. So his thing was clinical medicine. I would say when Taylor Wharton became chair, he came from somewhat the same era, but he was looking for something new that he could stake his claim to fame on, and it was developing that research program, and so the research program got elevated to a section in the department, which gave it variability. But in doing so it actually, as I think about it, made me the first African American administrator in a department, because I was section chief for Experimental Gynecology Laboratory and had a line item that came to-it wasn't a whole lot of money, but it was a line item that came to that section. And so I reported directly to Dr. Wharton, along with Dr. Freedman, who was the other section person, and we actually reported to Craig Netwitz, who reported to Dr. Wharton.

Tacey Ann Rosolowski, PhD:

Interesting. I want to come back and get more of a sense of your goals in that role, but I didn't want to lose track of your conversation with Dr. LeMaistre if you want to talk about that-or Dr. R. Lee Clark, rather.

Lovell A. Jones, PhD:

Right. Well, the Anderson Mayfair, which is no longer in existence, is where the-

Tacey Ann Rosolowski, PhD:

That was the hotel-

Lovell A. Jones, PhD:

That was the hotel on the corner where the new hotel is. Dr. Clark lived on the top floor in the penthouse.

Tacey Ann Rosolowski, PhD:

Oh, I didn't know that.

Lovell A. Jones, PhD:

That was his apartment. And he would come down, he would eat his meals in the restaurant, in the faculty restaurant. And actually, the history-I don't know if you know the history of that. We used to be a condominium. That was the first condominium in Houston.

Tacey Ann Rosolowski, PhD:

I didn't know that.

Lovell A. Jones, PhD:

And Anderson bought it initially for its patients to stay in, and converted the rooms for patient. Dr. Rutledge's office was in that building. That was one of the attractions that brought him here, was he could still have private patients, probably one of the last physicians at this place to have private patients. So he saw his patients over at the Anderson Mayfair on the first floor. So Dr. Clark would come down to the restaurant to eat, and one day-I don't know if it was done just to see what would happen or how it came about, but one of the waiters-because just as any restaurant, you waited to be seated. And he sat me at Dr. Clark's table. That was his table. So Dr. Clark came in, looked at me. I knew who he was, and I was looking around to see if he was looking for someone other than me. And he walked directly to the table, and he says, "You're at my table." And I go, "Um, oops." (laughter)

Tacey Ann Rosolowski, PhD:

Oops.

Lovell A. Jones, PhD:

"Um, I'll move." (laughter) And he says, "No, you stay right there, but don't let this happen again." (Rosolowski laughs.) I said, "Okay." And he sat down, and I said to him, "You know, I apologize," but would he mind me asking a few questions. The first would be how did he come up with the idea of MD Anderson. And that began a dialogue of the idea of-although he didn't describe it that way, it was the idea of linking discovery with delivery, to have the physician right next to the researcher, and so they could learn from each other and begin to develop new and different therapies that would be directed from the patient. So it was interesting that the space I was in was the space where Developmental Therapeutics had originally been, and you could see where there was the remnants of places patients were and then the lab being close to it.

Tacey Ann Rosolowski, PhD:

So you found that a very productive environment? Or what was your reaction to his answer and the environment you found yourself in?

Lovell A. Jones, PhD:

Well, it was-to be honest, I think we've gotten away from it. I think just the size of the place has really gotten away from it. I thought, in subsequent years later, that it was the right concept, the right idea, and when I went to Moffitt and served on its Scientific Advisory Board-

Tacey Ann Rosolowski, PhD:

And Moffitt is?

Lovell A. Jones, PhD:

Moffitt Cancer Center in Tampa. Moffitt, who the Center is named after, I also had a chance to have a personal one-on-one interaction with him, and he was good friends with R. Lee Clark and took the lessons that Clark had learned and then repeat them for Moffitt in terms of [unclear]. And the one thing Clark told him that if he had to do it all over again, he would have a different relationship with the University of Texas.

Tacey Ann Rosolowski, PhD:

Oh, really?

Lovell A. Jones, PhD:

Because the rules and regulations that govern the University of Texas had an inhibiting impact on the development of MD Anderson because you couldn't buy certain things, you couldn't do certain things. For instance, I don't know if it's changed, but we had a hard time-we had to go through a number of hoops of buying instrumentation that had been used as demos at scientific meetings that you could get at reduced costs. You couldn't buy because it fell under the used equipment. And that applied to the university buying cars. They couldn't buy used cars, they had to buy used cars, and that sort of thing, and so that inhibited a lot of things that took place. And so Clark suggested a relationship with the university that was different. And what Moffitt is, is all of the faculty are part of a Department of Oncology in University of South Florida. That's the relationship. So Moffitt has its own board-

Tacey Ann Rosolowski, PhD:

Interesting.

Lovell A. Jones, PhD:

-and the University of South Florida has its own board. So every faculty member is an assistant professor of oncology in the department at the University of South Florida Medical School. So it gives the relationship, you get the same benefits as you would being part of the UT System, but you don't have the inhibitions of the UT regulations in terms of doing things.

Tacey Ann Rosolowski, PhD:

[unclear]. Right.

Lovell A. Jones, PhD:

But the patient care, you walk into-I don't know, I haven't been there in about four years, but when you walk into the clinical arena of Moffitt, you think you've walked into MD Anderson, the old MD Anderson, in terms of the arrangement, because it's almost identical.

Tacey Ann Rosolowski, PhD:

How interesting. What were some of the other questions you asked Dr. Clark that day?

Lovell A. Jones, PhD:

Well, I asked him, I guess, the same thing that Moffitt had asked him; if he had to do it all over again, what would he do differently. And he didn't say in the same vein that he said to Moffitt, but somewhat along the same lines, that there were mistakes made that he would like to do over again. He questioned the idea of the dual appointments. It's changed over the years, but originally you had a dual appointment. You had the appointment to the hospital and you had the appointment to the UT System. You were an assistant whatever in the hospital and you were an assistant professor in the UT System. And to get tenure, you had to be promoted in both, and it was easier to be promoted in the hospital ranks, so you could be an associate biochemist in the hospital and still be an assistant professor in the UT System. And I think that was eventually gotten rid of because when LeMaistre became president, he pushed for a tenure system, and UT rebuffed him in terms of they had just started to bring in two new campuses, or three-well, several new campuses, and some were down in the valley. And they didn't know how these institutions would flourish, and they didn't want to give a set of faculty tenure and then have to get rid of the institution. So what the deal that was worked out is that they created what is referred to as term tenure. You know, MD Anderson is the only one that still has term tenure. All the other institutions have been elevated to regular tenure.

Tacey Ann Rosolowski, PhD:

Is that a positive or a negative?

Lovell A. Jones, PhD:

I think it's a negative.

Tacey Ann Rosolowski, PhD:

Why so?

Lovell A. Jones, PhD:

I think it does have its advantages, and I think some institutions are moving towards some modification of that, but I think it inhibits academic freedom, because if your voice is not what the administration doesn't want to hear, they can wait until your contract-because all of the advisory committees, as I was told, are advisory to the president. Although in Dr. LeMaistre's tenure as president, I can't think of any faculty, although there may have been some, and those that were may have been appropriate, because I didn't hear anything about it, where the president turned down a recommendation of the science faculty for promotion. But there were a few during the Mendelsohn era, and I would assume there probably will be some during the DePinho era as well. The one that I can think of that's maybe having some political ramification to it is Lynn Zwelling [phonetic] and his not having his tenure renewed. So, I mean, it has its good points in that you keep faculty on their toes. I mean, once you get tenure, some people say faculty retire, but for most faculty I don't see them not being productive.

Tacey Ann Rosolowski, PhD:

Especially here. (laughs)

Lovell A. Jones, PhD:

Right. They're on the treadmill to do something, and so that added stimulus of having your tenure renewed, I don't see it. Maybe at some academic institutions where all of your salary is paid by the institution, but here or other places where a percentage of your salary is paid by the grants you pull in, I don't see people sitting back and saying, "Oh, I could survive on 80 percent of my salary or 70 or 60 percent of my salary."

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Chapter 02: A Conversation with Dr. R. Lee Clark

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