Chapter 04: Research and Administration at Vanderbilt University, Focusing on Cancer

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Chapter 04: Research and Administration at Vanderbilt University, Focusing on Cancer

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Dr. DuBois begins this chapter by explaining how he was led to take a faculty position at Vanderbilt University in 1991, and where he would stay for sixteen years.2 He first talks about how he continued his research, leading to the discovery that COX-2 played a role in cancer and that it could be inhibited. This work was published in Cell in 1993, and helped him make his name. Next Dr. DuBois explains how he came to serve as the Research Director of the Department of Hepatology ('93/'94), then advanced to director of the division. He explains how his perspective on the institution changed with his expanded responsibilities and notes that he completed an executive MBA program at Vanderbilt. He talks about how administration is like running a small business and training in this perspective is essential for physician leaders. He notes that his biggest reward is seeing young faculty become successful.

Identifier

DuBoisR_01_20181113_C04

Publication Date

11-13-2018

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Professional Path; The Researcher; Discovery and Success; Overview; Definitions, Explanations, Translations; Leadership; On Leadership; Professional Practice; The Professional at Work; Professional Path; Evolution of Career; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care

Transcript

Raymond DuBois, MD, PhD:

Then, when I finished my clinical training, it was time to get a faculty position, they did offer me a position to stay on at Hopkins, so I thought that was a good sign, but I applied to Duke, Vanderbilt, and Iowa. I had an acquaintance in Iowa who said I should apply there. I got offered positions at all those places, and then it turns out that my mentor in San Antonio had since taken the job as Chief of Gastroenterology at Vanderbilt, so I felt secure there. He provided a great environment, and so I took the job at Vanderbilt and I stayed there, on faculty, for sixteen years, so that was long term.

Tacey A. Rosolowski, PhD:

And that’s where you started getting into more—

Raymond DuBois, MD, PhD:

Cancer.

Tacey A. Rosolowski, PhD:

Cancer, and also the administrative side as well.

Raymond DuBois, MD, PhD:

Yes, yes.

Tacey A. Rosolowski, PhD:

So tell me about that story, you know how you started, I don’t know bifurcating basically, from the academic and research side, into these other areas, and cancer obviously.

Raymond DuBois, MD, PhD:

Initially, the goal was to develop a funded laboratory, and Dr. Nathans was very generous. I brought a lot of reagents and other things with me from Baltimore. In fact, we had to rent a U-Haul trailer and put everything in dry ice, and we hauled it from Baltimore to Nashville, and we did it in one thing because we didn’t want anything to melt. We were very fastidious about that. I set up my lab there, started haring lab personnel, and one of the things, the offshoot from the cloning project at Hopkins, was that I was able to obtain a cell line from rad intestinal epithelium, RIE cells. In those cells, if you treat those cells with epidermal growth factor or other types of epidermal growth factor and ligands, it induced a gene to a very high level. We observed this several times and I cloned out and sequenced the gene and it turned out to be the Cyclooxygenase-2 gene, and so we discovered that and started doing a lot of work on that, and I really was able to get a lot of research funding to support those studies eventually, from the NIH.

Tacey A. Rosolowski, PhD:

Because that was really the big groundbreaker for you.

Raymond DuBois, MD, PhD:

For me, yeah.

Tacey A. Rosolowski, PhD:

Absolutely. Do you want to tell that story?

Raymond DuBois, MD, PhD:

Yeah. It was me and a lab tech and like one other person working there, and one of my colleagues from Hopkins came down for just a few days, to help us get those cloning experiments started, because he was the one that had the best expertise. And so we saw it. We didn’t understand why it was induced to such a great extent and we didn’t ever expect that particular gene to be expressed in epithelial cells, so there was a lot of questions about what was going on. But it all came together at that point in time, because there were—I guess this was started in the late ‘80s, early ‘90s—a lot of publications showing that people who take aspirin or other drugs that inhibit this enzyme have a decreased risk of cancer, and so just by reading the literature, I could tell that was going on. And then the other studies were initiated to try to prove that this thing was induced by growth factors and other oncogenes in these cells, and that maybe it was playing a role in driving the progression of cancer. So that was the hypothesis and we set up several animal models and we tested it by using drugs to inhibit it, or overexpressing the enzyme using expression vectors, or knocking it out in animals, to see what would happen when the gene was missing, and through a whole series of experiments, we were able to show that it did play a role in cancer progression, and by treating with these inhibitors, it did inhibit that progression. So that set up the whole sort of mechanism for what was going on with these anti-inflammatory agents in cancer, and that was a very exciting time. We published two cell papers on that and got a lot of international attention, and I was invited like everywhere at once, to give a talk and explain what was going on. It was overwhelming in a way because even in Dr. Nathans’ lab, this nuclear protein 475, nobody seemed to be interested in that. it was just a gene that was induced in those cells and we didn’t know what role it was playing, but after getting involved in this work at Vanderbilt, everything progressed pretty rapidly. A lot of students joined my lab, I had postdocs from all over, and we really were on a roll there, trying to understand what that gene was doing and how useful it might be in the cancer progression process.

Tacey A. Rosolowski, PhD:

Now, you started at Vanderbilt in ’91.

Raymond DuBois, MD, PhD:

Ninety-one.

Tacey A. Rosolowski, PhD:

Ninety one. What was the span of doing these initial studies.

Raymond DuBois, MD, PhD:

It all sort of got going quickly, within three years. I mean it took a year to get the lab up and running, it took another six to eight months to recruit more people in, but I think we published the cloning in ’93.

Tacey A. Rosolowski, PhD:

Wow.

Raymond DuBois, MD, PhD:

Everything started rolling after that. At one point, I had a team of about twenty-five people in the lab, and I felt that was too many. I just couldn’t keep up with what all of them were doing, and some of them were really wasting time, because I didn’t have enough time to be involved, and I was getting invited to talk all over the world and do a lot of traveling. At first that’s enticing, but then you realize, you know it really keeps you away from your family and from work, so you’ve got to balance that with the other jobs that need to be done.

Tacey A. Rosolowski, PhD:

Now, what was happening at this time? Were you focusing pretty much on the laboratory, basic sciences piece of this?

Raymond DuBois, MD, PhD:

Yeah, yeah.

Tacey A. Rosolowski, PhD:

But you were—probably part of your mind is oh yeah, that clinical piece.

Raymond DuBois, MD, PhD:

Yeah. So what was happening was that Dr. Burke needed somebody to be a research director for the Division of Gastroenterology. He was a clinical hepatologist, the division was very clinically oriented. There were a few people, other than myself, that were working on laboratory science, but he had never really had anybody in charge of that, so he asked me to take on the role as director. So we created a curriculum for our fellows, about different things they needed to learn about, basic and translational science. Actually, I got involved in teaching medical students on GI physiology. I don’t know how that happened. I guess they just needed somebody to do it.

Tacey A. Rosolowski, PhD:

And this was February, 1998 to 2004, you were director of—

Raymond DuBois, MD, PhD:

Research.

Tacey A. Rosolowski, PhD:

Yeah, Director of Research, Gastroenterology, Hepatology and Nutrition.

Raymond DuBois, MD, PhD:

Oh good, it’s on there, good.

Tacey A. Rosolowski, PhD:

I tried to do my homework.

Raymond DuBois, MD, PhD:

So that happened after that burst of science.

Tacey A. Rosolowski, PhD:

Right.

Raymond DuBois, MD, PhD:

And then I got promoted pretty quickly for Vanderbilt, because usually, it takes a bit longer for faculty to do it. So within three years, they promoted me to associate professor and then another three years to full professor.

Tacey A. Rosolowski, PhD:

To full, yeah.

Raymond DuBois, MD, PhD:

So that was pretty amazing. At the time, I just thought it was normal, but I think it doesn’t usually happen that way. And then Dr. Burke had decided he wanted to retire from being the director of the division. He had started that job long before I got there, and so they asked me to do that job eventually and I can’t remember exactly when that happened, the late ’90s probably.

Tacey A. Rosolowski, PhD:

Okay, so let’s see, I’m trying to see.

Raymond DuBois, MD, PhD:

Some time in the 2000s.

Tacey A. Rosolowski, PhD:

So this is interesting, the roles I have. February, 1998, I have you as Director of Gastroenterology, Hepatology and Nutrition. Now was that when you took over from Dr. Burke?

Raymond DuBois, MD, PhD:

Burke, yeah.

Tacey A. Rosolowski, PhD:

Okay, but before then, you were promoted to Director of Research.

Raymond DuBois, MD, PhD:

I was Director of Research.

Tacey A. Rosolowski, PhD:

And what was that date about do you think?

Raymond DuBois, MD, PhD:

It was probably ’93, ’94.

Tacey A. Rosolowski, PhD:

Oh, okay, ’93, ’94.

Raymond DuBois, MD, PhD:

I don’t even know if I put it on there.

Tacey A. Rosolowski, PhD:

Yeah, I don’t think I saw that. So—

Raymond DuBois, MD, PhD:

So then I got more involved in administration and it was a fairly small division. We had about twenty-five faculty and my role in that situation, I hired a person to be—I had the research part covered, and then I hired a person to be vice director for clinical affairs, and they helped run the clinic and the outpatient center, and all the stuff that dealt with clinical issues, and then I hired a person to be the fellowship director, because we trained a lot of GI fellows.

Tacey A. Rosolowski, PhD:

So how was your perspective on institutions changing with all of this?

Raymond DuBois, MD, PhD:

Well, I definitely got a different view of things, because I had only been in my lab, doing my own research, and then now, I went to meetings with all the other division directors for the Department of Medicine. I had to do the budget and personnel things. You know, I think the hardest thing is to do conflict resolution and deal with all the things that some of the angry faculty have to be counseled on. That was definitely a completely different aspect that I was never really trained for. They did offer sort of an executive MBA program through the Vanderbilt School of Business, and basically you go nights and weekends for a period of time, and I went through that because I really needed to learn more about budgeting and other things, to run a financially viable division.

Tacey A. Rosolowski, PhD:

Did you like it?

Raymond DuBois, MD, PhD:

I liked it. I met different people and interfaced with other administration, people from the administration at Vanderbilt, and our division did really well. Luckily, in gastroenterology, you have a lot of fee for service type procedures, and so we were making a healthy margin and had enough money to hire new people and expand the research program, expand the clinical program. It’s really like running a small business, because you have all the nursing personnel over in the hospital and clinic, you have all the research staff that work with the faculty. I generally get along well with everybody, so that I think they enjoyed working there.

Tacey A. Rosolowski, PhD:

I’m just observing, I mean there are a number of people who get promoted into administrative positions and they realize, no thank you, I’m backing away. But obviously that wasn’t your response.

Raymond DuBois, MD, PhD:

No, I enjoyed it.

Tacey A. Rosolowski, PhD:

What did you get out of it?

Raymond DuBois, MD, PhD:

Well, the most important thing, I think the biggest reward for that is to see individuals who come up the ladder, young faculty or even fellows, that also accomplish all these things and then they become successful, and you sort of can really multiply your impact through all these other people. Luckily, we chose really good people to be fellows, and one of our fellows eventually became the director when I went on to do other things, Rick Peek, and so seeing him excel and go through the whole process and now he’s been extremely successful. He’s working on how helicobacter pylori causes stomach cancer and has identified all these genes made by the bacterium that stimulate cancer formation in the stomach. I knew him when he was just an early fellow and could barely even do anything clinically, so that really was very rewarding and still is rewarding, to see that happen. And then I had several MD PhD students in my lab that have since become extremely successful, and just seeing those younger trainees go through the process and giving them the mentoring they need to make successful careers, to me is very rewarding. Everybody tends to focus on their own thing and they really want to see success for themselves over and over again. I really enjoyed the aspect of seeing others succeed and trying to promote their careers, and I think that’s why I eventually got involved in several other administrative roles at a variety of institutions.

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Chapter 04: Research and Administration at Vanderbilt University, Focusing on Cancer

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