Interview Chapters

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  Chapter 01: A Unique Institution: The Michale E. Keeling Center for Comparative Medicine

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield explains that the Michale E. Keeling Center for Comparative Medicine provides a variety of resources and services to physician-scientists at MD Anderson and the Texas Medical Center. He focuses in particular on the animal models using mice, sheep, chimpanzees and many other kinds of animals that enable experimentation with drugs, the mechanisms of cancer, and many other studies. These, in turn, provide the basis for translational research leading to therapies useful for human patients. In addition, the Center provides medical and surgical expertise for handling research animals as well as expertise in the many guidelines researchers must follow to comply with FDA regulations. He notes that the Keeling Center is a unique institution where veterinarians do more than provide clinical care and advance science. As an example, he describes his collaborative work with the Department of Neurosurgery studying the treatment of neuropathic pain in cancer patients.

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  Chapter 02 : Why Animals are Important in Cancer Research: Controversy Over Using Animals

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield explains some basic terms and describes how biological and genetic similarities make it possible for animals to serve as stand-ins for humans in experiments. He also notes some of the characteristics scientists look for to determine whether a particular animal will offer a good model for a specific disease or condition presents itself in humans. He then explains that animals are critical to the study of cancer because the disease is so complex and expresses itself in so many ways. He notes that rhesus monkeys, for example, can spontaneously develop colon cancer just like humans, whereas other animals do not. There is tremendous individuality in animals, just as there is in cancer. He says that if computers can eventually create a replica/model of a living organism, perhaps animal studies will no longer be needed. But he doubts that a computer could ever model anything so sophisticated. One of his roles, he says, is to help investigators select the correct animal models for their studies in order to most effectively lead to treatments for humans.

  Dr Satterfield next acknowledges that many people believe that animal experimentation –particularly with higher primates- is controversial and perhaps even immoral. He says he appreciates the controversy, but states that “it’s ok if we inconvenience a few animals to help millions of people.” The death of one of their research animals is a personal loss, and the staff cares deeply for all the animals at the Center. He then talks about studies of hepatitis C using chimpanzees (the only animals other than humans who can carry the disease), noting that a year and a half ago they cleared a chimp of hepatitis C. Dr. Satterfield then details the many ways that the Keeling Center cares for experimental animals: with yearly check ups, cardiac exams, and even geriatric medicine for the aging chimpanzee population. (In 1995, the NIH placed a moratorium on breeding chimpanzees, so the population is aging. IN addition, chimpanzees are not euthanized at the end of studies, as are other animals.) He also notes a case in which an experiment with a monoclonal antibody killed a chimpanzee, thus preventing that drug from being tested on human beings.

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  Chapter 03: Broad Experience and an Interest in Immunology Creates a Path to MD Anderson

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield briefly sketches his educational path and notes that when he assumed the position of Veterinarian at the Boston Zoo, he was one of the few fully employed zoo vets at the time. He also talks about his family background, noting that he elected to go into veterinary medicine because of his mother’s love of animals and her support for his habit of bringing home strays. He then lists his unique professional experiences. During his postgraduate training through the School of Veterinary Medicine at Harvard, for example, he worked with basic scientists who were looking at the transmission of disease. He acquired wide clinical experience working on animals as varied as fish, elephants, and primates. All this experience kindled his interest in basic biology and immunology. This will put him in a unique position to be recruited for MD Anderson’s Keeling Center.

  Dr. Satterfield describes how he was offered the opportunity to come to MD Anderson in 1983 to study the very poorly understood disease, AIDS, and try to develop treatments based on the model of hepatitis B. He worked with chimpanzees and tells the story of how the NIH was looking for a place to transfer its community of primates. R. Lee Clark found a donor to give one million dollars to bring the chimpanzees to MD Anderson, and he worked with Dr. Michale Keeling and Dr. Kenneth Riddle to create the chimpanzee program. He concludes this section with a brief discussion of research he conducted with the Department of Defense: this led to the discovery of a monoclonal antibody that defends against smallpox and that is now part of the anti-bioterrorism “National Stockpile.”

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  Chapter 04: The Keeling Center and Research on HIV and Hepatitis C

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  Dr. Satterfield recalls how small the Keeling Center was when he arrived in Bastrop and the many challenges he faced caging animals. He recalls the urgent need to create adequate bio-security provisions, as no one knew how AIDS was transmitted. He also notes that because Bastrop is a remote facility, many researchers in Houston didn’t know of their existence (and still do not) but are grateful to discover all the resources they offer. He describes how the faculty grew and became an incubator for collaboration. As an example, he talks about the over 40 protocols conducted with the NIH on hepatitis C and AIDS, which led to the discovery that AIDS is a retrovirus. Dr. Satterfield then goes into detail about his work on hepatitis C, talking about how he and collaborators tested clones of the six strains of the virus to develop a resource for future testing of vaccines. He also notes his work on hepatitis B and D. He returns briefly to talk about the “watershed” hepatitis C study that resulted in a chimpanzee being cleared of the disease. He closes this Chapter by talking about medical conditions that will disqualify an animal from being included in a study.

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  Chapter 05: A Father Who Beats Cancer

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this very personal Chapter, Dr. Satterfield recalls that in 1987 his father was diagnosed with lymphoma and all the physicians he had seen “had written him off.” Dr. Satterfield was able to have his father seen at MD Anderson and was still doing well in 1995. (Mr. Henry C. Satterfield died in an auto accident.) Dr. Satterfield explains that when he arrived at MD Anderson in 1983, he thought he would stay four years or so and move on. However, this personal experience with cancer galvanized his commitment to cancer research. “We do a little,” he says, “but everybody does, and it adds up to a lot.” He also recalls MD Anderson neurosurgeon, Dr. Samuel Hassenbusch, who died of cancer (the same cancer he studied). Dr. Satterfield collaborated with Dr. Hassenbusch and recalls him very fondly. Dr. Satterfield again says that the Keeling Center offers faculty a tremendous opportunity to enjoy work, stimulating colleagues, and a sense of purpose.

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  Chapter 06 :The Cattlemen for Cancer Research --Community Philanthropists

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield describes how in the late nineties, Dr. Keeling had a plan for raising seed money for new studies. Using his own strong connections to the community, he approached local ranchers to donate livestock for auction, and the Cattlemen for Cancer Research was born. They raised over 1 million dollars and give a percentage to an MD Anderson fund to help patients from a five-county area to pay for cancer treatment. Dr. Satterfield then talks about the Center’s connection to the community, noting that it is a major employer, purchases much of its supplies locally, and also brings students from Austin Community College in for educational experiences. He then notes that the auction has become a yearly event held in the fall, with a gala being held in the spring. This cancer related fund raising has become a community tradition.

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  Chapter 07: The Veterinarian as Research Collaborator

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  Dr. Satterfield here talks about the role he has served as Attending Veterinarian. He explains that this title was established as a result of FDA’s and the animal welfare act administered by the Animal Care and Use Committee. Though an Attending Veterinarian must report all violations of guidelines to the committee, Dr. Satterfield sees his role as a problem solver who helps investigators to think through protocols and clearly define their purposes and methods. He stresses that he sees his role as a facilitator who develops teams and fosters effective collaboration. He then describes how the FDA animal welfare regulations were set in place because of very public instances in which animals were mistreated –in some cases in the course of practicing poor science. At the time, the public also believed that pets were being used for research; he insists that MD Anderson has never used any dogs previously owned as pets for research. He notes the Tumor Referral Program, begun prior to his arrival in 1983, and run in both Bastrop and Houston, which enables the public to bring dogs suffering from canine lymphoma for treatment. He tells a touching story of a mother who brought in a dog that had belonged to her 10-year-old son who had been killed. The animal was all she felt she had left of her son. Dr. Satterfield notes that the Program’s purpose is to extend the life of pets.

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  Chapter 08: The History of ‘Good Laboratory Practice’ at the Keeling Center

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In the beginning of this Chapter, Dr. Satterfield notes that in his role as Attending Veterinarian for the Keeling Center he works for the good of human health and also for the highest standard of care for the animals he oversees. He underscores that research animals are “unsung heroes” in the long process of conducting research and taking drugs to the market; in his view, the FDA has a difficult job in regulating this process, and it has done a good job.

  Dr. Satterfield next goes into detail about the FDA’s Good Laboratory Practice [GLP] program and how the Keeling Center work to meets its criteria for quality insurance, training, documentation, and data storage –all to insure a secure and unbroken chain of experimental evidence so that other researchers can have confidence in reported methods and results and replicate experiments. As a contained unit within MD Anderson, Keeling is uniquely positioned to guarantee secure storage of data, for example, and also security of practices by providing in-house pathology services. Dr. Satterfield also explains describes the economic context in which The Keeling Center adopted the GLP standards: the GLP program enabled MD Anderson to retain control over the discoveries (intellectual property) of its researchers, derive royalties from them, and use those funds to fuel the “engine of development.” The Keeling Center, he explains, provides a piece of that development by providing animal models of use to MD Anderson researchers, as in the case of his collaboration with researchers in Plastic Surgery to engineer bone tissue. He then describes how working on projects with very high-quality research practices led him (in partnership with DR SASTRY) to propose that The Keeling Center make the investment to adopt the full GLP program.

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  Chapter 09: The Challenges of Collaboration and Proprietary Research

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield mentions his collaboration with Dr. Samuel Hassenbusch, M.D. in the Department of Neurosurgery to study in a study of alternatives to opioids in the treatment of neuropathic pain. He then diverts into career issues created when a researcher works on studies with proprietary devices and compounds. He explains that when work is proprietary, it cannot be published, a serious problem when publications are one of the main criteria used at MD Anderson for tenure and promotion. Dr. Satterfield notes that he “struggles with this as a career issue.” He also notes that veterinarians frequently contribute intellectually to the investigations they help support, but because they don’t have laboratories, their contributions are not as easily documented. The solution, he says, is sensitivity and awareness on the part of individuals who sit on the Promotions and Tenure Committee. He mentions that Dr. James Bowen and Dr. Stephen Tomasovic [Oral History Interview] have both been aware of the problem and helpful. He also anticipates that Dr. Ronald DePinho will appreciate the contributions that veterinarians make to drug research. At the end of this Chapter, he underscores that the faculty at The Keeling Center are collaborators in research more than service providers and that he enjoys working with others and seeing the work translated into patient-relevant practices.

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  Chapter 10: A Career of Collaborative Studies from HIV to Tissue Engineering

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  Dr. Satterfield discusses his research in this Chapter, beginning with his collaboration with Dr. Samuel Hassenbusch, M.D. in the Department of Neurosurgery to study midazolam, an alternative to opioids in the treatment of neuropathic pain (as opioids create small tumors that add to pain and obstruct the spinal cord). He describes the tests conducted on sheep and the subcutaneous pump used to deliver the drug, a highly sophisticated device that can be controlled by telemetry. He notes that study of this system went to clinical trials several years ago.

  Next, he talks about the hepatitis and AIDS research conducted on chimpanzees since his arrival at MD Anderson, though he notes that it is very difficult to meet the criteria to use great apes in studies, a great loss to science in his view. At this time there is only one animal in the study of a drug that successfully cleared hepatitis C. There is also a study in progress to determine the safety of a monoclonal antibody used to treat rheumatoid arthritis and autoimmune diseases. This topic leads to an explanation of “orphan products,” drugs used very selectively for a small number of patients with rare conditions.

  Dr. Satterfield then turns to his work with two gynecologic oncologists using rhesus monkeys to successfully demonstrate that oral contraceptives reduce markers for ovarian cancer. He notes that he helped the investigators select animals with ovarian cycles similar to humans as well as providing the physical services such as performing the biopsies and making slides. This discussion leads Dr. Satterfield to note that Keeling’s chimpanzee community is on oral contraceptives because of the FDA moratorium on breeding.

  The next study described is the work with Dr. Miller, Chair of Plastic Surgery, who was looking for a way of recreating bony body parts using molds. Dr. Satterfield describes the process of recreating a mandible for a sheep by filling a mold with crushed bone, attaching it to the body wall so it could regenerate and grow a blood supply, then transplanting it to the jaw. This process would address clinical mandible problems in humans created by tobacco use. (The process has been used on humans in Germany.) Dr. Satterfield notes that the study was stopped 3-4 years ago. He then talks about the difficulties that physician-scientists face in sustaining a demanding research project while attending to clinical responsibilities. Dr. Satterfield explains that he sees his role as setting up a “turn-key” project where everything is prepared, saving time for the investigator who comes to Bastrop for essential tasks.

  Dr. Satterfield then speaks briefly about his collaboration on a project developing cartilage surfaces for joint surface replacements. A private orthopedic pharmaceutical company funded this study in which sheep and goats were used to explore alternatives for artificial knee replacements. Finally, Dr. Satterfield talks about an ongoing NIH-funded study of a possible HIV vaccine that uses a conserved peptide to stimulate T-cells to kill the virus.

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  Chapter 11: Managing Animals, Research, and Disasters

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield reviews his administrative roles. He describes his responsibilities as Chief of Livestock and Land Management (1986 – present), noting he has been primarily involved with caring for the Center’s sheep and goats, including providing surgical and radiology services, training technicians, and organizing programs that provide the State with these animals’ blood products. He gives an overview of the Center’s land holdings of 380 acres, most of which is pasturage. He talks briefly a Master Plan drawn up in 2004 and CIPRIT grants that have enabled the Center to serve as a research resource for drug development.

  Next Dr. Satterfield describes his work with the Center’s chimpanzee program. He first explains that chimpanzees are difficult to maintain because they are so intelligent, strong, and social –though they do not necessarily coexist harmoniously. The Center has a Ph.D. behavioral psychologist on staff to organize social groupings. Each chimpanzee also has a name, a medical history and a behavioral profile so the animals can be placed in healthy groupings. In his role on the External Advisory Committee (2006 – ’08) Dr. Satterfield explored funding and research opportunities from outside MD Anderson, including NIH studies, and studies of aging, diabetes, and cardiac disease. His Internal Advisory Role (2007) involved reviewing programs, chimpanzee health, and the facilities. Dr. Satterfield tells a dramatic and moving story about a male chimpanzee [Tony] who escaped and was ultimately shot by an off-duty University of Texas police officer. Dr. Satterfield is clearly still upset by this memory, and he notes this was “a dark period in our history.” It also resulted in the Keeling Center offering raining to the UTPD for chimpanzee escapes, 99% of which occur through human error: Dr. Satterfield notes that there has been no problem in the last 4-5 years.

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  Chapter 12: Roles that Protect Animals and the Institution

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Satterfield notes that his goal in working with the chimpanzees was to understand autoimmune responses and to advance the understanding of chimpanzees as a species. The care of this aging colony, however, has taken on a life of its own. The United States is the only country left in the world that maintains research colonies of chimpanzees. He notes that other countries outsource their research on great apes to the U.S. so they can claim that they do not experiment on animals. Dr. Satterfield notes that the Keeling Center has been under pressure from animal rights extremists, who “data mine” –request vast amounts of information under the Public Information Act in order to disrupt the Center’s operations. Dr. Satterfield underscores that great apes all over the world are so threatened that there may not be wild communities in a few generations. The colonies in captivity are irreplaceable. He believes that the NIH’s ban on breeding the colonies is shortsighted and indicates that it has submitted to public pressure.

  Dr. Satterfield then talks about his work on the Institutional Animal Care and Use Committee (2005 – present). He notes his work protecting MD Anderson by ensuring that principal investigators meet FDA guidelines. He explains that this committee has enabled him to meet great scientists and develop productive collaborations. With budget cuts, he notes, the committee now meets via tele-conference, and this cost saving measure has hurt the collegial connection.

  Next Dr. Satterfield touches on his work with the Pharmaceutical Development Center Steering Committee (2003), his role as the Center’s licensed Controlled Drug Officer, and his work as the Center’s representative for the Freedom on Information Act. He took on this role in response to data mining by animal rights activists. He is responsible for reviewing all documents requested to determine what information is proprietary and can be protected by MD Anderson. He then talks briefly about his role as Deputy Director under Dr. Keeling and his role as Ad Interim Chair after Dr. Keeling’s death (2003). He notes that he was a candidate for Director, but was glad when Dr. Christian Abee took the position, as we has glad not to move fully into administration.

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  Chapter 13: Connections: Bonds with Animals and with Collaborators who Insured a Good Career

  William C. Satterfield DVM and Tacey A. Rosolowski PhD

  Dr. Satterfield begins this Chapter by looking back on the collaborators he has worked with over the years. He says he hopes that the Center will continue to support research and collaborative relationships. He also hopes that the Center will maintain a viable chimpanzee community. He says he is happy not to have any particular post-retirement plans. (He retires at the end of August 2012.) Thinking about people who have inspired him, he recalls a high school biology teacher, Mrs. Lowry, whose class was “great” and guided him to science. At the close of the interview, he speaks again about his connection to the animals he has worked with over his entire career. He returns to the shooting of the chimpanzee, Tony, and notes that the Center requested the services of an MD Anderson grief counselor to help them survive the loss –another example of the human-animal bond.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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.

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  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

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  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.

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  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.

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  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

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  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

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  Chapter 04: The Eighties Crisis: the Push to Expand MD Anderson and Create Patient-Centered Experiences

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 05: An Encouraging and Supportive Father

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 06: Serving as the VP of Hospitals and Clinics: Budget Stresses and Impact on Employees

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 07: Confronting Managed Care

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 08: Responding to Managed Care: Moving Toward multi-disciplinary Patient-Centered Care

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 09: Turning MD Anderson Around Through the Aim For Excellence Program

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 10: Changes When John Mendelsohn Arrives

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 11: The First Woman Vice President at MD Anderson

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

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  Chapter 12: MD Anderson Now and in the Future

  Donna K. Sollenberger and Tacey A. Rosolowski PhD

• 

  Chapter 01: An Early Start on a Research Path and Critical Thinking

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  Chapter 02: Building a Department of Pharmacology in the New UT Medical School

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  Chapter 03: A Brief History of the Texas Medical Center and MD Anderson

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  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 segment 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.

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  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.

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  Chapter 06: Building Curricula and Leveraging Institutional Connections to Create Educational Opportunities

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  Chapter 07: Current Challenges in Biomedical Education: Duration of Degree Programs and Mentoring

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  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 segment, 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 segment he mentions various books dealing with innovation and medical education.

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  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 segment he describes the process of closing down his laboratory.

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  Chapter 10: The First Uterine SPORE Grant

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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 segment, 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.

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  Chapter 12: Executive Vice President of Academic and Research Affairs

  George M. Stancel PhD and Tacey A. Rosolowski PhD

  In this segment, 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.

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  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 segment, 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.

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  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 chapter 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.

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  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.

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  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.

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  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.

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  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.

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  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 chapter, 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.

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  Chapter 15: A Key Publication: Making Cancer History

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

  In this chapter, 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.

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  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.

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  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.

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  Chapter 18: Departments Within Public Affairs

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

  In this chapter, 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.

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  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. Next Mr. 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.

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  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 chapter 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.
  

  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 is

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  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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  Chapter 11: John Mendelsohn: MD Anderson's Secret Weapon

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

  Mr. Stuyck begins this chapter on John Mendelsohn [Oral History Interview] by noting that he was a "dark-horse candidate" for president. He describes the interview process and how administrators were invited to participate. During an interview session, Mr. Stuyck found Dr. Mendelsohn to be very "energetic and wiry." Mr. Stuyck notes that MD Anderson had been ranked second to Memorial Sloan Kettering, but that changed under John Mendelsohn. He says the Dr. Mendelsohn arrived at just the right time in the institution's history: he describes Dr. Mendelsohn as "MD Anderson's secret weapon." He tells an anecdote about giving Dr. Mendelsohn advice"which he ignored.

  Mr. Stuyck then talks about Dr. Mendelsohn's difficulties with the media during two conflict of interest cases involving his involvement with Imclone and Enron.

  Mr. Stuyck explains how he prepared Dr. Mendelson for interviews with the media. He then describes how Dr. Mendelsohn handled his interview with a reporter from KTRK-TV, Channel 13, Wayne Dolcefino, about expenditures for furniture and art: Dr. Mendelsohn was very forthright and convincing, and the reporter let the story slide without publishing it. He then tells a story about a trip to Washington, D.C. for interviews at the Washington Post and PBS.

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  Chapter 12: Restricted

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

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  Chapter 13: The Changing Organization of Public Affairs

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

  A conversation about Cancer Bulletin, published through Scientific Publications, leads to a discussion of how and why Public Affairs has been reorganized over the years.

  Mr. Stuyck says there are rumors that it will be reorganized again, under Dr. DePinho. As an example of reorganization, Mr. Stuyck talks about the Place of Wellness, which he originally managed until he decided he was not in a position to make the necessary medical decisions, so it became the Integrated Medicine Program directed by Dr. Lorenzo Cohen.

  Mr. Stuyck also talks about the unique roles of JoAnn Ward and Louise Villejo [Oral History Interview].

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  Chapter 14: Public Affairs and Communication Tools

  Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

  Mr. Stuyck first talks about The Messenger, the first employee communication tool, which has been published for forty years. Next he discusses Conquest, a publication designed to generate awareness of MD Anderson among opinion leaders, donors, and corporate executives.

  Mr. Stuyck talks about how Conquest was started and how it tells the MD Anderson story. He tells an anecdote about putting a donor envelope inside of Conquest with no accompanying solicitation for funds: the envelope alone has generated three million dollars (never less than $25,000 per issue). Next Mr. Stuyck talks about Cancer NewsLine, a series of video news releases launched in 1986 to provide media with news about cancer research and treatment. He describes the impact of these on the institution's reputation. He then talks about the Network Newsletter, launched in 1988 and mailed to all former patients ("a lifeline to the institution"), then moves on to the CancerWise Community Speaker's Bureau and MD Anderson Ambassadors programs, through which MD Anderson employees go into the community to talk about cancer issues. He notes that many within higher levels of the institution were at first suspicious of employees going out into the community.

  Mr. Stuyck then talks about the "Too Cool to Smoke" program for kindergarten through fourth graders. Lastly he talks about Contributions to Making Cancer History (first published in 2007), launched because Dr. John Mendelsohn wanted to address the frequent question What are specific advances that MD Anderson has made against cancer? Mr. Stuyck explains how the approximately 100 advances were compiled and selected, and how Scientific Publications helped edit it to ensure its credibility.

  Mr. Stuyck notes that this is a unique document among academic institutions: the content is now on the website, with about 150 advances included. At the end of this session, Mr. Stuyck tells a story to demonstrate Dr. John Mendelsohn's communication skills.

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  Chapter 01: A Child with a Different Perspective

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler talks about her early realization that she had a different perspective on life than other children her age. She talks about her early affinity for nature when was a child in Connecticut, her fascination with questions about the universe and intuitive grasp of non-duality. She tells an anecdote about how her father would joke with her, inadvertently supporting her growing perspective. She then talks about discovering the Daoist koans, yoga and pranayamic breathing.

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  Chapter 02: Scoliosis Changes Life and Perspective

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  Ms. Sumler begins this chapter by noting that she initially aspired to be a dancer. She then narrates the progression of her scoliosis through the seventies and after her spine fusion surgery in 1976 and shares several stories of significant physical and psychological events. She talks about the grieving she had to do because of the blow scoliosis dealt to her identity as a dancer and describes her process of coming to accept her new physical state and identity.

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  Chapter 03: Exploring Massage and Raja Yoga; Cancer is a New Health Challenge

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  Ms. Sumler begins this chapter by explaining that she became interested in massage during the year she spent in bed after her spinal surgery for scoliosis and was learning about alternative treatments. She also talks about joining a raja yoga community because of her desire to live a spiritual life; her yogi was the source of her name, Sat Siri, and her yoga teaching practice at Yoga Central. She then talks about her diagnosis with melanoma and describes undertaking yogic death practices to confront this challenge.

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  Chapter 04: Massage and Cancer Patients: A Contemplative Practice

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  Ms. Sumler begins this chapter describing how she began to practice massage in 1986 and tells stories to illustrate how "massage is artistic expression." She also notes some myths in the massage community at that time, e.g. that massaging cancer patients would spread their disease through their bodies. Ms. Sumler questioned this belief and decided to know more about massage and cancer. At the same time, family and friends were referring clients with cancer to her for massage. She explains technical aspects of her work with cancer patients.
  
  Next, Ms. Sumler explains how she came in contact with Integrative Medicine at MD Anderson. She describes how she felt a "sense of calling" when she was at the institution. She was first invited to come and teach yoga, but that opportunity didn't work out.

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  Chapter 05: Bringing Massage to the Place of Wellness and Integrative Medicine

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  Ms. Sumler explains that she eventually was offered a contract position to offer chair massages for "brief relaxation" in patient waiting areas. She explains why the massage was labeled in that way and talks about progress made in creating an inviting space for patients at the Place of Wellness. She also discusses training she received in massage therapy at Memorial Sloan Kettering Cancer Center in 2002.

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  Chapter 06: Massage: Benefits to Patients

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler talks about what massage offers the cancer patient and tells several stories about patients' reactions to massage. She also discusses the supportive attitude of many MD Anderson clinicians, particularly in rehabilitative and supportive care. She notes that to document the safety of massage in the first three years of the massage program, she took patients' vital signs before and after massage.
  
  Next, Ms. Sumler talks briefly about the value of yoga for oncology patients. She ends this chapter with comments about how massage makes her contemplative practices manifest.

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  Chapter 07: Training Massage Therapists and Building Institutional Acceptance for Massage

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler talks about her work building a training program for massage therapists. She talks about the importance of critical thinking for massage therapists who have been trained to work with healthy populations. She gives examples of how critical thinking comes in to work with cancer patients. She says, "you are not taught what you don't know, and that's what you need to not harm someone."
  
  Next, Ms. Sumler gives examples of how MD Anderson staff have accepted massage as part of a patient's experience and treatment.

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  Chapter 08: Patient Acceptance (or Non-Acceptance) of Massage Therapy

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler talks about why patients in general may resist getting massage, and how cancer patients deal with special issues of vulnerability in massage. She also talks about the positive impact of massage on patients, recounting anecdotes to underscore the role of massage in reconnecting patients positively with their bodies. She also discusses how positive personal experiences with massage can lead patients to consider other complementary services, and vice versa.

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  Chapter 09: Clinician Acceptance (or Non-Acceptance) of Massage Therapy

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler talks about why clinicians may refuse to send their patients for therapeutic massage, usually out of a lack of information about how specifically this type of massage is tailored to the needs and limitations of patients undergoing specific treatments. She gives examples of how she and others in massage therapy opened communications with clinicians to provide education and overcome resistance.
  

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  Chapter 10: Contributing to Research on the Value of Massage

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler sketches her participation in research into the value of massage for patients with peripheral neuropathy and deep vein thrombosis. She also discusses how her own perspective on massage changed through these collaborations. She explains how one study led to a change in the organization of the scheduling of massage.

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  Chapter 11: A Few Words about Yoga and Views on MD Anderson's New Directions

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  Ms. Sumler begins this chapter by speaking briefly about teaching yoga at MD Anderson and how acceptance of that service has grown.
  
  Next, she reflects on the new direction MD Anderson seems to be taking under Dr. Peter Pisters, who became the institution's fifth president after Ronald DePinho's resignation. CLIP She says she feels that "a new light is shining" and she sees a new commitment to the institution's commitment to care and compassion and its mission to support both patients and employees. She has hopes that acceptance of Integrative Medicine will continue to grow.

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  Chapter 12: Reflections on Contributions and on the Art of Massage, Meditation, and Teaching

  Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

  In this chapter, Ms. Sumler reflects on the contributions that have meant the most to her and stresses that she loves to learn, and will continue to expand her knowledge of therapeutic massage during the rest of her time at the institution. At the end of the interview, she talks about her core identity as a meditation practitioner and an artist. She explains how these two currents combine her view of yoga, teaching, and massage as art forms.

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  Chapter 01: Inspired to Enter Nursing: An Altruistic and Intellectual Profession

  Barbara Summers and Tacey A. Rosolowski PhD

  Dr. Summers talks about her family and her mother’s influence as a role model. She sketches her educational background and her path to her first job in nursing.

  Dr. Summers explains that nursing attracted her because it is an interactive profession where the nurse positively influences the experience of another human being. She also underscores that nursing is intellectually rigorous and demands critical thinking skills and the ability to pull together data.

  She next traces her path to college (George Mason University, Fairfax, Virginia, BSN, 1978). She talks about working as a nurse throughout her program and the mentoring she received from the nurses at her job.

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  Chapter 10: The NIH and an Opportunity to Support Research Nurses

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Summers explains that she was recruited for NIH Clinical Services to develop cancer nursing research programs for research nurses. Dr. Summers explains Jean Watson’s care theory in greater detail and talks about its connections with transformational leadership. She then goes on to talk about her role at the NCI (where she arrived “knowing zip”): she developed a program to support research nurses proposing their own research projects.

  Dr. Summers gives an example of a project proposed by a nurse on drawing blood. This demonstrates how a nurse brings a unique perspective to care situations and the issues/questions they raise can be quantified to improve care for all patients.

  Dr. Summers next observes that she was a member of the Institutional Review Board at the NIH and learned a great deal about clinical research.

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  Chapter 11: An Opportunity to Work at a World-Class Institution

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Summers explains that after her experience at the NIH, she took a position in the Clinical Center which presented her with a whole new learning curve. At this point, a recruiter called her about a position at MD Anderson. She tells the story of her interaction with the recruiter and explains that she was interested as a new position would allow her to put her dissertation research into practice.

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  Chapter 2:The Theory and Advantages of Primary Nursing

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  Dr. Summers gives an overview of “primary nursing” and its development as a central concept in nursing. She also discusses its advantages for clinical practice and care of patients.

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  Chapter 3: A Focus on Primary Nursing

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  Dr. Summers observes that she started in nursing at a key point when primary nursing practice was also beginning, and she selected a hospital that focused in this new area, taking a job taking care of orthopedic surgery patients. She talks her job at a medical surgical ICU and the mentors who encouraged her to think about her career and future, particularly as a leader in nursing.

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  Chapter 4: A Master’s Program Leads to Oncology and to an Interest in Pain Management

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  Dr. Summers talks about the impact of her Master’s program on her nursing practice and her vision of her nursing career. She discusses her commitment to oncology nursing and providing “high intensity critical care” to patients and family members.

  She sketches her work history and the impact of working in a chronic pain clinic (not related to oncology). She explains social attitudes toward pain and notes her own subspecialty interest in pain and pain management. She tells a story about successfully using multi-modality interventions to treat an oysterman who was very injured and couldn’t work.

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  Chapter 5: Thinking about Leadership and Nurses as Self-Care Agents

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  In this Chapter, Dr. Summers describes the impact on her career of her Masters program (MSN, 1981, Advanced Clinical Practice) and her specialization in Advanced Clinical Practice. She explains what that practice meant at the time and how her work in this area helped give her grounding for leadership roles.

  Dr. Summers explains Dorothea Orem’s theory that the role of a nurse is to support a patient in his/her return to optimal heath so they can perform self-care. She stresses that nurses work as partners in a patient’s healthcare: Dr. Summers gives examples of how this works in practice.

  Dr. Summers next talks about how she learned to think differently in her graduate program about self-care and also how she began to realize that she could have more of an impact on care as a leader. Dr. Summers describes her leadership style as “transformational” in that she serves as a role model and inspires people to be at their best.

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  Chapter 6: Learning the Complexities of Nursing Care

  Barbara Summers PhD and Tacey A. Rosolowski PhD

  Dr. Summers talks about working at the Greater Southeast Community Hospital after receiving her Master’s. At this inner city hospital she focused on oncology and pain management and worked with great oncologists and physicians. She talks about the impact of working with patients in extreme poverty. She also recalls being nicknamed “LP” for Leader of the Pack –indication that her leadership impulse showed—and she started to see the impact she might have on nursing from a position of leadership.