In accordance with oral history best practices, this transcript was intentionally created to preserve the conversational language of the interview sessions. (Language has not been edited to conform to written prose).
The interview subject was given the opportunity to review the transcript. Any requested editorial changes are indicated in brackets [ ], and the audio file has not correspondingly altered.
Redactions to the transcript and audio files may have been made in response to the interview subject’s request or to eliminate personal health information in compliance with HIPAA.
The views expressed in this interview are solely the perspective of the interview subject. They are not to be interpreted as the official view of any other individual or of The University of Texas MD Anderson Cancer Center.
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Chapter 09: Research and Grants Related to Gender and Diversity
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
In this Chapter Dr. Travis describes her grant supported work on gender and diversity projects. She begins by describing the “Gatekeepers and Gender Schemas” project (run through the Office of Women Faculty Programs) –a real-time study of recruitment in the sciences. She also describes her contributions to an NIH U54 Partnership Grant in which MD Anderson is partnering with the University of Puerto Rico to build a cancer research center, a cancer hospital, and to train physicians and researchers. Dr. Travis is a PI on that grant and on the training program. She describes why she enjoys working with students and also what is involved in the training program. The MD/PHD program, she says, is the “jewel in the crown” of the program and this summer its first two graduates will receive their degrees. She notes the commitment of the Puerto Rican students to return to their home country to practice.
[The recorder is paused briefly.]
Dr. Travis notes some differences in the way that gender issues play out in Puerto Rico and in the United Sttes, then describes how the project is administered. Next she observes that her interest in teaching, training, and developing young minds has worked underneath the surface of her career.
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Chapter 10: Personal Choices and a Philosophy about the Importance of Having a Career and A Personal Life
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
Dr. Travis shares the name of her son, Scott Philips, whom she chose to have as a single parent. She goes on to talk about the issue of women, career and family, noting that she is tired of the question: “We aren’t over this yet.” She also says that it’s disturbing to her that this discussion usually focuses only on people with children. “Everyone deserves a personal life. We must provide people with time. Dr. Travis notes that her son is an “important legacy” for her to leave and she shares the advice she gives to women considering having children. She observes that the burden of child care still falls on women. Though more younger men are more involved, she still see vestiges of “old school” thinking even in younger men, citing what younger men say about women in leadership roles. Dr. Travis believes that the Office of Women Faculty Programs needs to develop a community of men discussing issues about life balance and personal life. She goes on to explain that careers in medicine and research demand obsession, obligation, and duty, but an individual must have down time to preserve resilience. She talks about her own interest in travel and the symphony and the pleasure she has taken in making friends around the world.
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Chapter 11: Setting up the Office of Women Faculty Programs
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
In this Chapter, Dr. Travis describes how she went about setting up an office that could create rapid results for women at MD Anderson. She first hired a data person, because “it’s all about the data.” She explains data is fundamental to all of the Office’s work, decisions about priorities, and role in debunking myths. She describes how her skills in presenting issues and responding to naysayers evolved as she set up the office. Next she explains the elements of the Office’s mission: to increase the visibility of women within the institution and beyond and to have an impact on policy. As an example of the latter role, she describes how the Office was instrumental in changing the policy on tenure clock extension for faculty with a new child. She also talks about the Office’s role in getting people to look at their unconscious biases: she does a lot of teaching about this issue, using a test developed at Harvard University for unconscious bias. She also discusses mentoring. Faculty Development runs the institution’s formal mentoring programs, however Women Faculty Programs addresses issues that this program misses, such as why women don’t like to promote themselves and the skills they lack in self-promotion. She quotes Walt Whitman: “Ya done it, you’re not bragging.” She also talks about training she does for men to help them understand that they must ask women questions.
Next Dr. Travis talks about the concept of “sponsorship.” She has published a paper on sponsorship and defines it in contrast to mentoring, explaining that it’s a business model that she is adapting to a medical/scientific concept. She intends to put together a sponsorship workshop at MD Anderson and will also develop a Women’s Leadership Network spanning all fifteen units of the University of Texas System, further breaking down barriers between faculty and administrative women.
Dr. Travis speaks about one project she has not yet been able to push through: Cultural competency training focused on gender for Department chairs. She explains the need and notes that this is on the calendar for August 2014. She intends this as a pilot program to see how it works.
Dr. Travis talks about the issues that cultural competency training would cover and stresses that she sees her role as helping department chairs develop the best of the best.
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Chapter 12: Leaving a Legacy of Visible Women
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
Dr. Travis talks about the legacy she feels she will leave at MD Anderson: more women in leadership roles and communities of women who feel visible and recognized. She is particularly gratified by the community building and gives an example of how the Office supports growth of community. She also feels she has had an impact on male colleagues who are now aware of gender issues. Dr. Travis shares some milestones she would like to see accomplished before she retires.
Dr. Travis says she has no immediate plans to retire. She is “having too much fun” and she has worked since she was twelve and would need to have an outlet for her energy. She talks about Dr. Margaret Kripke, who retired for a time, then took on another position.
Dr. Travis makes some final comments about MD Anderson, where “what we do is truly remarkable.”
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Chapter 7: Women Faculty Programs: Its Beginnings; Awards for Progress Made
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
In this Chapter, Dr. Travis reviews the history leading to the formation of the ad hoc committee in the 80s tasked to evaluate the status of women and discusses some documents (not yet in the MD Anderson Archive) related to this history. She talks about the report produced by the Committee to Evaluate the Status of Women (1988/89). (She also has a copy of the report made to the institution by consultant Wanda Wallace, called in to advice how to address gender inequity.) She notes that MD Anderson has a better track record than most medical institutions in promoting women. She notes that MD Anderson received a Leadership Development Award in 2012 from the American Association of Medical Colleges: this recognized the body of work accomplished by the Office of Women Faculty Programs. Dr. Travis herself received this award as an individual in 2009. She outlines the accomplishments that have been made, among them an increase in women in leadership roles from 15% to 27%. Dr. Travis says this is a “model office” and that she speaks all over the country to talk about its structure and role.
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Chapter 8: Leading Change for Women; Women as Leaders
Elizabeth L. Travis PhD and Tacey A. Rosolowski PhD
In this Chapter, Dr. Travis discusses the importance of developing leadership skills for women. She opens with the statement that one cannot leave leadership to luck: an individual must be noticed, be visible and prepared for opportunities. She then lists her formal leadership training experiences summarizes data gathered about these programs by Dr. Shine Chung and others confirming that they make a difference in helping women advance into leadership roles. She notes that the Office of Women Faculty Programs has money to send a number of women and some minority men to leadership programs each year. Next, Dr. Travis explains how her leadership training expanded her own skill set. She talks about how the training at Rice University trained her to deal with conflict situations that arose in 2003, when she was Chair of the Faculty Senate. She again stresses that leadership training gives women tools to navigate complex institutions, to self-promote, and to not only know the leadership theory, but to implement ideas.
Dr. Travis next tells a story about a nasty incident that arose during a meeting when men verbally and personally attacked her. She speaks about how shocked she felt and how her training enabled her to handle the situation. She observes that scientists are very accustomed to handling criticism and even attack when it comes to their work and data. But the skill set for handling personal attacks is different.
Dr. Travis next stresses that women must be prepared for opportunities and they must actually take them and not believe that they are not qualified. Dr. Travis defines the “imposter syndrome” that plagues women and discusses the fact that men and women are still perceived differently and that there is a much narrower band of acceptable behaviors for women in professional situations.
Next Dr. Travis turns to the qualities that women bring to organizations when they serve in leadership positions. She talks about women’s instinctive listening and collaboration skills, resulting in a different leadership style. She explains why this is needed (noting that the Sandusky sexual abuse scandal at Penn. State would not have occurred had women been involved).
Dr. Travis explains that complex problems require different points of view coming together to find solutions and that women bring valuable perspectives to the table. She also cites the importance of women as role models and the fact that women patients and the great numbers of women who serve in caregiving roles can connect to women in leadership positions. She describes a survey of research articles placed in journals: articles with women in the list of authors tend to be placed in higher impact journals.
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Chapter 01: A Large Eastern European Family, a Scholarship, and A Scientist’s View of Spirituality
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy talks about his family and early education and sketches the roots of his own spiritual beliefs.
He begins by sketching the immigrant roots of his family in the area formerly known as Slovenia in Eastern Europe. He talks about the origin of his name and the pride of place he grew up with in Pennsylvania in his large family. He also discusses being raised as a Byzantine Catholic, and his own relationship with faith, which transformed over his life into a spiritual sense connected to science.
Next, Dr. Tweardy explains how he was able to get a scholarship from U.S. Steel, where his father was employed, to transfer to South Kent High School. This gave him access to a very good secondary education.
He explains that he and his six siblings formed three subgroups, with he and his brother Jim and sister Susan being the spiritual ones in the family. He explains the influence of his mother, who had great emotional intelligence and who taught him that instances of deprivation could be seen in a spiritual light.
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Chapter 02 : A Focused Student Intent on Science Education
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy talks describes himself as a student, noting that he was always “on the spectrum” of autism and Asperger’s Syndrome, with an extraordinary ability to concentrate and a strong visual imagination. He describes his “excitement about everything” in elementary school and how he explored scientific topics, deciding he would be an astronomer. He explains how he zeroed in on engineering, so that when he was admitted to Princeton University [AB conferred, 1974, Cum Laude, Chemistry] he majored in aerospace engineering.
Dr. Tweardy compares the cultures of South Kent High School and Princeton.
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Chapter 03: An Inspirational Friend, Sports, and Spirituality
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy makes connections between his practice in sports and his spiritual sensibility. He begins by talking about an influential friend he at Princeton, Louis Rinaldini, who convinced him to join the crew team. Dr. Tweardy then talks about lot about the experience of rowing crew, where in peak moments, the rower will reach a state of ecstasy. He describes the spiritual dimensions of this experience, shares an analogous experience in basketball, and makes the connection with his sense of spirituality and science.
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Chapter 04: “Thinking Like an Electron” in College: From Engineering, to Chemistry, to Molecular Biology
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy explains how he shifted from a major in aerospace engineering to chemistry, eventually making the decision to apply to medical school. He talks about academic challenges he faced in his first year at Princeton University, how he developed the mindset of an academician, and how he discovered, while taking organic chemistry, that he could “think like an electron.” As this was in the early days of biochemistry, he made the move into cell biology. Dr. Tweardy then explains how he began to think about medical school for his further education.
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Chapter 05: Medical School Leads to a Research Focus on Cytokines
David J. Tweardy MD and Tacey A. Rosolowski PhD
Dr. Tweardy begins this chapter by noting that he was always a physician-scientist, and he explains why he did several post-doctoral fellowships after medical school [MD, 1978, Harvard Medical School, Medicine] instead of doing a PhD program.
He explains that he approached medical school through the sciences and particularly enjoyed the coursework in the first two years, when he refined his interest in chemical structures and macromolecules: he began to focus exclusively on proteins and their interactions with small molecules. He was doing this work in the early days of cloning, which led to his work on cytokines.
Next, Dr. Tweardy reflects on a “wrenching experience” at Case Western Reserve [1980 Case Western Reserve, Intern/Resident], when a patient with AML died of sepsis. Dr. Tweardy then became interested in how to treat infection and have an impact on the underlying problem of chemotherapy-induced neutropenia by working with molecular mechanisms that “jumpstart the marrow.”
Dr. Tweardy then speaks about his discovery of the complexity of immunology [1982] during his fellowship in infectious diseases at the same institution. He explains mechanisms for influencing macrophage activation to address the immune system. Through his work with Jerry Ellner, he was able to conduct a study where he isolated monocytes from patients and show that they didn’t have as much HLAD on their surfaces. After incubating them, they grew and they believed they were producing macrophage activating factor. They wrote a letter to Genentech requesting [WHAT?], which enabled him to show a positive result on all the immunological XXX that would affect the white cells.
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Chapter 06 :Cytokines and Cancer-Related Research at the University of Pittsburg (late Eighties)
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy traces the evolution of his work from the early stage of purifying and cloning cytokines (see Chapter 05) through the discovery of the relationship between STATG and STAT3. He begins by noting his interest in participating in the groundbreaking work on cytokines because of the further discoveries it promised. He talks about his move from the Wistar Institute to the University of Pittsburg, occasioned because of his wife’s career (Ruth Falik, MD; married 21 January 1982), then discusses his work with a library of bacterial RNA to discover mechanisms for producing cytokines, shifting to studies of neutrophils.
Dr. Tweardy then explains that his work at the new cancer institute at the University of Pittsburg enabled him to shift his focus to cancer and leukemia. He explains leukemia creates abnormalities in GCFS [granulocyte colony-stimulating factor?] its molecular signaling. He explains how he collaborated with an ENT surgeon to discover mechanisms of the role STAT3 serves in squamous cell proliferation and later work on how to block its function. He discusses how this work contributed to differentiating the roles of STAT3 and STATG.
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Chapter 07: Research and Administration at Baylor College of Medicine
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy sketches the work he accomplished once he joined the Department of Medicine at Baylor College of Medicine (in 2006) and assumed roles as deputy chair, chair ad interim, and chair. He notes that at the University of Pittsburg he learned to love administration and sketches the reasons he found Baylor attractive: administrative opportunities, clinical practice, and research technology.
Next, Dr. Tweardy talks about developments in his research as he began to work on small molecule probes. He explains that he began to act on his desire to mentor the next generation of physician-scientists [via a K award]. He illustrates some leadership lessons with anecdotes and comments on the stressed financial climate at Baylor. He also describes his leadership style and proclivity for working with teams. He gives overview of what he gained working in administrative roles at Baylor College of Medicine and comparing the culture at Baylor to MD Anderson’s.
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Chapter 08: A New Role as Division Head at MD Anderson
David J. Tweardy MD and Tacey A. Rosolowski PhD
He gives an overview of how he stepped into his role as head of the Division of Internal Medicine (2014). He begins by explaining that Dr. John Mendelsohn [oral history interview] began to organize departments around onco-medicine, and this included recruiting a critical mass of specialists to manage the Division of Internal Medicine. He sketches changes in division leadership.
Dr. Tweardy then explains how became aware of the job, the appeal of the position, and the vision he had for division. He then talks about differences in the culture at Baylor College of Medicine. He sketches leadership lessons he learned in his interim chair roles that would serve him at MD Anderson.
Next, Dr. Tweardy talks about his good working relationship with Ethan Dmitrovsky, MD [oral history interview], the provost, and the overlap in their ideas for developing the division: building service excellence, growing research, and recalibrating expectations.
Dr. Tweardy then talks about the “excessive siloism” at MD Anderson, the hierarchies among divisions, and the challenges of establishing the value of the Division of Internal Medicine. He explains the steps he took to address the visibility and perception of the Division’s value, discussing in particular the steps taken to improve and showcase financial accountability.
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Chapter 09: Stepping in to an Institution Undergoing Change
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy begins to share his impressions of the period of turbulence MD Anderson was experiencing in 2012, 2013, after Ronald DePinho [oral history interview] became president. He begins by recalling what he heard about the institution while he was still at the Baylor College of Medicine and explains why he didn’t allow the stories to influence his view of MD Anderson. He talks about his respect for Dr. DePinho then explains how his view of the situation at MD Anderson shifted once he became division head and he saw problems with morale and other issues.
Next, Dr. Tweardy comments on the “three factors” that turned the situation around: Dr. Steven Hahn’s appointment as Chief Operating Officer; the impact of the Faculty Senate and the work of Julie Izzo, MD and Ann Killary, PhD; Marshall Hick’s [oral history interview] role as interim president and the shared governance model he helped institute. He also talks about the impact of the McChrystal Group and the creation of the ROPR system for tracking institutional performance and change.
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Chapter 10: MD Anderson in Transition: Rebuilding and Integrating Relationships Before and After Dr. DePinho’s Resignation
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy discusses the creation of the Committee of Division Heads and the Committee of (Department) Chairs, two bodies needed to build communication channels and strengthen faculty trust and engagement. He points out that the Committee of Division Heads recognized Dr. Marshall Hicks as the best person to serve as interim president after Dr. DePinho’s resignation. Dr. Tweardy talks about the impact of these committees during the reduction in force in 2015 and the implementation of Epic.
Next Dr. Tweardy talks about the role of Julie Izzo and Ann Killary in strengthening the impact of the Faculty Senate in restabilizing the institution: he notes that this added another layer of integration to the institution.
Dr. Tweardy then talks about the divisional issues he brought to the Committee of Division Heads. He explains how he saw his role. He also notes that he was struck by the “level of alarm” that the Faculty Senate expressed regarding the new governance structure that was evolving: he makes comparisons with the faculty senates at the colleges of medicine at Baylor and Pittsburg. He reflects on the communication channels that evolved and observes that new people were stepping into the role of communication broker.
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Chapter 11: The McChrystal Group, the Rolling Operational Priorities (2015, and Observations on Strategic Planning
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy sketches the institution’s work with the McChrystal Group to develop the “rolling operational priorities” to organize the stabilization efforts. He sketches the process of working with the McChrystal Group and the two major outcomes: a decision-making process leading to Shared Governance Committee approval and the organization of work groups that addressed different institutional issues (the ROPRs). Dr. Tweardy notes that he was in charge of the ROPR3, which focused on education. He describes how each work group’s activities were organized to identify priorities to address.
Next, Dr. Tweardy talks about the value of this system and notes that when the relationship with McChrystal ended, the institution was very functional in decision making. He explains that the ROPR system was built on the “pyramid” structure of strategic planning and, in turn, laid the foundation on which the current strategic planning process (under Peter Pisters, MD) is built.
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Chapter 12: From Marshall Hicks, MD as Interim President to Peter Pisters, MD
David J. Tweardy MD and Tacey A. Rosolowski PhD
[pause in recording]
Dr. Tweardy explains that the research community has been waiting to see evidence of Dr. Pister’s commitment to the research agenda, and his appointment of Guilio Draetta as Chief Scientific Officer has begun to address this challenge
Next, Dr. Tweardy comments on Dr. Pister’s slow and deliberate decision making style. He then comments on the tradition of long-tenured presidents at the institution.
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Chapter 13: Emergency Medicine and the Hospitalist Service
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy talks about a major initiative he undertook on becoming division head: building the institution’s emergency medicine readiness and hospitalist service. He begins by explaining that the medical management of acutely ill patients is a challenge and that when he arrived in 2014, the institution was not addressing this as effectively as it should be, even though the emergency center was established in 2012. Dr. Tweardy explains that he wanted to institution to deliver not only the best cancer care, but the best onco-medical care then talks about developing hospitalist and emergency services.
Next, Dr. Tweardy comments on the resistance to emergency services and instances of the institution’s conservative thinking about the treatment of acute patients. He observes that it can be helpful to have an outsider bring in a new perspective and a new way of organizing functions.
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Chapter 14: Final Comments and What Might Be Next
David J. Tweardy MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tweardy talks about career paths for leaders, how his own has evolved, and what might be next though he has no immediate plans to leave the institution. He next talks about his plans for the Division: to stay aligned with the institution’s strategic plan and to address some issues in the internal leadership pipeline. He notes how his division has opportunities to grow through the MD Anderson Network.
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Chapter 01: A Family that Modeled Service to Others
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo sketches her family background and early education at Catholic Schools and the grounding this gave her in faith and values. She explains that her mother, in particular, provided her with a model of service to others.
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Chapter 02: College, Activism, and a First Taste of Leadership
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo explains her activist roles at the University of Houston where there was strong presence of the Women’s Movement, the Black Movement, and the Chicano Movement.
Ms. Villejo notes that she was interested in community empowerment and explains her work in the Chicano Movement, where she began to take a leadership role. She reflects on her impulse to speak her mind and the lessons about leadership she learned.
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Chapter 03: Working with Community Health Centers
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about her first job after college, working with the Rio Grande Federation of Health Care Centers. She explains the lessons she learned working with individuals with very limited access to health care. She also comments on what she learned from watching ineffective leaders.
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Chapter 04: A Masters in Public Health and a Focus on Education
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about her decision to return to school for her Masters in Public Health (1982, M.P.H. Health Administration, University of Texas Health Science Center, School of Public Health, San Antonio, TX). She describes her growing focus on education. She also notes the absence of formal mentors during her education and early career.
Ms. Villejo then talk about the impact of her National Cancer Institute Internship (1981-1982, University of Texas Health Science Center, School of Public Health), which allowed her to see educational programs developed at a national level. She also talks about the professional skills she learned in this training period.
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Chapter 05: The Patient Education Office in the Early Eighties; An Innovative Philosophy of Patient Education
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo explains how, in 1982, she came to MD Anderson as a Health Education Specialist in the Office of Patient Education at MD Anderson. She then provides a portrait of the Office’s scope and approach to education at that time.
She explains the types of educational materials and how they were organized by treatment areas. She talks about how educational content was developed and explains the main goal of the educational materials –to involve the patient as a decision maker in his/her own treatment.
Ms. Villejo explains how her view of patient education was shaped by her mother’s experience with breast cancer in 1980.
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Chapter 06: The Patient Education Office in the Eighties; Services Provided and Funding Challenges
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo notes in this Chapter that, at MD Anderson, “everyone is a patient educator.” She covers the process of integrating educational content from different sources. She also explains a major challenge: the Patient Education Office must secure its own funding for educational materials.
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Chapter 07: Expanding the Patient Education Office: The Learning Centers
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo begins by talking about her promotion to Director of the Patient Education Office in 1986/87 and the reporting structure in which she worked at this time, when the Office was made part of the Public Affairs Office.
She then tells the story of creating the first Learning Center in 1987, a forerunner of patient and family centered care that is now the focus of the institution. She then explains how two more centers were created. She notes a few programs held at the Centers and also underscores that thirty thousand people per year use the Centers.
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Chapter 08: The Patient Education Office: Raising Awareness of the Support Services Provided for Patients
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about other activities of the Office: supporting development of the Place of Wellness, bringing in speakers, helping to plan the kitchen in the Mays Clinic.
She next explains that the Office must work constantly to raise awareness of the services and materials that are available for patients. She talks about a survey done of the Patient Education Program in 2000 and the Patient Orientation Class created as a result. She also talks about an overview of psychosocial services available and a 1990s assessment of educational materials. She notes that staff are unaware of many of the materials available for patients .
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Chapter 09: Inspired by Family Members
Louise Villejo and Tacey A. Rosolowski PhD
In this Chapter, Ms. Villejo describes why her grandparents and parents served as inspirations and role models for her work ethic and personal values. She explains how these generations provided models of strong women and people who worked together and provided services to their communities. She recalls her father’s inspiring reaction to white flight from their neighborhood in the Third Ward of Houston when African American families began moving in. He refused to be part of that and decided to keep the family in the community.
Ms. Villejo recalls reactions to her gender and ethnicity and comments on her parents’ support for her ambitions. She tells a story about her father giving her a briefcase to take to grade school.
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Chapter 10: The Minority Faculty and Administrators’ Committee
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about the Minority Faculty and Administrators Committee (member 1990-96, chair 1992-93). She recalls that the Committee was formed to address “vestiges of racism” and increase recruiting of minorities. She explains how the committee was founded, talks about the contributions of Lovell Jones, MD [Oral History Interview]. She tells an anecdote about blatant racism, also noting that she had no person experience of being held back because of race. She tells an anecdote about producing bilingual educational material.
Ms. Villejo talks about the mentoring program she organized via the Committee. She then talks about the Diversity Committee and the Women and Minority Faculty Committee. She also describes her work with community schools and young professionals.
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Chapter 11: Patient Education --Developing Programs by Involving Patients; CancerWise
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo first talks about the community education program, CancerWise, then speaks at length about her Office’s policy of involving patients when educational materials and programs are developed.
She sketches the different ways in which patients are involved to provide feedback and guidance in order to tailor materials to different age groups and cultural backgrounds. She notes that MD Anderson’s Patient and Families Advisory Committee has reached its first anniversary and she sketches results of its work .
Ms. Villejo talks about her work with Kathy Meade on the Cancer, Culture, and Literacy Conference, including running sessions on developing educational materials for Hispanic audiences.
[The recorder is paused]
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Chapter 12: Developing Education Materials that Reflect a Deep Understanding of Cancer Care
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo first speaks briefly about assuming directorship of the Patient Education Office in 1985, noting that MD Anderson was the first cancer center to form such an office (1979). She notes that this set the priority to focus on patients and the development of materials was facilitated by the institution’s multi-disciplinary focus on disease sites.
Ms. Villejo then talks about the personal view on cancer that she developed as projects took her to various clinics at MD Anderson and as family members were diagnosed with cancer. She talks about the challenges of providing appropriate educational materials to patients who are going through and emotionally confusing period .
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Chapter 13: A Culinary-Nutrition Education Program in the New Mays Ambulatory Clinic
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo discusses the nutrition education program developed as the new Mays Ambulatory Clinic was being built and a suite of patient amenities were created. She worked with architects to include a demonstration kitchen. She describes the cooking classes offered by local chefs and how they were turned into nutrition education with a cancer focus. She discusses other programs with a culinary focus and explains why food is an important issue for cancer patients.
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Chapter 14: How a Patient’s Life and Experience Can Benefit from Cancer Education
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about the impact that cancer education can have on a patient’s life and experience of cancer.
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Chapter 15: Integrating Cancer Educators into a Healthcare Environment: Theory and Practice
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo first explains the challenges of working collaborative with care providers at MD Anderson. On one hand, educators can be intimidated by content experts. On the other, content experts can be suspicious that educators want to “tell us what to do.” She explains the importance of establishing fields of operation when working with experts and continually clarifying the services that educators provide.
Next, Ms. Villejo talks about a chapter she and others are contributing to a book on how to develop health promotion programs.She notes how important multi-disciplinary teams are to this and how MD Anderson was a forerunner in creating this approach.
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Chapter 16: The Patient Education Office Supports MD Anderson Initiatives
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about support that her office provides to the Patient and Family Advisory Committee, Nursing, the Advanced Care Planning initiative, the Psychosocial Council, and the Survivorship Program.
In the process she shares a personal story about insights she has gained from witnessing her mother’s battle with cancer. [Clip about two minutes.]
She notes that she led the Networking Committee as the Survivorship Program was being established (2007) to look at similar initiatives at other cancer centers.
Ms. Villejo tells the story of how Patient Education was invited to create a learning center in the new Cancer Prevention building.
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Chapter 17: Building Collaborations and a Discussion about Education and Electronic Health Records
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo first talks about working with the head of Public Affairs, Steve Stuyck [Oral History Interview], to build collaborations with care providers and leaders within MD Anderson. She then goes into detail about how Patient Education dovetails with the institution’s move to bring in EPIC, electronic health records.
She explains how electronic health records can identify the educational/informational materials required as a patient’s diagnosis and treatment evolves. She explains that executive leadership was interested in hiring a vendor to provide educational materials [Gemmi]. Patient Education performed a ‘gap analysis’ to discover significant overlap between their materials and the vendor’s, so the vendor was unnecessary. [redacted]
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Chapter 18: Significant Committee Work
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo first discusses her work on the Integrated Patient and Referring Provider Experience Team. She explains how MD Anderson began providing many additional materials when the NCI stopped providing their materials due to budget cuts. Many of these are still in use.
She next explains that her work on the Clinical Ethics Committee “opened her eyes” to issues that clinicians face. She describes Clinical Ethics Consults to illustrate.
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Chapter 19: The Patient Education Office in MD Anderson’s Organizational Structure, Past and Present
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo describes organizational restructuring that has led to Patient Education reporting to the administrative director of Radiotherapy. She critiques the administration’s decision to hire her replacement in a Directorship position rather than as an Executive Director. She notes that as the institution expands, the Patient Education Office does not have the staff to take on projects that would make a difference.
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Chapter 20: A Perspective on Recent Changes in Administration and MD Anderson’s Growth
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo talks about the vision Dr. Ronald DePinho has brought to MD Anderson and comments on how Patient Education fits into the recent spurt of institutional growth.
She offers the opinion that the Moon Shots Program is understandable for the public and brings excitement to the “war on cancer.” She discusses different metaphors used to describe research discoveries in cancer.
Next she notes that Patient Education must always stay connected to the institution’s strategic plans.
She observes that, with growth, heads of departments and offices have less immediate access to MD Anderson’s president. She notes that all the presidents have supported the Patient Education Office and credits Steve Stuyck [Oral History Interview] with bringing awareness to the Office’s contributions.
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Chapter 21: Key Accomplishments and Retirement Plans
Louise Villejo and Tacey A. Rosolowski PhD
Ms. Villejo begins by noting her key accomplishments. She talks about helping to shape the institution as a learning environment and integrating patients into the conversation about what that should be.
She reflects on how dramatically different today’s education materials are from those of the past. She notes that Nutrition Program as a key accomplishment.
Next, she talks about her plans for travel during her retirement. She also explains why purple boas were a decorative theme at her retirement party. In the process, she describes the pleasant working environment of the Patient Education Office.
Ms. Villejo concludes her interview with comments on working at MD Anderson.
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Chapter 01: An Interest in Moments of Turbulence Feeds an Approach to Leadership
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny begins by explaining that she is in the midst of writing a new job description for herself so she can begin to focus more exclusively on her major interest, leadership development. She mentions author Linda Hill's description of the transition into leadership positions as the equivalent of a big life transition. She goes on to reflect on her own qualities as a leader and an individual who has had to make many transitions, leading her to be "interested in moments of turbulence."
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Chapter 02: Establishing a New Department of Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny sketches how she came to MD Anderson in 1999 to establish a new Department of Faculty Development at a time when there was little research and literature on this new area. She mentions MD Anderson's reputation in the eighties as the "terminal hospital," where patients came to die, a feeling that persisted into the nineties. She sketches the history of unsuccessful leadership development offerings at the institution.
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Chapter 03: The First Successful Leadership Retreat Demonstrates Need for Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny explains that, in 2001, a team was put together to make a "last try" to set up a successful initiative. She discusses how the team went about creating a new faculty leadership program that would prove such an initiative could be effective and relevant to MD Anderson faculty. She sketches the process of finding the Executive Development Group. She explains that the team handpicked the sixteen people who would participate in the first retreat, held in The Woodlands. She notes that the response was immediate and unanimously positive and that the curriculum is still largely the same. She sketches other programs that came from that: the Administrative Leadership Program and the Heart of Leadership Program. Ms. Yadiny also begins to sketch how leadership initiatives at MD Anderson evolve within a politicized environment.
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Chapter 04: Faculty Development in a Politicized Context
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny talks about the political environment in which Faculty Development was established and has evolved. She shares anecdotes to illustrate.
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Chapter 05: Reflecting on Leadership Qualities
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny reflects on her own leadership qualities and discusses leadership in general. She tells another story of Marshall Hicks, head of the Division of Diagnostic Imaging, as an example of someone who has used the coaching services of Faculty Development to help him through leadership transitions and life transitions. She notes that the Executive Coaching service was established in 2008 to support new chairs and that Ethan Dmitrovsky is expanding coaching services. She notes that she earned her coaching certification. She lists her leadership traits (noting that she is a good idea person, "but this doesn't mean I'm a good manager") then talks about models of leadership she has discovered in her reading of literature. Ms. Yadiny then explains that, even though self-reflection is a key element of leadership training, many people "are terrified of it." She tells an anecdote that demonstrates how seemingly small issues can have a big impact on initiatives. Ms. Yadiny then notes that MD Anderson has had a "case study of leadership" over the past years, since Ronald DePinho came on a president. She notes that she would love to have a conversation with him about what he has learned about leadership and shares an anecdote that suggests he has been thinking about the subject.
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Chapter 06: A Wide Range of Interests Leads to Library School
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny talks about her family background and her educational path to Library School at McGill University. She talks about her love of reading, her skills with drawing and sports, and her love of life outdoors. She talks about the interests that led her to study literature at the University of Guelph in Ontario, Canada (BA in 1970) and her decision to go to McGill University in Montreal for her MLS (conferred 1973).
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Chapter 07: International Work and an Interest in Power Dynamics
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny discusses her early jobs with the Royal Society in London, then with the World Health Organization in Geneva, then in Tunisia. She tells anecdotes of the interesting characters she met in London; one of the stories allows her to demonstrate how she became interested in the master/slave relationship and how power factors into communication and power. She notes that she has encountered leaders who can be submissive or sadistic in their relationships with others. She describes the work she did in Geneva with the WHO, the lessons learned from her international experiences, and her reasons for leaving international work.
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Chapter 08: An Evolving Focus on Leadership Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny discusses the series of positions she held that solidified her focus on leadership development. She first talks about her work at the Houston Academy of Medicine in the Texas Medical Center Library ('79 - '90) where she did staff development programming and came to love working with leadership issues. She describes this as a "turning point in her life." She describes the positive work situation and the experience in leadership development she gained. [The recorder is paused.]
Next, Ms. Yadiny talks about her work at the University of Michigan in communications ('90 - '99). She was able to complete a year-long "Planned Change Internship" that enhanced her skills. She talks about meeting Larry Lippitt, whose at the time work provided a basis for the understanding of organization development and how individuals behave within groups. -
Chapter 09: Faculty Development: Offering Support in a Stressful Environment
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny discusses the stressful work culture at MD Anderson and the challenges that leaders face. She tells a story about a department chair who shed tears during a coaching session and a meeting with his department. She notes that the culture makes faculty members feel unsupported, and they come to Faculty Development for support. She also discusses cross-cultural issues that contribute to the stress, touching on issues that international faculty face and also on issues that arise because of U.S. regional, north/south, differences. She notes that the staff wields informal power, and gives examples of faculty women who have problems with staff members, who call them rude and demanding and often raise enough issues that the female faculty member "ends up in front of a Chair or HR." Ms. Yadiny notes that Faculty Development and the institution in general has not done enough to orient faculty to the southern dimensions of MD Anderson culture. She comments on the fact that 70% of employees are female, but MD Anderson "is a male institution." She comments on her own experience of gender issues and the slow progress made on addressing them since she began her professional life.
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Chapter 10: Changes in Academic Medicine over the Past Decades
Janis A. Yadiny and Tacey A. Rosolowski PhD
After reflecting briefly on the discussion in Interview Session one, Ms. Yadiny sketches how academic medicine has changed in the past decades. She notes the increase of expenses, patient volume, and structural changes to the healthcare system as well as the increasing competition for research money. She gives examples of how these contextual issues play out in the lives of faculty and leader. Ms. Yadiny comments on the challenges of mentoring faculty in this environment. She states that Dr. Ronald DePinho has positively "raised the level of the discussion" about research at MD Anderson, noting that this is threatening to those who aren't of the highest caliber. Ms. Yadiny comments on the challenge of balancing a commitment to compassionate care with a forceful pursuit of hard-driving science. She notes that MD Anderson is a unique institution because it is an academic-corporate hybrid.
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Chapter 11: The First Several Years of the Faculty Development Initiative
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny fills in details about the evolution of the Department of Faculty Development. She explains why Margaret Kripke, the VP of Academic Affairs in 1999, supported a leadership development initiative. Ms. Yadiny then talks about her activities as Director of Faculty Development between 1999 and 2001, when the first formal course of the Faculty Leadership Academy was put together by a collaborative committee. Ms. Yadiny explains that in 2001, academic medicine trailed the corporate world by about 15 years in understanding leadership. She explains why leadership is so important and notes that MD Anderson had no succession planning and no real culture of leadership. She explains the success of the Leadership Academy and discusses the coaching sessions that are provided to participants and new leaders.
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Chapter 12: Creating the Faculty Health and Well-being Program
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny recounts the story of how the Faculty Health and Well-being Program was established. She tells the story of the suicide of plastic surgeon, Steve Kroll, in 2001. She notes that when the institution did nothing to address this event, a group of individuals approached then-president John Mendelsohn about doing something for the faculty. This group included: Walter Bayle, MD; Warren Holleman, PhD; Ellen Gritz, PhD; Janis Apted, MLS. This group formed a committee and they set in place a response plan for addressing trauma. Ms. Yadiny next recounts how this initiative evolved into a program. She mentions groundbreaking work the Ellen Gritz and Warren Holleman did on burnout. [The recorder is paused] Ms. Yadiny then talks about several initiatives in Faculty Development. First she talks about Dr. Walter Bayle's use of Interpersonal Communication and Relationship Enhancement to teach communication and leadership. She then talks about Faculty Development's sponsorship of the Houston production of the play, "Wit." Focus groups with clinical faculty related to this production were audio taped and used to produce of the video, "On Being an Oncologist."
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Chapter 13: Preparing for Coming Challenges to Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny briefly comments on the goals she envisioned for Faculty Development when she became Executive Director in 2002. She then sketches the large-scale changes that MD Anderson will face as national demographics and the healthcare system continue to shift. She reflects on working with new staff members. She explains that she went back to school to earn her certification as a coach so she could be a better support to faculty.
Next, Ms. Yadiny lists the faculty's fears and frustrations and notes that most people who need help are not asking for it. -
Chapter 14: An MD Anderson Way of Leadership Training
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny characterizes the "MD Anderson way of leadership training." She explains that in 2002 her office settled on a skill-based approach that differed from the theoretical focus of earlier programs. She notes that Dr. Margaret Kripke advocated adoption of this approach and that the program for women faculty, Executive Leadership in Academic Medicine [ELAM], served as a model and was enthusiastically welcomed by all faculty. She next gives examples of challenging situations that MD Anderson leaders can find themselves in (e.g. emotional blackmail and manipulation). She notes that a psychologist at Rice University introduced her to the idea that transition into leadership is a turbulent process akin to an identity crisis. She talks about the learning curve for developing as a leader and emphasizes that MD Anderson is a very complex culture: some leadership consultants have characterized it as the most challenging and toxic they have encountered.
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Chapter 15: Faculty Development: Directions for Future Growth
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny explains that programs in Faculty Development will increasingly be organized around the idea that transition into leadership catalyzes an identity crisis. She explains a plan to conduct assessments for leadership potential (that could not come to fruition). She discusses motivations that individuals may have for aspiring to leadership roles and notes that most leaders say they get the most satisfaction from training the next generation of leaders or professional in their field. She notes that MD Anderson chair people have demanding roles with more responsibility than their colleagues at other institutions. She explains the growing number of populations that Faculty Development serves at the institution, noting that the faculty is not required to take mandatory classes in leadership (unlike staff people). She discusses preliminary efforts to offer leadership programming for fellows and graduate students. She discusses the advantages of having outside consultants conduct programs and offers a personal anecdote about offering tough feedback.
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Chapter 16: Growth as a Leader
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny evaluates her own growth as a leader since she "began as a freshman" in Faculty Development at MD Anderson in 1999. In this Chapter she also talks about the importance of emotional intelligence. She begins by discussing what she learned about herself by handling challenging leadership situations. She talks about her (excellent) working relationship with Robert Tillman [Associate Director, Faculty Development] and describes how some problems arose because of her strong working relationship with Janet Simon. She notes a theory that in workplaces, individuals recreate their family of origin around them. Ms. Yadiny then talks about the importance of the emotional brain to leadership development. She notes that she reads a sacred literature to learn more about this and that MD Anderson can "shrink" this dimension of self. She talks about conversations she has with a psychologist who is also a practicing shaman, José Luis Stevens, when she senses distance from her emotional brain. She tells an anecdote about discussing a work challenge with Provost Ethan Dmitrovsky, MD. She lists the serious consequences leaders face if they do not cultivate the emotional dimensions of themselves.
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Chapter 17: Faculty Development: Caring for the Soul of MD Anderson's Faculty
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny characterizes the essential role of the Department of Faculty Development: to caretake the soul of MD Anderson's faculty. She begins by talking about a retreat held recently to help a department deal with issues of retaliation. She discusses her own experience consulting with this department and recounts an anecdote she heard Bill Johnson (CEO of Heinz) tell about coach.
Next, Ms. Yadiny explains her goals in the years remaining before her retirement: she would like the institution to "understand the full scope of what Faculty Development does." She says that the department is "like a shaman" that brings in the whole person and provides a place of hope for faculty. In the final minutes of the interview, Ms. Yadiny discusses why her work has a spiritual dimension. She acknowledges that she has "played a pretty significant role" at MD Anderson, setting up programs and services to minister to faculty however they require. -
Chapter 01: Education and Family in Hong Kong
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung talks about his family background, education, and the challenges of growing up in Hong Kong during the recovery period in the aftermath of World War II. He first explains that his parents came to Hong Kong from China during the War. He describes the family's financial situation and the strong work ethic he gained by working in his father's business. Dr. Yung explains the educational system in Hong Kong. He talks about the origin and growth of his faith. He talks about meeting his wife, Susie Yung, in high school. Dr. Yung next recounts his early educational experiences under the British style, "pyramid" system education in Hong Kong and notes his transfer from a community school to the Jesuit-run Wah Yen College, a "vigorous" and well-funded school where all the teaching was in English. He notes that he became interested in medicine while he was in high school. Dr. Yung recounts how he came to the United States for college.
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Chapter 02: Medical Education and Laboratory Research Solidifies an Interest in Molecular Analysis
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about his college and medical education and his interest in working at MD Anderson. He begins with his arrival in the United States to attend college at the University of Minnesota (f 1968), a "defining moment" in his life, because of the culture shock. Dr. Yung notes that he began as a sophomore and that his research career began during his undergraduate years as he worked on a project that gave him an interested in cancer: he quantified radiation damage to tissue with different types of radiation.
Next, Dr. Yung talks about how his decision to focus on neurology and attend medical school at the University of Chicago, where he kept working on his own research. He talks about his residency and his fellowship at Memorial Sloan Kettering, where he framed his primary research interests: "How do we go from chromosome analysis to molecular analysis?" -
Chapter 03: Developing a Brain Tumor Clinic at MD Anderson
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about his first impressions of MD Anderson and his early efforts to develop the neurology offerings at the institution. He begins by explaining his decision to come to MD Anderson (in 1981) after his fellowship at Memorial Sloan-Kettering. MD Anderson contacted him because the institution needed a neurologist to handle neuro consults. Dr. Yung describes the neurological complications that he would see normally see during consults and explains why he wanted to start the first designated brain tumor clinic at MD Anderson to treat complications and offer but care for primary tumors. Dr. Yung notes that he wanted to continue his research at MD Anderson. He established his laboratory at the Medical School, but relocated to MD Anderson in 1983.
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Chapter 04: A Reputation For Experimentation and the Impact of Shifting to a Division System in the Eighties
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung connects MD Anderson's reputation for radical research in the 1980s to the move to reorganize the institution by Divisions in order to foster collaboration. He sets context by noting that MD Anderson struggled with a reputation for experimenting on people as well as with limits imposed on its growth. Dr. Yung explains how in 1982 the second president, Dr. Charles LeMaistre, reorganized the institution according to a division system to foster collaboration between departments and services and created a more systematic environment for promoting clinical research. The division system also fostered a more systematic approach to patient care and more structure in services by focusing on disease type. Dr. Yung next explains that, with that administrative reorganization, many new faculty were hired to provide a platform to enhance the quality of research and research driven patient care.
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Chapter 05: Stepping Down as Chair of Neuro-Oncology
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
The recorder is started during a conversation in progress. Dr. Yung offers brief comments on his decision to step down as Chair of Neuro-oncology. (He stepped into the role as interim chair in 1999 and became permanent chair in 2002.)
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Chapter 06: Looking at Chromosomal Patterns in Brain Tumors; Chromosomal Heterogeneity, Chemo-Sensitivity, and EGFR
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung discusses the evolution of his research, beginning with work on chromosomal patterns at Memorial Sloan-Kettering in the late 70s. He sets this work in the context of the science at that time and its development into the entirely new field of genomic medicine. Next he explains the evolution of his work to include epidermal growth factor receptors (EPGR) and their importance in cells, discussing connections to work of other MD Anderson faculty. He describes the relationship of the gene to kinase and EGFR functions. He then talks about his shift into translational research since 1997. Dr. Yung then sketches the history of translational research at MD Anderson, noting that in the Eighties and Nineties, the institution became a forerunner in applying translational research to clinical questions.
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Chapter 07: Research Pathways and Research Issues that Emerge from EGFR Work
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about the research paths that evolved from his work on EGFR, though he has been unsuccessful so far in discovering how to render glioblastoma sensitive to the receptor. He goes on to describe the lines of research that have opened up and also discusses controversies that have arisen around the issue of sequencing the cancer genome. He notes that MD Anderson is one of the suppliers of tissue to The Cancer Genome Atlas project -and he is involved in this. Dr. Yung also explains how the body of knowledge growing from this project and the International Cancer Genome Continuum has influenced how researchers look at tumors. Dr. Yung explains that the fundamental question is Can we understand the evolution of a tumor? He notes the special technical and ethical difficulties that arise with examining brain tumors.
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Chapter 08: Brain Tumor Research: Translational Studies in Progress and the NCI Study Section
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung sketches his other research activities on glioblastoma. He first talks about his activities with the NCI and other groups focused on developing clinical, translational studies of brain cancer. He talks about the challenges of setting up such studies. Dr. Yung next talks about his clinical trials with the drug, BKM 120. He explains how this study also demonstrates the difficultly of attracting attention to a "small cancer" and how MD Anderson can partner with drug companies.
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Chapter 09: The Challenges of Glioblastoma; MD Anderson's Moon Shot Program; No Low-Hanging Fruit for Neuro-Oncology Research
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung explains the challenges that glioblastoma presents to the researcher then sketches the work he is doing to build collaboration among the brain tumor community. He notes that Dr. Charles A. LeMaistre [Oral History Interview] started the Brain Tumor Group, now the largest in the country and the world. Dr. Yung next talks about MD Anderson's Moon Shots Program, now expanding to include more than the six cancers. He talks about the structure of the Moon Shots program and evaluates the lessons learned from its early years. He notes the aim of the Program to focus on "low hanging fruit" that can lead quickly to treatment advances, and explains that there are no such quick remedies on the horizon for treating glioblastoma.
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Chapter 10: Creating a New Department of Neuro-Oncology in 1983
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung tells the history of the Neuro-oncology Department from 1983 to 1988. The Department was formed around the same time as the structural reorganization of MD Anderson according to a division system. Dr. Yung talks about the autonomy that the Department was given within this new system. He notes the functions of the new Department: provide neuro consults, manage the Brain Tumor Clinic and Pain Management Section, and provide psychiatry services. Dr. Yung notes that his vision from the beginning was to build brain tumor research. He talks about milestones: the creation of the Brain Tumor Clinic, then the Fellowship Program, and the Department's growing patient load and reputation. Dr. Yung then explains that he and others created joint meetings and rounds cutting across departmental and division boundaries. He also explains that he took advantage of this collaboration to work with the NCI's Cancer Therapy Evaluation Program to develop clinical trials. Members of the Department joined the Brain Tumor Committee within the Radiation Therapy Oncology Group.
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Chapter 11: Creating Networks for Clinical Trials
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung begins this chapter by observing that, in 1988, the new Department had expanded and Dr. Field was ready to retire. Dr. LeMaistre wanted to expand neuro services and recruited Dr. Leaven to chair Neuro-Oncology and provided him with a large package to expand the research and clinical operations. Dr. Yung notes that he was still continuing to run his own research. He also took advantage of the NCI's desire to stimulate brain tumor research and he created a network of institutions for running Phase I clinical trials. He describes what he did to create the consortia under NCI guidelines and the lessons learned as the networks were reorganized. Dr. Yung observes that this project resulted in the NCI adding pediatric brain tumors to clinical trials. He explains that brain tumors are the second most common cancers in children. He also provides an overview of the limited array of drugs available for treating brain cancers, with focus now moving from cytotoxic agents to targeted therapies and immunotherapies. He notes that as the Department grew, there were more opportunities to take advantage of patient philanthropy to support research.
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Chapter 12: Becoming Chair of Neuro-Oncology and Developing Collaborations with Neuro-Surgery
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung explains that in 1990, Neuro-Surgery became a department and Dr. Raymond Sawaya [Oral History Interview] was recruited to head it. He describes the period of expansion that began for both departments at that time. Dr. Yung gives examples of research in Neuro-Oncology and their ties to the institution's status as a comprehensive cancer center. Dr. Yung explains Dr. John Mendelsohn's [Oral History Interview] continued support the combined activities of Neuro-Oncology and Neuro-Surgery, known as the Brain Tumor Program. He stresses that he and Dr. Sawaya shared a commitment to building multi-disciplinary research and care initiatives and he describes the "blessing" for this group that faculty work well together. He describes his goals at the time and his continued commitment to work with Neurosurgery and related fields to develop a cohesive program in patient care and research. He talks about collaborative projects, including development of an oncolytic virus -a rare example of a successful brain tumor drug.
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Chapter 13: Focusing on Work, Faith, and Hope During Cancer Treatment
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about his experiences as a patient after his 1999 diagnosis with a rare bladder cancer. He sketches the medical dimensions of the disease, the slow process of diagnosing it, and his choice to have chemotherapy followed by radical surgery. He talks about his faith and his choice to have treatment at MD Anderson and have a true patient experience, not special treatment for an MD or VIP. Dr. Yung observes that his patient experiences have made him a better caregiver and advisor to the department when changes to the clinics and care deliver are planned. Dr. Yung talks about the different ways patients cope with a cancer diagnosis. He notes the special case of brain cancer patients, who lose cognitive function and their independence. Dr. Yung says that he advises patients that accepting their diagnosis early will help them avoid depression and other complications. Dr. Yung notes that he took on the Chairmanship of the Department of Neuro-oncology during his treatment. He felt he had been given extra time to use for his department. He lists the projects he wanted to push forward.
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Chapter 14: Building the Advanced Practice Nurse Program
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about the expansion of the Advanced Practice Nurse program once he became department chair. He first notes how important support staff are to extending clinical care and then explains why he elected to expand APNs in particular. Dr. Young says that most institutions do not have the rich resource of nurses that MD Anderson has: research nurses, APNs, clinic nurses, and in-patient nurses. He sketches the roles that the APN services in assisting patients' caregivers and building quality of life for patients.
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Chapter 15: The Collaborative Ependymoma Research Network (CERN); Funding Research
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung describes his efforts to support research into the rare cancer, ependymoma and talks about the challenges of funding innovative research in a time of fiscal conservatism. He begins by giving an overview of the four types of brain cancers then recounts how the Collaborative Ependymoma Research Network (CERN) and now serves as model for using private funds to fund research. Next Dr. Yung offers his perspective on the conservatism of government funding of research versus private systems that can take risks. Innovative clinical trials require collaboration of government, the drug industry, and private foundations. Dr. Yung then describes a plan now being implemented to bring these forces together to look at the molecular characteristics of different types of glioblastoma to determine which drugs might target them, sharing the financial risk of running the trials. He notes that this approach has some features in common with MD Anderson's Moon Shots Program.
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Chapter 16: MD Anderson's "Horizonally-Organized" Brain Tumor Center
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung focuses on the Brain Tumor Center, created via the working relationships and shared resources that link sixty members from Neur-oncology, Neuro-surgery, Imaging, Neuro-pathology and other services. Dr. Yung explains that these working relationships enable neuro-focused members to get individual and multi-investigator funding, and that the SPORE grant is "a triumph of the Brain Tumor Center." Dr. Yung next comments on the difficulties of formalizing the Brain Tumor Center as a self-contained unit within MD Anderson. (This discussion refers to the fact that the head of Neuro-Surgery, Dr. Raymond Sawaya, is an advocate of such independent status. Dr. Sawaya discusses this at length in his oral history interview.) Dr. Yung cites the enormous cost of running an independent Center, given the expense of the technology required. Dr. Yung says that the Brain Tumor Center will enter a new phase when a new chairman of Neuro-Oncology replaces him. He also feels that the Center currently offers a solid platform to expand immunotherapy with a new emphasis on T-cell function.
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Chapter 17: The Defeat Glioblastoma Initiative and the NCI Brain Malignancy Steering Committee
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung first describes the The Defeat Glioblastoma Initiative, an inter-institutional collaboration he has established between UCSD, UCLA, Memorial Sloan-Kettering Cancer Center, and MD Anderson to address glioblastoma. He notes that the Initiative is poised to expand and add international collaborators. Dr. Yung next describes his service on the NCI Brain Malignancy Steering Committee, set up in 2001 response to the request from National Institute of Medicine to provide more review of applications for research funds. The aim is to identify high-value concepts, prevent duplication of efforts, and create collaborations. Dr. Yung explains that this committee's role reflects the new reality of team science and limited resources. Dr. Yung then comments on the challenges of creating collaborations between scientists who originally thought they would run projects independently.
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Chapter 18: Key Periods of Change at MD Anderson
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung offers his perspectives on periods when MD Anderson has undergone large changes. He first discusses Dr. Charles LeMaistre's role in handling the HMO crisis in the early nineties. He next talks about Dr. John Mendelsohn's in setting the institution on "an upswing" of growth and corporatization. He describes how hard it is to manage growth so the institution remains true to its mission of delivering research-driven care, rather than deviating and increasing patient care to generate income to sustain the institution. He notes the pressure and debates that come each year with requests to see more patients, cut back on expenses. Dr. Yung then talks about Dr. Ronald DePinho, who came in "with a good heart and an insightful" view of how to elevate MD Anderson to a position of making an impact on specific cancers. He explains that Dr. DePinho has brought in necessary change, notable addressing complacency and a lack of productivity among the faculty. He says that Dr. DePinho has yet to address the need for investment in infrastructure for clinical research.
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Chapter 19: Stepping Down as Chair; Accomplishments in Perspective; A Sunday School Teacher
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung begins this chapter by sketching the activities he will focus on after stepping down as chair. He next says that he is gratified to see how the Department has grown under his leadership, particularly in the areas of research and psychiatry. He talks about initiatives that have not advanced sufficiently, notable training of physician-scientists and providing a culture for their success. He shares what he would like the department to achieve in the next ten years, notably advances in brain metastasis. Finally, Dr. Yung talks about teaching adult "Sunday school" classes at his church, where he trains the next generation of church leaders. Dr. Yung says that his own faith enters into his work with patients, whom he encourages to have hope.