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 15: Minority Experiences in Healthcare: The Origins of Health Inequity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones begins by saying that it is important to see health issues from a patient's perspective. He describes how gaps between patients and healthcare systems develop. He gives an example of how African-American patients are inappropriately labeled "difficult" and so they are excluded from clinical trials. Dr. Jones next recounts a story about the NCI and bias. This leads to a discussion of hoe individuals respond to the information that bias exists. Dr. Jones emphasizes that he uses the term "bias" instead of "racist." He notes that there is little bias in dealing with pediatric cancer, but once children turn sixteen, bias begins to be evident in their treatment.
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Chapter 16: Evolution of Thinking About Race and Inequity
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Jones talks about his upbringing and the evolution of his thoughts about race. He talks about his "sheltered" upbringing and fluid experience of race in a community where blue-eyed, blond classmates were racially black and he himself was often identified as white. Dr. Jones notes aspects of Louisiana history that helped support this experience and taught him to be cautious about assumptions he made about race and how he interacted with others. Dr. Jones explains that he considers himself and optimist and a realist about race issues in this country. He compares his style with that of Harold Freeman, MD, a prominent African-American physician and friend.
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Chapter 17: Staying at an Institution Because They Want You To Leave
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones first talks about the creation of C-Change, a "white version" of the InterCultural Council (of which he was a member) and a forum for a national dialogue on cancer, arising from the 1998 March on Washington for Cancer.. Next Dr. Jones notes that he stayed at MD Anderson because individuals at the institution wanted him to leave. He finally decided to leave when his resources were increasingly being turned off. He also notes Dr. Raphael Pollock's comment that "you can say more by leaving than by staying." Dr. Jones notes that nothing was being done to retain him at MD Anderson. Dr. Jones talks about his attempts to find post-retirement connections, given his reputation as an agitator. He notes that he has just received an official appointment letter from Texas A and M at Corpus Christi.
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Chapter 18: The Health Disparities Education, Research and Training Consortium and Program
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Jones discusses the creation of the Health Disparities Education, Research, and Training Program in 2002. He gives context, traces reasons for speedy implementation and covers political dimensions of this process. He describes how the goals of the course, how it worked, and various presenters. He emphasizes that the overall goal of the course is to change how people think about health, so they include economics, housing and wealth distribution in their understanding of what has an impact on health.He then talks about the impact of the first year's success, resulting in forty institutions now involved. He explains why MD Anderson pulled out of the project.
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Chapter 19: Creating the SECURE Project
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones talks about the SECURE project begun in 2010 to address community needs for healthcare support in regional emergency situations. He explains that it grew out needs that became evident in the aftermath of Hurricane Katrina. Dr. Jones invited many institutions to participate, including Meharry Medical College. He offers some context, explaining how the Flexner Report reduced the number of African-American medical schools, and Meharry was able to survive the closures. He explains why it was important that Meharry be represented in the SECURE project. He explains the projects developed, including the Texas Partnership for Addressing Health Disparities, and notes that now that he is retired, the SECURE consortium will be housed at Texas A & M University, Corpus Christi.
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Chapter 20: The Dorothy I. Height Center for Health Equity and Evaluation Research
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones explains his work with the Dorothy I. Height Center for Health Equity and Evaluation Research (CHEER). He talks about meeting Dr. Height in 1992. He then discusses approaching Congress in 1997 for funds to start a research center --the Center for Research on Minority Health (CFRMH). Dr. Jones approached Dr. Height about renaming the center in her honor and explains the criticisms Dr. Height has of MD Anderson, leading her to decline. He then talks about how he resumed this discussion with relevant parties after DR. Height's death, including making a "passionate plea" to family members at Dr. Height's funeral. Dr. Jones explains the process whereby the family first agreed, but then withdrew the name after a few years. He notes that, at this time, the Height Center is "no longer functional." Dr. Jones notes that MD Anderson is more interested in the discovery of new knowledge rather than its delivery to patients.
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Chapter 21: Obstacles to Improving Healthcare in Texas
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones reflects on the poor healthcare in Texas and on factors that prevent improvement. He discusses Leonard Zwelling, MD, who writes a controversial blog about cancer issues and MD Anderson and their points of agreement expressed in a blog post. Dr. Jones talks about the negative reaction that followed. After talking about a documentary about former Texas governor, Ann Richards, Dr. Jones notes the power of the media in creating a picture of leaders at the city and state level. He goes on to affirm that "No one talks about how Texas has one of the worst health situations." He explains the factors leading to this situation.
Next, Dr. Jones explains how individuals are able to protect themselves from the reality of the healthcare situation by creating "bubbles" around themselves. -
Chapter 22: Denied Privileges as an Emeritus Professor; MD Anderson's Administrative Structure
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
He begins by noting that he has been talking the University of Texas System about the treatment of emeritus professions and has been able to acquire statistics about the numbers of minority professors and the privileges extended to them. He notes that unlike the other institutions in the University of Texas System, MD Anderson has not formal process for assigning privileges. He speculates on why MD Anderson has this procedure, providing context by explaining the history of term tenure. He goes on to describe governance at MD Anderson: a system with "no checks and balances," though prior to the current administration there was an "air of checks and balances." He discusses the current controversy over faculty members being denied tenure by Dr. Ronald DePinho, despite unanimous tenure committee votes. He then returns to a discussion of his own emeritus status.
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Chapter 23: Writing, Teaching, and A Legacy Left
Lovell A. Jones PhD and Tacey A. Rosolowski PhD
Dr. Jones talks about post-retirement projects not addressed in earlier chapters; working on a Texas A & M University grant for $21 million to educate STEM scientists; stabilizing the InterCultural Council and the Heath Disparities Education, Research, and Training (HDEART) Consortium. He lists venues for his writing and summarizes the points he makes in them. He notes his work with Louisiana State University and other institutions to support minority students and create a pipeline of people interested in health disparities. Next Dr. Jones talks about the demographic shift in the United States with regards to economics and education and explains how this has an impact on healthcare. He gives an overview of wealth distribution in the United States, noting that a large percentage of the have-nots are white Americans. At the end of the interview, Dr. Jones says that he would like to be remembered as a person who tried to make a difference and for his impact on education. The talks about students he remembers and the effect he was able to have on the direction of their careers. He recalls his mentor, Howard Bern. He regrets that MD Anderson did not offer him a true academic home to engrain change in next generations.
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Chapter 01: Attempt to Join the Navy Leads to Medical School
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Education: Dr. Knudson discusses his switch from physics to genetics in his second year at the California Institute of Technology. He humorously notes that he made the change because "they already knew everything" in the field of physics. He mentions that Thomas Hunt Morgan, a pioneer in genetic research, was the head of the Biology department at Cal Tech at the time.
Military Experience: Dr. Knudson then explains that at the start of World War II, Cal Tech encouraged its students to join the military, so he enlisted in the navy. However, a person in the navy encouraged Dr. Knudson to go to medical school instead because they "didn't need PhDs in the military." He took their advice and went to Columbia Medical School. Dr. Knudson says that he enjoyed the first two years more than the second because they were based on problem solving rather than memorization.
Mentoring: In the last moments of the chapter, Dr. Knudson provides some advice to young people on how to approach unexpected events in life.
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Chapter 02: Residency Experience Cultivates Interest in Pediatric Cancer
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Interest in Cancer: Dr. Knudson sketches the development of his interest in cancer. He notes that during medical school, he did not learn about cancer because there was no real treatment for cancer at the time. His interest came through his residency in pediatrics at New York Hospital, where he completed a month-long rotation in the children's cancer unit at Memorial Hospital. Dr. Knudson explains the impact this experience had on him.
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Chapter 03: A Geneticist Pediatrician Joins the Army; Return to Cal Tech
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Military Experience: Dr. Knudson talks about his enlistment in the army during the Korean War. He was supposed to spend a year in Korea and a year in the U.S. Instead, he spent two years in Fort Riley, Kansas because the army was not sure what to do with a geneticist pediatrician in Korea.
Education: Dr. Knudson then discusses his return to the California Institute of Technology in 1953 to study. He briefly talks about the influence of Watson and Crick's work on the field of genetics earlier that year. After he finished at Cal Tech, Dr. Knudson was put in charge of a small pediatrics unit at City of Hope Medical Center, which fit his previous experiences well.
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Chapter 04: A Slow-Moving Start at Stonybrook Opportunity at MD Anderson
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Interest in Cancer: Dr. Knudson continues outlining his path towards discovering the two-hit model. He explains that during his time at City of Hope Medical Center, he became more interested in cancer and hereditary predisposition and was asked to write a book on genetics and disease. Dr. Knudson notes that although this work helped him to put the cancer problem in perspective, it was too early for him to discover the two-hit model.
Administrative Experience:
Next, Dr. Knudson recalls his frustrations about his slow-moving experience starting a genetics unit at Stonybrook in New York. After three years at Stonybrook, Dr. Knudson accepted an invitation to come to MD Anderson to start a genetics unit. -
Chapter 05: Discovering the Two-Hit Model Through Studying Retinoblastoma
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
R. Lee Clark's Influence: Dr. Knudson reflects on the environment of MD Anderson under R. Lee Clark's presidency, saying that "Lee didn't understand [the word] 'can't.'" Dr. Knudson explains that Clark asked him to write a review article for a journal, which forced him to think about what kind of gene is important in cancer. He notes that research on cancer was mostly done on adult cancer, but children's cancer is important for answering that question.
Overview of Two-Hit Model: Dr. Knudson then describes how he discovered the two-hit model. Muller published a paper claiming that several steps are necessary to make cancer. Though the literature after Muller's paper attempted to figure out those steps, Dr. Knudson wanted to know what the smallest number of events could be. He explains that his experience in pediatrics led him to look at retinoblastoma, a cancer with a hereditary form, to figure out the problem. Through statistical studies, Dr. Knudson concluded that the smallest number of events is two.
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Chapter 06: Two-Hit Model Allows for Genetic Testing of Blood
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Contributions: Dr. Knudson discusses how the two-hit model influenced research by opening the possibility of testing for the gene in patients' blood. He explains that this is useful for adults who had childhood cancer who want to know the likelihood of passing on the cancer to their children. Dr. Knudson mentions that the two-hit model additionally called attention and interest to other hereditary cancers.
Research Reflections: Dr. Knudson then reflects on the research process that led to the two-hit model, saying that he was lucky that retinoblastoma gave a quick answer to the problem.
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Chapter 07: Work with Dr. Louise Strong
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Mentoring Experience: Dr. Knudson did not have much experience with trainees, because most of his work was theoretical. He discusses one meaningful experience with a young woman who asked to work in his lab. At that time, he had just arrived at MD Anderson and had not started to study retinoblastoma. Dr. Knudson says that after he wrote his paper on the two-hit model, he called the woman and invited her to work with him. The woman's name was Louise Strong.
Portrait of Dr. Strong: Dr. Knudson then tells an amusing anecdote about Dr. Strong. He describes the work that they completed together, reviewing the literature on tumors and publishing papers together. Dr. Knudson concludes by saying that he offered Dr. Strong an assistant professor position, which she accepted.
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Chapter 08: Curiosity and Asking Innovative Questions is "The Way He's Wired"
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Personal Character: When asked about how he developed his innovative style to problem solving, Dr. Knudson responds by saying that it is not a conscious decision. He states that a lot of people have an attraction to the unknown and are curious. The interviewer reveals that Dr. Strong remembered Dr. Knudson asking innovative questions from a diverse background and asks if he is aware of that characteristic. Dr. Knudson says that it is just the way he is.
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Chapter 09: Advice for Young Researchers and Mentoring
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Advice for Young Scientists: Dr. Knudson says that young scientists need curiosity, intelligence, and training to be successful.
Critical Perspectives: He then critiques the state of funding for scientists. He discusses the drop in funding from the NIH and points out that back in the 1960s, a handful of grants were approved that probably wouldn't work, but would be monumental if they did work. Now, he says, those projects are never funded. Dr. Knudson believes that too many grants are doing predictable research and not enough are surprising.
Perspectives on Research: Dr. Knudson then reiterates that to be successful, a scientist needs curiosity. He notes that he has never known a person conducting scientific research for a long time who regretted it. He additionally states that although physician scientists may benefit from seeing direct benefits from their work, some research may not be immediately beneficial to anyone, such as Einstein's work. Dr. Knudson declares that the greatest thing that humans can do is have new ideas. He says that people may come and go, but knowledge keeps building.
On Mentoring: Dr. Knudson outlines what students should expect from a mentor, saying that a mentor should minimally be able to identify whether a project is worthwhile. He notes that this impacts where a student should go, because some problems may not be able to be studied everywhere.
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Chapter 10: The Start of the Graduate School of Biomedical Sciences at MD Anderson
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Administrative Experience: Dr. Knudson outlines how he became dean of the Graduate School of Biomedical Sciences. He says that R. Lee Clark asked him to start a genetics program. As soon as he arrived, the plans changed because the medical school was created and would include a genetics program. He states that Clark believed the answer was the graduate school. Dr. Knudson explains that Clark persuaded him to become the dean. He notes the difference between MD Anderson and Stonybrook, where everything moved slowly.
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Chapter 11: The Graduate School: An "Amazing Experiment" in Sub-Institutional Collaboration
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
Education at MD Anderson: Dr. Knudson explains that the graduate school affected students by increased the faculty, which increased the student body as well. It also provided opportunities outside of the field of cancer. Dr. Knudson says that the dean of the medical school went along with this new graduate school. The School of Public Health additionally got involved in the collaboration. Dr. Knudson states that the graduate school was an "amazing experiment" because they went beyond what graduate schools typically do.
Effects of the Graduate School: Dr. Knudson admits that he has not kept track of the graduate school much over the years. When asked about the interdisciplinarity within the school and how it can prepare students, Dr. Knudson says that it is good for students to get a broad basis of understanding because new fields are appearing all of the time. He believes that understanding the human brain and what it can do is the future.
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Chapter 12: Perspectives on the Field of Cancer Biology and Neuroscience
Albert G. Knudson, Jr. MD, PhD and Tacey A. Rosolowski PhD
On Cancer Biology: Dr. Knudson reflects on the field of cancer biology. He says that knowing the genetic changes that can occur in cancer is important because different cancers have different cures. He presents radiation and chemotherapy as an example. Dr. Knudson additionally points out that leukemia did not use to have a treatment, but now, there are long-living survivors of leukemia. He explains how adult cancer is more challenging to cure than children's cancer.
On Neuroscience: Dr. Knudson talks about his interest in neuroscience when asked about which field he would chose if he was a young scientist today. He then explains that cancer and degenerative diseases will always exist because of the nature of the cells in the human body.
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Chapter 01: Northern California in the Sixties and Tracking into the Sciences
Margaret L. Kripke PhD and Lesley W. Brunet
Personal and educational background
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Chapter 02: New Work on Photoimmunology; Reflections on Mentors and Inspirations
Margaret L. Kripke PhD and Lesley W. Brunet
Research: Photoimmunology
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Chapter 03: Coming to MD Anderson to Build a New Department
Margaret L. Kripke PhD and Lesley W. Brunet
Photoimmunology
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Chapter 04: Taking on Gender Inequity at MD Anderson; Establishing the Organization for Women
Margaret L. Kripke PhD and Lesley W. Brunet
Founding, purpose, institutional support of Women Faculty Organization
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Chapter 01: Photo-Immunology: Creating a New Field out of an Observation
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
Dr. Kripke begins this segment with some comments about joining MD Anderson in 1983, noting differences between the hospital environment and the research contexts she was accustomed to. She notes that professionals came to MD Anderson for many reasons, but stay because of the mission to cure cancer, a mission that "permeates the activities of the institution." She then traces how her own research on photoimmunology evolved, beginning with an observation she made in her dissertation (on immune surveillance) that "it would important to investigate the immunology of animals exposed to ultraviolet light." She had the opportunity for exactly this study from 1972" 1975, when she went to the Department of Pathology at the University of Utah's College of Medicine in Salt Lake City to look at the role of immuno-suppressive drugs in animals, including those exposed to UV light. It was "tailor-made for her interests and background." She describes the effects of UV light on the skin and the cancers induced, noting that no one else was doing similar work at the time and that her findings went against common assumptions about the progress of cancer. She presented her results at the Society for Photobiology, and "the results were so black and white, it was hard to argue with them,"and other scientists were very interested. She describes the early days of understanding that the skin is an "immunological organ."
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Chapter 02: Administrative and Leadership Experience
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke descirbes her work at the National Cancer Institute in Frederick, Maryland (1975 -1983), including her administrative experience. She set up a laboratory from scratch and eventually became head of the Immunobiology Physical and Chemical Carcinogenesis Section in the Cancer Biology Program at the NCI-Frederick Cancer Research Facility. To streamline the discussion about the development of her research path during this time, Dr. Kripke provides the manuscript of a lecture she gave on the progress of her research. She notes that the period at the NCI broadened her outlook on biology, as it was devoted exclusively to doing science and exposed her to scientists from diverse fields. She also speaks about the administrative skills she acquired (how to manage people; how to run a scientific meeting), in addition to raising her own professional profile in the field. This period, she notes, stimulated her interest in the issues of leadership -this would continue with her increasingly significant administrative roles at MD Anderson.
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Chapter 03: Coming to MD Anderson: First Woman Chair; Setting Up a Laboratory, Leading a Department; Clinical Applications of Research
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke covers her arrival at MD Anderson (Hospital and Tumor Institute) in 1983 to establish a new Department of Immunology. She addresses gender issues very forthrightly: she is very proud of the fact that she was 39 when she came to MD Anderson as a department chair; the first woman chair of a department and the first women who was a tenured full professor in a research department. She recalls speaking with Dr. Charles LeMaistre about her two concerns: being a Ph.D. in a clinical, medical environment and being a woman in an environment that was much more male-oriented than NCI-Frederick. She tells anecdotes to flesh out the latter view. She offers examples of the practical challenges she faced while setting up a scientific research laboratory in an environment that is designed for clinical activity (noting that “starting a laboratory is like starting a small business”). She makes additional comments on the persistence of challenges to women, though she notes that the Vice President of Research, Frederick Becker, was a “true champion of women in the institution,” who made sure she had opportunities to progress. (She notes that new basic science departments were being created in the 80s, and in fact the Department of Immunology was “a little late in coming” to MD Anderson.) She talks about being pleasantly surprised that she enjoyed teaching and then outlines the goals she had as Chair of the Department. (She also talks about building a program that would integrate immunology into other cancer approaches housed in Research Building 1 on the South Campus.)
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Chapter 04: Research Advances and the Excitement of Scientific Discovery
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke expands on her research career. She talks about her collaborations with doctors who translated her research into clinical applications. She gives an example of research with liposomes ("fat capsules") to deliver an enzyme to repair DNA damage caused by ultraviolet light: these liposomes worked and also prevented further damage (though have not been translated into therapy for humans). She emphasizes that photoimmunology continues to tease apart the mechanisms that connect UV light to skin cancers. In response to a question about the mental dimensions of the research process, Dr. Kripke explains that interpreting data is like solving a crossword puzzle, but the "exciting part is designing the right experiment,"and "the feeling that you know something or know how to do something that no one else knows. The rest is just doing the work." She describes some of these moments she has experienced in her research career. She acknowledges her many collaborations with her husband, Dr. Isaiah Joshua Fidler ("all of our papers together were the result of an argument") and characterizes the role he has had on her career as an advisor about the processes and politics of science. She says that her daughter (Katherine Kripke) "grew up speaking metastasis and immunology." She also notes that she read Dr. Fidler's papers, that they improved each other's scientific output. (She notes that her own administrative roles have created awkward situations for both of them.)
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Chapter 05: Moving into Administration: a Path from Department Chair to Executive Vice President for Academic Affairs
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke talks about her shift from research to administration and her "learning curve"as she grappled with leadership. She talks about her (exclusively) mentors in leadership and also her participation in a program for women in academic medicine, ELAM, the Executive Leadership in Medicine Program in 1996-1997. (She was the only appointee from Texas that year.) She describes being interested in "the science of administration." She details the lessons she learned during this "phenomenally exciting time"that allowed her to reflect on where she wanted to go with her career. She explains her decision to leave her research career, resulting in her 1998 appointment as Vice President for Academic Programs (promoted to Senior Vice President in 1999 and to Executive Vice President in 2001). She outlines the principles on which she bases leadership and discusses institutional and cultural changes that evolved after 1996, when Dr. Mendelsohn became president, including a new openness compared to the secrecy of previous administrations. She describes how she tried to implement one of her goals as VP for Academic Programs --to "level the playing field"for researchers. She talks about her working relationship with Dr. Andrew von Eschenbach, whom Dr. Mendelsohn appointed to Senior VP of Academic Programs. She describes the scope of her role as Executive Vice President, emphasizing that she had to become familiar with the clinical side of research, "a completely different culture."
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Chapter 06: Roles in Building Research and Advocating for Faculty
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
Dr. Kripke begins this segment by further detailing her role as Vice President and Executive Vice President of Academic Affairs. She notes that when Dr. Mendelsohn took over as the institution's president, he combated the "spirit of retrenchment"at MD Anderson, creating an unexpected period of "explosive growth." She then underscores that the limiting factor for research at the institution is "facilities, even more than money"and describes how she worked with Dr. Mendelsohn to further specific research areas: immunology, genetics, and other programs. As part of this discussion, she talks about ongoing challenge of refining how researchers' careers are organized and managed within the institution, noting in particular the challenges associated with career paths for physician-scientists. Reflecting on her own achievements in the VP role, she notes particular pride in "leveling the playing field"for researchers, the assignment of space and resources to researchers based on merit, and the complete rewriting of the grievance policy for faculty.
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Chapter 07: MD Anderson Presidents
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke talks about Dr. Charles LeMaistre and Dr. John Mendelsohn. She notes that Dr. LeMaistre's greatest contribution may be the creation of the Department of Cancer Prevention, then goes on to discuss the leadership style of Dr. Mendelsohn, with whom she worked closely. She describes him as a consensus builder, and notes his success in fostering translational research (he is a physician-scientist) at MD Anderson, to the degree that there are more physician-scientists who want to come to the institution than they can afford to hire. She then speaks about her optimism that Dr. Ronald DePinho will be able to guide MD Anderson through another "quantum leap." She credits the Board of Regents for selecting the presidents that MD Anderson needs as a particular moment, even if the choice at first seem surprising.
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Chapter 08: Evaluating the Status of Women and Creating Programs for Women Faculty
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke narrates her role in advancing the status of women at the institution, beginning with her role in writing a report on the status of women and minorities. (She credits the administration with allowing the committee full access to all records to prepare this report.) She details the gender inequities at MD Anderson and lists the other women with whom she partnered to help start, first, the Organization for Women (1989) that included faculty and administrative staff, and then the Women Faculty Organization (1990) to address issues unique to women faculty. She also tells a significant anecdote about how she realized that she herself had the institutional power to do something about gender inequity. She notes that it is important for high-ranking women to advocate for gender equity in order for the initiatives to have credibility (rather than seeming self-serving). She talks about the process of assessing what women faculty needed and lists the changes they were able to effect (parental leave time, annual salary reviews, etc.). She explains that prior to her retirement she created the position of Associate Vice President for Women Faculty (leading to the creation of the Office of Women Faculty Programs) to insure that there would be a high-ranking individual to highlight women's issues at the institution. She underscores that even when there are more women being hired, it's necessary to aggressively address gender inequities in order for women to be given equal chances for career advancement, for their achievements to be recognized as equal to men's, etc. She then reflects on how her work as an activist for women influenced her own leadership and offers thoughts on her own leadership style: a consensus builder with a sense of how to pick the right battles. Dr. Kripke explains that she gave up traveling so she could achieve the same kind of excellence in her administrative work as she had in her research. She notes her open-door policy and believes that faculty appreciated her accessibility.
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Chapter 09: The President's Panel and Post Retirement Activities
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Kripke discusses the "great and unexpected honor"of serving for two terms on the President's Cancer Panel (2003 and 2006, appointed by George Bush). This experience, she says, taught her that cancer research does not necessarily serve patients, a discovery (after a career in research labs) that turned her into an advocate for changing the balance of how research is funded. She believes that the Panel's report on cancer survivorship ('03 term) helped to bring attention to the need for follow up plans when patients leave the hospital, as well as the necessity of providing them with complete medical records. She would like to see the Panel address issues of cancer prevention, noting that the most important report she contributed to was on the effects of the environment on cancer ('06 term) and how little we know about the cancer causing properties of agents in our food and environment and how agents banned in other countries are still in use in the U.S. She notes that "the government doesn't want to deal with it"and this kind of study has lagged behind everything else. The Panel took a lot of criticism for its "strongly worded report"(including from the American Cancer Society). She explains why the Cancer Panel elected to focus on environmental factors, given that only 6% of cancers are attributable to the environment. Dr. Kripke then turns to her post-retirement activities. She first talks about serving as Special Assistant to Provost Dr. Raymond DuBois to ease him into the culture and institution. She also served as ad interim department chair at the Smithville remote facility when the head stepped down. She also explains how she came to serve on the Mayor's Advisory Council on Health and Environment for the city of Houston (one project on the CEO Roundtable; one developing a resolution on obesity).
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Chapter 10: MD Anderson Growth; Key Awards; Views on Women in the Workplace; A Life in Magnolia, Texas
Margaret L. Kripke PhD and Tacey A. Rosolowski PhD
In this final segment of her interview, Dr. Kripke comments on the growth of MD Anderson and on her own career and life after retirement. She begins by noting that many people think that the institution has already become too big. She talks about the loss of personal relationships, but that the mission remains strong. She notes that there were concerns at the executive level about "how big is big enough,"but that the demand for services will increase as the population ages. She explains why satellite operations offer a good solution. Dr. Kripke reflecte on what has given her most satisfaction in her career. Scientifically, she says she was pleased to move forward the Montreal Protocol, which got rid of chlorofluorocarbons (noting with pride that Al Gore mentioned her in his book, An Inconvenient Truth). Administratively, she was proud to bring a sense of fairness, transparency, and a change of leadership style to the role of Vice President of Academic Programs. She also feels she made significant contributions to women in the institution. She hopes that the Office of Women Faculty Programs will continue. Dr. Kripke then speaks about her most meaningful awards, singling out her 1984 receipt of the Lila Gruber Award for Cancer Research from the American Academy of Dermatology, since it is more meaningful to be recognized by those outside one's field than by colleagues. In the last minutes of the interview, Dr. Kripke speaks about the person behind the research and administrative personas. Her "great escape place"is in Magnolia, Texas, where she and Dr. Fidler own property. She built a pool and a greenhouse so she could raise orchids and likes country life, being a "biologist at heart." Reflecting on career expectations of her daughter and stepdaughter, she notes differences between the experiences of career women today and when she was going through her career, acknowledging that things have changed.
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Chapter 01: A Medical Family
Mary Catherine McGready and Tacey A. Rosolowski PhD
In this chapter, Mrs. McGready sketches her family background and the tradition in her family of working in the medical profession. Her father was a pharmacist and three of her four brothers became physicians. Mrs. McGready shares memories of working in her father’s pharmacy, of segregation in Texas in the early part of the 20th century, and her father’s commitment to racial equality.
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Chapter 02: Becoming a Medical Librarian
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready recounts how her brother helped her get into medical archiving by introducing her to Miss Elizabeth Runge at the University of Texas Medical Branch archives. She talks about the conflict with her parents over wanting to leave her studies at North Texas College to take a position as a medical librarian at UTMB. Daughter Cathy Bacon mentions a story about exposure to library work in Waco, during college. Mrs. McGready tells an anecdote about the "scholarship she gave to herself." She talks about her parents attitudes toward education.
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Chapter 03: Working as the First Medical Librarian at MD Anderson
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready explains (with the help of daughter Cathy Bacon) how she came to the attention of Dr. Ernst Bertner, who was establishing the new MD Anderson. She shares memories of the young institution and a much smaller Houston, Texas. She explains some of her duties, including compiling the library and collecting duplicate books from the Medical School in Galveston and having them bound for the MD Anderson library. She shares a few memories of working at the Baker Estate.
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Chapter 04: An Opportunity to Work at the New Cancer Hospital, MD Anderson
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready sketches how she was working as a medical librarian at University of Texas Medical Branch when she was offered an opportunity to work at MD Anderson. MD Anderson had just come in to Houston, housed in Baker Estate. Dr. Bertner, in charge, everything comes through him. Repeat of story of MD Anderson’s one car, a Ford station wagon.
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Chapter 05: One of Five Employees at the New MD Anderson
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready notes that she was one of the first five employees at MD Anderson, and she shares memories of the others: Dr. Coogle, John Musgrove, Zuma Krum, and Florence Hanselman. She recounts that the MD Anderson library was housed in the dining room of the Baker Estate. She talks about the first set of books acquired, a series of medical texts by Rudolf Virchow, the basis of medicine. Mrs. McGready tells several stories that illustrate the social environment among the first employees of MD Anderson. She tells the story of getting her driver’s license so she could drive the MD Anderson Ford station wagon to downtown Houston so Dr. Bertner could sign papers.
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Chapter 06: Working for Dr. Bertner and the New MD Anderson
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready recalls taking papers down to Dr. Ernst Bertner's "private physicians'" office in the Second National Bank Building on Main Street in downtown Houston. She notes that she was with MD Anderson for nine months, until her fiancé was finished w medical school. She was asked to stay on, but made it clear she was "not a career person" and wanted to leave to be married.
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Chapter 07: A Fun Job, But Choosing to Focus on Family
Mary Catherine McGready and Tacey A. Rosolowski PhD
Mrs. McGready acknowledges that she didn't realize how special her position was at the time, working for a brand new cancer institute. She saw the job as really fun, and she worked with people she liked. She shares stories of their pleasant interactions. She next talks about attitudes toward cancer at the time and reflects on advances that have been made. She expresses satisfaction with her choice to marry and have a family. She sketches what her children are doing now. At the end of the interview, Mrs. McGready says, "I've just always been very proud of the fact that I did see the nucleus of it. And then when I went back and saw the Virchows all in this air-conditioned room, that was impressive. I positioned them. Well, I felt very, very lucky to have been in it at that stage."
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Chapter 01: An Education Designed to Keep Options Open
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills begins this chapter by sketching his blue-collar roots and noting that he was the first person in his family to graduate from college. He talks about his early interest in science, setting it in the context of broader interests. He explains that his aim in college (1975, Bachelors of Medical Science, University of Alberta, Edmonton, Canada) was to "keep as many options open as possible," which he accomplished by majoring in biochemistry and minoring in political science. He notes how this sensibility of preserving breadth influences his current strategy of recruiting broadly so the department "gains by integrating across areas."
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Chapter 02: Medical School with a Path to Research and Team Science
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills discusses the Canadian system in which he received his Bachelors of Medical Science in 1975 at the University of Alberta (Edmonton, Canada), leading to his MD in 1977. He also explains how he approached medical training with the intent of going into research: medical training gave him the breadth he needed for research by providing an understanding of how the body worked; he decided to specialize in obstetrics and gynecology because the question of why the mother's body does not reject a fetus is an analogue to the question of why a host does not reject a tumor. Dr. Mills also explains that he wanted to go into research in order to have a greater impact on patients. He notes that medical school at that time was very clinically focused and that he felt some tension with other students and faculty with that mindset.
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Chapter 03: Developing a Researcher's Approach; Observations on the Current Job Market and Team Science
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills sketches his next phase of professional training, beginning with his fellowship at Flinders Medical Center (Adelaide, Australia, 1/1976-1/1978), where he focused on immunology and beta-cell immune responses and worked with Warren Jones. He also notes that he experienced a very different "and positive"approach to professional training that he has tried to emulate. He compares the Canadian and Australian healthcare systems.
Next, Dr. Mills talks about his work at the Toronto Hospital for Sick Children (Research Fellow, Division of Immunology, The Hospital for Sick Children, Toronto, Canada, E. Gelfand, 1/1982-1/1985). This program, he explains, solidified the conceptual and administrative framework he now uses to approach research and also his attitudes toward mentoring. Dr. Mills explains some difficulties in replicating the situation at Toronto Hospital at MD Anderson. He notes that "science needs to come from the bottom up, not the top down." -
Chapter 04: The Challenging Job Market for Researchers and for Team Scientists
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills says that one of the most exciting things about being a department chair is having a hand in helping trainees mature. Here he reflects on several issues. He begins by observing that it is "painful" that there are so few jobs for talented scientists and explain what the challenges are, including how the focus on team science has created obstacles for individual scientists.
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Chapter 05: From Immunology to Targeted Therapy; More Observations about Team Science; Research on Interleukin-2 About 16 minutes
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills talks about the evolution of his work once he took a position in the Department of Immunology (Hospital for Sick Children University of Toronto, Toronto, Canada, 1/1982- 1/1985) where he shifted his perspective from immunology to signal transduction as a therapeutic target. He describes his promotion track leading to his final role as Director of the Department of Oncology, Oncology Research (1/1990-1/1994). He talks about his relationship with Lou Siminovitch with whom he would discuss management and team building issues. He talks about team science in the biological sciences in the early nineties, explains that the system of allocating grant money influences how science took shape, and gives a definition of translational research.
Next, Dr. Mills talks about research he conducted "at the interface between breast and ovarian cancer." He talks about studies he conducted during his PhD program looking at how IL-2 could regulate leukocytes, leading to clinical trials targeting pathways regulating a novel growth factor. -
Chapter 06: Recruited to MD Anderson; A History of Translational Research at MD Anderson
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills first tells how he was recruited to MD Anderson by Robert Bast, MD, VP of Translational Research, to set up "the best ovarian research center." He explains why he left Toronto Hospital and cites the fact that "no other institution has more potential to make a difference."
Next, Dr. Mills sketches the history of translational research at MD Anderson. He begins with the 1970s, noting that the patient driven clinical research at that time was "not real team science." He talks about the context for research under Charles LeMaistre and the VP of Research, Frederick Becker [oral history interview] and the vestiges of their approach still lingering. He explains that the institution has now embraced the concept that research is a driver in patient outcomes. Dr. Mills explains that leaders need to function as change agents and set in place processes that allow the success of research. He then compares the approach of John Mendelsohn, who allowed institutional change to be driven from the bottom up, with Ronald DePinho, who has taken the opposite approach as he framed the question, Is research progress an engineering and implementation question or do we lack the basic research to make progress at this time. -
Chapter 07: Major Roles Building Translational Research
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills begins sketching his approach to rebuilding the Department of Systems Biology. He discusses problems that departments have when they are built around "a cult of personality." Next he talks about his work as Deputy Head of the Division of Research, tasked with building and improving translational research across the institution.
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Chapter 08: Department Names Reflect Shifts in an Institution and in Cancer
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mill's discusses the organization of departments and connects the naming of departments to shifts in cancer medicine. He begins by explaining that Dr. Robert Bast recruited him to MD Anderson by asking the question, Would you like to build the preeminent ovarian cancer center in the world? Permission was secured from the Regents in 1994/1995 to create the Department of Molecular Oncology: Dr. Mills explains why this name was selected then talks about why the name was changed to Molecular Therapeutics after Dr. Mien Chie Hung [oral history interview] was recruited.
Next, Dr. Mills explains why so many department names include the word "molecular" and discusses why the molecular focus was tied to a "great convergence" of technological advances and exploration of DNA and RNA. -
Chapter 09: The World's First Cancer-Directed Department of Systems Biology Emerges from a Shift in Approach to Cancer
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills begins this chapter by explaining that as cancer research evolved in the nineties, it became clear that the usual "reductionist" approach to studying molecules was insufficient and he and others decided to found what turned out to be the world's first cancer-directed Department of Cancer Systems Biology. Dr. Mills explains the shifted mindset reflected in this department and its research.
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Chapter 10: A Controversial Department Evolves: On Recruitment, Flexibility, and the Value of Failure
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills first lists the faculty he recruited to develop a breadth of perspectives in the Department of Systems Biology.
Next, he sketches the research "precept" at work in the Department: when a researcher builds a model, its failure to work can be as revealing as a model that does work. He gives an example of a model built for the pi3 kinase pathway. Dr. Mills then follows up with an anecdote about the most challenging lecture he ever had to give: a lecture on the theme of failure at Rice University in which he stressed, If we do not fail, we are not doing work that is high-risk. He talks about the conservatism of current funding agencies. He then talks about how founding a Department of Systems Biology was risky and controversial, but notes that over the past ten years acceptance has grown and that the Department's approaches are well accepted now, with many collaborative relationships outside the department. He talks about his own role as a representative of the Department. -
Chapter 11: The Cancer Genome Atlas and the Positive Side of Serving as Department Chair
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills discusses the Department's work on the Cancer Genome Atlas, leading to over one hundred papers. He talks about what has been accomplished and comments on the satisfaction he derives from mentoring and developing junior faculty.
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Chapter 12: The Kleberg Center for Molecular Markers
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills begins this chapter on the creation of the Kleberg Institute for Molecular Markers by commenting that, as an administrator, he has been repeatedly asked to develop an area and then step away. His ability in this area gave MD Anderson leadership confidence in him and he was asked to develop a proposal for the Kleberg Foundation for a Kleberg Center for Molecular Markers. He talks about the sources of funding at MD Anderson, noting that the Kleberg Foundation's philanthropy funded the Kleberg Center (which was the basis for the Institute for Personalized Cancer Therapy). He describes a major Center initiative of characterizing ten thousand tumors (information that fed the Cancer Genome Atlas), now expanded to include 20 thousand patients. He describes the technology used for this project, developed from an idea he encountered in a lecture. He notes, We have incredible power to leverage what we are doing.
Next, Dr. Mills talks about how the focus of the Kleberg Center has shifted slightly after the founding of the Institute for Personalized Cancer Therapy, concentrating on discovery and on rare cancers, such as mall cell ovarian cancer.
Next, Dr. Mills talks about the intellectual context for this new focus and describes the knowledge that can be generated from the study of rare cancers, giving examples of studies that have led to clinical trials of new drugs. He talks about using models to rationally select drug combinations. -
Chapter 13: The Zayed Institute for Personalized Cancer Therapy, Part I
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills begins the story of his role in managing the The Zayed Institute for Personalized Cancer Therapy in 2006/2007. He notes that he was first asked to manage the Institute with pilot funding. He talks about the first efforts to hire an Institute director leading to the decision that he and John Mendelsohn would serve as co-directors.
Next, he talks about developing a plan for the Institute's growth, relying on significant philanthropic support. [the recorder is paused] -
Chapter 14: On Leadership, Leading, and Dealing with Kids
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills begins this chapter by telling the story of a pot he has on his office bookshelf that carries the title, "Ashes of Problem Employees." He says that a senior administrator needs to inspire a little fear in order to lead effectively, telling the story of serving in the Endowed Positions Committee to demonstrate.
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Chapter 15: The Zayed Institute for Personalized Cancer Therapy, Part II
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills returns to the story of the Zayed Institute in this chapter. He begins by talking about the new Zayed Building, designed to facilitate collaborations.
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Chapter 16: Creating Support for Team Science: The Challenges and Possible Solutions
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills first observes that one of his major contributions to MD Anderson and to the field has been to facilitate the research of other people. He then shifts to a discussion of the issues arising from the increasing focus on and need for team science strategies to adequately leverage the potential of current science and technology. In particular, he notes the challenge of adequately acknowledging the contributions of multiple researchers when the reward system is designed for individual investigators. He also mentions the challenge of building a career in a team science context and notes that the current model of the physician-scientist is not sustainable, nor is the current model for training individual investigators.
Next, Dr. Mills sketches the sources of resistance to changing the research culture to one more supportive of team science. He tells an anecdote to demonstrate how culture works in favor of individual investigators and he notes some personality qualities that team scientists share. -
Chapter 17: The Challenges of Big Data; Developing "Clinical Trial Grade" Data to Foster Data Use
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills talks about some of the practical and intellectual challenges that big data poses for research. He begins by explaining that it is a big challenge to create mechanisms and funding to simply sharing massive quantities of data (most generated from patient samples). He notes the costs of not sharing data. Dr. Mills states that this amount of information "has unbelievable promise," but it has to be linked to new strategies of collecting data in clinical trials and shared in "curated" formats in order to be meaningful. He defines the concept of "clinical trial grade" to define trials specifically designed to leverage their data. Dr. Mills also talks about the energy wasted in repeating work, giving the example of research studies that require documentation of cell lines whose pedigree is already proven. He talks about the idea of "curating" data
Next, Dr. Mills gives specific examples of strategies for data collection and use. He talks about his own research group's activities developing their own cell lines with a known pedigree. He then talks about the institution-wide effort to sequence patient tumors and discusses what is involved in putting this information into a usable format, noting that MD Anderson currently has a program in place to accomplish this. -
Chapter 18: Educating, Hiring and Retaining Team Scientists: A Challenging Time
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills continues his discussion of how a team scientist must be trained differently from the traditional individual researcher. He lists some challenges to creating a culture of team science. He also explains that currently there are more molecular biologists for the number of positions available, a situation that has evolved over the past five years. In addition, financial challenges have gotten in the way of fostering a strong team science culture. He tells some anecdotes that demonstrate the situation.
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Chapter 19: About the Moon Shots: Philosophy, Timelines, and Challenges
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills sketches Dr. Ronald DePinho's Moon Shots program. He explains that he embraces the philosophy of identifying where the obstacle to improving an outcome lies and then devoting resources to address that specific problem point. He develops the analogy between John F. Kennedy's Moon Shot program and Ronald DePinho's. He explains program implementation challenges, such as the fact that when one builds a new facility, "nothing happens for four to five years." He explains how this natural timeline created some problems, since the technological platforms were not completely ready when the research teams needed them.
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Chapter 20: The "Unholy Triad Moon Shot" and the Women's Cancer Moon Shots
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
Dr. Mills begins this chapter by explaining the intellectual foundation for the "Unholy Triad Moon Shot" he currently heads. This discussion also provides a snapshot of the organic process by which a new research area takes shape. First he lists the three "untarget-able mutations" included in the "unholy triad" --p53, Ras oncogene, and amplification of Myc. He explains that the executive leadership suggested combining the examination of all three of these mutations in a single Moon Shot. (He notes that the investigation of them will have relevance for all the Moon Shots.)
Next, Dr. Mills talks about the organization and aims of the Ovarian Cancer and Breast Moon Shots, originally included in one single, Women's Cancer Moon Shot. He tells the story of the evolution of these Moon Shots that address cancers in which inherited abnormalities of BRCA 1 and 2 play significant roles. He explains the process by which the diseases were separated into distinct initiatives.Dr. Mills next talks about how the approach taken in these Moon Shots has intrigued many observers. He gives the example of Astra Zeneca, a company which has agreed to supply drugs and funds for clinical trials in order to study how the drugs work. He sketches the importance of this kind of partnership and mentions that another company stepped forward to supply technology.
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Chapter 21: The Moon Shots at a National Level
Gordon B. Mills MD, PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Mills discusses the national Moon Shots initiative organized by Joe Biden in (starting May 2015) under instructions from President Barack Obama. He explains the pilot study conducted, notes the bi-partisan support shown for the initiative to date, and explains MD Anderson's interest in taking part.
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Chapter 01: The Origin of MD Anderson Land in Research Park, Smithville and Bastrop
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 02: Working with MDACC President Dr. Lee Clark on Research Science Park, Bastrop
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 03: Approval and Funding for MDACC Research Science Park
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 04: Approval for a Laboratory Facility; Naming the Facility; Ensuring Flexibility of the Land Use; R. Lee Clark’s Vision for a Rural Laboratory
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 05: Pride in the New Laboratory Facility; Key Supporters in the Legislature
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 06: The Early Leadership of Research Park and Others Who Contributed to the History of Research Park
James "Jake" Jerell Pickle, Clifford Drummond, Lesley W. Brunet, and Earl Walborg PhD
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Chapter 01: The First Person to Go to College
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff briefly sketches his family background, noting when his family emigrated from Kiev, Russia to the United States. He also explains that he was the first person in his family to go to college. An uncle who was a proctologist was the only member of the family involved in the sciences or medicine.
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Chapter 02: Chemistry and an Early Mentor Lead to a Focus on Medicine
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff begins this segment by explaining that he started out in public school, but then shifted to private school. He notes his interest in chemistry, describing the shelf full of chemicals he had in his room. He also talks about the family’s physician, Dr. Lucen, who treated his asthma and inspired his interest in medicine. He explains why, after beginning his undergraduate education at the University of Rochester, he transferred to New York University. He talks briefly about his style of thinking.
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Chapter 03: A Switch from Internal Medicine to Diagnostic Imaging (Never Losing the Internist’s Perspective)
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff talks about how he switched from his original focus on being an internist, with an interest in psychiatry. Dr. Podoloff tells the story of joining the Air Force after his residency, an experience that tracked him into radiology. He was stationed at the Clinton-Sherman Air Force Base in Clinton, Oklahoma. Though interested in psychiatry, he explains, he changed specialties because radiology services were contracted to external providers. Dr. Podoloff then explains how he got into a residency program in diagnostic imaging at the Wilford Hall Medical Center at the Lackland Air Force Base in San Antonio,TX (’70-’73). There he became interested in nuclear medicine.
Next, as part of a discussion of the kind of cognitive work that characterizes nuclear medicine, Dr. Podoloff explains why the field is jokingly referred to as “unclear medicine.” He refers to an image (provided below) to illustrate the fuzzy images he had to interpret.
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Chapter 04: Private Practice and an Opportunity to Develop a Radiology Department
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff begins this segment by noting that his dual focus in internal medicine and diagnostic imaging would be very important to the evolution of his career. He then talks about his years in private practice at the Diagnostic Clinic of Houston, Houston, TX, where he served as Director of the Department of Nuclear Medicine with responsibilities for building a new program (8/1975-5/1986). He then explains why internal medicine enhanced the diagnostic imaging perspective, enabling him both to work with patients and understand the science of disease from a physiological perspective.
Next Dr. Podoloff explains how he built a nuclear medicine program at the Diagnostic Clinic. He also explains how nuclear medicine differs from radiology. He notes that he built a very successful department.
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Chapter 05: Discovering How to Image a Beating Heart; Reflections on Radiology’s Shift in Focus from Form to Function
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff first notes that the Diagnostic Clinic conducted more cardiac scans than MD Anderson at the time he joined the institution. In the remainder of this segment, Dr. Podoloff explains how he conducted a bone scan on a patient and then a brain scan shortly after, and this led him to discover a process to image a beating heart. The brain scan showed not the brain tissue, but the vessels. Researchers at Harvard University published this technique –the MUGA labeling technique-- however he was recognized as an innovator.
Dr. Podoloff then comments on his academic connections while he was in private practice: he served as Clinical Associate Professor of Nuclear Medicine and Radiology at the University of Texas Health Science Center in Houston from 1976-1985. He comments on how advances such as the MUGA technique have shifted radiology’s focus from the form of organs to physiological processes.
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Chapter 06: An Opportunity for Intellectual Challenge at MD Anderson
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Here Dr. Podoloff tells how he decided to leave private practice in 1985 for a position at MD Anderson. At this time. Nuclear Medicine was splitting off as a separate department. He notes that he took a substantial salary cut, but lists the benefits of working in this new context. He notes that Drs. Marv Chasen and Gerald Dodd served as his mentors.
Next Dr. Podoloff observes that in 1985, the perception was that MD Anderson was a very depressing place where patients went to die. He tells an anecdote about the diversity among the faculty at MD Anderson.
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Chapter 07: Building a Clinical Nuclear Medicine Program
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff sketches the roles he served once he came to MD Anderson as Deputy Chairman of the Department of Nuclear Medicine. He explains that he ran a small clinical operation that generated income and explains how the system of keeping physicians on salary at MD Anderson leads to good medical practice. He talks about the impact of this shifted role on his own career and how he developed the clinical operation.
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Chapter 08: Contributions to the Institution: Leadership and Diversity; A New Research Project
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff explains that his has made his most important contributions to MD Anderson through involvement in leadership. He talks about his service on committees, particularly the Credentialing Committee. He explains the important of this committee and then notes that one of his biggest contributions was to increase the number of women on the committee from zero to fifty percent. He comments on what women bring to leadership roles.
Next, Dr. Podoloff notes that committee work helped him understand his own leadership abilities. He notes that he trained four out of the five department chairs in the Division of Radiology at MD Anderson.
Next, Dr. Podoloff briefly explains a clinical trial using the radiotracer, IPQA, to image a genetic mutation.
[The recorder is paused for about 4 minutes.]
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Chapter 09: Technological Advances that Have Transformed Diagnostic Imaging
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff explains the major technological breakthroughs that transformed the practice of diagnostic imaging. He begins with CT scans, which became usable in 1972, covering advantages and challenges.
[The recorder is paused briefly.]
Next, Dr. Podoloff explains how imaging aids in drugs treatments. He notes that the MUGA scan enabled MD Anderson researchers to adjust the dosages of Adriamycin.
Dr. Podoloff explains the next big advance, the PET-CT scan. He notes that cancer is a systemic disease, with the tumor representing the “tip of the iceberg.” The PET-CT scan enables oncologists to look functions within a patient’s physiology that indicate cancer activity beyond that localized area. There is a discussion of how “imaging” must be understood in a very new way as scans do more than visualize concrete anatomical structures.
Finally, Dr. Podoloff comments on how the timeline for the development of new instruments is much shorter than the development period for new drugs.
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Chapter 10: Advances in Radiology Continue to Raise Questions about Ethics and Consent
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
little oversight over doses of radiation administered. In 1986, however, the institution created new consent forms for oblating patients. Dr. Podoloff explains that this instituted a new process that eventually “humanized” radiology research by building in a view of the patient receiving experimental treatment.
As part of this discussion, Dr. Podoloff talks about the ethical complexities in Dr. Emil J Freireich’s work [Oral History Interview] and work in Developmental Therapeutics, where researchers often gave extremely high doses of drugs.
Dr. Podoloff says he faces a current dilemma in his own research, and he is considering whether questions about dosages of IPQA will prevent him moving forward with clinical trials.
Dr. Podoloff next observes that if you’re purely scientific about medicine, you treat a patient like a test tube, but “we have to be human.” He talks about attitudes of cancer patients when considering issues of consent: they want to feel better and function as they did before their illness. He also notes that it is hard to “sell” imaging to a patient as an experimental element of a treatment plan, as there is no direct outcome. He notes that he is very dependent on patients’ altruism.
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Chapter 11: A Brief History of PET Scans at MD Anderson
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff explains why PET scans were difficult to offer at MD Anderson. First, financial difficulties at the institution resulted in the PET program being closed between 1988 and 1994. Next, insurers were not reimbursing PET scans because there was no data to document their advantages. Dr. Podoloff discusses insurance and the damaging influence insurance policies can have on treatment. He notes that the PET program was restarted at MD Anderson in 1999 and currently does seventy to eighty scans per day.
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Chapter 12: A View of New Collegial Leadership
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff begins this segment by observing that he didn’t seek his current job as Head of the Division of Radiology, but has built clinical program to handle the workload and is now working on developing the research program.
Next he observes that the recruitment of David Pimwica-Worms and Helen Pimwica Worms has been very positive for the institution. David Pimica-Worms, now Head of Diagnostic Imaging, brings a collegial leadership style that contrasts with Dr. Yuri Galivani’s “top down” approach.
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Chapter 13: Training Radiology Residents and MD Anderson as an Educational Institution
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff discusses his role as Education Coordinator of Resident Training for the Department of Nuclear Medicine and related issues in education.
He begins by emphasizing the apprentice-style education of residents and the difference between looking at a radiology film and interpreting the images there. He notes that he became Education Coordinator because residents requested that he serve that role. He talks about developing a template for evaluating education effectiveness. He also explains why MD Anderson’s education of residents is unusual because they don’t interpret films and talks about the pros and cons of this.
Dr. Podoloff then talks about changes to medical education. He observes that MD Anderson offers education to individuals at the advanced fellowship level. He also notes that he talks to students about ethics and economics.
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Chapter 14: The Center for Advanced Biomedical Imaging: an Opportunity to Realize a Vision of Imaging for MD Anderson
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
After a brief discussion of his role as Deputy Chair of the Department of Nuclear Medicine, Dr. Podoloff tells the story of the Center for Advanced Biomedical Imaging (CABI). He explains that in 2000 conversations with Dr. John Mendelsohn [Oral History Interview] and Joe Hogan, the head of GE Medical resulted in a deal to develop CABI. This was also a recruitment incentive for him to take on the role as head of the Division of Radiology. Dr. Podoloff explains his vision for imaging at MD Anderson, referring to the image below. Dr. Podoloff then explains why he wanted to take the position of Division Head and create the Center for Advanced Biomedical Imaging. He notes that he had the support of both Dr. Mendelsohn and GE Medical.
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Chapter 15: Developing and Opening the Center for Advanced Biomedical Imaging: Challenges and Complexities
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Podoloff explains why it took ten years to open the Center for Advanced Biomedical Imaging, despite strong support from the institution and partners. He explains legal issues that emerged between MD Anderson and GE Health. He describes the process of finding a location for CABI.
Dr. Podoloff observes that the centers are located on South Campus for synergy: he lists the departments with strong connections to CABI.
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Chapter 16: The Center for Advanced Biomedical Imaging: More on the Story of Establishing CABI
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff begins by explaining that the Center for Biomedical Imaging is ready to begin promoting its services within MD Anderson. He notes the importance of talking to clinicians and researchers about their imaging needs. He gives the example of how a research project in the Department of Head and Neck Surgery led to a new standard of care.
Dr. Podoloff He talks about financial challenges of running CABI and legal challenges involved with acquiring instruments from GE Health. He explains the decision to offer standard of care imaging with research imaging tacked on in order to avoid “hemorrhaging money.” Dr. Podoloff talks about the different between a non-profit and a not-for-profit institution.
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Chapter 17: The Center for Advanced Biomedical Imaging: Part of the Changing Institutional Vision of Cancer Care
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
After discussing some controversies over establishing CABI, Dr. Podoloff explains how CABI fits in with the visions of cancer care developed by MD Anderson’s presidents. He discusses how CABI fits in with Dr. John Mendelsohn’s view of the “cancer care cycle” and how a system of research centers could offer a comprehensive approach to cancer prevention and treatment (see image next page). He then talks about its relationship to Dr. Ronald DePinho’s approach to research and targeted therapy.
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Chapter 18: The Center for Advanced Biomedical Imaging: A View at the Five Year Anniversary and Role as Medical Director
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff lists some of the immediate issues that have to be addressed in developing the Center for Advanced Biomedical Imaging and then discusses major accomplishments in the first five years of the Center’s operation, summarized in the McCombs Report. He first notes some financial issues must be resolved involving the cyclotron. Next he explains that the Center is considering working with inpatients. He explains how this came about and issues that will arise as they move ahead.
Next Dr. Podoloff talks about the difficulties of securing philanthropic dollars to support imaging studies. He uses the example of his own research and notes the altruism of patients.
He briefly sketches his role as Medical Director of CABI.
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Chapter 19: Overview of Administrative Roles; The Moon Shots; Translational Research and the Future of Targeted Therapy
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff covers several topics in this segment.
He first sketches his role as Director of Clinical Research and his related work on the Institutional Executive Research Committee. He then sketches his role as Director of Clinical/Translational Research for the Division of Diagnostic Imaging (role assumed in 2010).
Dr. Podoloff then sketches the evolution of translational research under Dr. Ronald DePinho and gives his impressions of the Moon Shots program. He talks about early data produced a multi-disciplinary group of diagnostic studies conducted within the Lung Cancer Moon Shot.
Next Dr. Podoloff reflects on the evolution of cancer care. He then talks about how the genetic mutability of cancer tumors in relation to tailored therapies and the Moon Shots.
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Chapter 20: Administrative Roles, Views on the Multi-disciplinary Environment of Centers and Institutes, and A Radiologist’s Contribution to a Care Team
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff first talks about his role as Chair of the Department of Nuclear Medicine and his related work as Chair of the Executive Committee of the Medical Staff. He explains that as Head of the Division of Radiology he was helped plan occupancy of the Alkek Hospital and the Mays Ambulatory Clinic. He was helped develop strategies to structurally integrate the Centers and Institutes in the Cancer Care System.
He then explains that the basic sciences are still organized around departments but the clinical functions are organized in multi-disciplinary care centers and environments. He explains the implications of this structure for Radiology, which does not operate in a multi-disciplinary environment. He sketches the pros and cons of this and talks about the importance of having a radiologist on a clinical team.
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Chapter 21: Next Steps --for the Division of Radiology and the Field
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff sketches what’s on the horizon for radiology at MD Anderson and for the development of the field.
He first talks about “big data” advances made via the Quantitative Image Analysis Core by linking molecular and computational imaging. He observes that as Radiology’s focus has shifted from form to function, it is serving a data storage function for many fields. To demonstrate the form to function shift, Dr. Podoloff uses examples from the Lung Cancer Moon Shot and his own research.
He talks about the “spin lab” where living systems can be imaged using new technologies. He explains the process.
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Chapter 22: Medical Education, Radiology Researchers, and The Future of Radiology Research (in the Healthcare Economy)
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff speaks broadly of advances in radiology research.
He first states that conservatism in medical education is the major reason that medicine does not advance rapidly. He talks about the qualities that an innovative researcher must have, reflecting on his own curiosity.
He makes final comments on how radiology’s shift in focus from form to function will give rise to entirely different kinds of inquiry in the future. He notes that the biggest influence on research will be changes in the healthcare systems. He talks about healthcare costs and policy.
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Chapter 23: MD Anderson Growth as an Impact on Institutional Culture and on Radiology
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
Dr. Podoloff talks about the need for growth at MD Anderson and sketches expansion has had an impact on how radiology is conceptualized as a practice.
He first talks about the need for regional care centers to better serve patients, then sketches changes to the institution as it has grown, with particular attention to the increases in regulation.
Dr. Podoloff then notes that the field of radiology is addressing a question: Is radiology a legitimate field of medical study or a technology? He gives background on why radiology can be seen as superflouous, and notes that other specialties have their methods of reading films. He talks about strategies for integrating radiologists into multi-disciplinary teams.
Dr. Podoloff praises MD Anderson’s method of paying physicians to take the profit motive out of care deliver. He addresses the period of turbulence at the institution since Dr. DePinho became president, noting the he is satisfied with his leadership with one exception.
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Chapter 24: Legacy Left at MD Anderson; A Love of French Cooking; Life and Work Fed by Spirituality
Donald A. Podoloff PhD and Tacey A. Rosolowski PhD
When asked about the legacy he will leave at MD Anderson, Dr. Podoloff immediately lists the individuals in leadership positions whom he trained or recruited. He sketches what he wishes to accomplish prior to retirement and expresses his views of a working with MD Anderson.
Next, Dr. Podoloff talks about favorite activities: he loves to cook French food, for example.
Finally, he talks about his relationship with Judaism and the importance of spirituality in his life and his work.
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Chapter 01: Growing Up in a Migrant-Worker Family
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez recalls her early life when her parents worked as migrant workers in the fields of Texas and in California. She talks about the effect of experiences in her neighborhood on her later life and recalls the huge range of illnesses she saw in her community where there was little medical care. Dr. Rodriguez also characterizes her parents as “survivors” who were committed to family. She recalls that her family was very frugal, but she never felts as though she lacked for anything.
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Chapter 02: Support from Teachers and Family Leads to a College Education
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez talks about her educational path leading up to medical school in this segment. She says that she was encouraged to study from elementary school, when she took an IQ test and scored very high. She recalls that she was asked if she had cheated on the test. Nevertheless, her parents were advised to encourage her to study. Dr. Rodriguez explains that her mother was concerned about her plans to leave their small town to go to college, though her father supported the idea. She says that coming from her background, going to college “was a miraculous thing.” She had little assistance applying to college, but explains that she was advised to apply for scholarships. She recalls going to San Antonio to meet with the selection panel for a scholarship. She was not awarded that scholarship, but one of the nuns on the panel arranged for a scholarship from Our Lady of the Lake College (BA conferred in 1975). Dr. Rodriguez explains that, for practical reasons, she majored in Spanish with the intention of teaching. However she did very well in the sciences and her advisor, Dr. Rigual, advised her to consider medical school. Dr. Rodriguez recalls the educational environment at Our Lady of the Lake College, including a research program that was available and gave her experience in research methods. She began to think about going to graduate school to do research
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Chapter 03: Going to Medical School
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez talks about her decision to go to medical school and describes her experience at the UT Medical School in Houston, Texas (degree conferred in 1979). She recalls that African-American students from Baylor College of Medicine came to Our Lady of the Lake College to talk about summer research projects at Baylor and recruit minority students to medical school. She applied to the research program, was accepted, and the experience encouraged her to consider applying to medical school. Dr. Rodriguez talks about getting a full-tuition scholarship to the Medical School in Houston and recalls the reactions of her family to this new move. She also talks about the unique and grueling three-year program and reviews the pros and cons of the different specialties she considered. Dr. Rodriguez speaks about a rotation at MD Anderson. She talks about the “personality” of cancer patients, who were so appreciative of care, and explains the features of oncology that appealed to her (though she did not decide to go into oncology at this point).
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Chapter 04: A Revealing Internship and Residency
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez talks about her residency and her decision to focus on oncology. She explains that she chose to do her internship in internal medicine at te UT Health Sciences Center in San Antonio (1/1979−1980) because she wanted to focus on health issues in the Hispanic population, particularly diabetes. She stayed in San Antonio for her Residency in Internal Medicine (1/1980−1982) and decided during her first year to focus on oncology. Next she decided to do a fellowship and approached Dr. Daniel von Hoff about working in his laboratory. (Research Fellow, Cancer Therapy and Research Center 1/1982−1983.) She explains that she wanted a year to familiarize herself with this new field and to take time for personal reflection. Dr. Rodriguez also describes the research she conducted at the time, relating to Dr. Hoff’s theory that treatments could be personalized to the specific sensitivities of a tumor. She explains the work she did on the research projects and notes that this intellectual environment influenced her thinking about cancer. Dr. Rodriguez then explains why she elected to do her fellowship in hematologic cancers (Fellow of Hematology/Oncology, University of Arizona Cancer Center, Arizona Health Sciences Center, Tucson, 1/1983−1986).
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Chapter 05: The Problem of Diabetes among Hispanics
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez explains why she abandoned her original intentions to work with diabetes in the Hispanic population. She explains that obesity is a cultural and medical issue for all patients. She talks about the centrality of (unhealthy) foods in Hispanic culture and the challenges of changing deeply engrained habits.
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Chapter 06: Fellowship Research and the Move to MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
To begin this segment, Dr. Rodriguez sketches her research while a Fellow at the University of Arizona Cancer Center. She recalls that is was an exciting time in cancer research, given the availability of DNA analysis and new techniques in molecular biology. Dr. Rodriguez says she knew she wanted to be in a research environment. Her mentors in Arizona eventually connected her with colleagues at MD Anderson. Dr. Rodriguez recalls that when she came to MD Anderson in 1986, the institution was undergoing a reorganization that made times difficult in the Division of Cancer Medicine. She explains that the turbulence made it difficult for a junior faculty member to settle in, as her mentors kept changing. Over the course of her first four years, Dr. Rodriguez says she realized she would not be successful as a researcher and explains the importance of having an anchor point in the institution as a basis for becoming a truly independent researcher.
Next, Dr. Rodriguez talks about her mentor, Dr. Fernando Cabanillas, who was passionate about advancing the treatment of lymphoma. Dr. Rodriguez explains that she designed studies and tested drug combinations within Dr. Cabanillas’ laboratory. -
Chapter 07: Shifting Focus from Research to Administration
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez sketches how she began to shift away from research as her main focus. She began, she says, by doing administrative work “in a surreptitious way.” Dr. Cabanillas asked her to serve as Director of the Lymphoma Clinic, a role that gave her experience, demonstrated her knack for administration, and her commitment to making things better for patients. She talks about working with clinical pharmacists, a new breed of specialists at MD Anderson, and the roles this connection led to. Dr. Rodriguez then talks about how important grantsmanship is for researchers.