Interview Chapters

Processing Information:

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.

Printing is not supported at the primary Gallery Thumbnail page. Please first navigate to a specific Image before printing.

Switch View to Grid View Slideshow

Chapter 04: Setting Up Testing Laboratories and Clinics and Building Research

Ralph Freedman MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freedman explains how he came to assume the positions of Director and Chief of Immunology and Molecular Biology Research (’88-‘07). This narrative brings together various details: treatment of rare gynecological cancers, billing practices, regulation of laboratory testing, and research.
Chapter 05: Building A Departmental Focus on Immunological Approaches to Gynecologic Cancers

Ralph Freedman MD and Tacey A. Rosolowski PhD

Dr. Freedman begins this chapter by sketching the hopes he had as Director and Chief: to understand the biology of the diseases from an immunological perspective and try to identify new strategies to treat ovarian and uterine cancer, with their (continued) dismal outcomes (in comparison to advances made with cervical and endometrial cancer). He notes that the main contribution IMBR made to ovarian cancer was to demonstrate that T-cells can be activated in the patient, a fact indicating that a vaccine approach might potentially be used. He goes into detail about the biological mechanisms of the tumors and of the patient’s immunological system. He notes that it is important for researchers to determine adequate ways to measure clinical benefit of treatments.
Chapter 06: Two Decades Overseeing Human-Subject Research

Ralph Freedman MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freedman discusses his more than twenty years of experience overseeing human subject research on the Institutional Review Board (IRB). He sketches the history of human subject guidelines and clarifies IRB procedures, potential conflicts of interest (between IRB members and the institution), and the kinds of research protocols of concern to the IRB, whose primary function is the protection of human subjects. He then discusses his belief that regulation is very necessary, but that it has currently gone too far. He points out that different protocols represent different levels of risk, some of which may not require IRB regulation, such as experiments in which the main risk is to patient privacy. Dr. Freedman offers rich detail about the challenges to researchers and describes systems that might satisfy the public’s need for privacy and information security while easing the burden on researchers who want to move ahead quickly with their work. “We needed these systems yesterday,” Dr. Freedman asserts. He gives examples of how his understanding of the need for regulation and its potential complexity evolved as his experience as a researcher grew, then expands his focus again and discusses how regulation can influence how a researcher focuses his or her career.
Chapter 07: Service on the National Cancer Advisory Board and Other National Bodies

Ralph Freedman MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freedman discusses his role as a presidential appointee to National Cancer Advisory Board (President Bill Clinton, ’00 – ’06). He begins with a brief sketch of the birth of the NCAB (and the National Cancer Institute) in the National Cancer Act, then covers NCAB review processes and grant procedures and compares the different styles of the Directors of the National Cancer Institute, who work with the NCAB. He shares his view that all the institutes need to reconsider the kinds of clinical research they are supporting. This discussion leads naturally to his post-retirement role on the Oncologic Drug Advisory Board (since ’09), “one of the most productive Boards at the FDA,” in Dr. Freedman’s words. He notes that he had to divest himself of certain stocks and remove himself from committees to satisfy the Board’s conflict of guidelines. He also talks about the Board’s procedures for questioning drug companies, offering several examples (including a drug company’s challenge to a rejection). He concludes that “They [the FDA] do a terrific job of protecting the public.”
Chapter 08: Working with LBJ Hospital and Indigent Care

Ralph Freedman MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freedman talks about the Lyndon Baines Johnson Hospital in Houston, a public county hospital that has many MD Anderson faculty who work part or full time. Dr. Freedman has worked with the gynecological oncology resident training program since his retirement: a choice he made to continue seeing patients, which he felt he could not do at MD Anderson under conditions where patients required continuous monitoring. He notes the economic burden that indigent patients represented for MD Anderson in the past; he has also had an opportunity to note how many more women physicians are in the field.
Chapter 09: MD Anderson Growth and Changes to Institutional Culture

Ralph Freedman MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freedman shares his observations about the growth of MD Anderson since he came to the institution in 1975. He notes its particular strength in clinical research and multi-disciplinary approaches (gynecologic oncology being one of the first Departments to put together multi-disciplinary fields). He hopes that MD Anderson will continue to always do the right thing for patients, “since we are there for them, not for ourselves.” In the final minutes of the interview, he talks about going to Galveston, Texas, to fish and enjoy the water, as he did when he was young, in Capetown, South Africa. Since retiring, he has been able to indulge his love of history and travel, talking about his trip to Russia. “It’s a good thing to leave some time,” he says, to have a chance to do other things besides work.
Chapter 01: Growing Up in Chicago with Unusual Opportunities

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about growing up in Chicago during the Great Depression, his early education, his difficult home life, the early influence of a family physician on his life, attending medical school at the University of Illinois at Urbana-Champaign, and being disqualified for service in World War II.
Chapter 02: Medical School and Residency in Chicago and a Growing Interest in the Science of Medicine

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks further about attending medical school at the University of Illinois at Urbana-Champaign, interning at Cook County Hospital, and why he got fired from Cook County Hospital.
Chapter 03: On to a Fellowship in Boston and to Hematology

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about moving to Boston and studying and practicing hematology, shares his observations on grant funding, talks about how success is defined in science and medicine, and talks about his wife.
Chapter 04: Oncology Research at a New Hospital at the National Institutes of Health

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about being drafted into the Army, why he thinks that World War II was won by the defeat of malaria, going to work at the National Institutes of Health, and dedicating himself to curing leukemia. “You could either go to Bethesda and take care of leukemia patients,” he was told, “or you could serve in the military and go get blown up in Korea. So what the heck? Cure leukemia—that’s what I’ll do.”
Chapter 05: Treating Leukemia at the NIH

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about researching and treating leukemia at the National Institutes of Health and how everything he is famous for was done during his 10 years there. He also talks about why academics hated him and starting the first formal clinical trials.
Chapter 06: The First Systematic Studies of Chemotherapy for Leukemia

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the first study of chemotherapy for treating leukemia, developing new treatments for childhood leukemia, and combination chemotherapy.
Chapter 07: Treating Hemorrhage in Pediatric Leukemia Patients

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about treating hemorrhaging in pediatric leukemia patients.
Chapter 08: A Research Controversy: Treating Hemorrhage in Childhood Leukemia

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the controversies surrounding treating hemorrhaging in pediatric leukemia patients.
Chapter 09: At the NIH: Studying Infection in Leukemic Patients [early 60s]

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about his studies of infection in childhood leukemia, conducted at the National Institutes of Health in the early 1960s.
Chapter 10: At the NIH: Vincristine, a Cure for Childhood Leukemia, and VAMP

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the development of a drug called vincristine and the work for which he is famous: curing childhood leukemia.
Chapter 11: Leaving the NIH for a Turbulent Research Environment at MD Anderson

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich says that “We’re now in ’64, and things are going along famously. I had the biggest and best pediatric leukemia service in the world. We were internationally famous. Everybody was following our lead. People came to learn how to do platelets, how to do white cells, how to do antibiotics, and how to do combination chemotherapy. We were really rolling.” He then talks about why he left the National Institutes of Health and joined MD Anderson Cancer Center, his relationship with Dr. R. Lee Clark, and why his family’s transition to Houston was “painful.”
Chapter 12: The Lay of the Land: Developmental Therapeutics and MD Anderson in 1965

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the Department of Developmental Therapeutics at MD Anderson, the prominent physicians he worked with at MD Anderson in the mid-1960s, more about Dr. R. Lee Clark, and the use of radiotherapy for treating cancer.
Chapter 13: Getting to Work, Diving into Controversy, and Studies of POMP

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the difficulties of treating children, getting fired as head of Pediatrics, and being put in charge of Leukemia.
Chapter 14: Developmental Therapeutics in the Midst of Opposition to Systemic Treatment of Cancer

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talk about the Department of Developmental Therapeutics amid opposition to systemic treatment of cancer, the development of the immunotherapy program, and animosity among different departments and personalities at MD Anderson.
Chapter 15: Developmental Therapeutics, the Division of Medicine, and Dr. Clark’s Final Years as President

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich continues talking about the Department of Developmental Therapeutics at MD Anderson, the Division of Medicine, the medical school in Houston, and Dr. R. Lee Cark’s final years.
Chapter 16: Charles LeMaistre, the New President, Initiates Reorganization, with Impact on Developmental Therapeutics

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the new president of MD Anderson, Dr. Charles LeMaistre; reorganization initiatives of the new president; and how Dr. LeMasitre’s changes affected the Department of Developmental Therapeutics.
Chapter 17: The Beginning of the Division System, Closing Developmental Therapeutics (1983), and the Legacy of the Department

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the beginning of the division system, the closing of the Department of Developmental Therapeutics in 1983, and the department’s legacy.
Chapter 18: Departments Undergoing Change under Charles LeMaistre

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the many changes that occurred at MD Anderson under the leadership of Dr. Charles LeMaistre.
Chapter 19: Head of the Adult Leukemia Program and a “Project Reassignment” Year at the NIH

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about his role as head of the Adult Leukemia Program and a “Project Reassignment” year at the NIH.
Chapter 20: A “Flexner Report for Cancer” and Commitment to Education

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about developing and writing a “Flexner Report” for cancer and touring medical centers nationwide.
Chapter 21: Views of Charles A. LeMaistre and MD and R. Lee Clark, MD

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about Dr. LeMaistre; how, in his view, Dr. LeMaistre abused his power as president; and why he thinks MD Anderson was hated by other state institutions.
Chapter 22: An NCI Audit and Problems with a Protocol and Leadership

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about being audited by the NCI and suffering a heart attack.
Chapter 23: Charles A. LeMaistre’s Administrative Success

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about some of Dr. Charles LeMaistre’s administrative successes.
Chapter 24: Controversies over Use of Drugs in Clinical Trials (1980s)

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about controversies over the use of drugs in clinical trials in the 1980s.
Chapter 25: Multi-Disciplinary Clinics in a Politicized Environment and a Review of Key MD Anderson People [Restricted]

Emil J. Freireich MD and Lesley W. Brunet

This interview chapter is restricted. Please contact archivist for details.

In this chapter, Dr. Freireich talks about the operation of multi-disciplinary clinics in a highly politicized environment and discusses his thoughts about key personnel and leaders at MD Anderson.
Chapter 26: Reflections on Leadership Style, Intellectual Freedom, and MD Anderson

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich reflects on leadership style, intellectual freedom, the legacy of Dr. Charles LeMaistre, Dr. John Mendelsohn, and MD Anderson in general.
Chapter 27: The Development of the ALZA Infusion Pump

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the development of the ALZA infusion pump.
Chapter 28: The Physician-Scientist Training Program and Other Activities and Some Thoughts on Retirement

Emil J. Freireich MD and Lesley W. Brunet

In this chapter, Dr. Freireich talks about the Physician-Scientist Training Program at MD Anderson and shares his thoughts about retirement.
Chapter 01: A New Idea and A Controversy: Transfusing Platelets in Leukemia Patients

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freireich begins this chapter by explaining the origin of his first name, "J".

Next, he describes how he worked with pediatric patients in the fifties, noting that he would see blood sprays on the walls of childrens' hospital rooms from their hemorrhages. This led to his decision to treat the patients with massive doses of platelets. Dr. Freireich gives detailed accounts of the patients' physiology, the technical challenges to overcome when giving patients blood from donors (as opposed to a bank blood), as well as the clinical trails he ran to determine the treatment's efficacy. Dr. Freireich explains in very dramatic terms, how treating leukemia patients was influenced by confrontations between those who advocated for laboratory over clinical research, as well as by intra-institutional political conflicts. What results is a full and realistic portrait of how scientific and clinical paradigms shift in complex social/political contexts
Chapter 02: Building the Continuous-Flow Blood Separator

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich describes treating infections by transfusing white blood cells. He goes over the technical difficulties of separating white cells from platelets. (He describes his lab at NCI, festooned with 50 feet of tubing.) Here he also specifies why a continuous flow of blood was needed: using the analogy of an artificial kidney, he explains that leukemia patients required a huge number of either platelets or white blood cells, so the aim was to process a donor's entire blood supply, while mobilizing the donor's body to replace the elements removed for the transfusion. The next phase of the blood separator story begins when an IBM engineer, Al Judson, appears and asks if there's something he might do to help cure leukemia. (His son was afflicted by the disease.) Dr. Freireich describes the materials and technical challenges of creating an instrument that would channel blood from a donor into a centrifuge, collect the proper layer of separated elements for the patient, and deliver plasma back to the donor.
Chapter 03: Perfecting the Blood Separator in the Department of Developmental Therapeutics: Shifting MD Anderson Culture to Innovative Research

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freireich explains why the slow evolution of the blood separator made it necessary for him to leave the NCI and join MD Anderson in 1965. He speaks at length about R. Lee Clark, "a giant of a person" (who visited Dr. Freireich's family at home in order to convince him to come to Houston). He compares leukemia treatment services at NCI and the "primitive" situation for clinical research at MD Anderson. The faculty, he notes, saw his treatment/research approaches as potentially disruptive. He illustrates Dr. Clark's political skill in the face of this enmity: Dr. Clark rented a mobile home and set it up in a parking lot, where Dr. Freireich and Dr Frei (his close colleague from NCI who also joined MD Anderson in the sixties) established the new Department of Developmental Therapeutics. Dr. Freireich describes the process of establishing a fully functioning program in two years. He also describes tensions in the institutin as Developmental Therapeutics presented a new model of innovative research on treatments other than surgery. He explains how they finalized the design of the continuous blood separator (Model 2997), and he describes how the device and innovations it stimulated led to a revolution in stem cells transfusion.
Chapter 04: MD Anderson Changes Under Charles LeMaistre: Expansions in Leukemia Research

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich covers several topics, among them changes in MD Anderson's administration when Charles LeMaistre became president, departmental reorganizations, and clinical experiments with "life islands" and granulocyte transfusions.
Chapter 05: New Chemotherapy Treatments for Breast and Cultural Challenges to Research Innovation

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich discusses his work on breast cancer chemotherapy, simultaneously reflecting on cultural trends in the United States that work against the spirit of innovation.
Chapter 06: A Commitment to Training and Education: A Failed Battle For an MD Anderson Medical School

Emil J. Freireich MD and Tacey A. Rosolowski PhD

this chapter begins with Dr. Freireich's reflections on the circuitous path that took him to hematology. He describes the unique clinical oncology program he helped set up at MD Anderson, and the "best and brightest" fellows who came to train. He traces the creation of graduate education at MD Anderson. He weaves in discussion of how growth at MD Anderson was tied to debates over bringing a medical school to Houston.
Chapter 07: Building the "Best Graduate Medical Education Program in the Country"

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freiriech next traces the growth of education at MD Anderson when Dr. Charles A. [Mickey] LeMaistre took over as president from Dr. R. Lee Clark. He describes his close collaboration with Dr. Emil Frei, III. He explains how the Department of Developmental Therapeutics evolved because of initial connections with Japanese and Mexican Fellowship students. He explains his role in taking medical oncology to Japan and to Mexico. Dr. Freireich also sheds light on the development of the administrative structure governing clinical and basic research and explains how he established the Institutional Grand Rounds, a contributor to what he calls "the best graduate medical education program in the country."
Chapter 08: A History of Institutional Grand Rounds, The Core Curriculum, and the Physician's Assistant Training Program

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich explains the Institutional Grand Rounds in greater detail, focusing on how it offers a multi-disciplinary perspective on a topic to appeal to a broad audience within MD Anderson. He discusses how he established the Core Curriculum, a program that all graduates students at MD Anderson are required to take and which he describes as the "best program in the country" because of the comprehensive view of cancer it provides. He also discusses how he believed that the new idea of a "physician's assistant" was worth pursuing, leading to the Physician's Assistant Training Program.
Chapter 09: Creating Patient-Oriented Research in a Complex Scientific and Institutional Context

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freirech begins this chapter by discussing the importance of research funding and the creation of the Association for Patient-Oriented Research. He sketches the "structural problem" that research funding through the NIH channels funds to basic scientists when "100% of our ability to manage diseases in man began at the bedside with a doctor." He speaks at length about the bias he perceives against physicians and clinically based research and the limitations of basic research to reveal the intricacies of disease in patients, despite the "ethos" in medicine and in the country to view clinical research as secondary because it merely applies discoveries revealed by basic research. Dr. Freireich talks about the origin of the K-series NIH grants for physicians. He then gives examples of how the bias against clinicians has influenced funding and administrative organization at MD Anderson. He speaks about the Physician Scientist Program (funded by a K-30 grant) and the Patient-Based Research Program. He talks about the challenges arising from the fact that MD Anderson does not administer its own Graduate School.
Chapter 10: Advocating for Patient-Oriented Research and Patients

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freireich begins this chapter by sketching the educational opportunities that MD Anderson offers. He then talks about his continued commitment to education and his pride in one of his trainees, Dr. Hagop Kantarjian, who now heads the Department of Leukemia. Dr. Freireich then further discusses the bias he perceives operating when it comes to awarding grants and awards to physician-scientists. He sketches the history of science in medicine, beginning with the founding of the Association of American Physicians and leading to his role in founding the Society of Patient-Oriented Research in 1998. He sketches the challenges the struggling organization is facing. He stresses that MD Anderson is set up to allow physicians to focus on their specialty, which means their minds are always immersed in their research area as well.
Chapter 11: A Critical Need to Fund Patient-Oriented Research

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freireich begins this chapter by reflecting on the role that national and international organizations have served in furthering research in his field (the fifties to the present), circling back to the main theme of Session Two by pointing out that the character of these organizations again demonstrates that basic research is valued more highly than clinical research. He also presents his belief that funding research on cures for cancer will be more effective than funding preventative measures.
Chapter 12: The FDA as a Barrier to Research Innovation

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter Dr. Freireich stresses that cancer will only be cured by funding clinical research into cures for cancer and offers his personal belief that the population at large understands this. (He uses the example of AIDS activists, who were successfully organized and lobbied for effective treatments.) He talks about the role of the FDA, which he sees curtailing physicians' ability to make progress by restricting the use of experimental drugs in dying patients. He sums up the affect of what he sees as bureaucratic conservatism: "If there's no drug, there's no danger, and there's no progress."
Chapter 13: Leukemia as a Key to Understanding

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich presents his theory that the ability to control cancer (determining which cancers will metastasize and kill) will come from research in leukemia because leukemia is a systemic cancer and everything discovered about it is immediately transferable to solid tumors. He talks about molecular and genetic advances in understanding cancer. He notes that we don't need to understand the source of cancer, since will never be eradicate it, we need to understand how cancer operates so it can be controlled. At the end of this chapter, Dr. Freireich observes that individuals understand that tobacco and alcohol have an impact on cancer and health but it is a slow process to regulate against their use.
Chapter 14: The Partnership Between Basic Science and Clinical Research

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Freireich further clarifies his view of the relationship between clinical and basic research. "I want to spend double the money on basic research. The problem is the translation. If you don't have the clinical arm, it's like trying to play the piano with one hand. We need basic sciences to do the rhythm and the clinical scientists to do the melody and then we get music." He talks about some of his collaborations with basic sciences, but also gives examples of how, contrary to popular opinion, patient-oriented research is basic research. He explains why global oncology should be a lower priority than other missions: e.g. funding clinical research, targeted therapy.
Chapter 15: A Legacy of Strong Faculty and Advances in Blood Cancers; Awards; as a Disease and MD Anderson Presidents

Emil J. Freireich MD and Tacey A. Rosolowski PhD

Dr. Freireich begins this chapter by listing some of the key faculty he has brought to MD Anderson. He then reviews advances in blood cancers that have been made during his time at the institution. He next compares the three presidents of MD Anderson and speculates that incoming president Dr. DePinho has "the same genes" as R. Lee Clark, and may prove a visionary leader.
Chapter 16: A Life of Work with the Support of a Strong Wife and Family

Emil J. Freireich MD and Tacey A. Rosolowski PhD

In this very personal chapter, Dr. Freireich reflects on his lifelong focus on work. He speaks at length about his relationship with his wife and beloved partner, Haroldine Freireich (Cunningham), whom he married on a Saturday morning when there were no samples to count. He talks about the importance of his family and notes that his children and grandchildren in providing distraction from intense focus on his research life.
Chapter 05: The Leadership Styles of Dr. Frei and Dr. Freireich and Working with the Southwest Oncology Group (SWOG)

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

In this chapter, Dr. Gehan contrasts Dr’s Frei III and J. Freireich’s administrative styles and capabilities. He mentions the adult and pediatric divisions in the Southwest Oncology Group (SWOG) and MD Anderson pediatric researchers Dr. Margaret Patricia Sullivan and Dr. Wataru "Walter" Sutow. Dr. Gehan then discusses the politics, group composition of the Southwest Oncology Group (SWOG), and MD Anderson’s participation in it. Specifically, he talks about the election of the successor to Dr. Tom Frei III as Chairman of the Southwest Oncology Group and mentions successors Dr. Barth Hoogstrate and Dr. Charles A. Coltman Jr.
Chapter 06: Dr. Gehan's Research and Publishing Impact

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

In this chapter, Dr. Gehan assesses his research output. He talks about: the number of patients required in Phase II clinical trial, comparison of two survival distributions with no average survival time, the extension of the Wilcoxin (Frank) Test with two-sample tests with censoring (loss) when working with Professor Sir David Roxbee Cox in London, the Gehan-Breslow (Norman Edward)-Wilcoxon generalization of the Wilcoxon statistic test to the two-sample problem with censored data, and hazard functions. Dr. Gehan then discusses the impact of computers on statistical research publications. He talks about the necessity for, and research perspectives and publications regarding, non-randomized controls in cancer clinical trials. He mentions the influence of Dr. Franz Joseph Ingelfinger, Editor of the New England Journal of Medicine, in promoting a constructive Gehan/Freireich publication approach where there was a conflicting research theory (Thomas C. Chalmers, known for randomized clinical trials). He also discusses the development of cancer research cooperative groups, epidemiologist Eleanor Macdonald and many of his co-authored biostatics articles.
Chapter 07: The Relationship Between the Department of Developmental Therapeutics and Department of Medicine at MD Anderson

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

Dr. Gehan talks about patient referral practices and perspectives between the Department of Medicine, headed by Dr. Clifton “Cliff” Howe, and the Department of Developmental Therapeutics headed by Dr. Emil Frei III. He discusses direct referrals to Dr. Frei III and Freireich, Dr. C. C. Shullenberger (chronic leukemias), and Dr. Raymond “Ray” Alexanian (multiple myeloma).
Chapter 13: Transitions at the Department of Developmental Therapeutics

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

Dr. Gehan concludes the interview by discussing changes at the institution including the closure of the Department of Developmental Therapeutics. He talks about the importance of having passion in cancer research, a trait he greatly admired in Drs. Frei and Freireich. He talks about the role of pharmaceutical companies and Rituxan, the first monoclonal antibody to be approved by the Food and Drug Administration (FDA).
Chapter 01: Early Life and Education in Brooklyn, New York

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

Dr. Edmund “Ed” Gehan summarizes his tenure at MD Anderson, how he came to MD Anderson, prior work in the Biostatistics area of the National Cancer Institute (NCI)/National Institute of Health (NIH), and graduate education. He briefly talks about his pre-collegiate life and career influences in Brooklyn, New York - including his attendance at St. Augustine’s Catholic High School. Dr. Gehan then details his range of performance on career aptitude tests (e.g. Wiggly Block Test) at the Johnson O’Connor Research Foundation and how his enjoyment of Reader’s Digest Word Power influenced his decision to attend Manhattan College.
Chapter 02: Choosing An Educational Background Focusing on Statistics

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

Dr. Gehan reflects on his curriculum, performance, and choice of major at Manhattan College, and factors that influenced his selection of the University of North Carolina, Chapel Hill for graduate study in statistics. He talks about the “giants” at UNC Chapel Hill in the Department of Theoretical Statistics: Harold Hotelling, Herbert Robbins in probability, R. C. Bose, and S. N. Roy while he spent a year in that program. Dr. Gehan switched to the Department of Applied Statistics at North Carolina State in Raleigh, North Carolina under Gertrude M. Cox. While he graduated from NC State, Dr. Gehan spent most of his in Chapel Hill and reminisced about his time there. His last years at Chapel Hill were spent as a doctoral candidate and faculty member under the leadership of Bernard “Bernie” G. Greenberg, Dean of UNC School of Public Health.
Chapter 08: Working as Adjunct Faculty at Rice University and The University of Texas School of Public Health and Consulting Work with the Southwest Oncology Group

Edmund A. Gehan PhD, Lesley W. Brunet, and James S. Olson PhD

In this chapter, Dr. Gehan talks about his adjunct faculty work at Rice University when Dr. James “Jim” R. Thompson was the head of the Department of Statistics, and at The University of Texas School of Public Health’s Department of Biometry. While at the latter, he supervised Lina Asmar’s master's thesis and participated on her Ph.D. committee, which she completed in 1992. Then, he gives an overview of Terry L. Smith’s and his consulting work in the Department of Biostatistics supporting several people/entities, like Dr. Raymond “Ray” Alexanian (Department of Medicine), the Department of Developmental Therapeutics, and while serving as the head statistician of the Southwest Oncology Group (SWOG), he mentions work with Dr. Micheal Keating, Dr. Kenneth “Ken” B. McCredie, Dr. Wataru “Wat” Walter Sutoh (pediatrics), Dr. Margaret Patricia “Pat” Sullivan (Intergroup Hodgkin's disease). He talks in detail about Dr. Grant Taylor (Chair of the SWOG), his relationship with President R. Lee Clark, his authoring of the book “Pioneers in Pediatric Oncology” (of which Mr. Gehan’s autobiography is included), and his involvement in the MD Anderson’s purchase of the Prudential building.
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.
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.
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.
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.
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.
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.
Chapter 01: Head and Neck Oncology and Related Specialties

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert explains that Head and Neck Oncologists work in concert with Radiation oncologists and Medical oncology in order to address the challenges of cancers of the head and neck. “Head and neck” specialists address any cancer occurring between the chest and the brain, and Dr. Goepfert lists the organs, tissues, structures, and functions that cancer can attack. Dr. Goepfert notes that Head and Neck is an “abundant field,” that draws on additional specialties, such as pathology, imaging, oncologic dentistry and such rehabilitative specialties as speech pathology.
Chapter 02: An Overview of a Surgeon’s Education

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert sketches his surgical training in Chile, the U.S. and Germany. He explains that he “fell into” surgery as a result of his training in his native country of Chile in the 1960s, where he started as a general surgeon. His interest in cancer grew just as the American Society of Clinical Oncology was being created (1965), and chemotherapy was generally put in the hands of surgeons. He describes how he received a fellowship in 1964 to go to UCLA to train in the chemotherapeutic management of solid tumors, then extending his visa to come to MD Anderson to train under Drs. John Stahling and Dr. Richard Jesse. He spent four years in Stuttgart, Germany, setting up a radiation therapy unit at a the Katherinenhospital, then was offered a job at MD Anderson by Richard Jess. Dr. Goepfert had to pass his board certification, and so became a Resident at Baylor.
Chapter 03: Friction in the Evolving Field of Head and Neck Surgery

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert explains the debates in the 60s and afterward, over how to divide conditions of the head and neck between general surgeons and those trained in Otorhinolaryngology (Ear, Nose, and Throat). He talks about the friction between the Society of Head and Neck Surgeons (mostly general and plastic surgeons) and the American Society for Head and Neck Surgery, founded by ortolaryngolosts. He gives an example of the Mayo Clinic, where (in the 1080s) cancer was treated by a Head and Neck surgeon and a general surgeon performed necessary neck dissections. He also discusses the debates over which field should handle surgical reconstruction after procedures to address cancer –plastic surgeons or the head and neck surgeon. He notes that, at MD Anderson all plastic surgeons are trained in that specialty, not in head and neck surgery, then lists various plastic surgeons at the institution, beginning with Margaret Sinclair, the first reconstructive surgeon at MD Anderson.
Chapter 04: Farming or Medicine?

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert explains that his father, Pablo Goepfert, was a surgeon and had a strong influence on his choice of career. Nevertheless, Dr. Goepfert recalls how much he enjoyed working on his uncle’s farm during the summer, helping with farming, taking apart engines, driving a tractor at age nine and then a track at twelve. Though he enjoyed biology, geometry, and algebra in school, he thought of farming as an alternative career. He ends this chapter with a funny anecdote about taking his medical school admissions test.
Chapter 05: Surgery in Transition to Multi-disciplinary Collaboration

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert observes that he came to MD Anderson during a time when cancer treatment was expanding beyond surgery to include chemotherapy. He gives a brief overview of the treatment practices at the time and notes that specialties debated who would administer chemotherapy. While Dr. Goepfert was a Senior Fellow in Surgery at MD Anderson, he observed that hematologists were activity involved in redefining who administered treatment (not the case at UCLA). (He also notes that he wanted to leave Chile for a fellowship in the US because of the “dismal state” of cancer therapy.) He witnessed the evolution of multi-disciplinary cancer treatment while working with Dr. Gilbert Fletcher. Dr. Goepfert notes that he established the “Thursday Afternoon Planning Conferences in the Department of Head and Neck Surgery in 1982, where multidisciplinary treatment plans were created. These sessions became a model for the entire institution. Dr. Goepfert then shares memories of Dr. Fletcher’s influence on his own thinking about how disease processes respond to radiation, how important give and take is in interdisciplinary care, and how critical it is to establish liaisons with basic scientists. He notes that he took part in the initial efforts at MD Anderson to establish a track for physician-scientists, mentioning the key roles of Dr. Garth Nicholson and Dr. Josh Fidler. He explains how a tone was set for the interdisciplinary management of head and neck cancers. He describes the working relationship between Dr. Fletcher and the gifted surgeon, A.J. Ballantyne. He notes that the process of establishing multidisciplinary care was not as “bumpy” at MD Anderson as in other parts of the country. He credits R. Lee Clark’s vision in setting up the remuneration system at MD Anderson for smoothing this process.
Chapter 06: An International Pathway back to MD Anderson

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Dr. Goepfert begins this chapter by describing his activities on returning to Chile in 1968, after finishing his research project in the Section of Head and Neck Surgery at MD Anderson. He practiced general surgical oncology at the Instituto Radium in Santiago and also created a multidisciplinary pediatric tumor clinic at the Hospital Roberto del Rio. He explains that Chile was in political turmoil with coming elections and anticipated the election of a Socialist government that would not put a high priority on cancer treatment. He took his family to Stuttgart, Germany and went to work at the Katherinenhospital (’70-’71). He did not flourish in the rigid work environment in Germany, and he returned to Houston for a residency in Otorhinolaryngology at Baylor College of Medicine and was a research project investigator in the Section of Head and Neck Surgery6 at MD Anderson. In 1974, as he says, he walked out of his residency and became Chief of Surgery in the Otolaryngology under Dr. Stanley Dudrick at the University of Texas Health Science Center Medical School. He describes how he met his main goal: finding a way for a range of specialties (general surgeons, plastic surgeons, dentists, etc.) to collaborate in handling trauma of head and neck surgery. He also talks about the first resident in the Head and Neck section, Pedro Jimenez. He did not “give up” MD Anderson, but was appointed Associate Surgeon and Associate Professor in the Section of Head and Neck Surgery. He then describes the process of becoming Chair of the Head and Neck Section of MD Anderson, the first board-certified otorhinolaryngological surgeon to take on the role.
Chapter 07: Laryngeal Preservation Studies

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter Dr. Goepfert describes his long-term work on laryngeal therapy and survivorship (protocol 91-11). He begins by briefly characterizing the perspective that otolaryngeal specialist brings to cancer of the head and neck. He then notes that, at the beginning of his career, most of his research was retrospective (he conducted such studies with Gilbert Fletcher on effects of radiation therapy). Then he describes the context of the Protocol 91-11 study, beginning with a landmark article that demonstrated that the survivorship rates were identical, whether a patient was treated with a laryngectomy versus intravenous chemotherapy plus radiation therapy. With the second course of treatment clearly better for the patient (as it preserved the voicebox and, thus, the ability to speak), Dr. Goepfert explains that Protocol 91-11 looked at whether chemotherapy was essential to preserve the larynx or would radiation alone suffice. He some advances in radiation therapy that presented some stumbling blocks to initiating the study (launched in 1991), and MD Anderson provided the largest percentage of patients (10%) to this nationwide study.
Chapter 08: Financing Clinical Research

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert describes the difficult finances of clinical research in an environment where academic clinicians compete with private practitioners for patients. He broadens his focus and speaks about the country’s need for a “social network” system that covers all individuals, noting that Scandinavia and many European nations have “socialized medicine” systems and the highest rates of satisfaction with their health care systems. He notes that though MD Anderson offers some of the best health care, that level of are is not necessarily available to the general community. He notes that rising health care costs effect cancer care and also the viability of research. He observe that in the journal, Head and Neck, fewer and fewer innovative articles are published by American researchers; more authors come from Asia and Europe.
Chapter 09: Supporting Physician-Scientists

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Dr. Goepfert begins this chapter by noting any physician-scientist must have passion in order to succeed. The idea that time can be protected for research in the current work environment is a myth, and research simply has to be added to the long list of activities demanded of the academic medical professional. A main question for administrators planning support systems for surgical physician-scientists is When does one begin the training? Absence from clinical practice can compromise a surgeon’s skills. In the Head and Neck Department, physician-scientists spend 1-2 years in a lab before their advanced training, and it’s key that a department have a team of faculty who believe in the principles of translational research. He mentions Jeffrey Myers and J Freireich as true physician-scientists. He explains that the program for physician-scientists in Head and Neck began in the mid eighties, when the chief of surgery, Charles Balch, arranged for a outside review of the Department and received feedback that they needed a basic scientist on the faculty to encourage translational research. Dr. Goepfert sketches how this idea developed and the involvement of Garth Nicholson and Joshua Fidler. He notes that it has been difficult to fund head and neck research because the cancers are diseases of the working class. He mentions that he approached the president of the institution, John Mendelsohn, to establish the Helmuth Goepfert Society to train physician-scientists. He notes that Dr. Mendelsohn did not offer practical support, and the Society eventually was only able to support a lectureship.
Chapter 10: A Summary of Research

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Dr. Goepfert notes that he has generally served a supportive role in research studies. He participated in a study of a chemoprevention protocol involving derivatives of Vitamin A (Principle Investigator, Waun Ki Hong, MD [Oral History Interview]). His research in the eighties and nineties focused on the preservation of functionality of the larynx. He notes that his main contribution was to determine how to use chemotherapy in combination with surgery to preserve the voicebox, though that procedure was not long in use due to improvements in treatments using concomitant chemo- and radiation therapy. Dr. Goepfert ends this chapter with a description of endoscopic surgical techniques and the new robot surgery in use by Dr. Floyd Holsinger.
Chapter 11: Patient Reactions to News of Speech Loss

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert explains how devastating it can be for patients to receive the news that they will lose their ability to speak because of a cancer of the head or neck. He the field is still struggling to find better ways to both preserve the larynx and its many functions. He sketches how the stage of the cancer determines the treatment that offers the best hope for preservation, but that existing treatments often fall short of what the patient and surgeon both hope for: full preservation of the power of speech. He gives an example of a member of Houston society who refused a necessary treatment, noting that some patients simply cannot “face reality.” He also describes how surgeons must help patients understand their options and how treatment will proceed, especially when they have gotten “second opinions by Google,” sometimes arriving at MD Anderson with stacks of printouts from the internet. Dr. Goepfert gives a final example of a banker from Dallas who committed suicide rather than face losing his voice. Dr. Goepfert offers his philosophy about suicide in the face of such news.
Chapter 12: A Brief History of the Section of Head and Neck Surgery

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Here Dr. Goepfert sketches the history of the Section of Head and Neck Surgery, officially started in 1952 with Dr. William McComb. He discusses Dr. McComb’s commitment to the principle of radical surgery, noting that during this period there were only limited possibilities for reconstructive surgery. He also talks about Dr. McComb’s collaboration with Gilbert Fletcher to combine surgical intervention with cobalt-60 radiotherapy, also discussing radiation therapy applied via implants. He notes that Drs. McComb and Fletcher published an excellent book in ‘65/65, Cancer of the Head and Neck. Dr. McComb was succeeded by Dr. Richard Jesse, who advocated for surgery combined with radiation and chemo therapy. He worked to define specific treatments for disease sites, using a single treatment when possible to avoid complications. He also implemented blood saving techniques during surgery and started intra-arterial infusions of chemotherapy. He was also a strong proponent of multidisciplinary care during a time of antagonism between surgeons who believed in radical surgery and those advocating radiation therapy. Dr. Goepfert explains that Dr. Jesse should also be remembered for creating the creating the chaplaincy at MD Anderson, an initiative that was fundamental to creating the Lutheran Pavilion. Dr. Goepfert compares the leadership styles of Drs. Jesse and McComb. (Continues, Segment 13)
Chapter 13: Chair of the Section of Head and Neck Surgery

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this Segment, Dr. Goepfert talks about his leadership of the Head and Neck Surgery from 1982 until 2003. His primary goal on assuming the role was to facilitate multi-disciplinary care practices. He notes that all head and neck patients at MD Anderson came through Head and Neck Surgery, whether they ultimately needed surgery or not, and the Department followed each patient through treatment and aftercare. Dr. Goepfert notes again his role in establishing the Thursday Conferences where thirty or thirty five individuals from different specialties and services would gather to plan multidisciplinary treatment. These sessions served as a model eventually implemented by everyone at MD Anderson. Dr. Goepfert also says that he wanted to train physician-scientists, following the model of Dr. J Freireich in Developmental Therapeutics. He talks about the qualities needed to succeed as a physician-scientist, the need for proper mentors in both the clinical and laboratory science fields, and other requirements to support translational research. Dr. Goepfert sketches the evolution of the physician-scientist role at MD Anderson, and what he did to support this growth.
Chapter 14: MD Anderson Publications and Publication Ethics

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Dr. Goepfert has served on a number of editorial boards and is keenly interested in the educational dissemination of information critical to cancer research. In this section he talks about some of MD Anderson’s publications and also addresses some controversies with publication. He first raises the ethical issue of how authorship is assigned to a manuscript going out for publication. Today there are guidelines for assigning authorship, but twenty years ago, he explains, some department chairs at MD Anderson reviewed all manuscripts going for publication and insisted on being listed as first author of an article, whether they made any contribution to the research or not. Dr. Goepfert contrasts his own practice of putting his name on a paper only if he has contributed. Dr. Goepfert then shifts subjects and describes several MD Anderson educational publications, beginning with Cancer Bulletin, distributed free to all physicians across Texas.
Chapter 15: The First Web-Based Textbook

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this segment, Dr. Goepfert describes a promising, but ultimately failed, attempt to publish what was the first web-based text book. In 1997 he secured some funding to set up a team to plan the book and identified companies that could collaborate on design. His vision was to create an entirely web-based and interactive publication that kept text to a minimum, relying instead on multi-media and multidisciplinary training in head and neck surgery. The project was completed in 3-4 years and he presented it to the Vice President of Academic Affairs, Margaret Kripke, who was very enthusiastic. The textbook was launched and housed on the MD Anderson server. Dr. Goepfert then explains that a committee decided that MD Anderson could not pursue any web publishing. He then comments on the difficulty of obtaining high level support for projects. The web-book project closed down when an outside publishing company decided that marketing the book would not be profitable. He then talks about what the web can offer researchers and clinicians, e.g. education via visual documentation of surgical techniques; a forum in which physicians can submit cases and receive input from specialists; a storage bank for cases for future reference. He notes that MD Anderson could be producing educational programs and offered for a fee. Dr. Goepfert first talks bout the family origins of his interest in education and communication. He then mentions his Hayes Martin Lecture on education in ’95, which focused on the fundamentals on what it takes to be a physician scientist.
Chapter 16: Accrediting Head and Neck Services

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this segment Dr. Goepfert talks about his service on the Joint Council, a combined effort of two societies of Head and Neck surgeons to regularize accrediting of surgical services. He first describes how the two societies came to work together, then notes how rigorous their parameters were for accreditation and the process of making site visits and making reports. (Dr. Goepfert also notes his discovery that some hospitals do not care about accreditation.) He was interested in the training of fellows who assist faculty members and observes that MD Anderson has a very well-organized training program: often fellows who come into the program have to be retrained to meet MD Anderson standards.
Chapter 17: The Physicians Network

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Goepfert describes his post-retirement work on the Medical Board of the Physicians Network, a subsidiary of MD Anderson that helps physicians offer better patient care. He explains how a service can be connected to the Physicians Network through evaluation according to MD Anderson guidelines for best practices and standards set by other institutions. (Programs pay Physicians Network a fee.) Right now standards for care in breast, lung, prostate, and colo-rectal cancer are in place and standards are in development to evaluate care for more cancer types. Dr. Goepfert explains that there are nine host programs, and that the Physicians Network link –and the MD Anderson name—helps them with their marketing and funding. In response to a question about the expansion of the MD Anderson name, Dr. Goepfert says that the expansion of MD Anderson standards of care is still not well structured, and not much has been learned from past mistakes. He points out the Orlando, Florida remote site as one that is still very “nebulous” and MD Anderson Espana as a “model of what not to do.” He observes that quality of care relies on the participation of faculty to insure quality in both technical and intellectual components of care, but that faculty are still not clear on how to participate and how they will be rewarded. He explains his concern for the peer review program for Madrid oncology. He says that a strong future for the Physicians Network lies in better cooperation, and notes that while physicians see problems with care in remote sites, administration often does not and does not understand the danger of doing nothing.
Chapter 18: MD Anderson Presidents

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Here Dr. Goepfert gives his views of the leadership styles of MD Anderson’s first three presidents. He describes R. Lee Clark as a “unique leader” with a strong character and decisive leadership style. (He observes that Clark advocated thinking big, but “built small” when it came to the inpatient unit.) Dr. LeMaistre was a very gentlemanly man, a good delegator, who was able to put smoking cessation at the forefront of MD Anderson’s initiatives and also made the first connections with other institutions such as MD Anderson Orlando. Dr. Goepfert next describes the search process (including some internal political strife) that resulted in Dr. John Mendelsohn’s presidency, describing him as the most “eccentric” of all the presidents and a significant physician-scientist who conducted valuable work on epidermal growth factors and antibodies. Dr. Goepfert notes that Dr. Mendelsohn’s name was associated with an insider trading scandal and that Dr. Mendolsohn did not support him in his efforts to develop the Head and Neck physician-scientist program. He observes that Dr. Mendelsohn was able to stimulate significant philanthropy for MD Anderson. Dr. Goepfert also explains that he advised Dr. Mendelsohn to step away from MD Anderson once Dr. DePinho assumed the role of president (though he notes that Dr. Mendelsohn appears to be reestablishing his connection with the institution). Dr. Goepfert emphasizes his own philosophy and practice of stepping away once an administrative role is done: he could have continued in his department after retiring, but advocates that one should “go before they make you go” and that younger people in “the pipeline” need to have their chance.
Chapter 19: A Career Devoted to Interdisciplinary Teams; Earning the name, Dr. Fixit

Helmuth Goepfert MD and Tacey A. Rosolowski PhD

Here Dr. Goepfert comments on his accomplishments and a significant award and shares some details of his life outside of work. He says that as he looks back on his work at MD Anderson, he says he is very gratified that he got three sons through medical school and a daughter through college with no debt. Taking a more serious tone, he says that he believes he used resources in his Department and Section wisely and made Head and Neck surgery visible enough to be recognized as the number five program nationwide. He is proud of the fellowship program and hopes that his focus on interdisciplinary care will be carried on. He is also proud of the Distinguished Surgeon Award he received from the Association of Operating Room Nurses of Greater Houston in 1999. He notes that he was brought up as a scrub technician in his father’s operating room and knows the value of nurses to a team. Speaking about his hobbies, he immediately talks about his love of riding motorcycles. He only stopped riding about four and a half years ago, when he felt his reflexes were not quick enough to insure safety. Otherwise, he reads and listens to music. He enjoys car trips and looks forward to taking driving trips up both the east and west coasts of the country. He notes that he washes his own cars. He tells an amusing anecdote about fixing bicycles for kids in the neighborhood in Sugarland, Texas, an activity that earned him the nickname, Dr. Fixit.
Chapter 01: Recruitment to MD Anderson

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 02: Meeting Mary Lasker

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 03: The Early History of Interferon Research

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 04: Making Connections and Issues with Acquiring Interferon

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 05: Funding Interferon Treatment and Looking towards Future Developments

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 06: Funding Interferon Research through Connections and Industry

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 07: Challenges in Funding and Acquiring Interferon

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 08: Promoting and Publicizing Interferon Research

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 09 : The Ideal Patient

Jordan U. Gutterman MD and Lesley W. Brunet
Chapter 01: Early MD Anderson Pioneers

Jordan U. Gutterman MD, Lesley W. Brunet, and James S. Olson PhD
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
Chapter 03: On Writing about the History of Medicine

Jordan U. Gutterman MD, Lesley W. Brunet, and James S. Olson PhD
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).
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.
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.
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.
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.
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).

Search

Browse

Contribute to OpenWorks