Interview Chapters

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  Chapter 17: The Texas Cancer Council and the Texas Cancer Pain Initiative

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Hill talks about his appointment (by Lt. Governor Bill Hobby) to the Texas Cancer Council (President, 1992-94, 1994-6) and sketches his work starting up the Texas Cancer Pain Initiative (which began in the 1980s with an organizational meeting funded by the Hobby Foundation), an organization that lent its name to the attempts Dr. Hill and others were making to revise legislation with an impact on pain management. Reviewing the organization’s educational efforts (in the late 80s or early 90s), he explains the political and financial reasons why it is more difficult to change pain management practices now than in the past.

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  Chapter 18: The Open-Door Mission for Rehabilitation and Recovery; Awards

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Hill talks about his involvement with the Open Door Mission for Rehabilitation and Recovery, where volunteers his time now that he is retired. He talks about his various awards, hoping that they bring attention to issues that need further attention and funding. He speculates that his interest in relief of pain came from his upbringing.

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  Chapter 19: A Southern Baptist Background Inspires a Life of Service

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Hill speculates that his commitment to care is rooted in his upbringing. He notes that he was raised Southern Baptist by practicing parents who had basic beliefs in a religion of love and service to others. (Dr. Hill believes all religions share these values; he is studying comparative religion now that he is retired).

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  Chapter 20: Hospice and MD Anderson

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Hill focuses on his work with the Hospice Movement. He describes the beginning of the Hospice movement in the U.S. (Dr. Hill attended the movement’s first meetings; he serves on the Board of Houston Hospice.) He explains why Dr. Clark was anti-Hospice at the time. He describes some basic beliefs of the group he worked with, primary psychologists, and shares a number of stories that show how he helped shape how Hospice in Houston functioned and evolved into a centralized institution. He again notes that Dr. Clark was against Hospice and such efforts as “Reach to Recovery.” He contextualizes Dr. Clark’s attitude in the anti-MD Anderson movement in Texas (fueled by MD Anderson’s fee-for-service policy) and explains why his attitude eventually shifted, though he stresses that MD Anderson “does not exist to preside over anyone’s death.”

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  Chapter 21: Expanding MD Anderson’s Reputation

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  Dr. Hill begins this chapter by explaining why so many ENT cancers were referred to MD Anderson to have the successful, less disfiguring surgeries for people “who were supposed to be dead.” (He vividly describes the process of “walking a flap [of skin]” to perform reconstructive surgery.) He recalls that MD Anderson’s reputation was secured via non-surgical interventions of radio- and chemotherapy, and compares it to the more surgical focus of Memorial Sloan-Kettering. He also illustrates Dr. Clark’s “political moxie… that doctors in general don’t have” –a key factor in MD Anderson achieving prominence. Dr. Hill next returns to his own work on thyroid cancer, offering two specific cases in which he and other MD Anderson physicians were better able to diagnose cancer than others. He talks again about how he started up studies of families.

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  Chapter 22: An Endowment for Education, More Research, and a Think Tank

  C. Stratton Hill Jr. MD and Tacey A. Rosolowski PhD

  During this chapter, Dr. Hill talks about the endowment he made (1998) to MD Anderson for education in Pain Management that would show the complexity of pain associated with cancer. He talks about current plans to discuss toxicities from cancer treatment, “the backdoor of treating symptoms from cancer treatment,” and hopes that the money will be used to support a “think tank” about symptom relief tied to individualized therapy.

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  Chapter 01: A Family Tradition of Librarianship

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman sketches her family background and talks about the number of people in the family who have become librarians, beginning with her father, who headed the Saint Louis University Library. She tells several anecdotes to shed light on her own choice to enter library science.

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  Chapter 02 : Education and Activities Reflect a Broad Perspective

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman talks about the range of strengths and interests that emerged during her youth: a gift for mathematics, a love of reading, interest in music and sewing. She talks about her choice of undergraduate institution, Case Western Reserve University (B.A., 1971). For graduate school, she elected to go to the University of Illinois (M.S.L.S., 1973) because they has a program in biomedical librarianship.

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  Chapter 03: The Texas Medical Center Library: Aspirations to Leadership and How Context Affects Library Administration

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman talks taking her first position out of school at the Texas Medical Center library. She notes her early aspirations to rise to leadership positions where she would be “in charge.” She then talks about what library management meant in her experience and briefly discusses several changes in libraries that have presented management challenges.

  Next, Ms. Hoffman talks about the administrative environment at the TMC library, noting that resources dried up in 1986 with the drop in oil prices.

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  Chapter 04: The Texas Health Science Library Consortium: Building Collaborations and Connections around the TMC Library

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  Here Ms. Hoffman talks about her role and the challenges involved in setting up a the Texas Health Science Library Consortium, a system of shared services at the Texas Medical Center.

  Next, she talks about her involvement in professional associations and explains why they are important to the progress of a librarian’s career.

  She then talks about leadership lessons she learned through experiences at the TMC library and recounts an anecdote about her work on a credentialing committee.

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  Chapter 05: Stepping into Leadership at UT Southwestern Medical School

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  Ms. Hoffman begins this chapter by explaining why she chose to leave the Texas Medical Center Library and take a position as Executive Director of the Library and UT Southwestern Medical School in Dallas.

  She talks about the situation she inherited at UT Southwestern, digresses briefly on her role as Executive Director at MD Anderson’s Research Medical Library, then returns to talk about how her goal in Dallas was to take the library into the 21st century. Ms. Hoffman lists some differences in working at a public versus a private institution and comments on what she was able to achieve at UT Southwestern.

  Next she talks about her particular strengths in strategic planning. She notes, “I was a visionary,” and describes her vision for the UT Southwestern Library and how she set about making that a reality.

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  Chapter 06 : A New Opportunity at the Research Medical Library

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  Here Ms. Hoffman tells the story of being recruited to MD Anderson to become Executive Director of the Research Medical Library. She explains the situation she stepped into, commenting on limitations of staff at that time. She also talks about the pressing need to develop the Library’s technological base.

  She shares a story from her on site interview: an interaction with a faculty member very committed to the Library’s technology.

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  Chapter 07: First Steps to Develop the Research Medical Library

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman explains the situation she inherited from the previous director, Marie Harvin. She discusses two challenges that she first addressed: first, helping the staff address difficulties stemming from a staff members alcohol problems and, second, limitations places on the Library due to physical space in its location at that time in the Bates Freeman Building. She notes that originally library use was restricted to physicians and researchers only.

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  Chapter 08: Developing Areas of Staff Expertise in the Library

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  Ms. Hoffman begins by explaining that she strengthened RML services by recruiting individuals to perform high level online searches. Next, she discusses the creation of the Historical Resources Center, an action that was associated with the Library’s acquisition of the papers from the Office of the President. This acquisition brought awareness to the need for a formal mechanism to preserve the institution’s history. (Ms. Hoffman notes that her interactions with Beth White at the TMC Library underscored the importance of such archives). She explains that a task force was created to address the issue of preserving MD Anderson history, also resulting in the creation of the oral history project.

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  Chapter 09: Working on Leadership Structure and Developing Services to Align with Institution Mission

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  Ms. Hoffman begins this chapter by explaining how she changed the reporting structure in the Library for greater efficiency. She refers to an article she published in the Journal of Hospital Librarianship (document available). She discusses where the RML fits within the institution.

  Next, Ms. Hoffman explains the Library’s different service areas and how they align with the institution’s mission areas: research, education, patient care, prevention. She explains her role in establishing The Learning Center for patients, an initiative led by Louise Villejo [oral history interview].

  Next, she discusses funding for the Library, noting that it always has had good support from the institution.

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  Chapter 10 : The Creation of the Historical Resources Center

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman talks about the creation of the institution’s Historical Resources Center. A task force submitted a white paper to elaborate on the importance of this new center. She then talks about the three projects undertaken once the Center was established: creating a physical place to safely house documents and artifacts; writing the institution’s history; creating the oral history project.

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  Chapter 11: The Library’s New Location on the Penthouse Floor of Pickens Academic Tower

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman explains how, against standard corporate practice, the Library came to be located on the top floor of the newly build Pickens Academic Tower (with the presidential and other c-suite offices underneath). She talks about the process of designing the new library for that space and some of its special features.

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  Chapter 12: The 2008 Layoffs

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman discusses the “most difficult thing she had to do as a manager”: cut 10% of the library’s budget. She describes the instructions she received from the institution on how to make her decisions. She talks about the support the institution provided for you to go about notifying employees of layoffs. She provides advice to other managers facing this challenge.

  Next, Ms. Hoffman talks about the areas she targeted for cuts and why. She discusses the impact of this financial crisis on the staff.

  She segues to another management challenge: dealing with an incident of violence against a staff member, then returns to final comments on the reduction in force.

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  Chapter 13: An Interest in Teaching and Work with Professional Associations

  Kathryn Jones Hoffman MSLS and Tacey A. Rosolowski PhD

  In this chapter, Ms. Hoffman talks about the pleasure she took in teaching and describes the intensive courses she taught all around the world on MeSH and the NLMC classification systems. She also discusses the importance of her work with associations and talks about some of her ongoing, post-retirement activity with them.

  She then talks about retirement, noting why many people are afraid to retire. She discusses her involvement in the MD Anderson Retirees Association and comments on the continuing relevance of libraries and librarians.

  After closing the interview, she adds a story of working with Dr. Peter Pisters on a research project. Dr. Pisters was selected to be MD Anderson’s new president after Dr. Ronald DePinho’s resignation.

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  Chapter 01: The Importance of Addressing Faculty Health

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman sketches the range of reasons why it is important for institutions to address faculty health. He mentions the economic reasons as well as moral reasons. He sketches the sources of stress for clinicians and notes that physicians have conducted studies to understand how institutional pressures exert stress. He sketches the stressors for research faculty, noting that this population has not been significantly studied.

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  Chapter 02: Growing Up in a Small Town in North Carolina

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman describes the working class, racially diverse community of Apex, North Carolina, where he grew up.

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  Chapter 03: A Strong Mother Tells Stories with Impact

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman talks about his mother, a strong woman with a strong impact on him. He notes that her very difficult background formed her into a very strong woman who would speak her mind and stand up for what is right. She would also tell Dr. Holleman and his brother stories that captured lessons as they were growing up. He offers three stories that influenced him and that he says had an impact on the work on faculty health that he is doing at MD Anderson.

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  Chapter 04: Developing an Ability to Deal with Psychological Turbulence

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman talks about graduating from Apex High School [1973] and attending Harvard University. Dr. Holleman explains how he made that choice, unusual for his community. Next, Dr. Holleman explains more about the dynamics in his family. Growing up in this environment, he says, enabled him as a counselor to treat people with personality disorders and depression.

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  Chapter 05: A History Major at Harvard and a Desire to Make a Positive Difference

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman provides background for his desire to study history and possibly enter politics. He explains that he has skills much like his father, whom he admired. He recounts formative experiences with desegregation and political action that shaped his desire to address inequality and suffering and make a positive difference for people. He gives more insight into his family’s progressive values.

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  Chapter 06: A PhD Program and a Professional Focus on Ethics

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  Dr. Holleman begins this chapter by explaining that his educational path took a turn because of his fiancée, Marsha Cline, who wanted to go to medical school: he explains how they made the choice to come to Houston. Next, he explains that while looking for work and a course to take, he was offered the opportunity to begin a doctoral program in the Department of Religious Studies at Rice University [Ph.D., 1986, Religious Studies]. This program led to his focus on medical ethics, a specialization he pursued with a Fellowship in Ethics at Baylor College of Medicine [1987-1988]. He developed expertise in primary care medical ethics. He gives examples of ethical issues that can arise and explains that his work changed practice at Baylor.

  Completing his fellowship, Dr. Holleman explains, he advanced to faculty status as an Assistant Professor in the Center for Medical Ethics and Health Policy at Baylor College of Medicine [1988-1998]. He describes the theoretical and philosophical focus of the department, whereas his strength centered in communication with patients. He was tasked with starting the Medical Humanities program at and founded the Compassion and the Art of Medicine lecture series/course [in 1989] that is now in its 27th year.

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  Chapter 07: Discovering Work with Underserved Populations

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman talks about a third formative experience that shaped his professional focus. He explains that he decided to volunteer at Ben Taub Hospital, a hospital for the underserved where Baylor medical students and residents were trained, in order to understand what his students in the humanities program were experiencing. He tells some anecdotes to show how his time there opened his eyes to the suffering of both patients and young doctors and led to his conviction that this was the population he should be working with.

  Based on this, he explains, he started a home visit training program for residents and eventually added a program for conducting health visits for the homeless. He talks about the evolution of these programs and how they led to his decision to go back to school, as he was effectively running a community health center [the Search Center] and functioning as a coordinator and counselor.

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  Chapter 08: An MA in Counseling to Develop Expertise

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  Dr. Holleman explains that he “found himself” when he began his master’s program [M.A., 1996, Marriage and Family Therapy] in counseling at the University of Houston -Clear Lake. He explains how earning credentials in counseling altered his roles at Baylor Collect of Medicine, where he became an Associate Professor in Family and Community Medicine [1998] and founded the Baylor-Star of Hope Center for Counseling [1998] in addition to fulfilling his previous roles.

  He notes that the Department of Family and Community Medicine developed an expertise in psychosocial medicine because of the vision of the chair at the time, Robert Rakle.

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  Chapter 09: Time for a Change in Work Scene

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman explains decisions that led to him taking the job of Director of the Faculty and Health and Wellness Program at MD Anderson. He first summarizes the roles he was serving at Baylor College of Medicine in the 2000s, then explains why he quit that job in 2007.

  Next he explains how he had become acquainted with staff in MD Anderson’s faculty health program through collaborations with the “Compassion and the Art of Medicine” series he established. He talks about his reasons for taking the position at MD Anderson, including his interest in seeing the differences between working with homeless individuals and physicians. He explains how he discovered it was actually easier to work with the homeless.

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  Chapter 10: Discovering the Severity of Burnout at MD Anderson

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  Dr. Holleman notes that he started at MD Anderson in January 2010, then discusses the severity of the burnout he discovered among the physicians and researchers (also a national problem). He details the sources of burnout among physicians that stem from turbulence in the healthcare environment and at MD Anderson: increased time spent on paperwork, sense of losing autonomy in the clinic, the need for child care, loss of a sense of meaning in the workplace. He notes that no formal studies have been done of faculty scientists, but summarizes findings from an informal survey: increased grant paperwork, shrinking grant funding, drop in morale, conflict with institutional leadership.

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  Chapter 11: The Faculty Health and Wellness Program: History and Evolution

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman sketches the history of the Faculty Health and Wellness Program and briefly describes the initiatives he set in place, including the Stressbusters Program designed to address physician burnout. He first notes that when he arrived at MD Anderson he saw the effects of faculty burnout, but has also never worked at an institution with more employee commitment to the institutional mission.

  Next he talks about how he did a needs assessment through informal focus groups and began to hear about the serious morale issue among faculty, a problem that intensified when Dr. Ronald DePinho [oral history interview] assumed the presidency.

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  Chapter 12: Learning about MD Anderson Culture Inspires a Different Perspective on Burnout

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  Dr. Holleman begins this chapter by explaining that he was effectively offering the faculty resiliency training. He then devotes the rest of this chapter to explaining the “epiphany” he had as his experience of MD Anderson culture evolved.

  Dr. Holleman recounts that, during training sessions, faculty would be “boiling” and would state that offering resiliency training was effectively “blaming the victims”: defining burnout as a personal problem and individual responsibility, when in fact it had been created by systems within the institution. On realizing this, Dr. Holleman explains, he began to research burnout and mentally redefined his role as being an advocate for faculty to the administration. He confesses that he didn’t feel comfortable in this role. He gives examples to demonstrate that burnout is a systemic rather than a personal problem.

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  Chapter 13: Advocating for Faculty with a Blog under Ronald DePinho

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman describes how he started the first faculty happy hours to create time for faculty to build connections. He then tells the story of the blog he started to give voice to faculty concerns, The Faculty Voice. A primary reason, he explains, was the strong fear among faculty of expressing their critical views of the institution and its leadership. He explains why this sentiment took root among the faculty.

  Next he explains the reasons why the administration under Ronald DePinho demanded that the blog be taken down after he published an anonymous post on nepotism focused on Dr. DePinho’s wife, Lynda Chin, MD. He explains his editorial standards in writing and publishing posts. He explains the reasons that the Legal Department gave for demanding that the blog be removed. He also talks about conversations he had with colleagues in the Department of Behavioral Science, in which they expressed concerns that his blog would have repercussions for his department. Dr. Holleman conferred with the Faculty Senate and a plan was made that it would be taken over and renamed, The Sentinel, but the publication foundered after a few months.

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  Chapter 14: Changes to MD Anderson’s Culture and Ronald DePinho’s Resignation

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  Dr. Holleman sketches the faculty’s concerns about Dr. DePinho and Dr. Chin. He also sketches changes in MD Anderson culture that were created after Dr. DePinho assumed leadership of the institution.

  He then notes that Drs. Emil J Freireich and Emil Frei are “veteran physician-scientists” who represent the old culture of MD Anderson. He talks about the first impressions of Ronald DePinho and then explains how Dr. DePinho’s decisions shifted the culture.

  Next, Dr. Holleman talks about Dr. DePinho’s resignation and what appears to have led up to it. He notes that he is hearing a lot of optimism from the faculty now that Dr. Marshall Hicks has been named interim president. He also notes that the selection of the interim team represents a return to the old values of MD Anderson: a focus on patient care and clinical research under the stewardship of servant leaders.

  Dr. Holleman and the interviewer discuss how, during this interim period, the institution will be rediscovering its core values. Dr. Holleman then sketches the positives as well as the negatives that Dr. DePinho brought to the institution.

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  Chapter 15: A Role as “Toxin Handler”

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman reflects on the role he has served vis a vis the faculty during the last five and a half years. He notes that his job has been to listen to the faculty and reflect back what they are saying. He also tells an anecdote about learning the phrase, “toxin handler” to describe what his real job is. He defines this role more fully.

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  Chapter 16: Faculty Health and Wellness: Programs and the Anti-Bullying Task Force

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman begins to sketch the range of traditional and non-traditional programs that Faculty Health and Wellness offers, then turns to one initiative in particular, the Anti-Bully Task Force. He defines what shapes bullying can take in the workplace and stresses the “emotional immediacy” that victims of bullying experience. He then clarifies that the Task Force was created in 2013 in response to the way Dr. Ronald DePinho handled his policy of raising the standards for promotion and tenure.

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  Chapter 17: Faculty Senate and Changes to the Shared Governance System

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman observes that representatives of the University of Texas System intervened in Dr. DePinho’s style of addressing the promotions and tenure system. He explains that Dr. DePinho had diminished the role of the Faculty Senate, and UT System’s Chancellor McCrave expanded its original powers under the reorganized shared governance system. Dr. Holleman notes that the Faculty Senate continues to discuss and refine how this system should work. He praises Faculty Senate and observes that this new system has allowed new faculty leaders to emerge. He cites studies that have found that the effectiveness of leaders is dependent on burnout, and that empowering faculty leaders is key to reducing burnout at the institution.

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  Chapter 18: Faculty Health and Well Being: Programs and the Faculty Health and Well Being Committee

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman returns to the topic of the Program’s offerings, then focuses on the Faculty Health and Well Being Committee, which he chairs. Formed in 2010, this committee is designed to “multiply the effect” of the Program by bringing together faculty who are interested in providing additional programs to faculty and to conducting research on topics related to health and well-being. He talks about the activities of several committee members. He then talks about the areas that he and the committee would like to see expanded, notably social events for young faculty and for young faculty and spouses/families. He tells stories to demonstrate how successful and needed social events have been in the past.

  Next, Dr. Holleman notes that the Committee has recently included a new dimension in its mission: supporting the Faculty Senate and the Shared Governance System. He explains that such processes can address the problem of faculty health from the institutional level. He explains that the Committee wants to work more closely with Faculty Senate and that the Faculty Health and Well Being Program in general needs to develop its role in advocating for the faculty to leadership.

  Finally, he talks about the current environment of change, created when Dr. DePinho tendered his resignation. He observes that interim leaders are focusing on “what the institution’s calling is really about.”

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  Chapter 19: Looking Ahead to Writing

  Warren L. Holleman PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Holleman talks about his long love of playwriting. He talks about the plays that have been performed and his plans to work on others. He also talks about his plans to continue his academic study of physician burnout and he would like to write a book on life balance.

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  Chapter 01: A Nursing Student Discovers MD Anderson and Oncology Nursing

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment, Ms. Houston talks about her family background and the path that led her to oncology nursing. Born into a military family, she moved a great deal as a youngster. As her mother and aunts were nurses, she followed in their path, attended Texas Woman’s University in Denton, Texas. She began to work at MD Anderson while still in nursing school (in ’68 or ’69), choosing Anderson over Methodist Hospital, because of the higher wage ($18/8 hour shift). She describes her responsibilities at this time (dressing changes, for example). When she did her clinical rotation at MD Anderson, she was so impressed with the culture of work and care for the patients that she decided to become an oncology nurse.

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  Chapter 02: Why Oncology Nursing is Unique

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Ms. Houston describes how important a nurse is during the frequent “life ending” situations of cancer. She explains how a nurse gets to know patients and helps them confront all dimensions of their disease, though she also describes how uplifting it is to see patients beat cancer, as she was able to see when working with many lung cancer patients. She gives an example of a life-ending situation with a patient she particularly admired, and who spoke with her about how he could help his family during the rapid progression of his small-cell cancer.

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  Chapter 03: Nursing and Nursing Management at MD Anderson in the Seventies

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment, Ms. Houston talks about the progression of her nursing career. She first summarizes her experiences as Staff Nurse (“72 – ’76), when she worked with a number of units: Surgical, Thoracic, General, and Head and Neck. The separation of these units causes her to observe that although multi-disciplinary treatment was a goal from MD Anderson’s inception, it became a reality in the 90s with centralization of patient services. She also comments on the role of nurses in the team of care providers, noting that before the hiring of physicians assistants, nurses helped physicians manage their patients. Next she talks about her role as a teacher and mentor once she became a Nurse Manager (Head Nurse) in 1976, and she helped nurses under her to learn how to care for lung and esophageal patients. At the time, there were only three people in nursing staff development (now there are over thirty).

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  Chapter 04: Nursing Administration and a New Setting of Multi-Disciplinary Teams

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Ms. Houston sketches the next phase in her career (’79 – ’97): her move from Associate Director of Nursing, to Director of Nursing, and then into the position of Center Administrative Director of Hematology. (She was the first Center Administrative Director.” She summarizes the scope of her responsibilities in each role and then focuses on the restructuring MD Anderson was going through at the time to create “centers” for Radiation Therapy, Hematology, and other services in order to create continuity of care as patients shifted from being in-patients to out-patients or vice versa. This was part of a general institutional push to create “multi-disciplinary care environments.” Ms. Houston describes the reporting chains in these centers and the teams –made up of a surgeon, a medical oncologist, a radiation oncologist and a nurse, among other service providers. She confirms that giving clinics autonomy in this manner represented a cultural shift in MD Anderson, and its goal was greater cost effectiveness. She explains why this goal was not achieved. She then describes the roles that nurses served within the new structure. At the time, leaders in the field of nursing were becoming more vocal about the importance of nurses. At MD Anderson, however, she feels that nurses were involved as an afterthought and because individual physicians understood the role nurses play in organizing patient care, helping the physician to assess the patient, and supporting the patient who must ask the physician about his/her care. At the end of this segment, Ms. Houston talks about her role on the selection committee for the Ethel Fleming Arceneaux Outstanding Oncology Nurse Award, which recognizes the central role nurses play in patient care.

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  Chapter 05: Director of Nursing and Center Administrative Director

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Here Ms. Houston goes into detail about the operation of the different units she administered during the nursing phase of her career. She begins by speaking about the stresses associated with serving as a Director of Nursing ((’86 – ’95) in a “very physician-driven environment.” She notes some of the initiatives she took on: adding services for patients and a mentoring program for nurses, as well as setting up a satellite laboratory on the eighth floor of the Ambulatory Care Clinic. (In-patient nurses would work a week in the Clinic so they could see patients who had gotten better.) She then talks about her role as Center Administrative Director of Hematology responsible for four inpatient units. Most patients, she observes, were involved in research studies, and she describes the difference between nurses focused on patient care and research nurses, but goes on to explain the research element of all nursing at MD Anderson, as clinical nurses help the patient understand the investigational protocol.

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  Chapter 06: Inspirations and Observations About Changes in Nursing

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment Ms. Houston talks about people who inspired her. Renilda Hilkemeyer, “a phenomenal nurse and pioneer,” and the first Director of Nursing at MD Anderson, inspired Ms. Houston to be progressive. She learned how to conduct project and test out new work flows from Joyce Alt, the second Director of Nursing. And her late husband, Gary Houston, the first male nurse hired at MD Anderson and a Nurse Manager, involved her in many programs. This segment also includes Ms. Houston’s observations on how technology has increased the pace of care delivered, creating a rush in the work place and altering nurses’ relationship to patients and each other.

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  Chapter 07: A Career Change to Information Systems and the Challenges of New Technology

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Ms. Houston talks about how MD Anderson did not offer much leadership development support in the seventies. In the mid-seventies, she became involved in the Oncology Nursing Society (at both the local and national level) to build her leadership skills, and also absorbed a great deal via on-the-job training. Summarizing the qualities of a good leader, she says, “A good leader can go on vacation and no one knows you’re gone.”

  She then describes her shift in career from nursing to Information Systems: despite the fact that she knew nothing about computers, Dr. Mitchell Morris invited her to come to work on the Electronic Records Committee in 1997 because of her experience with both in-patient and out-patient care and her knowledge of forms and documentation (and because she was a fun person). Next, Ms. Houston describes the first project she worked on as Coordinator of Clinical Systems –Patient Care Information Systems (’97 –’99). She was part of a group comprised of two others from MD Anderson and 4-5 consultants from a software company, and strategized adoption of the Computer Based Patient Records. One of the first tasks, as she said, was to involve more MD Anderson staff and phase out the consultants. MD Anderson was an “early adopter” for technology and worked with software for dictation, pharmacy orders, and records. She stresses that they were looking for software that could assign a patient a single record number that would follow him/her across in-patient and out-patient care. She explains why this is important for patient safety, particularly those receiving chemotherapy whose total dosages must be closely monitored.

  Next Ms. Houston explains that Clinical Systems purchased a brand new product from Cerner Millennium [Health Information Technology] (though they stopped implementation a couple of years later). They adopted the Cerner Millennium product to speed requests for records and processing pharmacy orders, as well as to coordinate and consolidate patient care by reducing repeated work. She stresses that the MD Anderson record systems provides data in the form that MD Anderson users need. She is particularly pleased with the electronic reporting of laboratory data and vital signs. In contrast, she outlines the continuing challenges with regularizing data entry for physician dictation. Information Systems has adopted a system form M*Modal that processes natural language. The aim is to move physicians away from their habitual way of dictating to a structured output that can be electronically reported and searched.

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  Chapter 08: Recognizing Nurses and Nursing: The Brown Foundation Outstanding Nurse Oncologist Award

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment, Ms. Houston talks about winning MD Anderson’s first award for an Outstanding Nurse Oncologist (1982). (She has also served on the section committee.) She briefly recounts the history of the award then describes some of the peculiarities: it carried a $10,000 cash award (now $15,000), given at a Board of Visitor’s dinner, but awardees had to keep the honor secret (no longer the case). She describes the criteria used to select the Outstanding Nurse from among the names presented by nomination: going beyond MD Anderson’s very high standards for patient care and also making an impact developing programs and materials.

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  Chapter 09: Information Systems at MD Anderson

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Ms. Houston begins this segment by briefly describing what led her 1997 decision to shift from nursing into Information Systems after agreeing to serve on MD Anderson’s Computer Based Records Project. She then talks about how Information Systems has fit into (and driven) the 2005 restructuring and combining of Departments. She notes that much of her role involves serving as a liaison between Information Services and Clinical Operations and gives the example of working with critical care providers while implementing the Picis system to do preoperative evaluations and various kinds of documentation. She also notes that Information Systems was first perceived as a “top down” initiative, but after the 2005 restructuring, this shifted as “clients” within the institution requested services and support. She explains how IS is funded and how she helps Dr. Thomas Burke, M.D., Executive Vice President and Physician in Chief, prioritize the IS projects funded. She describes some of the challenges of satisfying the requests for IS support. They have funds, but a great deal is already committed to ongoing projects. With the case of Infection Control, for example, they have funds, but not enough people to implement and support a new IS initiative, and contracting this support would increase the price.

  Next, Ms. Houston describes the challenges that come from MD Anderson’s desire to always have the newest, most cutting-edge products. In Information Systems, this can mean purchasing newly developed software that may not be ready for full-blown use. The challenge of working with MD Anderson: patients have one record that follows them across inpatient and outpatient care, so providers can keep track of all procedures and drugs given. Chemotherapy administered in the hospital must be added to treatment given in the Ambulatory Care Clinic to avoid exceeding safe dosages. Ms. Houston then talks about how unique the laboratory systems are at MD Anderson and the high volumes of tests they perform, all of which have to be tracked by computer-based patient records.

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  Chapter 10: A Reality Check for Information Systems: Building Systems for Teams

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment, Ms. Houston talks about the role she has served “an interpreter” in building information systems at MD Anderson. She explains that her 27 years of experience in patient care have enabled her to represent users’ needs in Information Systems. When information services are planned, she understands how work flows in clinical situations, how providers integrate record-keeping and data entry into their work day, and how they relate to screens and the organization of applications. While Director of Enterprise Applications in Management Information Systems (’99 – ’05), she also set up a class for technical staff about cancer, so they would have some idea of the real life situations that Information Technology users at MD Anderson deal with. Ms. Houston also notes that on first joining IT she sometimes heard, “What’s that little nurse doing here,” and won respect by performing well also noting the increase in numbers of women in the field and change in attitude. She then expresses concern about how her skill set will be replaced after her retirement, given her unique view and the respect and collaborative networks she has built over the years. In a discussion of ClinicStation software, she gives an example of her ability to facilitate users’ understanding that technology may not be the solution to their problems if what is needed is a change in work process.

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  Chapter 11: Medical Records and System Design for Faster Work and Better Patient Care

  Deborah A. Houston and Tacey A. Rosolowski PhD

  In this segment, Ms. Houston explains a number of devices and services that IS has implemented to facilitate work at MD Anderson. She first talks about the Alkek Hospital Bed Expansion, and how the building’s design made it necessary to give nurses the VOCERA hands-free communication device. She explains why the attempt to install tablet computers in patient rooms to document vital signs and other information was unsuccessful (and how other computers are being installed) and explains the electronic white boards installed to monitor patient status. Next, Ms. Houston explains the decision made in 2005 to adopt ClinicStation. She talks about the assessment strategy and what this software allows. She explains that Information Systems has developed ClinicStation into a certified Electronic Medical Records system that meets government standards, The government takes an interest, she says, because electronic records should bring down the cost of healthcare. At the end of this segment, Ms. Houston talks about how Information Systems customized ClinicStation to suit MD Anderson needs.

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  Chapter 12: Information Systems as a Service Provider

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Next Ms. Houston notes that she plans to retire in three to four years, and by that time she would like to see efficient data entry for nurses and computerized systems for physician documentation, as well as completion of the project, Institutional Bar Code for Patient Safety. All of these initiatives, she says are key to safety and productivity. They are also tangible and achievable goals. As she looks back on goals already accomplished, she pleased to have started the hematology laboratory for patients and also gratified with the success of the Perioperative and Critical Care Informatics group that she directed from ’06 to ’09. MD Anderson faculty and staff are quick to ask for new technology, but the challenge is getting them to actually use it, Ms. Houston says.

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  Chapter 13: Perspectives on Changes at MD Anderson Culture and Contributions to the Institution

  Deborah A. Houston and Tacey A. Rosolowski PhD

  Ms. Houston begins this segment by observing that since the seventies, MD Anderson has grown so much that it is impossible to know everyone, and interactions have become more impersonal. Technology has contributed this, as people email and text one another instead of communicating by phone or fact-to-face. Reflecting on whether the Institution can become too large, Ms. Houston observes that the Regional Care Centers return in a sense to the more personal feel of the old, smaller MD Anderson. In the case of Information Systems, she says, there is no quality compromise as the institution expands into remote units. In the case of overseas units (Global Oncology), she notes there is always a question about whether patient care is delivered in the same way as in Houston.

  Next Ms. Houston says that her greatest concern is to find her replacement. She hopes that people in Information Systems will continue to foster a culture in which “everybody has worth” and can feel successful in what they do. MD Anderson has given her tremendous opportunities for success and to make friends. Once she retires, she intends to indulge her love of travel (especially taking cruises), her dogs who are like her children, and her various hobbies such as needlework.

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  Chapter 01: An Interest in Estrogen and an Important Discovery

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Jones talks about the graduate research that brought him to MD Anderson. He sketches the story of how he left the University of California, San Francisco to join MD Anderson to develop a research lab in endocrinology. He describes the research he conducted at on combined therapies for gynecologic diseases. In particular, his research had to do with the long-term impact of DES (diethylstilbestrol -synthetic estrogen) in promoting cancer, the work for which he is best known. He explains how his interest in medicine and oncology developed. He lists the individuals he worked with and describes the state of the field at the time. Next Dr. Jones explains that at MD Anderson he was hired to develop a pioneering model of a department with collaborative research connections supported by clinicians. Dr. Jones explains that the Endocrine Research Program was elevated to a Section, which him as head. He explains the reporting structure.

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  Chapter 02: A Conversation with Dr. R. Lee Clark

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones tells about a conversation he had with the first president of MD Anderson, Dr. R. Lee Clark, in the faculty restaurant of the Mayfair Hotel on the MD Anderson campus. He explains that Dr. Clark lived on the top floor of the hotel and had "his own table" at the restaurant. Dr. Jones was accidentally seated at that table, and Dr. Clark joined him. Dr. Jones recalls asking Dr. Clark how he came up with the idea for MD Anderson. Paraphrasing in his own terms, Dr. Jones says Dr. Clark was as concerned as he was about "linking discovery and delivery." He also recalls Dr. Clark speaking about decisions he would have made differently: relations with the UT System; dual appointments for faculty; the tenure system. Dr. Jones offers his own, negative view of the term tenure system.

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  Chapter 03: Coming to MD Anderson to Link Discovery to Delivery of Care

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Jones explains that his mother's breast cancer diagnosis motivated him to leave the University of California and come to MD Anderson. He comments on attitudes toward breast cancer in the African-American community. He recalls his realization at the time: "No matter how many discoveries I made, it's hollow if there's no impact on people I love." He looked for an institution with more connection and was also interested in being closer to Baton Rouge, where his mother lived. He notes that he knew about the history of racism in Houston. He recalls his conversation with mentor, Dr. Pentti K. Siiteri about MD Anderson.

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  Chapter 04: The First African-American Basic Researcher at MD Anderson

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Here Dr. Jones talks about race-related experiences at MD Anderson. He observes that he was one of five black clinicians at MD Anderson when he was hired. He explains that because of Dr. Charles LeMaistre's support, there was a protective "bubble" around him. He tells about establishing a rapport with the janitorial staff, who didn't believe he was black because "MD Anderson doesn't hire black doctors." Dr. Jones notes that a "˜bubble of protection' could make diversity hires much more vulnerable when their sponsors left. He says he was required to present eighteen letters of support for his promotion from assistant to associate professor (as opposed to the usual three). He explains challenges in his tenure and promotion processes.

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  Chapter 05: The Minority Faculty Association; What Health Disparities Can Mean

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones talks about his work in the late eighties to address inequities in the treatment of minority faculty members. He tells how the Minority Faculty Organization was formed and discusses controversies surrounding it and its impact. He tells the story of the Association's push for the first survey of salary equity. He discusses the severe salary inequities discovered and the changes it led to. Dr. Jones next talks about the demographics of MD Anderson's patient population in comparison to the demographics of cancer patients beyond the institution. He mentions working with Dr. Martin Raber on a strategic plan to integrate a broader patient population into MD Anderson. He demonstrates the idea of health disparities with a story about the son of a wealthy Houston family whose son died because there was no acute care center within easy distance to treat his injury.

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  Chapter 06: The Effect of Estrogen on Cancer

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones talks his role in the Department of Gynecologic Oncology: to bring reproductive endocrinology back into the conversation about cancer. He talks about "turf wars" that prevented him from pursuing some topics. He explains that he began looking at benign diseases (fibroids, endometriosis) to consider how these might be connected to cancer, as they are over-present in women treated at MD Anderson. He next talks about his studies of the early effects of steroid on cancer, focusing in particular on DES (diethylstilbestrol). He talks about creating the first culture of an immature mammary gland cell line with a functioning estrogen receptor (describing the innovative features of this work). Dr. Jones talks about the mechanisms of cell membranes and indicates that, at the time, researchers were not focusing on the mechanisms of normal tissues. He next outlines the treatments that came from his discoveries.

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  Chapter 07: Research on Cancer in Diversity Populations

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones outlines several studies he has conducted on cancer patients from different ethic/racial groups. He begins with the Tri-Ethnic study conducted in partnership with the Kellogg's Company. He talks about setting up the partnership then talks about the Healthy Friends initiative that focused on screening Hispanic women for cancer and his involvement in trials in South American focused on secondary and tertiary prevention of breast cancer via diet. He showed that intervention with diet had the same effect as treatment with Tamoxifen. Dr. Jones then returns to the Tri-Ethnic Study and explains nuances in the results: the media reported that the results showed no influence of diet on cancer rates, but he explains how this was an extreme oversimplification and, in fact, they discovered very positive results.

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  Chapter 08: Initiatives to Foreground Minority Populations and Diversity

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones reviews several of the initiatives he took on to bring minority populations into the conversation about cancer at MD Anderson. He first talks about the Center for Minority Research and Health, which created a holistic approach to doing research. Next he talks about starting the Biennial Symposium Series on "˜Minorities, the Medically Underserved and Cancer' (begun in 1987). He explains that the Biennial figured into a plan to change how MD Anderson addressed minority health issues. Dr. Jones then mentions establishing the National Minority Cancer Awareness Week: he explains why this was needed. Dr. Jones tells the history of how the Biennial was established, beginning in 1985 when the NCI began looking at cancer disparities. He talks about the challenges securing funding, noting MD Anderson's lack of support for this initiative and for him.

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  Chapter 09: A Stressful Relationship with MD Anderson Administration

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones sketches many tensions in his relationship with MD Anderson's administration. He mentions a Houston Chronicle article that stated "Lovell Jones was a boat-rocker and a malcontent." Dr. Jones explains why he was determined to stay at the institution, building on his solid research record: no one could accuse him of focusing on minority issues and discrimination because he couldn't make it as a researcher. Dr. Jones mentions Dr. Fred Conrad's murder at MD Anderson. Dr. Jones recalls that in the early eighties he took safety precautions and his staff feared for his life. He talks about his attitude toward any danger, noting that his connections with powerful people in the field helped protect him.

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  Chapter 10: Early Experiences with Race and Civil Rights Instill a Commitment to Equity

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones talks developing his commitment to work for equity. He describes the unusual features of Baton Rouge, Louisiana, where he was raised. This community was isolated and unusually integrated, characteristics that gave him a false sense of the country's integration. He was never told that he couldn't succeed. Dr. Jones then tells a story of disobeying his grandmother, who had told him never to take the bus downtown. He recalls sitting in the front of the bus only to be pulled to a seat in the back. Next he talks about how South University (a Black college) has a school on the campus of the laboratory school that Dr. Jones attended at the time. He was "adopted" by some college students and through them was introduced to civil rights activities. He then had the opportunity to attend the Robert E. Lee High School that was being integrated. He recalls being shot at and attacked during this period. Nevertheless, he explains, when he enters a room he never sees race. At the end of this chapter Dr. Jones explains why his mother threw him out of the house when he was thirteen.

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  Chapter 11: The Intercultural Council; the Biennial Symposium, The Center for Research on Minority Health

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones begins with stories to demonstrate the positive impact of the Biennial and how it advanced awareness of the health disparities movement.
  
  Next, he tells how he met with Arlan Specter (Senator, Pennsylvania) and eventually convinced him to appropriate money for a study that showed the lack of focus on health disparities, a precursor to the creation of a new NIH institute, the Office on Research on Minority Health. Dr. Jones next tells the story of forming the Center for Research on Minority Health. He describes how the Center was set up and positioned within MD Anderson. He explains its mission and initiatives directed at closing the gap in health disparities through science and education. Dr. Jones explains difficulties in sustaining his connection to the Department of Health Disparities Research after his retirement.

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  Chapter 12: Race at MD Anderson: Slow to Make Real Changes for Minorities

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  In this chapter, Dr. Jones provides a portrait of MD Anderson's approach to race and diversity during his tenure. Dr. Jones explains how race became a focus for him then shares his view of racism in America and racial inequality in Houston. He recalls segregation at MD Anderson still had separate eating areas for blacks and whites and observes that when he arrived, there was still a "psychological separation" between the races. He describes a conversation with Dr. Ronald DePinho about race. He notes resistance in leadership at MD Anderson and the Texas Medical Center to seeing race as an issue. He notes that there is "visible diversity" at lower levels of the institution but not in top leadership. Dr. Jones makes a comparison with the situation for women at MD Anderson, a situation that leadership addressed in ways that changed the climate. He observes that this has never been done for minorities at MD Anderson.

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  Chapter 13: MD Anderson Leaders and Diversity

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Dr. Jones evaluates MD Anderson and discusses the ability of key leaders to recognize race as an issue within the institution. He notes that Dr. Ronald DePinho, the fourth full-time president of MD Anderson, can empathize with, but not fully relate to the experience of African-Americans. He explains how important it is to make individuals aware of their biases without putting them on the defensive. He talks about Fred Levine, president of UT Medical Branch in Galveston, then compares Dr. Charles LeMaistre [Oral History Interview] and Dr. John Mendelsohn [Oral History Interview]. He talks about Dr. Emil J Freireich [Oral History Interview], Dr. Waun Ki Hong [Oral History Interview], Dr. Andrew von Eschenbach, and Dr. Bernard Levin [Oral History Interview].

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  Chapter 14: The National Black Leadership Initiative on Cancer: Developing Grassroots Action for Health Equity

  Lovell A. Jones PhD and Tacey A. Rosolowski PhD

  Here Dr. Jones tells the story of The National Black Leadership Initiative on Cancer. He defines "health disparities and health equity" (using the World Health Organization's definition). He then tells the story of helping to start the National Black Leadership Initiative on Cancer after the publication of a report on minority cancer. He explains the scope of the Initiative's activities (and notes MD Anderson's lack of support and criticisms). Dr. Jones tells anecdotes about his stressful relationship with MD Anderson that made him consider leaving Houston.

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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.

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  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.

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  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.