Interview Chapters

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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.]
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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).
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).
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.
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.
Chapter 08: Research on Lymphoma Treatments

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this segment, Dr. Rodriguez describes studies she conducted on lymphoma treatments in collaboration with Dr. Cabanillas. She first explains a study that showed the efficacy of ifosfamide among patients who did not respond to the CHOP treatment. She next talks about use of the same drug for patients awaiting stem cell transplantation. This study is still in regular use. Dr. Rodriguez then says that the current atmosphere at MD Anderson focuses on developing new drugs rather than optimizing older drugs. As an example of the value of retaining older ideas, she mentioned work by Dr. Wilson that shows that continuous infusion of drugs is more effective than bolus administration, an idea that Dr. Cabanillas originally explored.
Chapter 09: Learning Administrative Approaches by Leading the Myeloma Clinic

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this segment by explaining that the Myeloma Clinic was originally jointly managed with Transplant Leukemia services. She served as Clinic Chief of the Lymphoma/Myeloma Section from 1994−1996. Dr. Rodriguez explains what she learned from working in this environment of shared resources and how she acquired basic knowledge of how to assess patient volume and flow and determine hours of clinic operation. Next Dr. Rodriguez explains how the administrative issues shifted once the Myeloma Clinic became autonomous in 2003 and was stressed with challenged of internal utilization of resources. At this point she began her habit of writing reports to ensure transparency. (She notes that she used to have access to downstream revenue reports, but these have since disappeared.) She talks about the biggest lesson she learned at the time: how an individual’s work has an effect on the whole. As an example, Dr. Rodriguez explains that she became aware that the Myeloma Clinic was one of the biggest customers of the CT Scan Unit. She details how this effected operations of the CT Unit and had an effect on other services. She explains that this refined her thinking about how to strategize care delivery in an arena of low resources. Dr. Rodriguez also notes that most physicians tend not to see the big picture in which the deliver care and use resources; she gives examples of stresses to the system that can result. Dr. Rodriguez observes that she began to attend administrator education courses around this time. As an example of slow administrative development at MD Anderson, Dr. Rodriguez notes that she never filled out a for-service charge form until the 1990s. She talks about issues that arose once billing forms were introduced.
Chapter 10: The Role of the Physician-Leader at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this segment, Dr. Rodriguez talks about the important role that physician-leaders can serve in an organization. She explains that a primary responsibility is to explain the need for institutional changes in terms that clinicians can understand. She stresses that physician-leaders must be able to listen, have a toehold in specific services, and demonstrate that they share common experience with clinical peers. She returns to the example of the Myeloma Clinic’s heavy use of the CT Scan Unit and the pressures that created among all services. She notes that she was first made aware of this resource issue by listening to clinicians vent their frustrations about difficult access to the Unit. Next Dr. Rodriguez explains that physician leaders must be able to explain a larger reality to data-driven MDs who generally have a much narrower focus. She talks about why, traditionally, there has been a gap between clinical and administrative levels of an organization. Dr. Rodriguez next talks about the history of physicians and leadership at MD Anderson, beginning with the first president, R. Lee Clark, who went to hire other clinicians with leadership abilities. She explains that in academic institutions, most physicians assume leadership positions that carry academic titles and that reflect their knowledge rather than specific skill at administration or leadership. Dr. Rodriguez believes that today one cannot excel as a clinician and administrator and this is why one is now seeing different titles for physician-leaders.
Chapter 11: Today’s Medical Paradigm Shift

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this segment, Dr. Rodriguez provides perspective on what she calls “the medical paradigm shift” that currently challenges everyone in healthcare. She begins by sketching how landmarks in the history of research into causes of disease created paradigm shifts in the pass. She begins with the long period in which doctors learned their craft through apprenticeship to other individual physicians. She then explains that a paradigm shift occurred in the 19th Century, when hospitals became the primary setting for acquiring this training. She notes that the growth of nursing also had an effect on the practice of medicine. She then talks about the technical developments of the 20th century that led to another paradigm shift. Dr. Rodriguez explains that the current paradigm shift is not focused on technology, but on how care is delivered and diseases managed. She stresses that the new paradigm focuses not merely on the doctor-patient relationship, but on the management of relationships between teams of providers and the institution to deliver optimal care. Dr. Rodriguez says that MD Anderson is still in the investigational paradigm and may not have the skills to engage patients in being their own health care advocates. She explains that there is a great deal of data available to help individuals prevent cancer and that nearly seventy percent of patients survive for five years. Dr. Rodriguez cites several MD Anderson initiatives that focus on prevention.
Chapter 12: The Survivorship Initiative

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this segment Dr. Rodriguez talks about MD Anderson Survivorship initiative, which began to take shape, she explains, after the Institute of Medicine released its presidential report From Cancer Patient to Cancer Survivor: Lost in Transition (November 3, 2005). This report, she says, detailed why care for survivors was lacking. Dr. Margaret Kripke, PhD [Oral History Interview] had been appointed to the president’s Committee on Cancer and became aware of the issues. She brought this information to the president of the institution, Dr. John Mendelsohn, who decided to integrate survivorship into MD Anderson’s care delivery system. A committee was formed and Dr. Rodriguez took on implementation of their plan in 2006. Dr. Rodriguez notes that MD Anderson began transitioning patients to survivorship in 2010. There is now a significant body of patients and Dr. Rodriguez says her next step is to leverage the information that has been collected. Dr. Rodriguez explains the process she and her committee went through to determine how to implement survivorship care, a process that began with listening closely to all constituents. She summarizes: they build the survivor care clinics in the same way they build acute care clinics. Next Dr. Rodriguez sketches why a focus on survivorship was controversial when it was first proposed. She touches on bond that forms between the patient and the physician and notes that a primary concern was survivorship programs would ask the patient to divorce him/herself from the main oncologist. Dr. Rodriguez notes that this break can sometimes be more painful for oncologists, who say they enjoy seeing well patients –often the high point of their day. Dr. Rodriguez explains that they finally settled on a model where one supervising physician determined the activities of mid-level providers in a situation that de-escalates the intensity of visits by focusing on wellness. Dr. Rodriguez sketches the approach. She notes that a key issue they had to consider: at what point does the primary oncologist see the patient as a survivor? This question will be answered differently in each treatment area and the committee built algorithms to determine the transition point to survivor care, when the risk of relapse is nil. The entire care model for each service is built around four common domains: Surveillance, Prevention, Monitoring for Late Effects, Psychosocial Health. Dr. Rodriguez explains how this model works using the example of lymphoma. She confirms that all the survivorship services are amassing a great deal of knowledge about survivor care.
Chapter 13: Aimed Toward an Interest in Survival; Survivorship Care and the Affordable Care Act

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this segment by sketching how the Affordable Care Act has an impact on care for survivors. She focuses on the assumption payers make that it’s most cost effective to transition patients to their primary care physician after treatment, as oncologists are expensive. She says that is premature for patient who have had aggressive tumors or treatments. Dr. Rodriguez notes that she spoke at ASCO about MD Anderson model of survivor care. She communicated that the four domains MD Anderson uses to structure a care plan is relevant at all stages of cancer care. Dr. Rodriguez then explains that her interest in survivorship was a natural extension of her work with lymphoma patients, as lymphoma was one of the first malignancies that could be cured. She understood early the four domains of Surveillance, Prevention, Late Effects Monitoring, and Psychosocial Health.
Chapter 14: Lessons in Administration as Ad-Interim Chair of Lymphoma/Myeloma

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this segment by explaining how her view of the institution changed as she stepped into the role of Ad-Interim Chair of Lymphoma/Myeloma when Dr. Cabanillas retired. She sketches her new areas of responsibility and how this changed her view of operations and the institution as a whole.

Next, Dr. Rodriguez explains that traditionally, a Department Chair is seen as an “erudite expert,” but to be successful a chair must let go of her/his ego and bring forth future leaders in the field.
Chapter 15: Vice President of the Office of Medical Affairs; the Value of Faculty Credentialing

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins this segment by explaining how conversations with the outgoing and incoming physicians-in-chief around she came to her role as Vice President of the Office of Medical Affairs. When Thomas Burke, MD [Oral History Interview] became physician in chief in 2004, her role was expanded to include medical affairs functions. She was officially named in 2005 with service to the present. Next Dr. Rodriguez notes that learned a great deal about Texas law and regulations of medical practice. She also had to familiarize herself with the roles of Physicians Assistants and Advanced Practice Nurses.

Next, as an example of a function within Medical Affairs, Dr. Rodriguez talks about the process of documenting the credentials that physicians present for employment. She explains why this process is key to the reputation of MD Anderson. She also notes that employees have occasionally falsified documents.
Chapter 16: The Office of Medical Affairs: Credentialing, Quality Indicators, and Building a Culture of Improvement and Quality Care

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez explains a key function of the Office of Medical Affairs: to credential all individuals at MD Anderson to ensure their competence. She next explains that, since 2009, MD Anderson has been involved in developing performance and quality indicators for professional practice. She explains this history of this focus and the different reactions of clinicians to professional evaluation, given that most evaluation is perceived as adversarial and punitive, rather than part of a culture of self-awareness and self-improvement. She comments on Texas requirements that support a culture of improvement. Dr. Rodriguez then talks about how the Office of Medical Affairs created an infrastructure to shift to quality indicators.
Chapter 17: The Office of Medical Affairs: Patient Concerns, Patient Advocacy, Conflict Resolution

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez discusses another important role of Medical Affairs: to provide support for patient who wish to voice complaints. This segment covers sources of patient complaints and distress, the importance of communication, the role of Patient Advocates and the sources of stress in that role. (She notes that patients can become abusive because they would like a second opinion to be a different, hopeful opinion, but often a lack of options is confirmed.) She notes that having an Advanced Directive conversation is a quality indicator and explains the issues that this raises. She notes that there is more emphasis now on selecting health care providers who have communication skills.
Chapter 18: Creating MD Anderson’s Practice Algorithms; On Blending Art and Science in Medical Practice: Practice Algorithms and Targeted Therapy

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez tells the story of MD Anderson’s 147 Practice Algorithms beginning with the origin of this initiative in the 1990s movement to define “pathways of care.” She talks about the process of establishing an algorithm and discusses the effects. She also notes the different reactions of clinicians, who may immediately adopt the algorithm or who may take convincing. Dr. Rodriguez talks about the dangers of dogmatism in medicine. She notes that medicine is both an art and a science, but the poles need to be harmonized in order to be humane. Dr. Rodriguez notes that limits of targeted therapy and sketches an emerging view that this approach will be replaced by a focus on failures in the body’s surveillance and regulation mechanisms. She notes committees in place to support clinicians as they self-monitor the quality of their practice.
Chapter 19: Integrating Advance Practice Providers into Care Teams; Training Program for Physician Assistants

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez talks about the increasing reliance on advance practice providers in medicine and in oncology. She notes that, at MD Anderson, General Internal Medicine is a hold out. She sketches what an APP can bring to a care team. She talks about her own experience working with a Physician’s Assistant. She explains why she shares oversight of Advanced Practice Nurses with the Division of Nursing. Next Dr. Rodriguez talks about the Physician’s Assistant Oncology Fellowship Program, started in 2008. She sketches differences in the education of MDs and PAs and explains the need for an oncology fellowship. She talks about the impact of the program and an e-course developed for fellows at a distance.
Chapter 20: The Office of Medical Affairs: Job Satisfaction Survey of Mid-level Providers

Alma Rodriguez MD and Tacey A. Rosolowski PhD

After sketching changes to the office of medical affairs in the last ten years, Dr. Rodriguez discusses the purpose and results of the regular survey of mid-level providers at MD Anderson. She notes that, in general, the workforce is very stable, but the institution wants to monitor reasons that pockets of high turnover exist. She notes results of the survey: everyone at MD Anderson is committed to the job; some fear retaliation if they voice complaints; many feel they are not paid enough. Dr. Rodriguez stresses that employees’ pay is in line with other state institutions. She talks about requests for mentoring made via the survey and how that was acted on and to what affect.
Chapter 21: Patient-Centered Care: Formalizing the Practice at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez talks about the shift in healthcare to a focus on patient-centered care and addresses the specific ways that MD Anderson is putting this approach into practice. She first explains that patient-centered care is a shift in focus and explains the value is shifting from treating disease to treating people (and seeing them as customers). She notes that MD Anderson patients experience the kindness and devotion of providers. She lists some patient centered practices instituted and notes others that need improvement.
Chapter 22: Patient-Centered Care: the Psychosocial Council, Advanced Care Planning

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this segment, Dr. Rodriguez continues her discussion of patient-centered care. She discusses the work of the Psychosocial Council, in particular on the latter’s work on creating guidelines to talk to patients about advanced care planning, then talking about the Department of Chaplaincy and Pastoral Education. She first talks about the Psychosocial Council and advanced care planning, offering her view that advanced care planning is not a conversation about death, but about health care planning for the future that needs to be integrated into a patient’s treatment plan. She explains strategies for bringing awareness to this at MD Anderson and also notes that this is part of a national conversation. Dr. Rodriguez next talks in general terms about the Psychosocial Council (formed 2007), its roles, and the pushback it has received for treating disease from an emotional perspective.
Chapter 23: Patient-Centered Care: the Department of Chaplaincy and Pastoral Education and the Future of Psychosocial Approaches at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez discusses the Department of Chaplaincy and Pastoral Education and its focus on spiritual concerns. She lists the kinds of issues that arise for cancer patients. Dr. Rodriguez explains that, historically, MD Anderson has sustained linkages with spiritual/religious organizations and communities. This is one reason the Department of Chaplaincy at MD Anderson is so robust. She then talks about the future of psychosocial approaches at MD Anderson, looking ahead to the creation of a Division of Psychosocial Oncology. She list some research studies the faculty are conducting in this area.
Chapter 24: Transitional Moments in MD Anderson History

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez sketches key moments of change in MD Anderson history since her arrival. She first talks about the eighties and the “growing consciousness that MD Anderson is an economic entity,” moving on to the nineties and the complexities that evolved with more billing forms, rules, and concern for downstream revenue generated from patient care. She gives an example of chemo therapy orders and talks about pros and cons. Dr. Rodriquez then talks about the MD Anderson’s physical expansion to the point where she “can’t embrace” the institution. She notes that the physicians and nursing staff have preserved their dedication and pride.
Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez states that MD Anderson has shifted away from its mission as a care facility since Ronald DePinho assume the institution’s presidency in 2011, moving toward a research-generating facility. She sets context by discussing the growth of research under Dr. John Mendelsohn, noting that research still served patient care despite accelerated industry-sponsored research. She next talks about MD Anderson’s focus on new drug development and the implications, specifically in the demand for financial and intellectual resources this requires.
Chapter 26: Turbulence During Dr. DePinho’s Early Presidency; MD Anderson’s Future

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez comments on the changes created at MD Anderson under Dr. DePinho’s early presidency then talks about the future of MD Anderson under the Affordable Care Act. Dr. Rodriguez first comments on the magnitude of institutional change that Dr. DePinho’s administration has brought to MD Anderson. Making reference to literature from the field of organization transformation, she notes that change on such a scale requires a “message of urgency” that was not verbalized by the administration. Change has felt imposed from outside, creating tensions in the institution, she observes. She notes that the Board of Regents was slow to recognize problems.
Chapter 27: Creating a Future Under the Affordable Care Act

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez explains that MD Anderson’s future will be determined by changes to healthcare under the Affordable Care Act. She first talks about the loss in revenue anticipated, then describes initiatives that the Office of Medical Affairs is setting in place to help address anticipated problems. She talks about the need to document all care processes in the spirit of moving toward more evidence-based care and shifting the mindset of providers away from an expert mentality to a spirit of self-reflection and improvement. She also talks about the importance of examining and optimizing all of MD Anderson’s resources.
Chapter 28: Women and Leadership at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez provides her views of women and leadership at MD Anderson. She cites statistics in support of her view that “the workforce in medicine is about women.” She stresses that women have to know systems in order to succeed in leadership positions. She offers her view of coming up through the ranks when there were many fewer women and notes that MD Anderson does not have clear processes for filling leadership positions or establishing a pipeline of leaders. She talks about her own strategy for cultivating leadership.
Chapter 29: Accomplishments, Retirement, and a Love of Cosmology

Alma Rodriguez MD and Tacey A. Rosolowski PhD

Dr. Rodriguez begins by listing her most significant accomplishments: launching the concept of survivorship; imbedding into MD Anderson culture the role of quality officers; integrating Advanced Care Planning into treatment planning; serving as champion for the Physician Assistants Program; helping everyone who has reached out to her as a role model. Next she talks about the interests she plans to pursue in retirement: psychology, art, reading, and cosmology. She notes that she minored in philosophy as an undergraduate and her thinking has been very influenced by process philosophers who believe that reality self-creates. She believes that the Universal Mind is also self-creating and explains that this spiritual component of her belief system helps her cope with change.
Chapter 01: Multidisciplinary Care at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez provides an overview of MD Anderson’s multidisciplinary approach to patient care. She defines the approach and notes that it began with R. Lee Clark’s vision for cancer care. She gives examples of the specialties that collaborate to provide comprehensive management of a patient’s disease throughout treatment. She also offers observations on how the tradition of multidisciplinary care has had an influence on the culture of the institution.
Chapter 02: The Important of Clinical Leadership at MD Anderson

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez about the important role that clinical leadership has played in developing the institution and that it continues to play in the current healthcare environment. She sketches the qualities that leaders must have to steward institutions in the current climate and connects that to the culture of the institution.
Chapter 03: Leadership in a Period of Change

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez comments on the period of change the institution is experiencing, stemming from changes in the healthcare system, financial stressors, and internal turbulence stemming from Dr. Ronald DePinho’s resignation as president in March 2017.
Chapter 04: Multidisciplinary Care and the MD Anderson Algorithms

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez defines the MD Anderson algorithms of care and explains how they were created and are continually evolving, based on current research. She explains how they are connected to multidisciplinary care, and how important they are for standardizing care at MD Anderson’s partner institutions.
Chapter 05: Envisioning the Next Period of Leadership

Alma Rodriguez MD and Tacey A. Rosolowski PhD

In this chapter, Dr. Rodriguez talks about the qualities that the next president of MD Anderson will need to confront successfully the institution’s fiscal and other challenges. She comments on the stability that MD Anderson’s tradition of physician leadership has provided.
Chapter 01: Inspired By Work at a Medical Institution

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck explains that he came to work for MD Anderson's Department of Public Information and Education in 1975. (Prior to that he worked in a University of Texas Medical School Information Office that served both the Medical School and MD Anderson.) He then offers some background information, including how he came to spend his "formative years" in Houston. He notes that he spent his undergraduate years at University of Texas at Austin majoring in advertising and journalism. He secured a job in public information at the University of Texas Medical Branch in Galveston after graduation. Seeing the caring dimension of medicine inspired him to continue to work with the medical field, however he was drafted in 1969, going to Vietnam in 1970 as a public information specialist who wrote for the Army until his discharge in 1971. Though he returned to the University of Texas at Austin for graduate work, he left because for a job in the Public Affairs office at the University of Texas Houston.
Chapter 02: Public Affairs: Working Closely with MD Anderson Presidents

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck describes the work he did promoting awareness of the new medical school (University of Texas Medical School) until 1975, when he was made Director of MD Anderson's Department of Public Information. He explains why the rapidly growing institution needed such a Department at that time and why Dr. R. Lee Clark offered him the job [the letter mentioned is reproduced in Steve Stuyck: The MD Anderson Years]. He talks about Dr. Glen Knots, to whom Mr. Stuyck reported, and the lessons he learned from him about management and leadership. He then explains why, in 1981, Dr. Charles LeMaistre arranged for Mr. Stuyck to report directly to him. He tells a story about a speech he volunteered to write for Dr. LeMaistre when he had to testify in Washington D.C. about the deaths of several patients, and how pleased Dr. LeMaistre was with his work.

Mr. Stuyck explains the particular abilities he was able to bring to MD Anderson and to the institution's presidents. In addition to being a good editor of others' work, Mr. Stuyck describes himself as a strong writer about MD Anderson and about cancer, with a skill to commit issues to paper. He had a special sense of Dr. Charles LeMaistre's way of expressing himself and could capture it. (Mr. Stuyck says that "I could hear him saying the words from the podium.) He notes that the archives have about 700 speeches that he wrote over the course of his career.

Mr. Stuyck describes the exhausting schedule of working with Dr. LeMaistre's speech trips and notes that, when Dr. John Mendelsohn arrived, it was agreed that Mr. Stuyck would not write his speeches.

Mr. Stuyck then tells several anecdotes to demonstrate what he learned about leadership from Dr. Charles LeMaistre. In particular, he mentions Dr. LeMaistre's habit of encouraging people who worked for him.

Mr. Stuyck recalls that Governor Bill Clemmons shouted at him during a visit, and Dr. LeMaistre phoned him later in the evening to tell him not to worry about it. Next he speaks briefly about Dr. John Mendelsohn, noting that he was just what the institution needed at the time. Dr. Mendelsohn promoted Mr. Stuyck to Vice President of Public Affairs.

Mr. Stuyck notes that he had thirty years of working with great bosses and great leaders.
Chapter 03: Early Developments in the Department of Public Information and Education

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

This chapter opens with the interviewer providing an overview of the three story threads told in Mr. Stuyck's interview: the story of his career, of the Public Affairs at MD Anderson, and a story of what public affairs encompasses.

Mr. Stuyck asserts that he had a direct effect on the broad scope of Public Affairs, citing the gradual absorption of Volunteer Services into the Department.

Mr. Stuyck next explains that he was able to secure a contract to set up the Cancer Information Service in 1974. This was the first NCI-funded initiative to create a public information call-in line, and it was controversial, as most professionals did not believe that laypersons could be sufficiently trained to provide medical information.

Mr. Stuyck explains how he became principle investigator, and what was involved in setting up the service on this grant, which has run for 30 years for a total of twenty-six million dollars. Mr. Stuyck then provides historical context. He notes that the CIS was part of a larger national effort to open up communication about cancer, to develop advocacy for many groups, and to increase the role patients could play in their health decisions. He also notes that the President Nixon signed the National Cancer Act in 1971 and that knowledge in the sciences was growing at a tremendous pace during this time. He also cites the culture of excellence that existed at MD Anderson in the seventies.

Mr. Stuyck gives several examples to demonstrate how far cancer treatment has come since the seventies: the first BCG (Bacillus Calmette-Guerin) trials that required patients to be scarified; "gruesome" chemotherapy treatments; and treatments that required extreme surgical damage to a patient. He also recalls the first outpatient clinic at MD Anderson, which was very primitive by today's standards.
Chapter 04: The Faculty: The Intellectual Engine of MD Anderson

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck expresses his appreciation for the MD Anderson faculty who are the "intellectual engine" of the institution even though they represent only twenty percent of employees. He says he has always tried to understand faculty issues and "speak their lingo." He traces his support for faculty back to his experiences at University of Texas Medical Branch, where he loved attending Grand Rounds. He sketches how issues have changed for faculty and lists the pressures upon them. He also characterizes MD Anderson faculty as possessing great intellectual curiosity.
Chapter 05: Expanding the Scope of Public Affairs: Increasing Services for Faculty, Patients, and the Public

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck talks about the expansion of the idea of public affairs at MD Anderson.

Mr. Stuyck explains that after he secured the NCI contract for the Cancer Information Service, "Public Education" was added to the name of the Department of Public Information, going on to detail what education can do for an institution.

Next, Patient Education came under the scope of Public Information, and he explains what sorts of educational materials the department produced. Volunteer Services was next folded into Public Affairs, and Mr. Stuyck explains that he wanted to bring together in one unified division all the functions that would reach out into the public. Next he explains why Public Affairs was sequentially identified as a Department, then an Office, and finally a Division. He comments on the perception of Public Affairs within the institution then goes on to explain some of the many services provided to MD Anderson. He begins by explaining Creative Services then talks about the role Public Affairs played when Dr. Jordan Gutterman [Oral History Interview] and his work on Interferon attracted tremendous media attention. He explains that Dr. Gutterman received 7,000 to 8,000 letters from people begging to participate in his trials. Public Affairs set up a service to answer all of these letters.

Mr. Stuyck talks about preparing faculty to deal with media appearances. Then he identifies the sections within Public Affairs and notes that he and his management team produced both monthly and annual reports to document the contributions they made to the institution. At the end of this chapter, Mr. Stuyck notes that MD Anderson has generally received very good press. Most of the negative press has come during the last year.
Chapter 06: Public Affairs: External Communications

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck explains the changing role of Public Affairs since the seventies. At that time, physicians were not concerned about public relations. He then points to Dr. John Mendelsohn's arrival as a turning point in the institution's dealings with the public: Mr. Stuyck explains how he and others worked with Dr. Mendelsohn to draw greater attention from national and international media, eventually hiring a New York public relations firm, The GabbeGroup (which still works for MD Anderson). He also explains that the single greatest factor to change the institution's media needs was the passing of the self-referral legislation in 1994.

Mr. Stuyck describes the challenges created when the bill went into effect in 1995 and forty percent of patients could suddenly request their own appointments. He explains that the information service, Ask MD Anderson, was created to help patients navigate the complex institution: it takes 100,000 calls per year.

Mr. Stuyck next describes several strategies used to raise the institution's profile. He describes the trips that Public Affairs planned for Dr. Mendelsohn, designing them to create more exposure for cancer and the institution. The GabbeGroup suggested that Public Affairs submit profiles on cancer issues to the US News and World Report website. Public Affairs also published surveys on attitudes about cancer and attitudes about breast cancer in Prevention Magazine.

Mr. Stuyck explains that departments that heavily use Public Affairs services fund positions within the Department. This insures that Public Affairs serves their needs.

Mr. Stuyck points to the important and productive link between Development and Public Affairs. He then identifies some key moments in the institution's relationship to the public: achieving status as a cancer center; the change in the institution's name in the 1980s; the impact of the Internet.
Chapter 07: Public Affairs: Internal Communications

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck gives an overview of internal communications in the institution. He notes that, in 2001, MD Anderson was at a crisis point in communications and Public Affairs hired the management group, Deloitte &Touche, to analyze the issues. At this time he proposed to the Management Committee of Public Affairs to establish a section for internal communication. As an example of communication difficulties, he talks about the mistrust created by layoffs in the early to mid-nineties, describing the publications created to address the issue. He compares the paper communications of past decades with the online communications of today. He then talks about new technologies that communications specialists must master today, noting that "it's fun to be around" the new media specialists and to strategize how to use new technologies. He notes that Communications has "reinvented itself" six or seven times in the past decades.
Chapter 08: Public Affairs: Writing the MD Anderson Mission Statement and the Code of Ethics

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck next talks about his work on two key documents: the Vision and Mission Statement and the MD Anderson Core Values. He explains why there was controversy over the core values.

Mr. Stuyck gives an example of why the word "hope" was controversial in the Core Values, saying that he was "never a fan of hope," but other committee members convinced him it was key to MD Anderson. He then talks about the impact of the two documents, citing a survey of employees that revealed almost 100% satisfaction with the institution values. Next Mr. Stuyck briefly compares Public Affairs at MD Anderson to analogous departments at other institutions. He comments on the role of the Management Group within Public Affairs and its strategic work in guiding the departments activities and evolution. He briefly comments on how Public Affairs is working with the current controversies surrounding Dr. Ronald DePinho.
Chapter 15: A Key Publication: Making Cancer History

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck tells the story of how Making Cancer History, a history of MD Anderson came to be written. Dr. James Olsen, a historian at Sam Houston State University, originally approached Dr. James Bowen with the idea, however the Management Board under Dr. Charles LeMaistre had no enthusiasm for the project.

Mr. Stuyck speculates on why this was the case, then goes on to trace how the Historical Resources Committee was created under Dr. Stephen Tomasovic, with a first goal of producing a history of the institution. He explains the lengthy process of looking for a writer and the eventual hiring of Dr. Olsen, as well as securing Johns Hopkins University Press to publish it.

Mr. Stuyck recalls that he and Stephen Tomasovic [Oral History Interview] both read the manuscript.

Mr. Stuyck says that Making Cancer History is a great book that tells history in a human way. He also talks about his favorite chapter. Next he next talks about what it meant for the institution to have a book that celebrates the culture. He speaks about the number of documents James Olsen reviewed as part of his research, the committee members who worked on it, and what was done to promote it.
Chapter 16: Changes at MD Anderson

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck gives an overview of the changes he has seen at the institution over the course of his career. He notes that people in the past worked just as hard as they do now, but worked differently. He talks about the dramatic expansions to ambulatory care and patient care in general and the improvement of quality of life issues for patients. He makes some observations on cultural changes and the increasing interest in work/life balance. He then talks about the plan to merge the University of Texas Health Science Center with MD Anderson, a move that was resisted to preserve the institutions mission and resources.

Mr. Stuyck also talks about changes that Dr. John Mendelsohn brought to the institution, particularly the dramatic growth, for which the institution is now paying the price, he says.
Chapter 17: The Murder of Dr. Fred: A Challenge for Public Affairs and the Institution

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck talks about the day that Dr. Fred G. Conrad, Vice President for Patient Care, was fatally shot (17 December 1982). He recalls Elmer Gilley calling him early Friday morning, and he went to MD Anderson to wait for the police and the coroner and to handle the reporters.

Mr. Stuyck recalls how calmly Dr. LeMaistre handled the situation and helped calm the tension. He then talks about how Public Affairs handled the media, noting that the crisis brought out the best in people at the institution. He describes Dr. Conrad and explains why his murder was a "seminal moment" in the institution. He ends with a story about a woman who had flown into town to be interviewed for a job, arriving at MD Anderson to discover "bedlam" so she returned to New York.
Chapter 18: Departments Within Public Affairs

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

In this chapter, Mr. Stuyck talks about four departments within Public Affairs: Volunteer Services, the Children's Art Project, Public Education, and Patient Education. He begins with Volunteer Services, a service within MD Anderson that goes back to the 1950s. He then talks about Page Lawson, a director who greatly expanded Volunteer Services in the 1970s. He explains how he came to oversee the Department and tells a story about Tommie Stewart, a volunteer known as "the Hug Lady." He notes that MD ANdserson has 1200 volunteers who contribute the equivalent of 100 full time employees. He mentions the series of directors leading up to Page Lawson, whom he calls "a dynamo." Mr. Stuyck explains the lesson he learned from Page Lawson about remembering the names of volunteers.

Mr. Stuyck next talks about the Department of Patient Education, created by Dr. Charles LeMaistre. He explains how it came from the first patient satisfaction survey conducted in the 1980s. Dr. LeMaistre used the results of the survey to add valet parking, patient advocates, and patient education functions.

Mr. Stuyck explains changes in the reporting structure that came about with these changes, as well as the database that evolved to support patient education activities. He sketches the types of materials produced and who works on them. Next Mr. Stuyck talks about the Children's Art Project, beginning with an anecdote: Page Lawson showed him children's drawings arranged on an ironing board and asked him which ones would make a good card. He talks about his decision to separate the Art Project from Volunteer Services.

Mr. Stuyck describes what the Children's Art Project contributes to MD Anderson. He explains that it gives the institution a chance to talk about its successes. He notes how the Children's Art Project has come to be part of the MD Anderson brand.

Mr. Stuyck then tells the story of how the Public Education Department started. He comments on his colleagues in the Division of Public Affairs. Finally, Mr. Stuyck talks about what the Department of Public Education does for ME Anderson.
Chapter 19: A Fun Job at an Institution that Inspires Commitment

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck speaks briefly about some constraints he felt for his activities at MD Anderson. He notes the commitment employees at MD Anderson feel for what they do and how much job satisfaction employees have.

Mr. Stuyck speaks briefly about receiving the Anderson Network Award. He also notes that the Division of Public Affairs is one of only three institutions that have twice received recognition as an Outstanding Public Affairs Program. He briefly talks about the book that he received on his retirement, Steve Stuyck, the MD Anderson Years, and clarifies two mysterious references in that book. He then notes that his is most proud to have started the Cancer Information and Public Information services, both of which were groundbreaking at the time. He is also very proud that he engaged the institution's first public relations group. Next Mr. Stuyck talks about what MD Anderson has given him over the years: a rewarding and fun job. At the end of the interview he notes that he gave his job "his all" and hopes that MD Anderson will continue to lift the "huge burden" that cancer represents.
Chapter 09: Public Affairs at MD Anderson: Supporting Cancer Prevention and Education

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck begins this chapter talking about a joint project between Public Affairs and the Division of Cancer Prevention. He provides context, explaining that Dr. Bernard Levin (Vice President of Cancer Prevention, [Oral History Interview]) was approached by Channel 13 to do a promotion of the new fecal test for colon cancer screening. He explains how the project turned into a research project supported by SmithKline as well as a public service initiative. Nine thousand people participated in a study to compare fecal testing methods. Laboratory Medicine helped, but Public Affairs organized volunteers to read the cards. This study was eventually published.

Mr. Stuyck explains his axiom that "good public education is the best public relations. He then describes how he used that axiom to make decisions about public affairs is
Chapter 10: R. Lee Clark and Charles LeMaistre

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

Mr. Stuyck notes that MD Anderson has been strong because of the continuity of its CEOs. He notes that the institution's first full-time president, Dr. R. Lee Clark, had a solid public relations staff; he also focused on international activities.

Mr. Stuyck tells an anecdote about accompanying Dr. Clark to a television interview prior to his retirement.

Mr. Stuyck then talks about Dr. Charles LeMaistre [Oral History Interview], noting that he was erudite and chose his words carefully. Dr. LeMaistre also improved the look of MD Anderson and enhanced the clinical environment.

Mr. Stuyck notes that paying patients would go to other institutions, but Dr. LeMaistre's initiatives made MD Anderson more attractive, and turned that around. He says that Dr. LeMaistre was very effective at representing the institution to the public. He also contributed to the institution in many ways. One was by making the controversial move of starting the Division of Cancer Prevention. Dr. LeMaistre also led the initiative to change legislation to patients could self-refer. He explains why attitudes of physicians outside of MD Anderson made self-referral controversial at the time.

Mr. Stuyck notes that the transition to self-referral was very smooth.
Chapter 11: John Mendelsohn: MD Anderson's Secret Weapon

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

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

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

Mr. Stuyck explains how he prepared Dr. Mendelson for interviews with the media. He then describes how Dr. Mendelsohn handled his interview with a reporter from KTRK-TV, Channel 13, Wayne Dolcefino, about expenditures for furniture and art: Dr. Mendelsohn was very forthright and convincing, and the reporter let the story slide without publishing it. He then tells a story about a trip to Washington, D.C. for interviews at the Washington Post and PBS.
Chapter 12: Restricted

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Chapter 13: The Changing Organization of Public Affairs

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

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

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

Mr. Stuyck also talks about the unique roles of JoAnn Ward and Louise Villejo [Oral History Interview].
Chapter 14: Public Affairs and Communication Tools

Steve C. Stuyck MPH and Tacey A. Rosolowski PhD

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

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

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

Mr. Stuyck notes that this is a unique document among academic institutions: the content is now on the website, with about 150 advances included. At the end of this session, Mr. Stuyck tells a story to demonstrate Dr. John Mendelsohn's communication skills.
Chapter 01: A Child with a Different Perspective

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler talks about her early realization that she had a different perspective on life than other children her age. She talks about her early affinity for nature when was a child in Connecticut, her fascination with questions about the universe and intuitive grasp of non-duality. She tells an anecdote about how her father would joke with her, inadvertently supporting her growing perspective. She then talks about discovering the Daoist koans, yoga and pranayamic breathing.
Chapter 02: Scoliosis Changes Life and Perspective

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

Ms. Sumler begins this chapter by noting that she initially aspired to be a dancer. She then narrates the progression of her scoliosis through the seventies and after her spine fusion surgery in 1976 and shares several stories of significant physical and psychological events. She talks about the grieving she had to do because of the blow scoliosis dealt to her identity as a dancer and describes her process of coming to accept her new physical state and identity.
Chapter 03: Exploring Massage and Raja Yoga; Cancer is a New Health Challenge

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

Ms. Sumler begins this chapter by explaining that she became interested in massage during the year she spent in bed after her spinal surgery for scoliosis and was learning about alternative treatments. She also talks about joining a raja yoga community because of her desire to live a spiritual life; her yogi was the source of her name, Sat Siri, and her yoga teaching practice at Yoga Central. She then talks about her diagnosis with melanoma and describes undertaking yogic death practices to confront this challenge.
Chapter 04: Massage and Cancer Patients: A Contemplative Practice

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

Ms. Sumler begins this chapter describing how she began to practice massage in 1986 and tells stories to illustrate how "massage is artistic expression." She also notes some myths in the massage community at that time, e.g. that massaging cancer patients would spread their disease through their bodies. Ms. Sumler questioned this belief and decided to know more about massage and cancer. At the same time, family and friends were referring clients with cancer to her for massage. She explains technical aspects of her work with cancer patients.

Next, Ms. Sumler explains how she came in contact with Integrative Medicine at MD Anderson. She describes how she felt a "sense of calling" when she was at the institution. She was first invited to come and teach yoga, but that opportunity didn't work out.
Chapter 05: Bringing Massage to the Place of Wellness and Integrative Medicine

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

Ms. Sumler explains that she eventually was offered a contract position to offer chair massages for "brief relaxation" in patient waiting areas. She explains why the massage was labeled in that way and talks about progress made in creating an inviting space for patients at the Place of Wellness. She also discusses training she received in massage therapy at Memorial Sloan Kettering Cancer Center in 2002.
Chapter 06: Massage: Benefits to Patients

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler talks about what massage offers the cancer patient and tells several stories about patients' reactions to massage. She also discusses the supportive attitude of many MD Anderson clinicians, particularly in rehabilitative and supportive care. She notes that to document the safety of massage in the first three years of the massage program, she took patients' vital signs before and after massage.

Next, Ms. Sumler talks briefly about the value of yoga for oncology patients. She ends this chapter with comments about how massage makes her contemplative practices manifest.
Chapter 07: Training Massage Therapists and Building Institutional Acceptance for Massage

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

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

Next, Ms. Sumler gives examples of how MD Anderson staff have accepted massage as part of a patient's experience and treatment.
Chapter 08: Patient Acceptance (or Non-Acceptance) of Massage Therapy

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler talks about why patients in general may resist getting massage, and how cancer patients deal with special issues of vulnerability in massage. She also talks about the positive impact of massage on patients, recounting anecdotes to underscore the role of massage in reconnecting patients positively with their bodies. She also discusses how positive personal experiences with massage can lead patients to consider other complementary services, and vice versa.
Chapter 09: Clinician Acceptance (or Non-Acceptance) of Massage Therapy

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler talks about why clinicians may refuse to send their patients for therapeutic massage, usually out of a lack of information about how specifically this type of massage is tailored to the needs and limitations of patients undergoing specific treatments. She gives examples of how she and others in massage therapy opened communications with clinicians to provide education and overcome resistance.
Chapter 10: Contributing to Research on the Value of Massage

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler sketches her participation in research into the value of massage for patients with peripheral neuropathy and deep vein thrombosis. She also discusses how her own perspective on massage changed through these collaborations. She explains how one study led to a change in the organization of the scheduling of massage.
Chapter 11: A Few Words about Yoga and Views on MD Anderson's New Directions

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

Ms. Sumler begins this chapter by speaking briefly about teaching yoga at MD Anderson and how acceptance of that service has grown.

Next, she reflects on the new direction MD Anderson seems to be taking under Dr. Peter Pisters, who became the institution's fifth president after Ronald DePinho's resignation. CLIP She says she feels that "a new light is shining" and she sees a new commitment to the institution's commitment to care and compassion and its mission to support both patients and employees. She has hopes that acceptance of Integrative Medicine will continue to grow.
Chapter 12: Reflections on Contributions and on the Art of Massage, Meditation, and Teaching

Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD

In this chapter, Ms. Sumler reflects on the contributions that have meant the most to her and stresses that she loves to learn, and will continue to expand her knowledge of therapeutic massage during the rest of her time at the institution. At the end of the interview, she talks about her core identity as a meditation practitioner and an artist. She explains how these two currents combine her view of yoga, teaching, and massage as art forms.
Chapter 01: The Making Cancer History® Voices Oral History Project

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic provides an overview of the Historical Resources Center –which he founded-- and the Making Cancer History Voices Oral History Project that it oversees.
Chapter 02: Vietnam Trains an Administrator

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic talks sketches his educational background and describes the significance of his military service. Drafted as a college senior, his service in Military Intelligence during the Vietnam War not only gave him focus for his later graduate studies, but also strengthened specific characteristics and skills that would eventually suit him to a career in administration.
Chapter 03: Choosing Cancer Research

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic traces the evolution of his interests in graduate school, eventually leading him to focus on cancer research.
Chapter 04: Joining the Department of Tumor Biology at MD Anderson

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic talks about coming to MD Anderson in 1980 as an Assistant Professor in the Department of Tumor Biology (now Molecular and Cellular Biology). He explains that this was the period when Dr. Charles LeMaistre [Oral History Interview] and Dr. Frederick Becker [Oral History Interview] were bolstering the basic sciences. He explains how he re-evaluated his career, and shifted toward a focus on administration.
Chapter 05: The Cancer Biology Program

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

Dr. Tomasovic begins this segment with comments on MD Anderson’s perceived weaknesses in basic research. He talks about the important role that graduate students serve in driving research at an institution and how they were integrated into departments at MD Anderson. He then describes his first “forays into leadership”: e.g. during 1986-’88 he created and directed the multi-disciplinary Program in Cancer Biology (first called Interdisciplinary Studies in Cancer Biology) in the Graduate School in Biomedical Sciences.
Chapter 06: Fostering Innovation and Multi-disciplinary Research

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic talks about how interdisciplinary work –at MD Anderson and in general-- is crucial to treating cancer and fostering creativity in research.
Chapter 07: Academic Affairs: Administrative Structure and the Role of the Vice President

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic provides an overview of the administrative structure of the Division of Academic Affairs and his responsibilities as Senior Vice President.
Chapter 08: An Ability to Work With and Within Structure

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic reflects on his leadership style and how this has facilitated his effectiveness. He notes how he came to the attention of James Bowen, then Vice President for Academic Affairs, who worked with him in creating the Faculty Senate (Dr. Tomasovic was the first Chair, ’91-93), and who appointed him Assistant to the Vice President for Academic Affairs (1994). The session closes with a sketch of the institutional flux in play during 1998 when Dr. Mendelsohn [Oral History Interview] assumed leadership of MD Anderson.
Chapter 09: The MD Anderson Presidents: Continuity of Leadership

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

Dr. Tomasovic begins this segment with the observation that MD Anderson is unusual because of the long tenure of its key leaders and administrators. He characterizes the three presidents and gives examples of how the institution successfully met the managed care crisis. He notes that the institution has faced strong, external financial challenges at the transitions between Dr. LeMaistre and Dr. Mendelsohn and Dr. Mendelsohn and Dr. DePinho.
Chapter 10: A Lesson About Leadership and an Institutional Blind Spot

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this chapter, Dr. Tomasovic shares a story that taught him lessons about leadership.
Chapter 11: Institutional Reorganization and Becoming Vice President of Academic Affairs

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

Dr. Tomasovic begins this segment by sketching the administrative restructuring that occurred when Dr. John Mendelsohn arrived as institution president. He also described Dr. Margaret Kripke's [Oral History Interview] plans for restructuring Academic Affairs' and his role in this process. Dr. Tomasovic notes that Dr. Kripke expected him to iron out a range of difficulties arising among faculty.
Chapter 12: The Education Council, Sister Institutions, and Views On Leading Faculty

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic gives numerous examples of how he has built educational culture at MD Anderson through, for the formation of The Education Council (2001), strengthening faculty development initiatives, serving as Vice President of Extramural Programs (to become Global Academic Programs).
Chapter 13: The Faculty Senate and a Vision of Faculty Influence

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

Dr. Tomasovic begins this chapter by sketching the history of the Faculty Senate. He discusses term-tenure then expands on the idea that the Faculty Senate was part of a larger vision of building faculty control over the governance of the institution. Dr. Tomasovic also explains how he came to found the Faculty Leadership Academy (1991), devoted to nurturing leadership qualities of faculty.
Chapter 14: A Mark Left on Education and Faculty Achievement

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

This interview takes place a few weeks before Dr. Tomasovic’s retirement. Dr. Tomasovic closes the session with comments on his hopes that MD Anderson preserves its educational mission, which distinguishes it from other care-delivery institutions. He also hopes that his efforts to foster leadership among the faculty will endure.
Chapter 15: Serving as Special Assistant to Dr. Oliver Bogler

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic talks about his role as Special Assistant to the Provost. Dr. Tomasovic begins by describing the transition-support role he will serve in the coming year, assisting Dr. Oliver Bogler, who took over Dr. Tomasovic’s position as Senior Vice President of Academic Affairs. He discusses how he and Dr. Bogler are finding ways to link activities in Academic Affairs to the mission of the new MD Anderson president, Dr. Ronald DePinho. He gives examples of how he and Dr. Bogler are streamlining the bureaucracy of Academic Affairs to help faculty and graduate students as well as supporting Dr. DePinho’s mission.
Chapter 16: Changing Institutional Focus Under a New President

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

Dr. Tomasovic begins this segment by comparing the leadership styles of John Mendelsohn [Oral History Interview] and Dr. DePinho, whose charisma, decisiveness and vision are reminiscent, he feels, of R. Lee Clark. Dr. Tomasovic talks about the impact of Dr. DePihno’s “Town Hall” session on 7 November 2011, when he announced that MD Anderson will now take a Moon Shot approach to curing cancer, focusing on five specific cancers (not yet announced). Dr. Tomasovic speculates on the cultural shifts this focused mission will create, influencing the commitment to global oncology, and educational programs.
Chapter 17: Academic Programs under a New President

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic notes Dr. DePinho’s commitment to graduate education and research. He describes the many discussions currently taking place in Academic Affairs to insure that all activities are in line with the new directions the institution is taking. He this segment with comments on his optimism that Dr. DePinho will steer the institution in positive directions.
Chapter 18: Travel, Photography, and a Story about Meerkats

Stephen Tomasovic PhD and Tacey A. Rosolowski PhD

In this segment, Dr. Tomasovic talks about his retirement, noting that he has more energy now that he can spend more time taking care of himself. He talks about getting back into the photography and he has planned several of the eco-travel trips he and his wife enjoy, including a trip to India to see tigers. He tells an amusing anecdote connected to a photo snapped of him during his first trip to Africa: he is reclining in a meerkat colony, with meerkats perched on his hat and hip. He tells of sending that photo for use at the awards banquet when he was elected to the UT Academy of Health Science Education. Popping up amid the formal shots of other awardees, his photo caused a lot of reaction among the attendees. At the interview’s close, he returns to the subject of Dr. DePihno, noting that the focus on institutional growth caused MD Anderson to lose some of its connection to people –a key part of the culture that R. Lee Clark established. Dr. DePinho’s “common touch,” he believes, will help turn the culture of MD Anderson back to those roots. In this segment, Dr. Tomasovic also talks about the human side of R. Lee Clark.

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