Interview Chapters

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Chapter 13: Aimed Toward an Interest in Survival; Survivorship Care and the Affordable Care Act

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this chapter by sketching how the Affordable Care Act has an impact on care for survivors. She focuses on the assumption payers make that it’s most cost effective to transition patients to their primary care physician after treatment, as oncologists are expensive. She says that is premature for patient who have had aggressive tumors or treatments. Dr. Rodriguez notes that she spoke at ASCO about MD Anderson model of survivor care. She communicated that the four domains MD Anderson uses to structure a care plan is relevant at all stages of cancer care. Dr. Rodriguez then explains that her interest in survivorship was a natural extension of her work with lymphoma patients, as lymphoma was one of the first malignancies that could be cured. She understood early the four domains of Surveillance, Prevention, Late Effects Monitoring, and Psychosocial Health.
Chapter 14: Lessons in Administration as Ad-Interim Chair of Lymphoma/Myeloma

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this chapter by explaining how her view of the institution changed as she stepped into the role of Ad-Interim Chair of Lymphoma/Myeloma when Dr. Cabanillas retired. She sketches her new areas of responsibility and how this changed her view of operations and the institution as a whole.

Next, Dr. Rodriguez explains that traditionally, a Department Chair is seen as an “erudite expert,” but to be successful a chair must let go of her/his ego and bring forth future leaders in the field.
Chapter 15: Vice President of the Office of Medical Affairs; the Value of Faculty Credentialing

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this chapter by explaining how conversations with the outgoing and incoming physicians-in-chief around she came to her role as Vice President of the Office of Medical Affairs. When Thomas Burke, MD [Oral History Interview] became physician in chief in 2004, her role was expanded to include medical affairs functions. She was officially named in 2005 with service to the present. Next Dr. Rodriguez notes that learned a great deal about Texas law and regulations of medical practice. She also had to familiarize herself with the roles of Physicians Assistants and Advanced Practice Nurses.

Next, as an example of a function within Medical Affairs, Dr. Rodriguez talks about the process of documenting the credentials that physicians present for employment. She explains why this process is key to the reputation of MD Anderson. She also notes that employees have occasionally falsified documents.
Chapter 16: The Office of Medical Affairs: Credentialing, Quality Indicators, and Building a Culture of Improvement and Quality Care

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez explains a key function of the Office of Medical Affairs: to credential all individuals at MD Anderson to ensure their competence. She next explains that, since 2009, MD Anderson has been involved in developing performance and quality indicators for professional practice. She explains this history of this focus and the different reactions of clinicians to professional evaluation, given that most evaluation is perceived as adversarial and punitive, rather than part of a culture of self-awareness and self-improvement. She comments on Texas requirements that support a culture of improvement. Dr. Rodriguez then talks about how the Office of Medical Affairs created an infrastructure to shift to quality indicators.
Chapter 17: The Office of Medical Affairs: Patient Concerns, Patient Advocacy, Conflict Resolution

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez discusses another important role of Medical Affairs: to provide support for patient who wish to voice complaints. This chapter covers sources of patient complaints and distress, the importance of communication, the role of Patient Advocates and the sources of stress in that role. (She notes that patients can become abusive because they would like a second opinion to be a different, hopeful opinion, but often a lack of options is confirmed.) She notes that having an Advanced Directive conversation is a quality indicator and explains the issues that this raises. She notes that there is more emphasis now on selecting health care providers who have communication skills.
Chapter 18: Creating MD Anderson’s Practice Algorithms; On Blending Art and Science in Medical Practice: Practice Algorithms and Targeted Therapy

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez tells the story of MD Anderson’s 147 Practice Algorithms beginning with the origin of this initiative in the 1990s movement to define “pathways of care.” She talks about the process of establishing an algorithm and discusses the effects. She also notes the different reactions of clinicians, who may immediately adopt the algorithm or who may take convincing. Dr. Rodriguez talks about the dangers of dogmatism in medicine. She notes that medicine is both an art and a science, but the poles need to be harmonized in order to be humane. Dr. Rodriguez notes that limits of targeted therapy and sketches an emerging view that this approach will be replaced by a focus on failures in the body’s surveillance and regulation mechanisms. She notes committees in place to support clinicians as they self-monitor the quality of their practice.
Chapter 19: Integrating Advance Practice Providers into Care Teams; Training Program for Physician Assistants

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez talks about the increasing reliance on advance practice providers in medicine and in oncology. She notes that, at MD Anderson, General Internal Medicine is a hold out. She sketches what an APP can bring to a care team. She talks about her own experience working with a Physician’s Assistant. She explains why she shares oversight of Advanced Practice Nurses with the Division of Nursing. Next Dr. Rodriguez talks about the Physician’s Assistant Oncology Fellowship Program, started in 2008. She sketches differences in the education of MDs and PAs and explains the need for an oncology fellowship. She talks about the impact of the program and an e-course developed for fellows at a distance.
Chapter 20: The Office of Medical Affairs: Job Satisfaction Survey of Mid-level Providers

Alma Rodriguez MD and Tacey A. Rosolowski PhD

After sketching changes to the office of medical affairs in the last ten years, Dr. Rodriguez discusses the purpose and results of the regular survey of mid-level providers at MD Anderson. She notes that, in general, the workforce is very stable, but the institution wants to monitor reasons that pockets of high turnover exist. She notes results of the survey: everyone at MD Anderson is committed to the job; some fear retaliation if they voice complaints; many feel they are not paid enough. Dr. Rodriguez stresses that employees’ pay is in line with other state institutions. She talks about requests for mentoring made via the survey and how that was acted on and to what affect.
Chapter 21: Patient-Centered Care: Formalizing the Practice at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez talks about the shift in healthcare to a focus on patient-centered care and addresses the specific ways that MD Anderson is putting this approach into practice. She first explains that patient-centered care is a shift in focus and explains the value is shifting from treating disease to treating people (and seeing them as customers). She notes that MD Anderson patients experience the kindness and devotion of providers. She lists some patient centered practices instituted and notes others that need improvement.
Chapter 22: Patient-Centered Care: the Psychosocial Council, Advanced Care Planning

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez continues her discussion of patient-centered care. She discusses the work of the Psychosocial Council, in particular on the latter’s work on creating guidelines to talk to patients about advanced care planning, then talking about the Department of Chaplaincy and Pastoral Education. She first talks about the Psychosocial Council and advanced care planning, offering her view that advanced care planning is not a conversation about death, but about health care planning for the future that needs to be integrated into a patient’s treatment plan. She explains strategies for bringing awareness to this at MD Anderson and also notes that this is part of a national conversation. Dr. Rodriguez next talks in general terms about the Psychosocial Council (formed 2007), its roles, and the pushback it has received for treating disease from an emotional perspective.
Chapter 23: Patient-Centered Care: the Department of Chaplaincy and Pastoral Education and the Future of Psychosocial Approaches at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez discusses the Department of Chaplaincy and Pastoral Education and its focus on spiritual concerns. She lists the kinds of issues that arise for cancer patients. Dr. Rodriguez explains that, historically, MD Anderson has sustained linkages with spiritual/religious organizations and communities. This is one reason the Department of Chaplaincy at MD Anderson is so robust. She then talks about the future of psychosocial approaches at MD Anderson, looking ahead to the creation of a Division of Psychosocial Oncology. She list some research studies the faculty are conducting in this area.
Chapter 24: Transitional Moments in MD Anderson History

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez sketches key moments of change in MD Anderson history since her arrival. She first talks about the eighties and the “growing consciousness that MD Anderson is an economic entity,” moving on to the nineties and the complexities that evolved with more billing forms, rules, and concern for downstream revenue generated from patient care. She gives an example of chemo therapy orders and talks about pros and cons. Dr. Rodriquez then talks about the MD Anderson’s physical expansion to the point where she “can’t embrace” the institution. She notes that the physicians and nursing staff have preserved their dedication and pride.
Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez states that MD Anderson has shifted away from its mission as a care facility since Ronald DePinho assume the institution’s presidency in 2011, moving toward a research-generating facility. She sets context by discussing the growth of research under Dr. John Mendelsohn, noting that research still served patient care despite accelerated industry-sponsored research. She next talks about MD Anderson’s focus on new drug development and the implications, specifically in the demand for financial and intellectual resources this requires.
Chapter 26: Turbulence During Dr. DePinho’s Early Presidency; MD Anderson’s Future

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez comments on the changes created at MD Anderson under Dr. DePinho’s early presidency then talks about the future of MD Anderson under the Affordable Care Act. Dr. Rodriguez first comments on the magnitude of institutional change that Dr. DePinho’s administration has brought to MD Anderson. Making reference to literature from the field of organization transformation, she notes that change on such a scale requires a “message of urgency” that was not verbalized by the administration. Change has felt imposed from outside, creating tensions in the institution, she observes. She notes that the Board of Regents was slow to recognize problems.
Chapter 27: Creating a Future Under the Affordable Care Act

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez explains that MD Anderson’s future will be determined by changes to healthcare under the Affordable Care Act. She first talks about the loss in revenue anticipated, then describes initiatives that the Office of Medical Affairs is setting in place to help address anticipated problems. She talks about the need to document all care processes in the spirit of moving toward more evidence-based care and shifting the mindset of providers away from an expert mentality to a spirit of self-reflection and improvement. She also talks about the importance of examining and optimizing all of MD Anderson’s resources.
Chapter 28: Women and Leadership at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez provides her views of women and leadership at MD Anderson. She cites statistics in support of her view that “the workforce in medicine is about women.” She stresses that women have to know systems in order to succeed in leadership positions. She offers her view of coming up through the ranks when there were many fewer women and notes that MD Anderson does not have clear processes for filling leadership positions or establishing a pipeline of leaders. She talks about her own strategy for cultivating leadership.
Chapter 29: Accomplishments, Retirement, and a Love of Cosmology

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins by listing her most significant accomplishments: launching the concept of survivorship; imbedding into MD Anderson culture the role of quality officers; integrating Advanced Care Planning into treatment planning; serving as champion for the Physician Assistants Program; helping everyone who has reached out to her as a role model. Next she talks about the interests she plans to pursue in retirement: psychology, art, reading, and cosmology. She notes that she minored in philosophy as an undergraduate and her thinking has been very influenced by process philosophers who believe that reality self-creates. She believes that the Universal Mind is also self-creating and explains that this spiritual component of her belief system helps her cope with change.
Chapter 01: Multidisciplinary Care at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez provides an overview of MD Anderson’s multidisciplinary approach to patient care. She defines the approach and notes that it began with R. Lee Clark’s vision for cancer care. She gives examples of the specialties that collaborate to provide comprehensive management of a patient’s disease throughout treatment. She also offers observations on how the tradition of multidisciplinary care has had an influence on the culture of the institution.
Chapter 02: The Important of Clinical Leadership at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez about the important role that clinical leadership has played in developing the institution and that it continues to play in the current healthcare environment. She sketches the qualities that leaders must have to steward institutions in the current climate and connects that to the culture of the institution.
Chapter 03: Leadership in a Period of Change

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez comments on the period of change the institution is experiencing, stemming from changes in the healthcare system, financial stressors, and internal turbulence stemming from Dr. Ronald DePinho’s resignation as president in March 2017.
Chapter 04: Multidisciplinary Care and the MD Anderson Algorithms

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez defines the MD Anderson algorithms of care and explains how they were created and are continually evolving, based on current research. She explains how they are connected to multidisciplinary care, and how important they are for standardizing care at MD Anderson’s partner institutions.
Chapter 05: Envisioning the Next Period of Leadership

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez talks about the qualities that the next president of MD Anderson will need to confront successfully the institution’s fiscal and other challenges. She comments on the stability that MD Anderson’s tradition of physician leadership has provided.
Chapter 05: The New Division of Cancer Prevention and Department of Epidemiology

Tacey A. Rosolowksi PhD and Margaret R. Spitz MD

In this chapter, Dr. Spitz talks about the creation of the new Division of Cancer Prevention and Population Science under Dr. Charles LeMaistre and her role heading the new Department of Epidemiology. She notes that she suggested Dr. Bernard Levin [oral history interview] to head the Division. She also notes that MD Anderson had three population sciences programs at the time, which was “unheard of” in a cancer center.

Dr. Spitz then talks about why the Department of Epidemiology was formed at this time she then talks about her activities as Acting Chair and then Chair of the Department (1992 – 1995; 1995 – 2008). She lists her recruits and tells an anecdote about securing laboratory space for them.

Dr. Spitz notes that the Department was “my baby.” She talks about intentionally creating an environment to provide a good quality of life. She notes that many of the supports for staff and faculty that she instituted are no longer in existence.

Next, Dr. Spitz notes some particular achievements in the Department. Lung cancer research became a focus and the Department created a Lung Cancer Database that continues to serve as a great resource. She lists several activities that focus on lung cancer.

Dr. Spitz next explains why she stepped down as Chair in 2008.
Chapter 01: Coming to MD Anderson for Resources to Support a Vision

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya tells the story of how was recruited by Dr. Charles LeMaistre to come to MD Anderson in 1990. He begins by explaining why the decision was made in the late eighties to turn the Section of Neurosurgery into a department and create a Brain Tumor Center. He recalls his first visit to MD Anderson. He also speaks about the possibilities the institution offered for the future –and his vision for a comprehensive neuro-surgery department-- because of resources and institutional support to build a brain center (in stark contrast to the limitations at the University of Cincinnati Medical College, where he was on the faculty until 1990). The interviewer comments that Dr. Frederick Becker [Oral History Interview], Vice President of Research, was quoted as saying that the creation of a comprehensive brain and spine center was a priority for the nineties. Dr. Sawaya also recalls that the NIH had declared the 90s to be the “decade of the brain.”
Chapter 02: Creating a Comprehensive Neuro Service –and the Best Service

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya states that his goal was to create a comprehensive neuro-service that was the best in all activities, a vision he (literally) illustrates by reference to an image entitled, “Neurosurgical Oncology.” (See image next page. Dr. Sawaya explains that he sketched the image and Dr. Ian Suk, a medical illustrationist, created the final design.)

Dr. Sawaya explains the elements of a comprehensive neuro-service: high-level surgery supported by technologies, infrastructure (such as a tissue bank); a database; and education and training. (Dr. Sawaya notes that he created the first neurosurgical oncology fellowship program in 1990, accepting its first fellows in 1991.) He goes on to explain other features of a comprehensive neuro-service. Next, he notes that pain is an essential element of neuro-oncology and describes how a patient’s suffering and reliance on opiates can be surgically alleviated in some cases. The surgeon creates a tiny brain lesion that destroys the patient’s ability to sense the cancer pain. Dr. Sawaya sketches the Department’s growth (300 procedures/year in 1972 to 1,700 during 2012), and notes that the faculty works well together.
Chapter 03: Creating a Collaborative and Compassionate Neuro-Service

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya begins this Chapter with comments on the challenges of creating collegiality among high-intensity personalities, citing the importance of looking at interpersonal skills while hiring. Dr. Sawaya affirms that the Department has developed a culture that does not tolerate selfishness and arrogance, noting that not all departments are like that. He says he is dismayed when he hears, “You’re nice for a neurosurgeon.” He explains that a diagnosis of brain cancer is “mind boggling” for a patient, and good interactions with the care team gives the patient confidence. He then Dr. Sawaya tells the story of a young man who was given a prognosis of only six months to live before coming to MD Anderson for treatment. He is still alive, married with children.

Dr. Sawaya describes a patient conference on brain cancers that he started at MD Anderson in the mid-nineties. It is now held every two years and designed to provide the public with information about all dimensions of brain cancer and treatment. Dr. Sawaya again talks about the “scare factor” of brain cancer, noting that it the surgeon must interact with the patient and family so the patient regains his or her confidence to begin the fight.
Chapter 04: Interpersonal Skills and Philosophy of Leadership

Raymond Sawaya MD and Tacey A. Rosolowski PhD

CLIP Included: Dr. Sawaya begins this Chapter by explaining that he learned his interpersonal skills from his father (recently deceased) who was an internist and his mentor. Dr. Sawaya credits his father with introducing him to the life and work of a physician, most importantly by taking him along on house calls.

He next says that that he knew he would be a neurosurgeon when he took his first neuro-anatomy course in college: he was fascinated by the organization of the brain. He goes on talk about being mentored by superb neurosurgeons, then notes how proud he is of the group that he trains.

Dr. Sawaya underscores that he has not advocated a departmental culture where everyone is the same, going on to explain some of the leadership principles he has relied on to build the department (understanding strengths, building collegiality, giving credit).
Chapter 05: Recruitments for the New Department of Neurosurgery

Raymond Sawaya MD and Tacey A. Rosolowski PhD

In this Chapter, Dr. Sawaya begins to sketch the process he went through to turn his vision for a neuro-service into a reality. He first talks about recruitments. He first hired Dr. Justi Rao, a basic scientist whose work on brain invasiveness supported his own interest in the subject. He notes that the Department’s research portfolio has diversified significantly since that time.

Dr. Sawaya next hired neurosurgeon Ian McCutcheon, who worked on mapping the brain. Dr. Sawaya explains the problems brain surgeons face when trying to locate tumors, focusing in particular on the challenges that base-of-skull tumors present. He notes that he hired Dr. Frank Delmonte to address tumors in this region.

Dr. Sawaya next hired neurosurgeon Sam Hassenbusch, who became the director of the pain program and the stereotactic surgery program. Dr. Sawaya explains the equipment that makes stereotactic surgery possible.

Dr. Sawaya next hired Dr. Zia Gokaslan to develop the program in spinal oncology. He then goes on to talk about the “rough patch” with managed care in the mid-nineties, and the way he managed to hire Dr. Fred Lang in 1996 as Director of Clinical Research, despite budget limitations. Dr. Sawaya notes that by 1996, he had established the nucleus of the Department.
Chapter 06: The Neurosurgery Database and Tissue Bank

Raymond Sawaya MD and Tacey A. Rosolowski PhD

In this Chapter, Dr. Sawaya recounts how the Department established a database to record detailed information about all surgical procedures performed by clinicians. He begins by explaining why it is important to have a volumetric measurement of brain tumors. Dr. Sawaya explains how recording the size of brain tumors resected helped resolve controversy over the surgical treatment of glioblastoma. A 2001 publication of the results has been cited over 7000 times, and Dr. Sawaya explains how the database provided hard numbers about percentages of resection, replacing the vague terms surgeons previously used to determine how much tumor and normal tissue to remove.

Dr. Sawaya next says that a “very amateurish” database was started in June of 1993, but professionalized in 1997, when the Department hired Dr. Dima Suki. He explains how Dr. Suki developed the database and data collection. He describes how data is collected from surgeons about the procedures they perform so the information can be preserved in the database.

Dr. Sawaya explains how fundamental data and data management are in neurosurgery and explains the strict protocols that govern data collection and entering. The Neuroscience database is IRB approved, a very rare designation, he notes. It is also important that Dr. Suki oversees audits of the database and manages any mistakes to maintain database credibility.

Dr. Sawaya next talks about the Department’s tissue bank was developed to preserve tissue samples from each patient treated. He notes the link with personalized therapy, then goes on to explain why tissue is time sensitive, requiring special handling. The Department received funding in 2001 to support handling of tissue samples.
Chapter 07: Developing Clinical Research Initiatives: Challenging Surgical Conventions

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya explains that Dr. Fred Lang established the infrastructure for the research program in the Department of Neurosurgery. He describes the types of questions that the Department’s research projects investigate. He next discusses the Department’s controversial study of surgery performed on patients with multiple brain metastases, a taboo intervention according to conventional surgical wisdom. The Department performed a retrospective investigation of data which then went to a randomized trial documenting the effectiveness of the procedure. Dr. Sawaya contributed to these studies and the findings that changed therapy nationally.

Dr. Sawaya briefly speaks about his work with lasers, then explains a surgical probe that uses a GPS system to establish its location. He discusses the many challenges that tumors present and some of the technology used to determine tumor location and size. He stresses the importance of learning much more about brain anatomy.
Chapter 08: Strategic Educational Choices to Build a Solid Career

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya begins this Chapter with recollections of his father, who was a physician and a mentor to him. He states that he saw his father make contributions to medicine and to society alike, and that by accompanying his father on house calls, he witnessed the impact a physician could have on an entire family. Dr. Sawaya then sketches his educational path, which took him away from Syria to a French University of Medicine in Beirut, where he could receive a superior education under the French system. He note his mentor in medical school, neuroanatomist Jedeon Mohassab, and neurosurgeon Fuad Haddad who eventually established the first neurosurgery center in the Middle East, and with whom Dr. Sawaya studied during a sub-internship. Dr. Sawaya then explains his decision to come to the United States to specialize in neurosurgery and describes the (lengthy) process of securing a surgical internship at Beekman Downtown Hospital in New York. He describes the educational and cultural adjustments he had to go through. He then sketches his Surgical Residency at Upstate Medical Center in Syracuse, New York. He explains why he did not feel ready to specialize in neurosurgery at this point, but notes that Dr. Robert King “opened the door” to his eventual specialization in neurosurgery. He then traces his training in neurosurgery, finishing at Johns Hopkins, where he was Chief Resident.
Chapter 09: Specializing in Brain Tumors –Once an “Orphan Disease”—And Research on Fibrinolysis

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya first explains that the outbreak of the Civil War in Lebanon helped convince him to stay in the United States. He then explains his decision to specialize in brain tumors, a field that did not appeal to most physicians in the seventies, and his application to the NIH to investigate why tumors invade the brain, work that led to his eventual publication of Fibrinolysis and the Central Nervous System (1990). He explains where he developed his experience with research design; notes that he joined the faculty at the University of Cincinnati College of Medicine (advancing to full professor in 1990). Dr. Sawaya then explains the mechanisms by which tumors invade the brain, using fibrinogen as a kind of scaffold to crawl into brain tissue. During this discussion, Dr. Sawaya refers to Figure 4 from his book, Fibrinolysis and the Central Nervous System (see below).

From: Raymond Sawaya, Fibrinolysis and the Central Nervous System (Philadelphia, PA: Hanley and Belfus, Inc., 1990), p. 15.
Chapter 10: Big Visions for the Tumor Program and Frustrations

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya notes that MD Anderson attracted him because resources at the University of Cincinnati were limited, and he was unable to build an adequate neuroscience team. He notes that when he arrived at MD Anderson to head the Department of Neurosurgery, he turned his research over to Dr.Justi Rao to run his RO1 grants. He was pleased with the balance of his responsibilities: 60% program building, 20% clinical, 20% educational.

Dr. Sawaya explains that in 1997 he offered Dr. John Mendelsohn a plan for a “truly multi-disciplinary” brain tumor program. The plan was rejected, and Dr. Sawaya speculates on why that happened. He next explains that he now has plans for a whole new building to house the neurological program. He speculates on the reaction of new president, Dr. Ronald DePinho, to this proposal. (Dr. Sawaya thinks out loud during this Chapter, planning his strategy of presenting his proposal.) He also explains why physical proximity enhances the effectiveness of multi-disciplinary teams and helps prevents problems with accountability and coordination of activities. Dr. Sawaya also notes the difficulty of promoting multi-disciplinary research and other initiatives, when there is no formal system of accountability in place to hold individuals to the plan.

Dr. Sawaya next says that Dr. Mendelsohn named him Director of the Tumor Institute in 2001, speculating that Dr. Mendelsohn felt “he owed” him the favor. Dr. Sawaya admits that he was so frustrated at the time that he almost left MD Anderson. He explains why he stayed and lists some of the concessions he received: the Directorship; the executive committee that was allowed to raise dedicated funds; permission to recruit a Director for Research (Dr. Oliver Bogler) for all labs in brain tumor programs (and that resulted in a SPORE grant). He reports that a review of the program by five outside reviewers listed MD Anderson’s tumor program as one of the top if not the top program in North America.

Dr. Sawaya believes that more could be done for the neuro patient in a “brick and mortar” institution wher all activities related to all tumors of the nervous system were located under one roof. He describes what would be possible. He then notes that an article about him in the Texas Medical Center News states that he “dreams big.”
Chapter 11: Technology to Support Neurosurgery

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya begins this Chapter by noting that Dr. John Tew, chair of Neurosurgery at the University of Cincinnati Medical College in the 1980s, saw that technology was essential to a strong department. Dr. Tew secured many of the first prototypes of devices in order to test them. When Dr. Sawaya came to MD Anderson, he made sure that he secured all of the technological advances. Dr. Sawaye describes the advantages of the following: brain mapping; drills to open the skull; navigation systems for the brain and spine; the first robotic microscope and Surgi scope; Brain Suite and the Intra-Operative MRI; Vector Vision.

Dr. Sawaya states that the next important advance will be the ability of the MRI to image microstructures in the brain, such as the speech areas. He also notes that a professor of neurosurgery in Calgary, Canada, has built a robot for use in the operating room. Dr. Sawaya explains the importance of robotics for neurosurgery, then talks about mastering the challenges of Brain Suite. He admits that he hesitated about investing in Brain Suite, but was convinced when he realized that it would allow surgeons to remove an entire tumor, leaving no pieces behind.
Chapter 12: Complex Training for Neurosurgeons

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya first sketches the usual educational requirements for a neurosurgical specialization: seven years after medical school, including a year of research, then a period of training for sub specialization. He then explains the one- to two-year Tumor Fellowship begun at MD Anderson in 1990/’91 with one fellow (there are now four). Very few institutions have training in tumor surgery, and MD Anderson’s program is very specialized. Dr. Sawaya describes what it offers to fellows: a large volume of patients, opportunities for constant use of technology; frequent awake craniotomies. Dr. Sawaya notes that MD Anderson fellows are very desirable hires after their training.

Dr. Sawaya then talk about his role as head of the joint program in neurosurgery established in 2005 between MD Anderson and the Baylor College of Medicine. He tells the story of why Baylor was interested in setting up such a program and how he was approached to serve as Chair. (He tells an anecdote about going to John Mendelsohn after the five-year review of the joint program: Dr. Mendelsohn asked him at that meeting if he wanted to submit his name as a candidate for MD Anderson’s president, as Dr. Mendelsohn was leaving.) His contract to serve as Chair was renewed for another five years, and Dr. Sawaya notes that the program hired thirteen faculty in the first three years.

Next Dr. Sawaya explains what neurosurgery residents bring to the Tumor Program and to MD Anderson. He then explains the computer matching process that links residents with institutions whose programs they might enter. He then describes the process of selecting residents and how a residency unfolds, noting that fellows have a different mindset than residents. He talks briefly about employment for neurosurgeons, which is a very small specialty. He briefly compares MD Anderson with Memorial Sloan-Kettering. Dr. Sawaya notes how the diversity of specializations and functions housed in the Department of Neurosurgical Oncology has enabled each to grow stronger.
Chapter 13: A History of the Brain Tumor Institute

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Here Dr. Sawaya tells the story of MD Anderson’s Brain Tumor Institute. He begins by noting that the multi-disciplinary Brain Tumor Program is one of the top three programs in the country and that it is the product of three decades of accumulated development. The story begins, he says, when Dr. Victor Levine was recruited from the University of California San Francisco to head the Department of Neuro-Oncoloy and brought with him an initial vision of a multi-disciplinary program with basic and translational research. In the mid-nineties, Dr. Levine secured the first program project grant from the NCI to study the molecular biology of gliomas. Dr. Sawaya describes the significance of that grant for MD Anderson and then goes on to talk about Dr. Peter Steck’s work on the genetics of brain tumors. This work led to the discovery (1997) of the tumor suppressor gene, PTEN –a major discovery that “crowned the project program effort.” Over the course of this time building research, Dr. Sawaya and Dr. Levine were also hiring clinical faculty, among them medical oncologists and neurooncologists. Dr. Sawaya created the largest brain tumor surgery department in the country and expanded neuropathology and neuroradiology as well.

Dr. Sawaya then explains that Dr. Levine was asked to step down, “a significant change.” Dr. Sawaya’s next move (1998) was to propose to Dr. John Mendelsohn that all the neuro-related activities be housed in a single brick and mortar location. He explains why Dr. Mendelsohn rejected this proposal, allowing Dr. Sawaya (2001) to lead the multi-disciplinary effort of the brain tumor program, including giving him permission to raise dedicated funds. Dr. Sawaya describes the composition and activities of the Brain Tumor Institute Executive Committee, which has had monthly meetings for the last 12 years.

Dr. Sawaya explains that the presidential permission to fundraise allows the Brain Tumor Institute to establish a premiere class tissue bank. He eplains that validation of the tissue bank came when the NCI decided to perform genetic studies of five cancers and selected the MD Anderson Tissue Bank to provide the samples of glioblastoma. Dr. Sawaya then explain how he worked with Development to identify donors. In the process he gives an overview of how Development presents possible projects to donors to secure their support.

Dr. Sawaya next explains that funding for the Brain Tumor Institute initiatives is never funneled to individual research programs but is used to build core facilities for research, including the Animal Core, the Tissue Bank, specialized equipment, and other shared resources. He then notes that when the Mitchell Building was constructed, he was given permission to consolidate all the research laboratories in one place (2005). He explains the key role that new-hire Dr. Oliver Bogler played in organizing research in the new location and in securing the SPORE grant for brain tumors. He talks about the difficulties that neurosurgery had in getting this kind of grant and how Dr. Bogler was able to “get them back on track” so MD Anderson could be a “major player” in brain research. Dr. Sawaya then summarizes the evolution of the Brain Tumor Institute and what it required.
Chapter 14: Leadership Principles and Values

Raymond Sawaya MD and Tacey A. Rosolowski PhD

NOTE: This Chapter includes three Clips.

Dr. Sawaya begins this Chapter with a statement about how it is key to recognize the individual when implementing complex plans, such as those he undertook to develop the Brain Tumor Institute. He explains how individual recognition a motivator is and how a leader must balance recognition of individual efforts with a larger vision. He states that the Brain Tumor Institute has reached a point of “maturity” that must now be maintained. He then acknowledges that the Brain Tumor Program trains high-level leaders and that some senior faculty are leaving to lead other departments and programs. He also notes, however, that individuals often see so many advantages at MD Anderson, that they do not feel the need.

Dr. Sawaya next explains that he always had an “inner drive” to be a leader. He explains that he saw the difficulties arising from a lack of good leadership while he was at the University of Cincinnati. He notes that integrity is essential in leadership. He tells a story about attending a leadership course at Rice University.

Dr. Sawaya summarizes his philosophy of integrity and honesty. He tells a story about a senior leader at MD Anderson who made a promise to Dr. Sawaya, then did not stick by his word during a public meeting. Dr. Sawaya specifies that this was not an instance of someone changing his mind and failing to communicate. Next he talks about his experiences in the Faculty Leadership Academy (2005) and in the leadership course offered at Baylor (2008-2009), a course he helped plan and then attended. He then explains that an institution must provide leadership training because physicians and researchers do not cultivate those skills during their professional training curricula, and they inevitably find themselves in situations where they must pay attention to systems and direct complex activities. He notes that his faculty have ambitions to chair departments, but lack skill. He then tells a story about a woman in one of his leadership classes who was not suited to administration.

Dr. Sawaya then talks about the composition and function of the Executive Management Committee, which he serves on from 2005 – 2007). The committee included executive vice presidents and three other individuals “from the trenches” to ensure that the vice presidents were not too separated from the working reality of MD Anderson. Dr. Sawaya explains that the Committee gave him an inside look at the working of the institution at a very high level and changed his perspective on top leaders.
Chapter 15: The Neurosurgeon: Making Decisions about Course of Treatment

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya says that it is easy for a neurosurgeon to take a conservative, timid approach to a patient’s course of treatment, but that is a losing proposition. He explains how the mindset at MD Anderson is to “shift the risk from the patient to the surgeon” and go after the tumor in the most aggressive way. He emphasizes that the development of new technologies have to accompany this approach, as neurosurgeons need tools to help them preserve the function centers in the brain. He explains that the Department routinely images every patient before and after surgery and takes tissue samples for volumetric analysis of tumors.

Dr. Sawaya explains how he works with patients to advise them of the risks and benefits of surgery. He notes how important it is to spend time to build trust. He concludes that “This is the best form of leadership I know,” where a surgeon distills and transmits knowledge to help a patient.
Chapter 16: MD Anderson in Periods of Change and Crisis

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya begins this Chapter by noting that the periods of major change at the institution are tied to administrative changes. He first reviews the period of change that came when Dr. John Mendelsohn [Oral History Interview] replaced Charles LeMaistre [Oral History Interview] in the aftermath of the Sharp Report and Charles LeMaistre’s successful attempts to convince the Texas Legislature to allow patients to self-refer to MD Anderson. Dr. Sawaya recalls the dramatic increase in the numbers of patients seen at the institution, with more business and money coming in. He also notes some of the programmatic expansions made under John Mendelsohn. He then notes that after Dr. Mendelsohn’s tenure, the institution was due for a change and welcomed a major scientist such as Dr. Ronald DePinho. He explains, however, that the institution is currently facing “a crisis” caused by too much controversy surrounding Dr. DePinho. He notes that the faculty feels ‘disenfranchised” and that morale is low. Though, as he says, the situation is not yet affecting patients, he has concerns for the long-term damage to the institution. Dr. Sawaya then explains that he uses the term “corporate” to describe a situation in which senior leaders are separated from faculty.

[The recorder is paused]

Dr. Sawaya says that an institution is greatly influenced by how a leader responds to employees’ concerns. As MD Anderson in still in the midst of crisis, it is not possible to answer questions about this administration.
Chapter 17: Defining What Neurosurgery Should Be and Looking Ahead to an Institute

Raymond Sawaya MD and Tacey A. Rosolowski PhD

Dr. Sawaya notes that he has led the development of two major programs (at MD Anderson and Baylor) and will transition out of administrative positions in each. He would ideally like to act on his vision to create a free-standing neurosurgery institute at MD Anderson that houses all laboratory and patient care activities under one roof. He suspects that MD Anderson is the only place in the country where this kind of development could happen.

Looking back, Dr. Sawaya states that he is pleased that he has defined neurosurgery “as what it should be.” He makes reference to the tree image discussed in Session I, noting that this is a model that others would like to emulate, but cannot. He emphasizes that this multi-disciplinary approach is not theory, but can and has worked and is thriving.

Dr. Sawaya states that each member of the Department of Neurosurgery should understand that they exist in partnership with a great department with the full backing of what MD Anderson is as an institution. MD Anderson is also stronger, he says, because of what each individual offers and creates.
Chapter 01: Tracking Toward a Career in Therapy Approaches

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover sketches her family background and educational pathway up to her graduate education. She talks about her areas of skill, her early interest in archeology, and how her adolescent experience of being in therapy stimulated her interest in that field. She talks about influences from her father and mother, who taught her the value of being self-directed.

Next, she talks about selecting her college and sketches the honor’s thesis topic she worked on at Brown University (BA in psychology, 1974): selective attention in autistic children.
Chapter 02 : A Focus on Sex Therapy

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover explains how she shifted her focus to sex therapy, an evolving field in the seventies when she entered graduate school at UCLA (MA in psychology in 1975; PhD in clinical psychology, 1979). She explains that part of her interest arose from the fact that she was sexually harassed by her honor’s thesis advisor at Brown University, an experience that raised her awareness of gender roles and created an interest in addressing them. She also notes that more and more researchers were focusing on issues of gender and sexuality. She describes her working relationship with Ken Pope, PhD. She also talks about her own research into the reaction of psychotherapists when patients would raise issues of sexuality during sessions.

Next, Dr. Schover talks about her postdoctoral fellowship in the department of Psychology (Clinical) Sex Therapy and Research at the State University of New York, Stony Brook (7/1979-2/1981). She describes the atmosphere in this department, which she describes as the “Camelot of sex therapy,” and where she had real mentors for the first time.
Chapter 03: The Decision to Bring Sex Therapy to Oncology

Leslie Schover PhD and Tacey A. Rosolowski PhD

Dr. Schover begins this chapter with stories about her first job, as an instructor in the Department of Psychiatry, Sleep Disorders and Research Center at the Baylor College of Medicine in Houston (3/1981-1/1982). She describes a study she conducted, looking at erections in aging men. She discusses an ethical issue that arose during a research study at Baylor and explains how her time there taught her about physiology and disillusionment.

Next, she explains how in 1982 she made the decision to take a position (Assistant Professor in Urology; Assistant Clinical Psychologist in Psychology, 2/1982-6/1986) at MD Anderson based on an interview with Andrew von Eschenbach, MD. She explains her strategies of transitioning to a focus on oncology, knowing little about the field. She also talks about how she presented herself and her clinical services to patients, as discussing sexuality was quite new in patients’ experience of treatment at the institution.
Chapter 04: Acceptance of Sex Therapy in Oncology and at MD Anderson

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover discusses the acceptance of sex therapy in oncology nationally and at MD Anderson. She begins by noting that in the 80s, sex therapy was seen as the latest thing, but it was not applied to chronic illnesses. In oncology at the time, only a few clinicians felt that addressing quality of life was a primary concern, although research showed that 60% of people with cancer end up with severe sexual problems that influence their quality of life. Dr. Schover sketches the types of problems that arise.

Next, she explains how faculty members helped her come up to speed on oncology treatments, providing her with insight into the patients’ experience of cancer. She also talks about working with patients, her passion for educating them about choices.

Next, Dr. Schover discusses why clinicians do not address sexuality in their work with patients and, on the other side, why patients don’t raise the issue with their oncology team.
Chapter 05: Issues with Multi-Disciplinary Care and Taking a Position at the Cleveland Clinic

Leslie Schover PhD and Tacey A. Rosolowski PhD

Dr. Schover begins this chapter by explaining why she chose to leave MD Anderson in 1986 for a position as staff psychologist at the Cleveland Clinic. She sketches the political environment in the Department of Urology that motivated her decision.

Next, Dr. Schover describes her work at the Cleveland Clinic, where she began to focus on fertility issues and conducted a first, pioneering study of fertility in young cancer patients. She also co-authored a textbook on sexuality and chronic illness with Tony Thomas: this book is still in print.

Dr. Schover then explains why she left the Cleveland Clinic. Ellen Gritz, PhD, the head of Behavioral Science at MD Anderson offered her a job. Dr. Schover talks about the decision she had to make between her marriage and her career and other work/life issues.
Chapter 06 : Building a Program in Reproductive Health at MD Anderson

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover explains that Dr. Ellen Gritz hired her in the Department of Behavioral Science to bring in grants and create programs in reproductive health. She discusses projects she worked on: intervention studies for men undergoing prostate cancer treatment; effectiveness of online interventions for follow up; studies of women under 35 undergoing treatment who wanted to have children later.

Dr. Schover explains the impact of her research in an evolving field and the fact that her work helped to launch the field of onco-fertility, predating even work done at the Onco-fertility Institute at Northwestern University.
Chapter 07: The Evolution of Onco-Fertility

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover provides an overview of the growth of the field of onco-fertility and acceptance of it within MD Anderson. She first talks about what spurred interest in the issue of fertility, citing the cancer survivorship movement as well as the adolescent/young adult movement. She sketches how the field has changed since the 1980s. She also explains how problems arose because institutions found it easy to cast onco-fertility as a “frill” rather than a service essential to cancer care; researchers were also finding it difficult to get grants to move the field ahead.

Next, Dr. Schover talks about views of onco-fertility at MD Anderson. She explains that she made a proposal for a reproductive health center in 2010, gaining support from several departments and from then-president John Mendelsohn, MD. That plan never came to fruition, but funds were provided to hire faculty for a program.
Chapter 08: A Landmark Conference on Cancer Survivorship and Parenthood

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover explains that in 2004, she and others at MD Anderson wrote a conference grant to bring together basic scientists and individuals in psychological fields to discuss cancer and parenthood at a landmark conference that furthered the field of onco-fertility. She explains the issues involved in this topic and also explains that two conference participants has authored embargoed papers, attesting to the national significance of the topic. Dr. Schover explains that this conferenced spurred collaborations across disciplines and that the conference proceedings were published in 2005, the same year a follow-up conference was held. She also comments on the
Chapter 09: Three Small Business Grants to Advance Onco-Fertility

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover discusses three projects she developed with NCI small business grants when she returned to MD Anderson in 1999 from the Cleveland Clinic, all of which were geared to providing accurate, timely information about fertility preservation for different populations of cancer patients. The first study (1999) surveyed physicians for their attitudes and practices working with patients around the issue of sperm banking. A second part of that study involved creating interventions: guidance for both male patients and for oncology professionals to increase awareness and use of sperm banking. She talks about the challenges evaluating this study and the importance of having strong networks among clinicians to ensure a robust population for a study. Dr. Schover also discusses why MD Anderson had not invested in in-house sperm banking services.

Next, she talks about the second study (2004) and its focus on providing an educational and counseling tool for women with regards to sexuality and fertility. The interventions included a website and a randomized trial to determine the effectiveness of in-person counseling versus 24/7 online access to information and guides to self-help in decision making. She then explains that the third grant focused on creating a similar reproductive health resource for men.

Next, Dr. Schover notes that she used an American Cancer Society grant to develop an online intervention for couples after prostate cancer treatment.
Chapter 10: Will2Love: A Start-Up to Disseminate and Commercialize Work in Onco-Fertility

Leslie Schover PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Schover sketches her work with her start-up company, Will2Love. She explains that after the third business grant from the NCI came to a close, she began to explore how to create a digital health business. In 2015 the Texas medical Center was initiating the TMCx program to enhance innovation and she received special permission to take part. She talks about the process of shifting to an entrepreneurial mindset and explains why hospitals have been resistant to undertaking programs in onco-fertility and sexuality.

Next, she sketches the services that Will2Love offers for both patients and providers. She also talks about work with a provider, Greenville Health System in South Carolina, a innovative, APN-directed fertility program. She talks about the lessons learned in developing both the patient and provider materials. She discusses a possible contract with MD Anderson.

Next, Dr. Schover talks about what is next for Will2Love.
Chapter 11 : Additional Programs and Final Thoughts

Leslie Schover PhD and Tacey A. Rosolowski PhD

Dr. Schover begins this chapter by discussing two additional projects she has worked on to test online interventions for sexuality and fertility. Next she talks about “Bring It Up,” a marketing effort for Will2Love aimed at increasing the number of people who discuss sexuality with their oncology teams. She talks about the self-help tool provided on the site to give patients an action plan for discussing sexuality with their providers.

Next, Dr. Schover reflects on her hopes that onco-fertility will evolve into a topic of easy discussion with patients that is fully integrated in daily care of the active cancer patient and the survivor.

Finally, she reflects on her time at MD Anderson, noting that when she first came to the institution, the focus was on providing drugs and has shifted productively to greater focus on quality of life issues. She notes that she has contributed to strides made and is pleased to have been recognized as a pioneer in onco-fertility.
Chapter 01: Stimulated By Challenging Situations; Building a Career as a Woman

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 02: An Institution on the Rise Provides New Opportunities

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 03: The Division of Surgery and Anesthesiology in 1991: Advocating for the Value of a Division

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 04: The Eighties Crisis: the Push to Expand MD Anderson and Create Patient-Centered Experiences

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 05: An Encouraging and Supportive Father

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 06: Serving as the VP of Hospitals and Clinics: Budget Stresses and Impact on Employees

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 07: Confronting Managed Care

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 08: Responding to Managed Care: Moving Toward multi-disciplinary Patient-Centered Care

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 09: Turning MD Anderson Around Through the Aim For Excellence Program

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 10: Changes When John Mendelsohn Arrives

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 11: The First Woman Vice President at MD Anderson

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 12: MD Anderson Now and in the Future

Donna K. Sollenberger and Tacey A. Rosolowski PhD
Chapter 03: A Job in a New Department and Research Successes

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

Dr. Spitz begins by noting that she received her MPH from the University of Texas School of Public Health in 1981 and began to look at job offers. This was when Guy Newell offered her an assistant professorship in the new Department of Cancer Prevention and Control. She briefly sketches Dr. Charles LeMaistre’s vision of cancer prevention.

Next, Dr. Spitz tells the story of discovering salivary gland cancer, which led to several publications, then her work linking parental occupations and pediatric neuroblastoma. The latter work gave her exposure. She then discusses her study of lung cancer and mutations to the p53 gene in Mexican Americans and African-Americans. She notes that this study marked the beginning of her real success.
Chapter 04: Epidemiology in the Eighties

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

In this chapter, Dr. Spitz talks about the state of the field of epidemiology in the Eighties. She notes that it was generally regarded as a “second-class science.” She quotes a colleague who made dismissive comments about the field. This situation began to change when the NCI required SPORE programs to have a population science component. At that point, Dr. Spitz explains, epidemiologists became very much in demand at MD Anderson. MD Anderson’s growing focus on prevention under Charles LeMaistre also created demand, as “epidemiology was the basic science of cancer prevention.”
Chapter 07: Founding Integrative Epidemiology and New Training for the New Era of Team Science

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

Dr. Spitz next observes that this has created the need for training programs to provide researchers with the necessary skills to work on teams. She also states that the culture of institutions needs to change to adequately recognize team science. Dr. Spitz talks about her pride in having developed the Integrative Epidemiology Workshop, an outgrowth of her innovative concept of integrative epidemiology. She explains this concept and talks about the mindset, skills, and temperament that researchers need to bring to work in this area. She explains how academic science needs to change to foster more team science. She reflects on the legacy she has left in MD Anderson’s research culture.
Chapter 08: Reflections on Career, Mentoring and Leadership

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

Dr. Spitz notes that she would like to be able to spend more time with her grandchildren, an observation that leads her to share that mentoring has been both the most challenging and rewarding dimension of her career.

Dr. Spitz explains that she had no real mentors, which made her realize how important this is. She talks about the ways in which she has mentored others and distinguishes scientific mentors from career mentors. She also explains that she didn’t really plan her career but was in the “right place at the right time.”

She next talks about her leadership style and explains that to be a lea

ders, one must have reached a career pinnacle and leave competition behind. She talks about participating in leadership training and offers advice to young leaders.
Chapter 09: Working through Challenges for Women at MD Anderson

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

In this chapter, Dr. Spitz talks about challenges and changes for women faculty at MD Anderson. She recalls the salary review spearheaded by Elizabeth Travis and others and changes that came from that initiative. She notes that she herself was the first female MD to become a department chair. She also recalls the dinner for senior women at which she receive the Faculty Alumnus Award. She talks about contributing an essay to the book about senior women, Legends and Legacies and shares her views about the group photo of the contributors in eveningwear.
Chapter 10: A Look Back at Institutional Change and a Legacy Left

Margaret R. Spitz MD and Tacey A. Rosolowksi PhD

Dr. Spitz first talks about big changes she saw at MD Anderson during her career and then reviews her contributions to the Department of Epidemiology.

She first talks about the impact of the requirement under Dr. Mendelsohn’s presidency that faculty supply 30% of their salaries from grants. She talks about the effect of rapid growth on the culture of the institution.

Dr. Spitz then turns to a discussion of the culture of the Department, noting her efforts to create a collegial environment with good quality of life.

At the end of the interview, she talks about the sub-area she created, integrative epidemiology that leverages the strengths of multiple sciences.
Chapter 01: Family and Educational Path in South Africa

Margaret R. Spitz MD and Tacey A. Rosolowski PhD

Dr. Spitz begins this chapter by sketching her family background, her original dream of becoming a nuclear scientist, and her transition to medicine because her father thought the field was “transportable.”

She talks about her experiences as a woman in medical school in South Africa, where she was told she was “taking the place of a man” and where even nurses were unsupportive of women students and physicians. She explains that she and her husband, Lewis Berman, left South Africa because of their opposition to Apartheid. Dr. Spitz also notes that, at the time, she didn’t realize how submissive and deferential she was.

Next, Dr. Spitz sketches her educational background, noting stark differences between education for boys and the curriculum she followed at an all-girls high school, where no physics or chemistry was taught. She also notes the lack of mentoring she received, which has motivated her to serve as a mentor in her own professional life.

Turning to her medical education, Dr. Spitz notes that her clinical training in South Africa was “exceptional” (1966 Medicine, MB, BCh, University of Witwatersrand, Medical School, Johannesburg, South Africa). She tells an anecdote from her internship at the same University, where she turned down an internship with an anti-female surgeon and was blackballed.

Dr. Spitz then explains that she took a hiatus from work for a time after her daughter was born in 1968; she began to do research out of convenience and discovered she really liked it.
Chapter 02:Leaving South Africa and A Focus on Oncology and Epidemiology

Margaret R. Spitz MD and Tacey A. Rosolowski PhD

Dr. Spitz begins this chapter by explaining that she and her family left South Africa in 1978. She notes that “emigration isn’t for sissies,” talks about the decision to come to Houston and then sketches the process of settling in. Dr. Spitz explains that she worked as a physician at an old age home and then decided to do a master’s in public health. Her interest in cancer evolved during this time; she also talks about how family issues influenced her career’s evolution. She notes that she always make family her priority.
Chapter 06: A Research Focus on Lung Cancer and Views on Evolution of the Field

Margaret R. Spitz MD and Tacey A. Rosolowski PhD

Dr. Spitz talks about her research interests in lung cancer in this chapter, beginning with the idea that captured her intellectual interest: only a small percentage of people who smoke develop lung cancer. This led to her major contribution to the field: creation of a lung cancer prediction model that was used for many years (she notes that another, better one is now in use). She then talks about her other roles as a consultant and as a recently appointed member of the National Cancer Advisory Board.

Dr. Spitz then gives an overview of the evolution of the field since the eighties. She notes that in the nineties, the concept of molecular epidemiology furthered the understanding of carcinogenesis. (MD Anderson was one of the first places to operationalize this research.) She then cites technology as an important factor in conducting genome-wide association studies. Now, she says, basic science functional studies are advancing the field and creates the need for epidemiologists to work with basic science colleagues, creating “team science at its best.”
Chapter 01: An Early Start on a Research Path and Critical Thinking

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel sketches the experiences that inspired him to pursue science and shaped his attitudes about education. After tracing his own educational track through chemistry, to biochemistry, to physiology, and to a first faculty appt in pharmacology he concludes: “If you get good training as a doctor of philosophy you are trained to think critically and that skill in experimental work transfers to a lot of different fields.” He reflects on how key critical thinking skills are to the contemporary researcher –a recurring theme in these sessions and a keystone in his philosophy of education.
Chapter 02: Building a Department of Pharmacology in the New UT Medical School

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel notes that his research path in endocrinology evolved at the time when the link between estrogen and cancer was first demonstrated. (He will speak in detail about his research in Session II.) Here, he focuses on his recruitment (in 1972) to help build a Department of Pharmacology in the brand new UT Medical School. He gives a vivid picture of this unique enterprise: building every dimension of a new school and new academic venture. He talks about the teamwork and trust required as the new faculty met an array of challenges, noting also that he immediately struck up connections with MD Anderson Cancer Center. Talking about this “remarkable time,” he brings alive the social life of the medical professionals (and their families) as they devoted themselves to building the new school.
Chapter 03: A Brief History of the Texas Medical Center and MD Anderson

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel sketches the history of the Texas Medical Center and MD Anderson (and how they came to be located in Houston) and clarifies the administrative relationships between the UT System, the UT Health Science Center, the Texas Medical Center, the Graduate School of Biomedical Sciences, and MD Anderson.
Chapter 04: The Graduate School of Biomedical Science: Creating A Unique Approach to Biomedical Education

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter Dr. Stancel talks about the environment of young institutions in place when he came to Texas in the Seventies. He talks about the founding of the Graduate School and recalls R. Lee Clark’s vision of researchers in basic sciences working alongside clinical researchers and those delivering patient care (an early version of translational research). He observes that to bring this environment into being in the GSBS, the faculty faced dual challenges: building careers and defining the identity of an institution made unique by its relationship to a cancer center and a mission to promote interdisciplinary communication among cancer scientists from many areas. Dr. Stancel describes how the GSBS preserves interdisciplinary breadth of education while developing programs with focal points defined by faculty interests. He sketches the major tasks of the GSBS during each decade of its existence, focusing in particular on the challenge of lobbying the Texas legislature to allow the MD Anderson to award graduate degrees jointly with the Health Science Center --the first instance, Dr. Stancel, notes, of a dedicated cancer center becoming a degree-granting institution.
Chapter 05: Developing an Administrative Track and Dealing with Multiple Institutional Connections

George M. Stancel PhD and Tacey A. Rosolowski PhD

Dr. Stancel discusses his administrative track during the last forty minutes. He traces his various roles in the Medical School, culminating in his GSBS Deanship (’99), an appointment that made him “the Dean for everybody,” both Dr. John Mendelsohn, president of MD Anderson, and Dr. David Low, president of the Health Science Center. He talks about the process of winning degree-granting status for MD Anderson. He tells a story to illustrate the kinds of dilemmas he works with as a Dean who must collaborate with multiple institutions. Dr. Stancel gives an overview of his responsibilities: reviewing of programs, building enrollments, improving academic planning processes, and integrating young faculty more effectively into their roles.
Chapter 06: Building Curricula and Leveraging Institutional Connections to Create Educational Opportunities

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel first talks about leveraging regional resources for biomedical education with training grants that draw build on the Gulf Coast Consortium (formed to broaden the educational/research resources available to students at six regional institutions). He then talks about the unique features of the education offered at the Graduate School.
Chapter 07: Current Challenges in Biomedical Education: Duration of Degree Programs and Mentoring

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel first explains why the time to get a PhD in the biomedical sciences has increased and then talks about how the Graduate School is addressing the (national) challenge of reducing the length of time required to earn this degree. He then moves to the related issue of changes in mentoring of graduate students.
Chapter 08: Issues in Graduate Education: Attracting and Retaining Women in the Graduate School; The Future of Biomedical Education

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel first observes that women had difficulty finding mentors in the early years of the GSBS (and recounts how the newly-created UT Medical School wanted to compete for the best students with more established schools and so actively recruited women and tailored courses to what were perceived to be women’s learning/working style). He explains discussing why the GSBS must have “a much deeper conversation with itself” about preparing students for careers outside of academia and how to foster innovation and creativity. At the end of this chapter he mentions various books dealing with innovation and medical education.
Chapter 09: Evolution of Research on Estrogen and Sweeping Changes in Biomedical Science

George M. Stancel PhD and Tacey A. Rosolowski PhD

Dr. Stancel next turns to his own research linking estrogen and uterine cancer. During his postdoctoral fellowship at the University of Illinois at Urbana he worked in the “hot contemporary area” of hormone mechanisms. He summarizes the shift in thinking about hormones at the time and the innovations that enabled detailed investigation of these substances and their relationship to cancer. Dr. Stancel was recruited for his work on steroid hormone action. He gives a vivid description of how technical innovations completely transformed his laboratory between 1972 and 2000. He describes several of the projects undertaken in his lab, including attempts to distinguish estrogenicity and carcinogenicity, successful demonstrations that hormones such as insulin and thyroid hormone would effect how a female animal would respond to estrogen, and work on mechanisms to predict susceptibility to uterine cancers. Dr. Stancel offers a lively anecdote of how the lab relied on-cutting edge equipment, such as the RT-PCR --a first reverse transcription polymerase chain reaction processor, the first at the UT Medical Center (and one of the first in the nation –their processor had serial #8), which they shared with others. At the end of this chapter he describes the process of closing down his laboratory.
Chapter 10: The First Uterine SPORE Grant

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel talks his role (partnered with two junior faculty members at MD Anderson) on the first uterine SPORE grant (Specialized Programs of Research Excellence) in the country.
Chapter 11: The First Course in Ethics

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel talks about his role on the Research Ethics Task Force. He stresses that as far as he knows the Graduate School of Biomedical Science is the first institution to offer a course in ethics and to require it. He explains why teaching ethics has been controversial, then talks about the plans to formally track the effect of this program and possible ethical dilemmas medical professionals will face. He vividly describes some of the teaching methods.
Chapter 12: Executive Vice President of Academic and Research Affairs

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stancel talks about his role as Executive Vice President of Academic and Research Affairs for the Texas Health Science Center (appointed in 2011). He observes that this high-level administrative work is much like “building a structure or a framework to help people” do their work more effectively and effortlessly. He foresees that future collaborations between UT Health Sciences and MD Anderson (and other institutions) will become more important as these institutions deal creatively with budgetary constraints and share resources and expensive equipment.
Chapter 13: Proud of Teaching; A Goal of Maximizing Intellectual Cooperation Between UT Institutions

George M. Stancel PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Stances shares some of his private life and perspectives. He talks about his long-time participation in the Ride for Multiple Sclerosis, a bike ride between Houston and Austin that hundred of people participate in, including many teams of Houston medical professionals. Among his professional achievements, he is most proud of developing new educational programs from scratch or significantly modifying them. He is also proud of having taught every single medical student who has come through the Texas Medical School, as well as teaching students in every school in the health science center, including graduate students at MD Anderson. He concludes the interview with a snapshot of what he would like to achieve in his remaining time in administration: a maximization of intellectual cooperation between all the University of Texas components and other institutions in Houston. He hopes that institutions might find ways of overcoming unhealthy rivalry and “build a better family” of biomedical intellectuals and institutions that might serve as “better stewards of public trust.”
Chapter 01: Inspired By Work at a Medical Institution

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck explains that he came to work for MD Anderson's Department of Public Information and Education in 1975. (Prior to that he worked in a University of Texas Medical School Information Office that served both the Medical School and MD Anderson.) He then offers some background information, including how he came to spend his "formative years" in Houston. He notes that he spent his undergraduate years at University of Texas at Austin majoring in advertising and journalism. He secured a job in public information at the University of Texas Medical Branch in Galveston after graduation. Seeing the caring dimension of medicine inspired him to continue to work with the medical field, however he was drafted in 1969, going to Vietnam in 1970 as a public information specialist who wrote for the Army until his discharge in 1971. Though he returned to the University of Texas at Austin for graduate work, he left because for a job in the Public Affairs office at the University of Texas Houston.
Chapter 02: Public Affairs: Working Closely with MD Anderson Presidents

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck describes the work he did promoting awareness of the new medical school (University of Texas Medical School) until 1975, when he was made Director of MD Anderson’s Department of Public Information. He explains why the rapidly growing institution needed such a Department at that time and why Dr. R. Lee Clark offered him the job [the letter mentioned is reproduced in Steve Stuyck: The MD Anderson Years]. He talks about Dr. Glen Knots, to whom Mr. Stuyck reported, and the lessons he learned from him about management and leadership. He then explains why, in 1981, Dr. Charles LeMaistre arranged for Mr. Stuyck to report directly to him. He tells a story about a speech he volunteered to write for Dr. LeMaistre when he had to testify in Washington D.C. about the deaths of several patients, and how pleased Dr. LeMaistre was with his work.

Mr. Stuyck explains the particular abilities he was able to bring to MD Anderson and to the institution’s presidents. In addition to being a good editor of others’ work, Mr. Stuyck describes himself as a strong writer about MD Anderson and about cancer, with a skill to commit issues to paper. He had a special sense of Dr. Charles LeMaistre’s way of expressing himself and could capture it. (Mr. Stuyck says that “I could hear him saying the words from the podium.) He notes that the archives have about 700 speeches that he wrote over the course of his career.

Mr. Stuyck describes the exhausting schedule of working with Dr. LeMaistre’s speech trips and notes that, when Dr. John Mendelsohn arrived, it was agreed that Mr. Stuyck would not write his speeches. Mr. Stuyck then tells several anecdotes to demonstrate what he learned about leadership from Dr. Charles LeMaistre. In particular, he mentions Dr. LeMaistre’s habit of encouraging people who worked for him. Mr. Stuyck recalls that Governor Bill Clemmons shouted at him during a visit, and Dr. LeMaistre phoned him later in the evening to tell him not to worry about it. Next he speaks briefly about Dr. John Mendelsohn, noting that he was just what the institution needed at the time. Dr. Mendelsohn promoted Mr. Stuyck to Vice President of Public Affairs. Mr. Stuyck notes that he had thirty years of working with great bosses and great leaders.
Chapter 03: Early Developments in the Department of Public Information and Education

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

This segment 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.
Chapter 04: The Faculty: The Intellectual Engine of MD Anderson

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck expresses his appreciation for the MD Anderson faculty who are the "intellectual engine" of the institution even though they represent only twenty percent of employees. He says he has always tried to understand faculty issues and "speak their lingo." He traces his support for faculty back to his experiences at University of Texas Medical Branch, where he loved attending Grand Rounds. He sketches how issues have changed for faculty and lists the pressures upon them. He also characterizes MD Anderson faculty as possessing great intellectual curiosity.
Chapter 05: Expanding the Scope of Public Affairs: Increasing Services for Faculty, Patients, and the Public

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck talks about the expansion of the idea of public affairs at MD Anderson. Mr. Stuyck explains that after he secured the NCI contract for the Cancer Information Service, "Public Education" was added to the name of the Department of Public Information, going on to detail what education can do for an institution. Next, Patient Education came under the scope of Public Information, and he explains what sorts of educational materials the department produced. Volunteer Services was next folded into Public Affairs, and Mr. Stuyck explains that he wanted to bring together in one unified division all the functions that would reach out into the public. Next he explains why Public Affairs was sequentially identified as a Department, then an Office, and finally a Division. He comments on the perception of Public Affairs within the institution then goes on to explain some of the many services provided to MD Anderson. He begins by explaining Creative Services then talks about the role Public Affairs played when Dr. Jordan Gutterman [Oral History Interview] and his work on Interferon attracted tremendous media attention. He explains that Dr. Gutterman received 7,000 to 8,000 letters from people begging to participate in his trials. Public Affairs set up a service to answer all of these letters. Mr. Stuyck talks about preparing faculty to deal with media appearances. Then he identifies the sections within Public Affairs and notes that he and his management team produced both monthly and annual reports to document the contributions they made to the institution. At the end of this chapter, Mr. Stuyck notes that MD Anderson has generally received very good press. Most of the negative press has come during the last year.
Chapter 06: Public Affairs: External Communications

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck explains the changing role of Public Affairs since the seventies. At that time, physicians were not concerned about public relations. He then points to Dr. John Mendelsohn’s arrival as a turning point in the institution’s dealings with the public: Mr. Stuyck explains how he and others worked with Dr. Mendelsohn to draw greater attention from national and international media, eventually hiring a New York public relations firm, The GabbeGroup (which still works for MD Anderson). He also explains that the single greatest factor to change the institution’s media needs was the passing of the self-referral legislation in 1994. Mr. Stuyck describes the challenges created when the bill went into effect in 1995 and forty percent of patients could suddenly request their own appointments. He explains that the information service, Ask MD Anderson, was created to help patients navigate the complex institution: it takes 100,000 calls per year.

Mr. Stuyck next describes several strategies used to raise the institution’s profile. He describes the trips that Public Affairs planned for Dr. Mendelsohn, designing them to create more exposure for cancer and the institution. The GabbeGroup suggested that Public Affairs submit profiles on cancer issues to the US News and World Report website. Public Affairs also published surveys on attitudes about cancer and attitudes about breast cancer in Prevention Magazine.

Mr. Stuyck explains that departments that heavily use Public Affairs services fund positions within the Department. This insures that Public Affairs serves their needs. Mr. Stuyck points to the important and productive link between Development and Public Affairs. He then identifies some key moments in the institution’s relationship to the public: achieving status as a cancer center; the change in the institution’s name in the 1980s; the impact of the Internet.
Chapter 07: Public Affairs: Internal Communications

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck gives an overview of internal communications in the institution. He notes that, in 2001, MD Anderson was at a crisis point in communications and Public Affairs hired the management group, Deloitte &Touche, to analyze the issues. At this time he proposed to the Management Committee of Public Affairs to establish a section for internal communication. As an example of communication difficulties, he talks about the mistrust created by layoffs in the early to mid-nineties, describing the publications created to address the issue. He compares the paper communications of past decades with the online communications of today. He then talks about new technologies that communications specialists must master today, noting that "it's fun to be around" the new media specialists and to strategize how to use new technologies. He notes that Communications has "reinvented itself" six or seven times in the past decades.
Chapter 08: Public Affairs: Writing the MD Anderson Mission Statement and the Code of Ethics

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this segment, Mr. Stuyck next talks about his work on two key documents: the Vision and Mission Statement and the MD Anderson Core Values. He explains why there was controversy over the core values.

Mr. Stuyck gives an example of why the word “hope” was controversial in the Core Values, saying that he was “never a fan of hope,” but other committee members convinced him it was key to MD Anderson. He then talks about the impact of the two documents, citing a survey of employees that revealed almost 100% satisfaction with the institution values.

Next Mr. Stuyck briefly compares Public Affairs at MD Anderson to analogous departments at other institutions. He comments on the role of the Management Group within Public Affairs and its strategic work in guiding the departments activities and evolution. He briefly comments on how Public Affairs is working with the current controversies surrounding Dr. Ronald DePinho.
Chapter 15: A Key Publication: Making Cancer History

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this segment, Mr. Stuyck tells the story of how Making Cancer History, a history of MD Anderson came to be written. Dr. James Olsen, a historian at Sam Houston State University, originally approached Dr. James Bowen with the idea, however the Management Board under Dr. Charles LeMaistre had no enthusiasm for the project. Mr. Stuyck speculates on why this was the case, then goes on to trace how the Historical Resources Committee was created under Dr. Stephen Tomasovic, with a first goal of producing a history of the institution. He explains the lengthy process of looking for a writer and the eventual hiring of Dr. Olsen, as well as securing Johns Hopkins University Press to publish it. Mr. Stuyck recalls that he and Stephen Tomasovic [Oral History Interview] both read the manuscript.

Mr. Stuyck says that Making Cancer History is a great book that tells history in a human way. He also talks about his favorite chapter. Next he next talks about what it meant for the institution to have a book that celebrates the culture. He speaks about the number of documents James Olsen reviewed as part of his research, the committee members who worked on it, and what was done to promote it.
Chapter 16: Changes at MD Anderson

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck gives an overview of the changes he has seen at the institution over the course of his career. He notes that people in the past worked just as hard as they do now, but worked differently. He talks about the dramatic expansions to ambulatory care and patient care in general and the improvement of quality of life issues for patients. He makes some observations on cultural changes and the increasing interest in work/life balance. He then talks about the plan to merge the University of Texas Health Science Center with MD Anderson, a move that was resisted to preserve the institutions mission and resources. Mr. Stuyck also talks about changes that Dr. John Mendelsohn brought to the institution, particularly the dramatic growth, for which the institution is now paying the price, he says.
Chapter 17: The Murder of Dr. Fred: A Challenge for Public Affairs and the Institution

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck talks about the day that Dr. Fred G. Conrad, Vice President for Patient Care, was fatally shot (17 December 1982). He recalls Elmer Gilley calling him early Friday morning, and he went to MD Anderson to wait for the police and the coroner and to handle the reporters. Mr. Stuyck recalls how calmly Dr. LeMaistre handled the situation and helped calm the tension. He then talks about how Public Affairs handled the media, noting that the crisis brought out the best in people at the institution. He describes Dr. Conrad and explains why his murder was a “seminal moment” in the institution. He ends with a story about a woman who had flown into town to be interviewed for a job, arriving at MD Anderson to discover “bedlam” so she returned to New York.
Chapter 18: Departments Within Public Affairs

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this segment, Mr. Stuyck talks about four departments within Public Affairs: Volunteer Services, the Children’s Art Project, Public Education, and Patient Education. He begins with Volunteer Services, a service within MD Anderson that goes back to the 1950s.

He then talks about Page Lawson, a director who greatly expanded Volunteer Services in the 1970s. He explains how he came to oversee the Department and tells a story about Tommie Stewart, a volunteer known as “the Hug Lady.” He notes that MD ANdserson has 1200 volunteers who contribute the equivalent of 100 full time employees. He mentions the series of directors leading up to Page Lawson, whom he calls “a dynamo.”

Mr. Stuyck explains the lesson he learned from Page Lawson about remembering the names of volunteers.

Mr. Stuyck next talks about the Department of Patient Education, created by Dr. Charles LeMaistre. He explains how it came from the first patient satisfaction survey conducted in the 1980s. Dr. LeMaistre used the results of the survey to add valet parking, patient advocates, and patient education functions. Mr. Stuyck explains changes in the reporting structure that came about with these changes, as well as the database that evolved to support patient education activities. He sketches the types of materials produced and who works on them.

Next Mr. Stuyck talks about the Children’s Art Project, beginning with an anecdote: Page Lawson showed him children’s drawings arranged on an ironing board and asked him which ones would make a good card. He talks about his decision to separate the Art Project from Volunteer Services. Mr. Stuyck describes what the Children’s Art Project contributes to MD Anderson. He explains that it gives the institution a chance to talk about its successes. He notes how the Children’s Art Project has come to be part of the MD Anderson brand.

Mr. Stuyck then tells the story of how the Public Education Department started. He comments on his colleagues in the Division of Public Affairs. Finally, Mr. Stuyck talks about what the Department of Public Education does for ME Anderson.
Chapter 19: A Fun Job at an Institution that Inspires Commitment

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck speaks briefly about some constraints he felt for his activities at MD Anderson. He notes the commitment employees at MD Anderson feel for what they do and how much job satisfaction employees have.

Mr. Stuyck speaks briefly about receiving the Anderson Network Award. He also notes that the Division of Public Affairs is one of only three institutions that have twice received recognition as an Outstanding Public Affairs Program. He briefly talks about the book that he received on his retirement, Steve Stuyck, the MD Anderson Years, and clarifies two mysterious references in that book. He then notes that his is most proud to have started the Cancer Information and Public Information services, both of which were groundbreaking at the time. He is also very proud that he engaged the institution’s first public relations group.

Stuyck talks about what MD Anderson has given him over the years: a rewarding and fun job. At the end of the interview he notes that he gave his job “his all” and hopes that MD Anderson will continue to lift the “huge burden” that cancer represents.
Chapter 09: Public Affairs at MD Anderson: Supporting Cancer Prevention and Education

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck begins this segment talking about a joint project between Public Affairs and the Division of Cancer Prevention. He provides context, explaining that Dr. Bernard Levin (Vice President of Cancer Prevention, [Oral History Interview]) was approached by Channel 13 to do a promotion of the new fecal test for colon cancer screening. He explains how the project turned into a research project supported by SmithKline as well as a public service initiative. Nine thousand people participated in a study to compare fecal testing methods. Laboratory Medicine helped, but Public Affairs organized volunteers to read the cards. This study was eventually published. Next Mr. Stuyck describes another cancer prevention project that involved taking measurements of ultra-violet light at five locations four times per day.

Mr. Stuyck explains his axiom that “good public education is the best public relations. He then describes how he used that axiom to make decisions about public affairs issues.

Mr. Stuyck mentions an article that appeared in Prevention and gives background on how this research started as a survey conducted by a collaborating group of people from marketing, education, and research.

He confirms that the partnership between Public Affairs and Cancer Prevention was unusual, but notes that part of the mission of Public Affairs is to support faculty. He then gives background on how the Division of Cancer Prevention was founded at MD Anderson, going back to a group of researchers who met for lunch once a month for several years and educated other interested faculty and staff. Public Affairs would convert the research ideas into education ideas, and continued when Bernard Levin was head of the Division of Cancer Prevention. He notes that Dr. Levin was the first administrator to fund a full-time communications specialist. He also notes that the lunch group is still meeting.

Mr. Stuyck explains that the staff in the Department of Patient Education all have Master’s degrees and they are involved in attracting patients to clinical trials. He describes the challenges of this work and mentions Louise Villejo, who a range of education tools designed to help patients understand trials.
Chapter 10: R. Lee Clark and Charles LeMaistre

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck notes that MD Anderson has been strong because of the continuity of its CEOs. He notes that the institution’s first full-time president, Dr. R. Lee Clark, had a solid public relations staff; he also focused on international activities. Mr. Stuyck tells an anecdote about accompanying Dr. Clark to a television interview prior to his retirement.

Mr. Stuyck then talks about Dr. Charles LeMaistre [Oral History Interview], noting that he was erudite and chose his words carefully. Dr. LeMaistre also improved the look of MD Anderson and enhanced the clinical environment. Mr. Stuyck notes that paying patients would go to other institutions, but Dr. LeMaistre’s initiatives made MD Anderson more attractive, and turned that around. He says that Dr. LeMaistre was very effective at representing the institution to the public. He also contributed to the institution in many ways. One was by making the controversial move of starting the Division of Cancer Prevention. Dr. LeMaistre also led the initiative to change legislation to patients could self-refer. He explains why attitudes of physicians outside of MD Anderson made self-referral controversial at the time. Mr. Stuyck notes that the transition to self-referral was very smooth.

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