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: Luminaries in the Department of Pediatrics and Evolution in the Field of Cancer Research
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
Dr. Gehan fondly recalls Dr. Wataru Walter Sutow, recollects his participation with Dr’s Grant Taylor and Margaret Patricia Sullivan in a group studying the effects of atomic radiation, and speculates on how they came to MD Anderson’s Department of Pediatrics. He discusses pediatric cancer researchers’ perspectives on cancer research, how they differed from cancer research in adults, and changing involvement over time in various research groups (e.g. Southwest Oncology Group). Lastly, he notes Dr. Archie Bleyer would know more information regarding the pediatric cancer research activity.
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Chapter 10: Dr. Jan VanEys and the Development of MD Anderson’s Code of Ethics; Working with Pharmaceutical Industry
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
In this chapter, Dr. Gehan talks about Dr. Jan VanEys’ work in pediatrics and as an ethicist at MD Anderson. He mentions Dr. VanEys’ work with Dr. James M. Bowen in the creation of a code of ethics at MD Anderson. He then talks about the role of statistics in cancer research, cancer research ethics, and the ethical use of randomized trials. He goes on to reference Donald “Don” Arthur Berry, head of the Department of Biostatistics at MD Anderson, talks about clinical equipoise, contrasts Bayesian and Frequentist reasoning, sequential analysis, randomized trials, etc. Dr. Gehan talks about the statistics department’s working relationship with other areas at the institution including working with Dr. Charles Blach who was the Head of the Department of Surgery at the time. Before 1980, the National Institute of Health (NIH) funded most research. Changes in the industry saw a bulk of funds coming from drug companies, which required new logistical concerns regarding data management and patient participation numbers to justify expenses. He provides examples of Dr. Bodey's research in protective environments for cancer patients.
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Chapter 11: The Differing Leadership Styles of Drs. Clark and LeMaistre
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
Dr. Gehan provides a brief comparison of Dr. R. Lee Clark and Dr. Charles A. LeMasitre, who were the first two MD Anderson Presidents. According to Dr. Gehan, Dr. Clark was personable compared to Dr. LeMaistre's more organizational management style.
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Chapter 12: The Contributions of Colleagues to MD Anderson's Legacy
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
The interviewers ask Dr. Gehan to talk about his MD Anderson colleagues. A statistician by nature he offers to evaluate his colleagues on a 1-10 rating scale while identifying the strengths and weaknesses of each individual.
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Chapter 03: Work at NCI/NIH, the Role of Statistics in Medical Research, and its Application in Sequential and Combination Cancer Treatment Evaluation
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
Dr. Gehan talks about working for, and remembrances of, Nathan Mantel (known for survival rate analysis) at the NCI/NIH. Also at that time, he received direction from Jerome “Jerry” Cornfield, senior statistician (best known for the causal relation between cigarette smoking and lung cancer). He talks about the importance of statistics in medical research and publication, gives an example of a “6-Mercaptopurine (6MP) and Methotrexate (MTX)” treatment response rate study, and how he provided “analytical support” for Drs. Emil “Tom” Frei III and Emil J. Freireich’s sequential and combination treatment “ideas” for Leukemia treatment.
At an MD Anderson dinner event the prior evening, Mr. Gehan mentions several prominent researchers (Dr’s Emil J Freireich, Emil “Tom” Frei III, Michael Keating, Jeffrey Gotlieb, Levy[?], and 6th Annual Emil J. Freireich Award for outstanding achievement of a young researcher in clinical cancer therapeutic award recipient Eric K. Rowinsky), their passion for research work, and being “turned on” serving as the statistical “member of the team.” The beginning of work with Drs. Frei and Freireich in January 1958, Dr. Gehan lists his roles over time as the replacement for Marvin A. Schneiderman, his career advancement to Acting Head, then Head of the Biometrics Section, Cancer Chemotherapy National Service Center and NCI Southwest and Eastern Clinical Trials Cooperative Groups. As a member of the Acute (now Cancer) Leukemia Group B, he reminisces about the face-to-face meeting style where Dr’s Frei III, Freireich, and James “Jim” F. Holland developed ideas for clinical studies. Additionally, he mentions his marriage to wife Brenda (nee McKeon) before his time working for Sir David Roxbee Cox (known for Regression Models and Life Tables) from 1962-1964 as a special Fellow at Birkbeck College of London, England.
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Chapter 04: Strengthening Medical Oncology at MD Anderson with the Aid of NCI Researchers in the Department of Biostatistics
Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD
Dr. Gehan recollects Dr. R. Lee Clark’s approach to funding, recruitment, and management and the attraction of MD Anderson/Houston to Dr. “Tom” Frei III, his wife Elizabeth “Liz” (nee Smith), as well as himself. Dr. Olson mentions from Kenneth Endicott (NCI Director) to Dr. R. Lee Clark (President, MD Anderson) lamenting the move of Dr’s Frei III and Freireich to MD Anderson. When Dr. Gehan started at MD Anderson in 1967, Dr. Lee D. Cady Jr. was the Head of the Department of Biomathematics. Dr. Gehan talks about the impact of the arrival of Dr’s Frei III and Freireich on MD Anderson Research. Dr. Gehan cites the cooperative group collaboration model of NCI/NIH Clinical Chairman Dr. C. Gordon Zubrod and biostatistician Marvin A. Schneiderman on the first randomized trials in acute leukemia and solid tumors. He recalls the members of the administration and the research team at MD Anderson before the arrival of Dr’s Frei III and Freireich: Dr. H. Grant Taylor, Chairman of the Southwest Oncology Group (Southwest Oncology Group), epidemiologist Eleanor Josephine McDonald (known for creating the National Cancer Registry) statistician Kenneth M. Griffith, Dr. Roy C. Heflebower, Joe E. Boyd and Dr. Stuart O. Zimmerman, Chairman of the Biomathematics Department. He also mentions other MD Anderson administrators and researchers: Terry L. Smith, Dr. Peter F. Thall, Dr. J. Jack Lee, President Dr. Charles A. LeMaistre, Dr. Frederick F. Becker and President Dr. John Mendelsohn. Finally, he talks about the Department of Biostatistics, how it differs from Biomathematics, and the effort to strengthen medical oncology at MD Anderson.
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Chapter 04: Making Connections and Issues with Acquiring Interferon
Jordan U. Gutterman MD and Lesley W. Brunet
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Chapter 05: Funding Interferon Treatment and Looking towards Future Developments
Jordan U. Gutterman MD and Lesley W. Brunet
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Chapter 06: Funding Interferon Research through Connections and Industry
Jordan U. Gutterman MD and Lesley W. Brunet
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Chapter 07: Challenges in Funding and Acquiring Interferon
Jordan U. Gutterman MD and Lesley W. Brunet
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Chapter 08: Promoting and Publicizing Interferon Research
Jordan U. Gutterman MD and Lesley W. Brunet
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Chapter 01: Early MD Anderson Pioneers
Jordan U. Gutterman MD, Lesley W. Brunet, and James S. Olson PhD
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Chapter 02: Dr. Emil J Freireich and the Early Years in Departmental Therapeutics
Jordan U. Gutterman MD, Lesley W. Brunet, and James S. Olson PhD
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Chapter 03: On Writing about the History of Medicine
Jordan U. Gutterman MD, Lesley W. Brunet, and James S. Olson PhD
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Chapter 01: Lessons from Family and the Liberal Arts
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman talks about growing up in a small South Dakota town, and the "amazing training" he received by accompanying his mother on her habitual visits to shut ins and ill neighbors. He also reflects on his own character and the faceted approach he brings to medicine and science, given his broad interests in religion and philosophy (both of which he studied in college).
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Chapter 02: Mary Lasker: Personal and Financial Support for Research
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
Dr. Gutterman discusses his close relationship with Mary Lasker (treated in depth in the 2006 sessions with Lesley Brunet), a philanthropist who was immediately interested in his interferon work in the seventies and who eventually gifted one million dollars toward his research. Mrs. Lasker schooled him in dealing with people and in strategizing to get a job done in the face of obstacles. Dr. Gutterman also talks about his gifts for visual thinking, his colorist paintings, and his habits of self-reflections which come from an interest in holistic systems.
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Chapter 04: Research Challenges: Ethical Questions and Celebrity
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
Dr. Gutterman talks about how he dealt with two problems that the interferon studies raised. First he discusses the ethics of selecting patients for treatment and of treating patients because they can afford to pay for an experimental drug (while others cannot pay). He gives specific examples of patients he has treated. Second, Dr. Gutterman talks about how he coped with the public attention and even notoriety that arose from his work. He digresses and talks about how the Mary Lasker came to fund the Lasker Award to raise awareness of medical research.
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Chapter 05: Interferon and the Control of Hairy Cell Leukemia
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
Dr. Gutterman recounts one his great success stories with interferon "the control of hairy-cell leukemia". He talks about the dramatic and unexpected results seen in patients with this heretofore incurable disease.
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Chapter 06: The Department of Developmental Therapeutics; Personal Stories and Reflections
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman talks about MD Anderson and the Department of Developmental Therapeutics, which he joined as a Senior Fellow in 1971. He first explains that his participation in the Berry Plan brought him to MD Anderson. He talks about immediately sensing the spirit of freedom and possibility, the availability of money to support research, and the presence of many accomplished people, such as Dr. Emil J Freireich, who influenced him with his passion and intellect. Dr. Gutterman speaks about his brother and father as inspirations as well as his own artwork, his paintings. The session comes to a close with two personal stories that demonstrate that angiogenesis can both kill and heal.
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Chapter 07: Testing Interferon against Many Cancers
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman picks up the story of his interferon work during the early Eighties. He explains that, after repeating his first experiments with the newly-manufactured recombinant interferon, he was eager to try the drug on other cancers, such as renal cell carcinoma and chronic myeloid leukemia. This was a bold move in some eyes, but the unique intellectual environment in the Department of Developmental Therapeutics in the Seventies supported this kind of creative experimentation. He speaks briefly about finding funding for this work, then focuses on his work with chronic myeloid leukemia (for which there was no treatment at the time).
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Chapter 08: Furthering Research through Partnerships with Drug Companies
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman offers several examples of how he learned to work with drug companies to further his own research. He was approached, for example, to test GM-CSF [granulocyte macrophage colony-stimulating factor] to restore platelet counts in chemotherapy patients. He also learned to protect his intellectual property. He attended meetings at the emerging drug companies and describes the impact of "seeing the power of venture money." He also observed how the biotech companies set up creative environments, sensing a kinship with the imaginative work they were doing.
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Chapter 09: Research Money: The Economics of Drug Companies; Philanthropy
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman talks about working with "big pharma" and operating largely independently of MD Anderson. He discusses the economics of pharmaceuticals, noting a lesson he learned from philanthropist Mary Lasker, who said "money is frozen energy." He talkss about his own entrepreneurial spirit, linking it to his father's business ventures and critiques "conservative approaches" to drug experimentation. Dr. Gutterman ends this section with a passionate description of Houston philanthropy at that time. He then responds to a question about the downside of working with drug companies, concluding, "Don't count on the drug companies," because he discovered interferon's hairy cell leukemia at MD Anderson, with private money.
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Chapter 10: R. Lee Clark, Charles LeMaistre, and Philanthropic Houston Oilmen
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman shares memories and observations about Dr. R. Lee Clark and Dr. Charles LeMaistre. This includes a narrative of how Dr. Clark worked with Mary Lasker to support Dr. Gutterman's work on chronic myeloid leukemia, resulting in the use of interferon to suppress malignant clones while normal cells return. Dr. Gutterman provides many examples of challenges that arose within the institution to hold back his work. At the close of the session, Dr. Gutterman sketches the formation of the Interferon Foundation by several Houston oilmen, several of whom visited Charles LeMaistre to insist he remove obstacles to Dr. Gutterman's work.
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Chapter 11: Funding Innovative Clinical Research: Some Institutional Obstacles
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter Dr. Gutterman comments on the reaction of MD Anderson "and then president Dr. Charles LeMaistre-- to the private funding of his interferon research." He also underscores how unique MD Anderson is, with all of its many resources, intellectual, creative, financial, etc. He also comments on his role as Chair of the Department of Clinical Immunology and Biological Therapy, noting candidly that he was not passionate about administration and unable to manage the Department adequately.
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Chapter 12: Department Chair and Section Chief: Leadership Issues
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Gutterman comments on his role as Chair of the Department of Clinical Immunology and Biological Therapy, noting candidly that he was not passionate about administration and unable to manage the Department adequately.
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Chapter 13: Going on Record with New Research: Avicins and Nutrition
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
For the first time, Dr. Gutterman goes on record with a discussion of his current research on avicins and nutrition, work that required him to "change fields" and study botany. He explains that in the mid-Eighties he found inspiration in an early article on the isoflavone Genistein, then speaks about the deaths of his mother and father, sources of the values that are personal foundations to that work. He notes that the epidemiology of cancer itself suggests that its cure lies in the understanding the interaction of genes with the environment. Near the end of this section, he notes that in 1994, financial difficulties at MD Anderson made it necessary for clinical departments to generate more revenue "another impetus for him to leave administration and find a new research arena."
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Chapter 14: Establishing a New Research Focus: Experiments, Money, Organization
Jordan U. Gutterman MD and Tacey A. Rosolowski PhD
Dr. Gutterman then speaks at length about the intricacies of setting up his new research program. He describes his new collaboration with botanist Dr. Charles Arntzen at (the Biodesign Institute at the University of Arizona?) and the Clayton Foundation's role in financing his research. During the next half hour he details how he was invited to study desert plants in Tuscon. He believed that these plants must contain substances that protect them from UV light and dehydration, and that might be helpful in combating cancer. He describes the long process of making extracts from the plants and the studies that revealed that one extract, from the acacia victoria, would kill ovarian cancer cells (and not kill normal cells). He talks about the process of finding a lab to make a pure extract (needed in the late nineties), a goal achieved in October of 1998: "Now I have to learn chemistry," Dr. Gutterman recalls saying. He and colleagues successfully mapped the chemical structure of the active terpinioid and then embarked on discovering the mechanism of its action. Near the end of this section he talks about how they named avicin and applied for the patent, awarded in 2002. (This session ends abruptly, due to Dr. Gutterman's throat irritation from allergies.)
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Chapter 01: Resolving to Become a Volunteer
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison begins this segment by noting that she and her husband, Bedford Harrison, moved to Houston in 1947. She began as a floor hostess in about 1968, working with both adult and pediatric patients. When the new building was constructed, she chose to work with adults and explains that she eventually worked in the protective environment floor: she explains some of the requests that family members made, as she could interact with their loved ones in ways they could not.
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Chapter 02: The Children’s Christmas Card Project
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison begins by talking about Page Lawson, “the most innovative person in the world” (who served as Director of Volunteer Services at MD Anderson from 1973 – 1991). As an example, she says that Ms. Lawson arranged for the volunteers to have t’ai chi classes as a relaxation technique. She also speculates that the Children’s Christmas Card Project was really Ms. Lawson’s idea, though Ms. Lawson circulated the story that the idea came from an unnamed volunteer who taught art classes for children at MD Anderson and discovered a particular piece of artwork she thought would make a wonderful Christmas card. Mrs. Harrison then explains how Ms. Lawson offered her a job as manager of the Children’s Christmas Card Project; her first main task was to develop a five-year plan to expand the project. She was fortunate, she notes, because MD Anderson was connected to the UT System: she actively promoted the project at all the UT Divisions. She also explains that an important expansion occurred when Randall’s Supermarket agreed to sell the cards at no profit (and continues to sell them today).
Next, Mrs. Harrison talks about how funds from the Project were used: MD Anderson employees submitted requests for funds to a board of volunteers who decided how money should be spent. She notes that the aquariums one can still see around MD Anderson were one of the first projects funded. At the end of this segment, Mrs. Harrison talks about the importance of spirituality in her life.
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Chapter 03: Details about the Children’s Christmas Card Project
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison begins this segment talking about several volunteers who worked on the Children’s Christmas Card Project. She then describes how the cards were selected: artwork up for consideration was presented at an event where volunteers could vote for the designs to be turned into cards. She describes one of her favorite cards and then notes that the five-year plan included an initiative to offer cards for the Jewish community. She goes on to explain that the Art Department turned selected designs into production-ready images and the Project then took bids for producing the cards. All this work first took place in a single room on the first floor of Volunteer Services, she explains, then moved to a larger room as the Project grew. She notes that there is a Karen Harrison Award given to a volunteer each year at the Volunteer Appreciation Luncheon.
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Chapter 04: Expanding the Children’s Christmas Card Project
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison begins this section talking about “some political things that influenced the Project,” citing as an example the invitation extended to Barbara Bush to attend the Project kickoff party. Mrs. Bush’s presence had a very positive effect. She then goes on to explain that after Randall’s Supermarket began selling the cards, she hired a consultant to help the Project break into grocery stores nationwide. The describes attending a supermarket trade fair and the resulting success of selling MD Anderson holiday cards in markets around the country. She also explains that the Project eventually separated from Volunteer Services (coming under the management of Steve Stuyck in Public Affairs) because there was too much to do. She speaks briefly about the art classes offered to children and notes that Page Lawson offered an award to each child who entered a piece to be considered for a card. The children whose designs were selected participated in the holiday parade that circulated through MD Anderson.
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Chapter 05: Creating an MD Anderson Annex to House Patients
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison explains that she purchased a very large home after her husband died and patients coming in from out of town stay with her. One woman gave her two robes to keep in the guest room, embroidered with “MD Harrison.” This is “another step in her love of Anderson.” Mrs. Harrison then describes the accommodating nature of people who work and volunteer at MD Anderson.
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Chapter 06: On the Children’s Christmas Card Project, Volunteers, and Faith
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison tells of a holiday card that was sent into outer space and talks about the generosity of volunteers that kept the Children’s Christmas Card Project moving forward. She then clarifies the progressive expansion of her role as she worked with the Card Project. Mrs. Harrison next talks about Page Lawson, who was known nationally as an expert in volunteer affairs and sought after as a speaker. Mrs. Harrison shows a picture of Ms. Lawson and goes on to describe her character. She recalls support that Ms. Lawson gave cancer patients. Mrs. Harrison recalls some volunteers she worked with and talks about her plans to continue volunteering with the institution. She talks about qualities that a person needs to volunteer.
Mrs. Harrison says that many people shudder when she mentions volunteering at MD Anderson, but explains that she always leaves feeling better than she did when she arrived because she has helped people.
Mrs. Harrison talks about the importance of her faith in her work as a volunteer: “God gave me the job.”
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Chapter 07: Memorable Volunteers and Caring for Patients
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison explains that when she began to volunteer at MD Anderson, she worked with young men with testicular cancer. She describes them as very determined to fight their disease and believes that she was able to give them confidence. Next Mrs. Harrison talks about working with patients on the protected environment floor. She describes the physical setting, in which patients were separated from their families by a glass window. Mrs. Harrison entered the protected environment (she put on scrubs), and she explains her role with patients. Often patients asked her to take personal items, such as a bible, to be sterilized so they might have it in the room with them. She tells a story of one woman who asked her to massage her daughter’s shoulder. Mrs. Harrison also explains that she served as an informal recruiter of other volunteers: she brought in her husband and a former classmate of her husband, Rock Rabinowitz, who worked volunteered many, many hours. Mrs. Harrison notes that people would often react very negatively to the idea of working in a cancer center, and explains how she countered their qualms. She explains that she established strong connections with patients and their families. She invited many of them for the holidays.
In this touching story, Mrs. Harrison describes how she cared for a little girl who came from Hawaii with her family for treatment. After the child’s death, her mother asked Mrs. Harrison to help her choose the dress her daughter would be buried in.
Mrs. Harrison says that she believes that her ability to connect with people is “God given.” She describes her relationship with a patient who now has an externship with MD Anderson. She then recalls Sister Alice, an energetic volunteer who was a “cheerleader” at one of the Children’s Art Project kick off parades. Finally she talks about Tom Jean Moore, the volunteer who took care of the rose garden and brought roses to be delivered to any patient who did not have flowers that day.
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Chapter 08: Recalling Volunteer Events and Volunteers
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison first recalls the Children’s Christmas Card Project kick off parade, which took place in early fall. She describes the parade, recalling the young men pushing their IV poles, the St. Thomas bagpipers, and the fire truck that drove patients along the route. She describes the route and notes that the barbecue restaurant, Goode Company, served sandwiches for lunch. Next Mrs. Harrison recalls valued volunteers. She notes that when she was promoted from Manager of the Children’s to Assistant Director of Volunteer Services, her role did not change, though her income increased. Next Mrs. Harrison talks about Page Lawson, “volunteer extraordinaire,” who had good business sense, enthusiasm, and a gift for matching people to the right job. She recalls that Ms. Lawson told her she’d been watching her in the cafeteria and decided that she “had what we needed.”
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Chapter 09: Memorable Volunteers and the “MD Anderson Annex”
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison explains that her husband, a chemical engineer, volunteered in the radiology department and could be comforting to patients, in part, because of his technical understanding of radiology. Mrs. Harrison then recalls a woman who became a volunteer after undergoing an hemi-hipectomy and who continued to volunteer, even after her husband died.
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Chapter 10: The “MD Anderson Annex”
Karen K. Harrison and Tacey A. Rosolowski PhD
In this segment, Mrs. Harrison describes the “annex” she has been running for the past 8 years. She explains that she purchased a very large home after her husband died, acting on her son’s comment that she could turn it into an annex for MD Anderson. She explains how she invited her first MD Anderson patient to stay with her, then recalls some of the other patients and families who have stayed with her over the years when they came into town for treatment.
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Chapter 11: Family Background
Karen K. Harrison and Tacey A. Rosolowski PhD
When asked whether she came from a large family (which might explain her gregariousness), Mrs. Harrison says that she had many, many cousins. She also explains that she was married before she graduated from college, though eventually she finished her degree, earning a degree in Political Science from the University of Houston in 1951. He notes that her husband did not want her to work, but she did, teaching third grade. She explains some of the challenges of teaching and recalls an autistic child in her class. She speaks briefly about the television and radio appearances that she made while working with the Children’s Christmas Card Project. She tells an anecdote to demonstrate that she inherited her public speaking skills from her “daddy.”
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Chapter 12: At Eight-Three, Still Providing Service to Patients
Karen K. Harrison and Tacey A. Rosolowski PhD
Mrs. Harrison tells of her plan to accrue another 2,000 hours of volunteer time so she will be “neck in neck” with her late husband’s 10,000 hours. She notes that she has introduced people to MD Anderson. She ends by talking about what she has received from her years of service to the institution.
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Chapter 01: A Career in Medicine
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks sketches his family background and talk about how his older brother influenced his decision to go into medicine. He also talks about his visual thinking skills, noting that he started out in surgery but switched when he became excited about the new imaging technologies that were introduced when he was a young professional.
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Chapter 02: College and Medical School
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks about the economic realities behind his decision to go to college and to medical school at the University of Kentucky (MD, 1982). He tells stories about doing one of his rotations in Appalachia and the dedication and compassion of the physicians there. He shares stories of his mentor in medical school, Ward Griffin, MD, as well as his skills in visual thinking.
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Chapter 03: Specializing in Diagnostic Imaging [Part 1]
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins by noting that he realized that “the diagnostic dilemma would be solved by imaging” while he was interning in general surgery at Memorial University Medical Center in Savannah, Georgia (1982 – 1983). This prompted him to undertake his clinical residency in radiology at the Indiana University Medical Center (Indianapolis, 1983-1986). He describes how imaging was used to enhance the surgical perspective and also comments on how the entire practice of medicine was changing at that time.
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Chapter 04: A Child with Cancer
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks about the turbulent period that ensued after his son, Graham was diagnosed with kidney cancer at 8 months of age. He describes his experience as a parent, the lessons learned, and the impact that experience has had on his own work with patients.
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Chapter 05: Specializing in Diagnostic Imaging [Part 2]
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks more about his experiences in his clinical residency in radiology at the Indiana University Medical Center (1983-1986) where he went on to serve as an instructor in vascular radiology (1986-1987). He talks about what it is like to practice medicine in an evolving field/specialty.||The recording cuts off mid-sentence at 36:30.||
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Chapter 06: A Sketch of Research in an Evolving Field
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks sketches the research he did in his early career, prior to switching his focus to administration. He notes that he “loved anatomy” and focused on research to perfect early interventional radiology devices and quantify their value for patient outcomes. He gives an example of his work with IVC filters. He explains how this experience with research served him when he came to MD Anderson to become Section Chief of Interventional Radiology.
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Chapter 07: Challenges for the Section of Interventional Radiology in 1998
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks explains how his experiences at the University of Washington in research served him when he came to MD Anderson to become Section Chief of Interventional Radiology. He notes that his mandate when he came to MD Anderson in 1998 as a section chief was to rebuild the Section of Interventional Radiology. He explains why the section had fallen into a period of dormancy with a very small faculty/staff and few resources. The section required new leadership and he describes his first steps. He also talks about the challenges of leadership during this period and how he set an example by pitching in.
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Chapter 08: A Turning Point in Building Interventional Radiology in 1998
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks explains how the Section of Interventional Radiology emerged from its period of lassitude in the late 90s with the support of David Callendar, the Physician in Chief, who send Dr. Barbara Summers to help him devise an organized process for the section’s transformation into a strong program that attracted innovative, quality recruits.
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Chapter 09: Choosing to Focus on Administration
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks reflects on what attracted him to administration and institution building. He explains how he relied on his supportive family. He talks about how the commitment of faculty and leaders at MD Anderson to patients helped him overcome any periods of frustration.||He notes that the patients at MD Anderson are inspiring and shares stories of meaningful patient interactions.
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Chapter 10: A Discussion of Leadership Challenges
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this chapter with a few comments on growth in the Section of Interventional Radiology. He then takes the rest of the section to comment on leadership issues. He explains that he was part of the Faculty Leadership Academy, found it extremely valuable, and notes the long-term coaching relationship he established with Fred Schmidt. He talks about working with Dr. Schmidt to develop team alignments in the Division of Diagnostic Imaging.||Next he talks the importance of “in-the-moment coaching” and notes that the Faculty Leadership Academy began his “journey” to develop his own leadership. He talks about the importance of finding support via networks. He explains that he has contacted emerging leaders to support them. He explains his view that there are untapped resources for coaching among volunteers and gives an example of a former patient and volunteer, a highly placed individual at Dell, who was able to speak to MD Anderson faculty about leadership issues.||Session Three: 3 July 2018
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Chapter 11: Chair of the Department of Diagnostic Radiology
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks discusses how he stepped into the role of Chair of the Department of Diagnostic Radiology and developed a vision for developing the department. He explains that there had never been a dedicated chair of the department, that the head of the division had always served that role. He explains that to date there had been difficulty getting the section heads to work together. Dr. Hicks talks about his goal of creating a true department identity with a clear governance structure. He reflects on the value of this process as a kind of leadership training for the young section heads in the department and talks about the identity that emerged.
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Chapter 12: Leadership Lessons Learned with Growing the Department
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks summarizes what he learned from serving in this first major leadership role as department chair of Diagnostic Radiology. He begins by saying that his role required him to become “reacquainted with the broad field of radiology” in order to be able to properly understand issues in each of the sections. He also talks about gaining the confidence to elicit information and the challenge of creating an environment that fosters sharing of information.||Reflecting on his leadership style, Dr. Hicks explains that he allows others to air their views fully, often not sharing his own perspective in order to allow free flow of discussion. He notes that some colleagues have criticized him for being too slow to voice his own views and make decisions, but feels his slower style has served him well.||Dr. Hicks also comments on the importance of admitting when something didn’t go right, giving an example of the department’s inefficient first attempt to address effort allocation.
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Chapter 13: Landmark Moments in the Growth of Diagnostic Radiology
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks summarizes key moments of change during his leadership of the Department of Diagnostic Radiology. He first notes the governance structure he helped organize and his role working within the Division of Diagnostic Imaging so the department could function as a full partner with other departments. He also notes the strategic recruiting that build the research and clinical capacity of the department, as well as the strengthening of infrastructure and administrative support for the new activities.||Dr. Hicks also explains that the Department began looking beyond the confines of the Houston campus to the region. He talks about the “groundbreaking moment” of developing very patient-centric radiology services at West Houston Imaging in the Bellaire area of Houston. On this theme he also notes that the department shifted from a faculty-centric to patient-centric focus, with Dr. Joey Steele leading the patient experience initiative. Dr. Steele worked with the Dean of the hospitality institution, the Conrad Hilton School at University of Houston, to improve customer service. Dr. Hicks shares a summary of the positive feedback to a study on patient satisfaction.
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Chapter 14: Head of the Division of Diagnostic Imaging
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks about assuming the role of Head of the Division of Diagnostic Imaging in 2010 while also serving as Chair of the Department of Diagnostic Radiology –a doubling of roles he took on to encourage MD Anderson to appoint a permanent department chair. He explains that as division head, he was particularly concerned about “how do we develop leaders” and he lists the individuals in leadership positions at that time. He explains that the Department of Experimental Diagnostic Imaging was poised to make key changes regarding the evolution of research into areas of translational research and cancer systems imaging. He talks about the creation of CABIR [Center for Advanced Biomedical Imaging Research] and QAAC [Qualitative Imaging Analysis Core] as part of this growth. He discusses how challenging it is to develop new technological and research infrastructure in a complex institutional environment.
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Chapter 15: The Division of Diagnostic Imaging Creates a Leadership Development Program
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this chapter by talking about the vision he created for the Division in 2010, even before he took over as head, with a particular focus on developing internal leadership. Dr. Hicks explains that the division created a program of “Ten Things You Need to Know in a Year” to counteract the fact that the Faculty Leadership Academy did not address some practical skills that division leaders needed. These fell into three categories: knowing and managing self; managing others; systems management. He describes the pilot program the division ran and the positive results: the Leadership Academy began to absorb some of the division practices. He confirms that in the next fiscal year, the division will be working with HR and Faculty and Academic Development to continue the program. He also stresses that leaders need a support network for coaching and problem solving when challenges arise.||Session Four: 24 July 2018
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Chapter 16: Transitions under Ronald DePinho: Epic and Financial Struggles
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks begins to sketch the period of institutional turbulence during Ronald DePinho’s [oral history interview] presidency. He begins by sharing his personal view of Dr. DePinho and his vision for developing MD Anderson’s commitment to translational research. Dr. Hicks notes that many people saw Dr. DePinho’s Moon Shots program as a divisive force in the institution, but he saw its potential for bringing people together.||
Next, Dr. Hicks touches on factors leading to negative views of Dr. DePinho’s leadership: poor communication, top-down decision-making, and a growing feeling among clinicians that their perspectives were not heard.||Next he focuses on the financial crisis in the institution. He explains that MD Anderson came out of the recession to face a new financial environment in healthcare and that the decision to implement Epic (in spring 2016) greatly compromised the institution’s financial comeback, despite the fact that a $250 million loss was anticipated. The comeback took longer. He explains that the immediate fix –to see more patients—was not adequate to the situation. The measures needed to remedy the situation were complicated and difficult to implement. He explains that solutions were proposed from many sources, but the siloing in the institution as well as lack of responsiveness from executive leadership delayed the recovery and intensified the growing sense of mistrust in the institution. Dr. Hicks also observes that payroll expenses were out of control in 2017.l -
Chapter 17: Transitions under Ronald DePinho and the Seeds of Shared Governance
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks shapes his response to a question about shifts in MD Anderson culture under Ronald DePinho by discussing the Committee of Division Heads that he chaired in 2012. He explains that the committee meetings first functioned as gripe sessions, but by 2012, the committee decided to be solution oriented. They addressed the lack of trust between these levels of leadership by sending an invitation to the executive committee and Dr. DePinho to come and talk to the division heads. He sketches the topics discussed and noted that Dr. DePinho and the Executive Committee attended the meetings when they could.||
Next, he sketches landmark moments in the disintegration of leadership relationships which reached a low point in 2015, when Chancellor William H. McCraven took action. Dr. Hicks talks about the causes of the morale problems among faculty and notes his personal view of how frustrating the situation was at that time.||
Next, Dr. Hicks explains that the Division of Diagnostic Imaging began to look seriously at the issue of leadership, shifting perspective and viewing leadership within the Division as an institution-wide role. He notes that there was a growing desire to help the division heads make a difference with leadership as well as growing frustration that the executive leadership was not listening to genuine concerns, a situation that resulted in an increased lack of trust, disempowerment. Dr. Hicks discusses many aspects of leadership style and how this factored into growing problems at the institution. He explains that it is important for a leaders to let go of the desire to micromanage, to trust lower levels of the organization to do what is best. He also notes that leaders can give in to the temptation to not show they don’t have expertise in an area.||Dr. Hicks then discusses the problem of siloing in at MD Anderson and gives an example of how silos prevented solutions from being implemented to resolve financial difficulties stemming from the transition to Epic.||He ends this chapter by noting that Hurricane Harvey (2017) was a “stress test for shared governance.” -
Chapter 18: Transitions under Ronald DePinho: Creating Shared Governance
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks describes events of Spring and Summer of 2015 that marked the turning point in the institutional response to the institutional turbulence under Dr. DePinho. The Faculty Senate and the Division heads had been advocating for more of role in decision making, and the situation had become serious enough that UT System Chancellor McCraven visited in the spring. The Faculty Senate issued a White Paper (https://cancerletter.com/articles/20150713_1/) outlining issues underlying low faculty morale. Chancellor McCraven issued an invitation for a group of three members of the Executive Committee and three division heads to come to Austin to discuss the White Paper. This meeting led directly to the formation of the shared governance model. Dr. Hicks describes the mood of the meeting and the impact of the chancellor stepping in.||
Next, Dr. Hick talks about the first actions taken by the newly formed Shared Governance Committee: addressing issues of confidentiality of meetings, defining committee identity and principles, and creating a strategic plan from the Faculty Senate White Paper. He notes that the committee divided into two (informal) groups: one was committed to looking at issues of culture and communication and the other more focused on the scientific and clinical activities at the institution. The concerns of the first group were eventually dropped by the SGC, however Dr. Hicks, who was part of the group, says they continued meeting to discuss how the climate of the institution could be changed to stress how people come together and work together to save the institution.||
Next, Dr. Hicks talks about the impact of McChrystal Group in 2016. Dr. Hicks explains how he became aware of the book, Team of Teams, by General Stanley McChrystal, who was then invited to MD Anderson to speak when the SCG was still new. The Committee encouraged the institution to invite McChrystal associates to evaluate MD Anderson. Dr. Hicks explains that their four page assessment of the institution was on target and spurred concerned work [document in Supplementary Materials]. At this point, he says, people really began to come together. He also notes that at this point, the people working on institutional change began to realize the stakes of what they were doing. -
Chapter 19: The Shared Governance Committee: the McChrystal Group’s Recommendations for Change
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks reviews the assessment that the McChrystal Group performed (2016) to support the Shared Governance Committee as it restructured MD Anderson [document in Supplementary]. He reviews their key points: a lack of trust and transparency; siloing and lack of alignment; problems with accountability; and problems with communication. He also sketches how the McChrystal Group worked with the SGC beginning in February of 2017 to the end of that year to align groups and determine a new governance structure to facilitate transparency.
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Chapter 20: A New Administrative Structure and Lessons Learned from Working with the McChrystal Group
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks reflects on leadership lessons he learned by working with the McChrystal Group. CLIP: He explains that he learned to see decision-making as a disciplined process and details what he means by that, giving an example of a failure of process that led to poor decision making. He then discusses the importance of using a rational process to create alignments between teams and working group.||
Next, Dr. Hicks talks explains the rationale the Shared Governance Committee used to transform MD Anderson’s administrative structure, creating a more functionally driven structure aligned with new operational priorities. -
Chapter 21: An Interim President and His Team Address Institutional Challenges
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this session by explaining how he was offered to opportunity to become interim president of MD Anderson after Dr. Ronald DePinho [oral history interview] resigned. He explains his reasoning for accepting this role and clarifies how he saw his mandate for this short-term position. He notes that UT System did not intervene in MD Anderson’s change process. He describes the steps taken to use a team approach to turn around the financial crisis and return the focus of the institution to core values, multi-disciplinary care, and patient care.||Dr. Hicks discusses his working relationship with COO, Stephen Hahn, MD and the other members of the team he worked most closely with. He explains how Ben Nelson was selected to become CFO.||Next he discusses how a new administrative structure emerged from the joint work of the President’s Leadership Team, the McChrystal Group, and the Shared Governance Committee. He also describes the process of requesting input on the proposed structure from the UT System Chancellor and the Board of Visitors. Dr. Hicks talks about some challenges that emerged from this implementing this reorganization, which eliminated the need for certain formerly key leaders within the organization.||[The recorder is paused and the session is not resumed]
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Chapter 22: Changing the Institutional Governance Model: Challenges
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this chapter by reviewing how the shared governance committee was formed (Summer 2016). He notes that a good deal of the transformation process was set in motion when Dan Fontaine, Senior Vice President for Business Affairs, decided to retire. A reorganization was needed to ensure that the function areas and his people would have homes, and this was an opportunity to determine what would be the best structure for the organization. The Shared Governance Committee determined that a flattened structure would address the deep silos and communication issues and offer stability and flexibility.||Dr. Hicks then explains how the SGC worked out the reporting structure. He says that the Chancellor of the UT System liked the proposed structure and also put in place the Chief Operating Officer role to pull the silos together; however this new structure also changed the reporting structure and created stresses for people who previously reported directly to the president. He further clarifies the rationale for the new structure. He then begins to explain that it was very difficult for the VPs and others to take a reduced role.
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Chapter 23: Implementing Change, the Influence of the Board of Visitors
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks describes an obstacle to implementing the shared governance system. He explains that the majority of the higher level individuals accepted the reality that their own roles had to shift and also recognized the institutional problems the new structure was designed to address. However, it became clear that neither the physician in chief, Dr. Thomas Buccholz [oral history interview] nor provost Dr. Ethan Dmitrovsky shared a view of the need for change. Dr. Hicks explains that it became clear they needed to be removed from their roles. As discussion evolved, he says, the process became contentious and members of the Board of Visitors “kitchen cabinet” became involved, meeting with him and attempting to guide the process (which is beyond the official scope of the Board of Visitors). Dr. Hicks says that he decided to focus on advice provided by MD Anderson about MD Anderson processes.||Dr. Hicks reflects briefly on his handling of this difficult situation. He observes that leaders must not allow personalities and emotions get in the way of doing what is best for the organization.||
Next, Dr. Hicks reflects on Dr. DePinho’s leadership, noting that “he did not fail alone, he had a team.” He explains that the removal of Drs. Dmitrovsky and Buccholz was the last task before the institution could move out of the DePinho years and into a new transition. He also summarizes the Board of Visitors concerns and motivations for becoming involved in this process. He notes that removing these two key people and making the governance change had a positive effect on the new president’s administration [Peter Pisters, MD]. -
Chapter 24: Thoughts about Serving as President
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks traces the shift in his thinking about possibly serving as permanent president of the institution. He reports on conversations he had with Dr. Raymond S. Greenberg, University of Texas System’s Executive Vice Chancellor for Health Affairs: both he and Dr. Greenberg were concerned that looking ahead to permanent presidency would raise questions about decisions Dr. Hicks made as interim president. On the other hand, he says, he was energized by the thought of taking on the challenge of the permanent presidency and building a team-based culture for the institution. He notes that he received a lot of encouragement to apply and reflects on the challenges that a high profile, public role presents to an introvert, such as himself. He notes that he put in an application, which only went as far as the first round of interviews. At the end of the session, Dr. Hick talks about the challenges a leader can face that make you “lose a part of yourself.”
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Chapter 25: A Follow Up on Being Recruited for President and Views on Harvey
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this chapter with a brief follow up to last session’s discussion of his thoughts about applying for the position of permanent president. Despite his reservations, he explains, he was approached by a recruiter and after eliciting various opinions, decided to apply.||
Next, Dr. Hicks talks about how Hurricane Harvey, which made landfall in Houston during 2017 and which was “a coming-together moment” and a test of all the structures and skills that the Shared Governance Team was putting in place. He describes how the institution was at first caught off guard because of meteorological reports that underestimated the amount of rainfall and the rapidly shifting nature of the storm of increasing magnitude. He describes how the institution quickly put the skills and resiliency to use to manage institutional operations and successfully rebound. Dr. Hicks talks about the impact on employees and The Caring Fund of about one million dollars that was established via donations to help.||Dr. Hicks shares his “most precious memory” of his time as interim president: the post Harvey celebration at The Park that acknowledged the way that the institution came together during the storm.||
Next, he shares the lessons learned: specifically how the crisis revealed certain local areas of operation with less developed communication networks, resiliency, confidence in local decision-making, and abilities to ask for help. He explains that the McChrystal Group was still involved in mentoring the institution and helped them undertake an “After Action Review” to examine how Harvey was handled and identify areas that needed additional analysis and intervention.||
Next, Dr. Hicks talks about the financial impact of the institution, explaining that at the cusp of the 2017/’18 and 2018/’19 fiscal years, MD Anderson was on track to achieve a $25 million margin. The storm's impact was around $30 million. Dr. Hicks explains that he decided to make various institutional awards, despite the fact that those would increase the shortfall. -
Chapter 26: Defining Operational Priorities and Preparing for Dr. Pisters to Step into the Presidency
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks discusses the identification of the operational priorities [ROPR] during October and November of 2018 to manage the institution’s change process before Dr. Peter Pisters arrived to become institution president.||[The recorder is paused]||Dr. Hicks lists the Operational Priorities: patient experience; enhanced information systems; geographic expansion; discovery; education; recruitment and development; financial sustainability. He explains how this type of planning was different from what occurred prior to Dr. Ronald DePinho’s arrival and how it was managed to provide structure and also flexibility once Dr. Peter Pisters arrived.||Dr. Hicks provides a summary of what Peter Pisters brings to the institution (having worked at MD Anderson before) as well as his lack of immediate familiarity with the recent turbulence.||He comments on the selection of Dr. Pisters and how it reflected concerns that the new president have adequate familiarity with MD Anderson culture.
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Chapter 27: Views of MD Anderson Presidents; Peter Pisters and the “Care and Feeding” of MD Anderson Culture
Marshall Hicks MD and Tacey A. Rosolowski PhD
Dr. Hicks begins this chapter by commenting that the state legislature in Austin monitors MD Anderson because the financial health of the institution has an impact on the entire University of Texas system. He notes that MD Anderson has returned to a solid financial footing.||Dr. Hicks comments on Dr. Peter Pisters’ style, noting that he is a “student of leadership.” He also observes that leadership used to take culture for granted, but now there is a concerted effort to cultivate the culture of the institution.||
Next, Dr. Hicks sketches the leadership approaches of the MD Anderson presidents. He explains that Dr. Pisters is particularly attuned to the fact that healthcare is changing and brings skills in preparing the institution to navigate changes as the stakes and risks rise.||Dr. Hicks then explains that presidents need to resist the temptation to operate solely within their comfort zones. He comments on his own comfort zone and notes that he was tested by a financial crisis during his period as interim president. -
Chapter 28: Experiences at the Mallinckrodt Institute of Radiology and Their Impact on Later Leadership (1988-1998)
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks about the ten years he spent in the newly established interventional radiology group at the Mallinckrodt Institute of Radiology at the Washington University school of Medicine, St. Louis, Missouri. He talks about the opportunities this afforded him immediately after his fellowship period to build a clinical and educational training programs and makes connections between these early-career experiences and his later leadership at MD Anderson, e.g. immersion in a positive culture at the Institute; the opportunity to build a clinical practice and develop excellent patient care. He also describes his experience observing issues that arose at University of Washington, the academic and healthcare delivery arms of the institution were divided into different financial areas.||
Next, Dr. Hicks confirms that these experiences helped give him the skills to rebuild Interventional Radiology at MD Anderson and to recruit well. He also learned how to treat patients. He tells a story that illustrates how faculty in an emerging field can be tempted to push boundaries when the treat patients and how collaborative discussions can ensure responsible action is taken. He notes as well that he brought this team based approach to MD Anderson. -
Chapter 29: Transitioning out of the Interim President Role
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks focuses on his role as Head of the Division of Diagnostic Imaging after serving as MD Anderson’s interim president. He discusses issues the division was facing, including the discussion of how to move services out into the region as well as staffing needs occasioned by the implementation of the Epic electronic medical records.||Dr. Hicks also discusses challenges he experienced as he returned to a divisional role after serving at the highest executive level: after a few years looking at institutional issues from a very broad perspective has changed how he interprets issues that seem pressing when seen only from the departmental and divisional level. He explains that he is questioning whether he is best able to serve the institution as a division head and has been considering other options. Dr. Hicks notes he has enjoyed working on the In-Patient Planning Committee, and he reflects on the difficulty of making late-career moves.
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Chapter 30: On Ongoing Strategic Planning and the Future of MD Anderson (2019)
Marshall Hicks MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Hicks talks about the strategic planning model Play to Win (Lafley Martin) that Dr. Peter Pisters brought to MD Anderson in the early days of his presidency. He outlines several positive features of the model and notes the importance of defining MD Anderson’s “aspirational win” (a key concept in the method), given the need to avoid “turning into a corporation.” He talks about how important it is not to “lose the people” of MD Anderson, as patients constantly mention the caring people the encounter during treatment and this gives the institution its edge.||Dr. Hicks then sketches what lies ahead for the institution: the need to succeed in a changing healthcare environment linked to politics; the need to fund research more independently of clinical revenue; and to develop a wide range of clinical service to be flexible. He also notes that MD Anderson needs to position itself advantageously in the region to manage risk and also work collaboratively with institutions across Texas.
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Chapter 01: A Nursing Student Discovers MD Anderson and Oncology Nursing
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment, Ms. Houston talks about her family background and the path that led her to oncology nursing. Born into a military family, she moved a great deal as a youngster. As her mother and aunts were nurses, she followed in their path, attended Texas Woman’s University in Denton, Texas. She began to work at MD Anderson while still in nursing school (in ’68 or ’69), choosing Anderson over Methodist Hospital, because of the higher wage ($18/8 hour shift). She describes her responsibilities at this time (dressing changes, for example). When she did her clinical rotation at MD Anderson, she was so impressed with the culture of work and care for the patients that she decided to become an oncology nurse.
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Chapter 02: Why Oncology Nursing is Unique
Deborah A. Houston and Tacey A. Rosolowski PhD
Ms. Houston describes how important a nurse is during the frequent “life ending” situations of cancer. She explains how a nurse gets to know patients and helps them confront all dimensions of their disease, though she also describes how uplifting it is to see patients beat cancer, as she was able to see when working with many lung cancer patients. She gives an example of a life-ending situation with a patient she particularly admired, and who spoke with her about how he could help his family during the rapid progression of his small-cell cancer.
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Chapter 03: Nursing and Nursing Management at MD Anderson in the Seventies
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment, Ms. Houston talks about the progression of her nursing career. She first summarizes her experiences as Staff Nurse (“72 – ’76), when she worked with a number of units: Surgical, Thoracic, General, and Head and Neck. The separation of these units causes her to observe that although multi-disciplinary treatment was a goal from MD Anderson’s inception, it became a reality in the 90s with centralization of patient services. She also comments on the role of nurses in the team of care providers, noting that before the hiring of physicians assistants, nurses helped physicians manage their patients. Next she talks about her role as a teacher and mentor once she became a Nurse Manager (Head Nurse) in 1976, and she helped nurses under her to learn how to care for lung and esophageal patients. At the time, there were only three people in nursing staff development (now there are over thirty).
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Chapter 04: Nursing Administration and a New Setting of Multi-Disciplinary Teams
Deborah A. Houston and Tacey A. Rosolowski PhD
Ms. Houston sketches the next phase in her career (’79 – ’97): her move from Associate Director of Nursing, to Director of Nursing, and then into the position of Center Administrative Director of Hematology. (She was the first Center Administrative Director.” She summarizes the scope of her responsibilities in each role and then focuses on the restructuring MD Anderson was going through at the time to create “centers” for Radiation Therapy, Hematology, and other services in order to create continuity of care as patients shifted from being in-patients to out-patients or vice versa. This was part of a general institutional push to create “multi-disciplinary care environments.” Ms. Houston describes the reporting chains in these centers and the teams –made up of a surgeon, a medical oncologist, a radiation oncologist and a nurse, among other service providers. She confirms that giving clinics autonomy in this manner represented a cultural shift in MD Anderson, and its goal was greater cost effectiveness. She explains why this goal was not achieved. She then describes the roles that nurses served within the new structure. At the time, leaders in the field of nursing were becoming more vocal about the importance of nurses. At MD Anderson, however, she feels that nurses were involved as an afterthought and because individual physicians understood the role nurses play in organizing patient care, helping the physician to assess the patient, and supporting the patient who must ask the physician about his/her care. At the end of this segment, Ms. Houston talks about her role on the selection committee for the Ethel Fleming Arceneaux Outstanding Oncology Nurse Award, which recognizes the central role nurses play in patient care.
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Chapter 05: Director of Nursing and Center Administrative Director
Deborah A. Houston and Tacey A. Rosolowski PhD
Here Ms. Houston goes into detail about the operation of the different units she administered during the nursing phase of her career. She begins by speaking about the stresses associated with serving as a Director of Nursing ((’86 – ’95) in a “very physician-driven environment.” She notes some of the initiatives she took on: adding services for patients and a mentoring program for nurses, as well as setting up a satellite laboratory on the eighth floor of the Ambulatory Care Clinic. (In-patient nurses would work a week in the Clinic so they could see patients who had gotten better.) She then talks about her role as Center Administrative Director of Hematology responsible for four inpatient units. Most patients, she observes, were involved in research studies, and she describes the difference between nurses focused on patient care and research nurses, but goes on to explain the research element of all nursing at MD Anderson, as clinical nurses help the patient understand the investigational protocol.
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Chapter 06: Inspirations and Observations About Changes in Nursing
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment Ms. Houston talks about people who inspired her. Renilda Hilkemeyer, “a phenomenal nurse and pioneer,” and the first Director of Nursing at MD Anderson, inspired Ms. Houston to be progressive. She learned how to conduct project and test out new work flows from Joyce Alt, the second Director of Nursing. And her late husband, Gary Houston, the first male nurse hired at MD Anderson and a Nurse Manager, involved her in many programs. This segment also includes Ms. Houston’s observations on how technology has increased the pace of care delivered, creating a rush in the work place and altering nurses’ relationship to patients and each other.
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Chapter 07: A Career Change to Information Systems and the Challenges of New Technology
Deborah A. Houston and Tacey A. Rosolowski PhD
Ms. Houston talks about how MD Anderson did not offer much leadership development support in the seventies. In the mid-seventies, she became involved in the Oncology Nursing Society (at both the local and national level) to build her leadership skills, and also absorbed a great deal via on-the-job training. Summarizing the qualities of a good leader, she says, “A good leader can go on vacation and no one knows you’re gone.”
She then describes her shift in career from nursing to Information Systems: despite the fact that she knew nothing about computers, Dr. Mitchell Morris invited her to come to work on the Electronic Records Committee in 1997 because of her experience with both in-patient and out-patient care and her knowledge of forms and documentation (and because she was a fun person). Next, Ms. Houston describes the first project she worked on as Coordinator of Clinical Systems –Patient Care Information Systems (’97 –’99). She was part of a group comprised of two others from MD Anderson and 4-5 consultants from a software company, and strategized adoption of the Computer Based Patient Records. One of the first tasks, as she said, was to involve more MD Anderson staff and phase out the consultants. MD Anderson was an “early adopter” for technology and worked with software for dictation, pharmacy orders, and records. She stresses that they were looking for software that could assign a patient a single record number that would follow him/her across in-patient and out-patient care. She explains why this is important for patient safety, particularly those receiving chemotherapy whose total dosages must be closely monitored.
Next Ms. Houston explains that Clinical Systems purchased a brand new product from Cerner Millennium [Health Information Technology] (though they stopped implementation a couple of years later). They adopted the Cerner Millennium product to speed requests for records and processing pharmacy orders, as well as to coordinate and consolidate patient care by reducing repeated work. She stresses that the MD Anderson record systems provides data in the form that MD Anderson users need. She is particularly pleased with the electronic reporting of laboratory data and vital signs. In contrast, she outlines the continuing challenges with regularizing data entry for physician dictation. Information Systems has adopted a system form M*Modal that processes natural language. The aim is to move physicians away from their habitual way of dictating to a structured output that can be electronically reported and searched.
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Chapter 08: Recognizing Nurses and Nursing: The Brown Foundation Outstanding Nurse Oncologist Award
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment, Ms. Houston talks about winning MD Anderson’s first award for an Outstanding Nurse Oncologist (1982). (She has also served on the section committee.) She briefly recounts the history of the award then describes some of the peculiarities: it carried a $10,000 cash award (now $15,000), given at a Board of Visitor’s dinner, but awardees had to keep the honor secret (no longer the case). She describes the criteria used to select the Outstanding Nurse from among the names presented by nomination: going beyond MD Anderson’s very high standards for patient care and also making an impact developing programs and materials.
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Chapter 09: Information Systems at MD Anderson
Deborah A. Houston and Tacey A. Rosolowski PhD
Ms. Houston begins this segment by briefly describing what led her 1997 decision to shift from nursing into Information Systems after agreeing to serve on MD Anderson’s Computer Based Records Project. She then talks about how Information Systems has fit into (and driven) the 2005 restructuring and combining of Departments. She notes that much of her role involves serving as a liaison between Information Services and Clinical Operations and gives the example of working with critical care providers while implementing the Picis system to do preoperative evaluations and various kinds of documentation. She also notes that Information Systems was first perceived as a “top down” initiative, but after the 2005 restructuring, this shifted as “clients” within the institution requested services and support. She explains how IS is funded and how she helps Dr. Thomas Burke, M.D., Executive Vice President and Physician in Chief, prioritize the IS projects funded. She describes some of the challenges of satisfying the requests for IS support. They have funds, but a great deal is already committed to ongoing projects. With the case of Infection Control, for example, they have funds, but not enough people to implement and support a new IS initiative, and contracting this support would increase the price.
Next, Ms. Houston describes the challenges that come from MD Anderson’s desire to always have the newest, most cutting-edge products. In Information Systems, this can mean purchasing newly developed software that may not be ready for full-blown use. The challenge of working with MD Anderson: patients have one record that follows them across inpatient and outpatient care, so providers can keep track of all procedures and drugs given. Chemotherapy administered in the hospital must be added to treatment given in the Ambulatory Care Clinic to avoid exceeding safe dosages. Ms. Houston then talks about how unique the laboratory systems are at MD Anderson and the high volumes of tests they perform, all of which have to be tracked by computer-based patient records.
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Chapter 10: A Reality Check for Information Systems: Building Systems for Teams
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment, Ms. Houston talks about the role she has served “an interpreter” in building information systems at MD Anderson. She explains that her 27 years of experience in patient care have enabled her to represent users’ needs in Information Systems. When information services are planned, she understands how work flows in clinical situations, how providers integrate record-keeping and data entry into their work day, and how they relate to screens and the organization of applications. While Director of Enterprise Applications in Management Information Systems (’99 – ’05), she also set up a class for technical staff about cancer, so they would have some idea of the real life situations that Information Technology users at MD Anderson deal with. Ms. Houston also notes that on first joining IT she sometimes heard, “What’s that little nurse doing here,” and won respect by performing well also noting the increase in numbers of women in the field and change in attitude. She then expresses concern about how her skill set will be replaced after her retirement, given her unique view and the respect and collaborative networks she has built over the years. In a discussion of ClinicStation software, she gives an example of her ability to facilitate users’ understanding that technology may not be the solution to their problems if what is needed is a change in work process.
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Chapter 11: Medical Records and System Design for Faster Work and Better Patient Care
Deborah A. Houston and Tacey A. Rosolowski PhD
In this segment, Ms. Houston explains a number of devices and services that IS has implemented to facilitate work at MD Anderson. She first talks about the Alkek Hospital Bed Expansion, and how the building’s design made it necessary to give nurses the VOCERA hands-free communication device. She explains why the attempt to install tablet computers in patient rooms to document vital signs and other information was unsuccessful (and how other computers are being installed) and explains the electronic white boards installed to monitor patient status. Next, Ms. Houston explains the decision made in 2005 to adopt ClinicStation. She talks about the assessment strategy and what this software allows. She explains that Information Systems has developed ClinicStation into a certified Electronic Medical Records system that meets government standards, The government takes an interest, she says, because electronic records should bring down the cost of healthcare. At the end of this segment, Ms. Houston talks about how Information Systems customized ClinicStation to suit MD Anderson needs.
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Chapter 12: Information Systems as a Service Provider
Deborah A. Houston and Tacey A. Rosolowski PhD
Next Ms. Houston notes that she plans to retire in three to four years, and by that time she would like to see efficient data entry for nurses and computerized systems for physician documentation, as well as completion of the project, Institutional Bar Code for Patient Safety. All of these initiatives, she says are key to safety and productivity. They are also tangible and achievable goals. As she looks back on goals already accomplished, she pleased to have started the hematology laboratory for patients and also gratified with the success of the Perioperative and Critical Care Informatics group that she directed from ’06 to ’09. MD Anderson faculty and staff are quick to ask for new technology, but the challenge is getting them to actually use it, Ms. Houston says.
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Chapter 13: Perspectives on Changes at MD Anderson Culture and Contributions to the Institution
Deborah A. Houston and Tacey A. Rosolowski PhD
Ms. Houston begins this segment by observing that since the seventies, MD Anderson has grown so much that it is impossible to know everyone, and interactions have become more impersonal. Technology has contributed this, as people email and text one another instead of communicating by phone or fact-to-face. Reflecting on whether the Institution can become too large, Ms. Houston observes that the Regional Care Centers return in a sense to the more personal feel of the old, smaller MD Anderson. In the case of Information Systems, she says, there is no quality compromise as the institution expands into remote units. In the case of overseas units (Global Oncology), she notes there is always a question about whether patient care is delivered in the same way as in Houston.
Next Ms. Houston says that her greatest concern is to find her replacement. She hopes that people in Information Systems will continue to foster a culture in which “everybody has worth” and can feel successful in what they do. MD Anderson has given her tremendous opportunities for success and to make friends. Once she retires, she intends to indulge her love of travel (especially taking cruises), her dogs who are like her children, and her various hobbies such as needlework.
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Chapter 01: An Interest in Estrogen and an Important Discovery
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Jones talks about the graduate research that brought him to MD Anderson. He sketches the story of how he left the University of California, San Francisco to join MD Anderson to develop a research lab in endocrinology. He describes the research he conducted at on combined therapies for gynecologic diseases. In particular, his research had to do with the long-term impact of DES (diethylstilbestrol -synthetic estrogen) in promoting cancer, the work for which he is best known. He explains how his interest in medicine and oncology developed. He lists the individuals he worked with and describes the state of the field at the time. Next Dr. Jones explains that at MD Anderson he was hired to develop a pioneering model of a department with collaborative research connections supported by clinicians. Dr. Jones explains that the Endocrine Research Program was elevated to a Section, which him as head. He explains the reporting structure.
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Chapter 02: A Conversation with Dr. R. Lee Clark
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones tells about a conversation he had with the first president of MD Anderson, Dr. R. Lee Clark, in the faculty restaurant of the Mayfair Hotel on the MD Anderson campus. He explains that Dr. Clark lived on the top floor of the hotel and had "his own table" at the restaurant. Dr. Jones was accidentally seated at that table, and Dr. Clark joined him. Dr. Jones recalls asking Dr. Clark how he came up with the idea for MD Anderson. Paraphrasing in his own terms, Dr. Jones says Dr. Clark was as concerned as he was about "linking discovery and delivery." He also recalls Dr. Clark speaking about decisions he would have made differently: relations with the UT System; dual appointments for faculty; the tenure system. Dr. Jones offers his own, negative view of the term tenure system.
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Chapter 03: Coming to MD Anderson to Link Discovery to Delivery of Care
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Jones explains that his mother's breast cancer diagnosis motivated him to leave the University of California and come to MD Anderson. He comments on attitudes toward breast cancer in the African-American community. He recalls his realization at the time: "No matter how many discoveries I made, it's hollow if there's no impact on people I love." He looked for an institution with more connection and was also interested in being closer to Baton Rouge, where his mother lived. He notes that he knew about the history of racism in Houston. He recalls his conversation with mentor, Dr. Pentti K. Siiteri about MD Anderson.
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Chapter 04: The First African-American Basic Researcher at MD Anderson
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Here Dr. Jones talks about race-related experiences at MD Anderson. He observes that he was one of five black clinicians at MD Anderson when he was hired. He explains that because of Dr. Charles LeMaistre's support, there was a protective "bubble" around him. He tells about establishing a rapport with the janitorial staff, who didn't believe he was black because "MD Anderson doesn't hire black doctors." Dr. Jones notes that a "˜bubble of protection' could make diversity hires much more vulnerable when their sponsors left. He says he was required to present eighteen letters of support for his promotion from assistant to associate professor (as opposed to the usual three). He explains challenges in his tenure and promotion processes.
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Chapter 05: The Minority Faculty Association; What Health Disparities Can Mean
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones talks about his work in the late eighties to address inequities in the treatment of minority faculty members. He tells how the Minority Faculty Organization was formed and discusses controversies surrounding it and its impact. He tells the story of the Association's push for the first survey of salary equity. He discusses the severe salary inequities discovered and the changes it led to. Dr. Jones next talks about the demographics of MD Anderson's patient population in comparison to the demographics of cancer patients beyond the institution. He mentions working with Dr. Martin Raber on a strategic plan to integrate a broader patient population into MD Anderson. He demonstrates the idea of health disparities with a story about the son of a wealthy Houston family whose son died because there was no acute care center within easy distance to treat his injury.
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Chapter 06: The Effect of Estrogen on Cancer
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones talks his role in the Department of Gynecologic Oncology: to bring reproductive endocrinology back into the conversation about cancer. He talks about "turf wars" that prevented him from pursuing some topics. He explains that he began looking at benign diseases (fibroids, endometriosis) to consider how these might be connected to cancer, as they are over-present in women treated at MD Anderson. He next talks about his studies of the early effects of steroid on cancer, focusing in particular on DES (diethylstilbestrol). He talks about creating the first culture of an immature mammary gland cell line with a functioning estrogen receptor (describing the innovative features of this work). Dr. Jones talks about the mechanisms of cell membranes and indicates that, at the time, researchers were not focusing on the mechanisms of normal tissues. He next outlines the treatments that came from his discoveries.
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Chapter 07: Research on Cancer in Diversity Populations
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones outlines several studies he has conducted on cancer patients from different ethic/racial groups. He begins with the Tri-Ethnic study conducted in partnership with the Kellogg's Company. He talks about setting up the partnership then talks about the Healthy Friends initiative that focused on screening Hispanic women for cancer and his involvement in trials in South American focused on secondary and tertiary prevention of breast cancer via diet. He showed that intervention with diet had the same effect as treatment with Tamoxifen. Dr. Jones then returns to the Tri-Ethnic Study and explains nuances in the results: the media reported that the results showed no influence of diet on cancer rates, but he explains how this was an extreme oversimplification and, in fact, they discovered very positive results.
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Chapter 08: Initiatives to Foreground Minority Populations and Diversity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones reviews several of the initiatives he took on to bring minority populations into the conversation about cancer at MD Anderson. He first talks about the Center for Minority Research and Health, which created a holistic approach to doing research. Next he talks about starting the Biennial Symposium Series on "˜Minorities, the Medically Underserved and Cancer' (begun in 1987). He explains that the Biennial figured into a plan to change how MD Anderson addressed minority health issues. Dr. Jones then mentions establishing the National Minority Cancer Awareness Week: he explains why this was needed. Dr. Jones tells the history of how the Biennial was established, beginning in 1985 when the NCI began looking at cancer disparities. He talks about the challenges securing funding, noting MD Anderson's lack of support for this initiative and for him.
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Chapter 09: A Stressful Relationship with MD Anderson Administration
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones sketches many tensions in his relationship with MD Anderson's administration. He mentions a Houston Chronicle article that stated "Lovell Jones was a boat-rocker and a malcontent." Dr. Jones explains why he was determined to stay at the institution, building on his solid research record: no one could accuse him of focusing on minority issues and discrimination because he couldn't make it as a researcher. Dr. Jones mentions Dr. Fred Conrad's murder at MD Anderson. Dr. Jones recalls that in the early eighties he took safety precautions and his staff feared for his life. He talks about his attitude toward any danger, noting that his connections with powerful people in the field helped protect him.
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Chapter 10: Early Experiences with Race and Civil Rights Instill a Commitment to Equity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones talks developing his commitment to work for equity. He describes the unusual features of Baton Rouge, Louisiana, where he was raised. This community was isolated and unusually integrated, characteristics that gave him a false sense of the country's integration. He was never told that he couldn't succeed. Dr. Jones then tells a story of disobeying his grandmother, who had told him never to take the bus downtown. He recalls sitting in the front of the bus only to be pulled to a seat in the back. Next he talks about how South University (a Black college) has a school on the campus of the laboratory school that Dr. Jones attended at the time. He was "adopted" by some college students and through them was introduced to civil rights activities. He then had the opportunity to attend the Robert E. Lee High School that was being integrated. He recalls being shot at and attacked during this period. Nevertheless, he explains, when he enters a room he never sees race. At the end of this chapter Dr. Jones explains why his mother threw him out of the house when he was thirteen.
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Chapter 11: The Intercultural Council; the Biennial Symposium, The Center for Research on Minority Health
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones begins with stories to demonstrate the positive impact of the Biennial and how it advanced awareness of the health disparities movement.
Next, he tells how he met with Arlan Specter (Senator, Pennsylvania) and eventually convinced him to appropriate money for a study that showed the lack of focus on health disparities, a precursor to the creation of a new NIH institute, the Office on Research on Minority Health. Dr. Jones next tells the story of forming the Center for Research on Minority Health. He describes how the Center was set up and positioned within MD Anderson. He explains its mission and initiatives directed at closing the gap in health disparities through science and education. Dr. Jones explains difficulties in sustaining his connection to the Department of Health Disparities Research after his retirement. -
Chapter 12: Race at MD Anderson: Slow to Make Real Changes for Minorities
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Jones provides a portrait of MD Anderson's approach to race and diversity during his tenure. Dr. Jones explains how race became a focus for him then shares his view of racism in America and racial inequality in Houston. He recalls segregation at MD Anderson still had separate eating areas for blacks and whites and observes that when he arrived, there was still a "psychological separation" between the races. He describes a conversation with Dr. Ronald DePinho about race. He notes resistance in leadership at MD Anderson and the Texas Medical Center to seeing race as an issue. He notes that there is "visible diversity" at lower levels of the institution but not in top leadership. Dr. Jones makes a comparison with the situation for women at MD Anderson, a situation that leadership addressed in ways that changed the climate. He observes that this has never been done for minorities at MD Anderson.
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Chapter 13: MD Anderson Leaders and Diversity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones evaluates MD Anderson and discusses the ability of key leaders to recognize race as an issue within the institution. He notes that Dr. Ronald DePinho, the fourth full-time president of MD Anderson, can empathize with, but not fully relate to the experience of African-Americans. He explains how important it is to make individuals aware of their biases without putting them on the defensive. He talks about Fred Levine, president of UT Medical Branch in Galveston, then compares Dr. Charles LeMaistre [Oral History Interview] and Dr. John Mendelsohn [Oral History Interview]. He talks about Dr. Emil J Freireich [Oral History Interview], Dr. Waun Ki Hong [Oral History Interview], Dr. Andrew von Eschenbach, and Dr. Bernard Levin [Oral History Interview].
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Chapter 14: The National Black Leadership Initiative on Cancer: Developing Grassroots Action for Health Equity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Here Dr. Jones tells the story of The National Black Leadership Initiative on Cancer. He defines "health disparities and health equity" (using the World Health Organization's definition). He then tells the story of helping to start the National Black Leadership Initiative on Cancer after the publication of a report on minority cancer. He explains the scope of the Initiative's activities (and notes MD Anderson's lack of support and criticisms). Dr. Jones tells anecdotes about his stressful relationship with MD Anderson that made him consider leaving Houston.