In accordance with oral history best practices, this transcript was intentionally created to preserve the conversational language of the interview sessions. (Language has not been edited to conform to written prose).
The interview subject was given the opportunity to review the transcript. Any requested editorial changes are indicated in brackets [ ], and the audio file has not correspondingly altered.
Redactions to the transcript and audio files may have been made in response to the interview subject’s request or to eliminate personal health information in compliance with HIPAA.
The views expressed in this interview are solely the perspective of the interview subject. They are not to be interpreted as the official view of any other individual or of The University of Texas MD Anderson Cancer Center.
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Chapter 08: Research on Lymphoma Treatments
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez describes studies she conducted on lymphoma treatments in collaboration with Dr. Cabanillas. She first explains a study that showed the efficacy of ifosfamide among patients who did not respond to the CHOP treatment. She next talks about use of the same drug for patients awaiting stem cell transplantation. This study is still in regular use. Dr. Rodriguez then says that the current atmosphere at MD Anderson focuses on developing new drugs rather than optimizing older drugs. As an example of the value of retaining older ideas, she mentioned work by Dr. Wilson that shows that continuous infusion of drugs is more effective than bolus administration, an idea that Dr. Cabanillas originally explored.
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Chapter 09: Learning Administrative Approaches by Leading the Myeloma Clinic
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez begins this segment by explaining that the Myeloma Clinic was originally jointly managed with Transplant Leukemia services. She served as Clinic Chief of the Lymphoma/Myeloma Section from 1994−1996. Dr. Rodriguez explains what she learned from working in this environment of shared resources and how she acquired basic knowledge of how to assess patient volume and flow and determine hours of clinic operation. Next Dr. Rodriguez explains how the administrative issues shifted once the Myeloma Clinic became autonomous in 2003 and was stressed with challenged of internal utilization of resources. At this point she began her habit of writing reports to ensure transparency. (She notes that she used to have access to downstream revenue reports, but these have since disappeared.) She talks about the biggest lesson she learned at the time: how an individual’s work has an effect on the whole. As an example, Dr. Rodriguez explains that she became aware that the Myeloma Clinic was one of the biggest customers of the CT Scan Unit. She details how this effected operations of the CT Unit and had an effect on other services. She explains that this refined her thinking about how to strategize care delivery in an arena of low resources. Dr. Rodriguez also notes that most physicians tend not to see the big picture in which the deliver care and use resources; she gives examples of stresses to the system that can result. Dr. Rodriguez observes that she began to attend administrator education courses around this time. As an example of slow administrative development at MD Anderson, Dr. Rodriguez notes that she never filled out a for-service charge form until the 1990s. She talks about issues that arose once billing forms were introduced.
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Chapter 10: The Role of the Physician-Leader at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez talks about the important role that physician-leaders can serve in an organization. She explains that a primary responsibility is to explain the need for institutional changes in terms that clinicians can understand. She stresses that physician-leaders must be able to listen, have a toehold in specific services, and demonstrate that they share common experience with clinical peers. She returns to the example of the Myeloma Clinic’s heavy use of the CT Scan Unit and the pressures that created among all services. She notes that she was first made aware of this resource issue by listening to clinicians vent their frustrations about difficult access to the Unit. Next Dr. Rodriguez explains that physician leaders must be able to explain a larger reality to data-driven MDs who generally have a much narrower focus. She talks about why, traditionally, there has been a gap between clinical and administrative levels of an organization. Dr. Rodriguez next talks about the history of physicians and leadership at MD Anderson, beginning with the first president, R. Lee Clark, who went to hire other clinicians with leadership abilities. She explains that in academic institutions, most physicians assume leadership positions that carry academic titles and that reflect their knowledge rather than specific skill at administration or leadership. Dr. Rodriguez believes that today one cannot excel as a clinician and administrator and this is why one is now seeing different titles for physician-leaders.
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Chapter 11: Today’s Medical Paradigm Shift
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez provides perspective on what she calls “the medical paradigm shift” that currently challenges everyone in healthcare. She begins by sketching how landmarks in the history of research into causes of disease created paradigm shifts in the pass. She begins with the long period in which doctors learned their craft through apprenticeship to other individual physicians. She then explains that a paradigm shift occurred in the 19th Century, when hospitals became the primary setting for acquiring this training. She notes that the growth of nursing also had an effect on the practice of medicine. She then talks about the technical developments of the 20th century that led to another paradigm shift. Dr. Rodriguez explains that the current paradigm shift is not focused on technology, but on how care is delivered and diseases managed. She stresses that the new paradigm focuses not merely on the doctor-patient relationship, but on the management of relationships between teams of providers and the institution to deliver optimal care. Dr. Rodriguez says that MD Anderson is still in the investigational paradigm and may not have the skills to engage patients in being their own health care advocates. She explains that there is a great deal of data available to help individuals prevent cancer and that nearly seventy percent of patients survive for five years. Dr. Rodriguez cites several MD Anderson initiatives that focus on prevention.
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Chapter 12: The Survivorship Initiative
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment Dr. Rodriguez talks about MD Anderson Survivorship initiative, which began to take shape, she explains, after the Institute of Medicine released its presidential report From Cancer Patient to Cancer Survivor: Lost in Transition (November 3, 2005). This report, she says, detailed why care for survivors was lacking. Dr. Margaret Kripke, PhD [Oral History Interview] had been appointed to the president’s Committee on Cancer and became aware of the issues. She brought this information to the president of the institution, Dr. John Mendelsohn, who decided to integrate survivorship into MD Anderson’s care delivery system. A committee was formed and Dr. Rodriguez took on implementation of their plan in 2006. Dr. Rodriguez notes that MD Anderson began transitioning patients to survivorship in 2010. There is now a significant body of patients and Dr. Rodriguez says her next step is to leverage the information that has been collected. Dr. Rodriguez explains the process she and her committee went through to determine how to implement survivorship care, a process that began with listening closely to all constituents. She summarizes: they build the survivor care clinics in the same way they build acute care clinics. Next Dr. Rodriguez sketches why a focus on survivorship was controversial when it was first proposed. She touches on bond that forms between the patient and the physician and notes that a primary concern was survivorship programs would ask the patient to divorce him/herself from the main oncologist. Dr. Rodriguez notes that this break can sometimes be more painful for oncologists, who say they enjoy seeing well patients –often the high point of their day. Dr. Rodriguez explains that they finally settled on a model where one supervising physician determined the activities of mid-level providers in a situation that de-escalates the intensity of visits by focusing on wellness. Dr. Rodriguez sketches the approach. She notes that a key issue they had to consider: at what point does the primary oncologist see the patient as a survivor? This question will be answered differently in each treatment area and the committee built algorithms to determine the transition point to survivor care, when the risk of relapse is nil. The entire care model for each service is built around four common domains: Surveillance, Prevention, Monitoring for Late Effects, Psychosocial Health. Dr. Rodriguez explains how this model works using the example of lymphoma. She confirms that all the survivorship services are amassing a great deal of knowledge about survivor care.
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Chapter 13: Aimed Toward an Interest in Survival; Survivorship Care and the Affordable Care Act
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez begins this segment by sketching how the Affordable Care Act has an impact on care for survivors. She focuses on the assumption payers make that it’s most cost effective to transition patients to their primary care physician after treatment, as oncologists are expensive. She says that is premature for patient who have had aggressive tumors or treatments. Dr. Rodriguez notes that she spoke at ASCO about MD Anderson model of survivor care. She communicated that the four domains MD Anderson uses to structure a care plan is relevant at all stages of cancer care. Dr. Rodriguez then explains that her interest in survivorship was a natural extension of her work with lymphoma patients, as lymphoma was one of the first malignancies that could be cured. She understood early the four domains of Surveillance, Prevention, Late Effects Monitoring, and Psychosocial Health.
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Chapter 14: Lessons in Administration as Ad-Interim Chair of Lymphoma/Myeloma
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez begins this segment by explaining how her view of the institution changed as she stepped into the role of Ad-Interim Chair of Lymphoma/Myeloma when Dr. Cabanillas retired. She sketches her new areas of responsibility and how this changed her view of operations and the institution as a whole.
Next, Dr. Rodriguez explains that traditionally, a Department Chair is seen as an “erudite expert,” but to be successful a chair must let go of her/his ego and bring forth future leaders in the field. -
Chapter 15: Vice President of the Office of Medical Affairs; the Value of Faculty Credentialing
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez begins this segment by explaining how conversations with the outgoing and incoming physicians-in-chief around she came to her role as Vice President of the Office of Medical Affairs. When Thomas Burke, MD [Oral History Interview] became physician in chief in 2004, her role was expanded to include medical affairs functions. She was officially named in 2005 with service to the present. Next Dr. Rodriguez notes that learned a great deal about Texas law and regulations of medical practice. She also had to familiarize herself with the roles of Physicians Assistants and Advanced Practice Nurses.
Next, as an example of a function within Medical Affairs, Dr. Rodriguez talks about the process of documenting the credentials that physicians present for employment. She explains why this process is key to the reputation of MD Anderson. She also notes that employees have occasionally falsified documents. -
Chapter 16: The Office of Medical Affairs: Credentialing, Quality Indicators, and Building a Culture of Improvement and Quality Care
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez explains a key function of the Office of Medical Affairs: to credential all individuals at MD Anderson to ensure their competence. She next explains that, since 2009, MD Anderson has been involved in developing performance and quality indicators for professional practice. She explains this history of this focus and the different reactions of clinicians to professional evaluation, given that most evaluation is perceived as adversarial and punitive, rather than part of a culture of self-awareness and self-improvement. She comments on Texas requirements that support a culture of improvement. Dr. Rodriguez then talks about how the Office of Medical Affairs created an infrastructure to shift to quality indicators.
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Chapter 17: The Office of Medical Affairs: Patient Concerns, Patient Advocacy, Conflict Resolution
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez discusses another important role of Medical Affairs: to provide support for patient who wish to voice complaints. This segment covers sources of patient complaints and distress, the importance of communication, the role of Patient Advocates and the sources of stress in that role. (She notes that patients can become abusive because they would like a second opinion to be a different, hopeful opinion, but often a lack of options is confirmed.) She notes that having an Advanced Directive conversation is a quality indicator and explains the issues that this raises. She notes that there is more emphasis now on selecting health care providers who have communication skills.
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Chapter 18: Creating MD Anderson’s Practice Algorithms; On Blending Art and Science in Medical Practice: Practice Algorithms and Targeted Therapy
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez tells the story of MD Anderson’s 147 Practice Algorithms beginning with the origin of this initiative in the 1990s movement to define “pathways of care.” She talks about the process of establishing an algorithm and discusses the effects. She also notes the different reactions of clinicians, who may immediately adopt the algorithm or who may take convincing. Dr. Rodriguez talks about the dangers of dogmatism in medicine. She notes that medicine is both an art and a science, but the poles need to be harmonized in order to be humane. Dr. Rodriguez notes that limits of targeted therapy and sketches an emerging view that this approach will be replaced by a focus on failures in the body’s surveillance and regulation mechanisms. She notes committees in place to support clinicians as they self-monitor the quality of their practice.
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Chapter 19: Integrating Advance Practice Providers into Care Teams; Training Program for Physician Assistants
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez talks about the increasing reliance on advance practice providers in medicine and in oncology. She notes that, at MD Anderson, General Internal Medicine is a hold out. She sketches what an APP can bring to a care team. She talks about her own experience working with a Physician’s Assistant. She explains why she shares oversight of Advanced Practice Nurses with the Division of Nursing. Next Dr. Rodriguez talks about the Physician’s Assistant Oncology Fellowship Program, started in 2008. She sketches differences in the education of MDs and PAs and explains the need for an oncology fellowship. She talks about the impact of the program and an e-course developed for fellows at a distance.
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Chapter 20: The Office of Medical Affairs: Job Satisfaction Survey of Mid-level Providers
Alma Rodriguez MD and Tacey A. Rosolowski PhD
After sketching changes to the office of medical affairs in the last ten years, Dr. Rodriguez discusses the purpose and results of the regular survey of mid-level providers at MD Anderson. She notes that, in general, the workforce is very stable, but the institution wants to monitor reasons that pockets of high turnover exist. She notes results of the survey: everyone at MD Anderson is committed to the job; some fear retaliation if they voice complaints; many feel they are not paid enough. Dr. Rodriguez stresses that employees’ pay is in line with other state institutions. She talks about requests for mentoring made via the survey and how that was acted on and to what affect.
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Chapter 21: Patient-Centered Care: Formalizing the Practice at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez talks about the shift in healthcare to a focus on patient-centered care and addresses the specific ways that MD Anderson is putting this approach into practice. She first explains that patient-centered care is a shift in focus and explains the value is shifting from treating disease to treating people (and seeing them as customers). She notes that MD Anderson patients experience the kindness and devotion of providers. She lists some patient centered practices instituted and notes others that need improvement.
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Chapter 22: Patient-Centered Care: the Psychosocial Council, Advanced Care Planning
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this segment, Dr. Rodriguez continues her discussion of patient-centered care. She discusses the work of the Psychosocial Council, in particular on the latter’s work on creating guidelines to talk to patients about advanced care planning, then talking about the Department of Chaplaincy and Pastoral Education. She first talks about the Psychosocial Council and advanced care planning, offering her view that advanced care planning is not a conversation about death, but about health care planning for the future that needs to be integrated into a patient’s treatment plan. She explains strategies for bringing awareness to this at MD Anderson and also notes that this is part of a national conversation. Dr. Rodriguez next talks in general terms about the Psychosocial Council (formed 2007), its roles, and the pushback it has received for treating disease from an emotional perspective.
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Chapter 23: Patient-Centered Care: the Department of Chaplaincy and Pastoral Education and the Future of Psychosocial Approaches at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez discusses the Department of Chaplaincy and Pastoral Education and its focus on spiritual concerns. She lists the kinds of issues that arise for cancer patients. Dr. Rodriguez explains that, historically, MD Anderson has sustained linkages with spiritual/religious organizations and communities. This is one reason the Department of Chaplaincy at MD Anderson is so robust. She then talks about the future of psychosocial approaches at MD Anderson, looking ahead to the creation of a Division of Psychosocial Oncology. She list some research studies the faculty are conducting in this area.
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Chapter 24: Transitional Moments in MD Anderson History
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez sketches key moments of change in MD Anderson history since her arrival. She first talks about the eighties and the “growing consciousness that MD Anderson is an economic entity,” moving on to the nineties and the complexities that evolved with more billing forms, rules, and concern for downstream revenue generated from patient care. She gives an example of chemo therapy orders and talks about pros and cons. Dr. Rodriquez then talks about the MD Anderson’s physical expansion to the point where she “can’t embrace” the institution. She notes that the physicians and nursing staff have preserved their dedication and pride.
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Chapter 25: Change Under Ronald DePinho: The Balance Between Research and Clinical Care
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez states that MD Anderson has shifted away from its mission as a care facility since Ronald DePinho assume the institution’s presidency in 2011, moving toward a research-generating facility. She sets context by discussing the growth of research under Dr. John Mendelsohn, noting that research still served patient care despite accelerated industry-sponsored research. She next talks about MD Anderson’s focus on new drug development and the implications, specifically in the demand for financial and intellectual resources this requires.
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Chapter 26: Turbulence During Dr. DePinho’s Early Presidency; MD Anderson’s Future
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez comments on the changes created at MD Anderson under Dr. DePinho’s early presidency then talks about the future of MD Anderson under the Affordable Care Act. Dr. Rodriguez first comments on the magnitude of institutional change that Dr. DePinho’s administration has brought to MD Anderson. Making reference to literature from the field of organization transformation, she notes that change on such a scale requires a “message of urgency” that was not verbalized by the administration. Change has felt imposed from outside, creating tensions in the institution, she observes. She notes that the Board of Regents was slow to recognize problems.
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Chapter 27: Creating a Future Under the Affordable Care Act
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez explains that MD Anderson’s future will be determined by changes to healthcare under the Affordable Care Act. She first talks about the loss in revenue anticipated, then describes initiatives that the Office of Medical Affairs is setting in place to help address anticipated problems. She talks about the need to document all care processes in the spirit of moving toward more evidence-based care and shifting the mindset of providers away from an expert mentality to a spirit of self-reflection and improvement. She also talks about the importance of examining and optimizing all of MD Anderson’s resources.
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Chapter 28: Women and Leadership at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez provides her views of women and leadership at MD Anderson. She cites statistics in support of her view that “the workforce in medicine is about women.” She stresses that women have to know systems in order to succeed in leadership positions. She offers her view of coming up through the ranks when there were many fewer women and notes that MD Anderson does not have clear processes for filling leadership positions or establishing a pipeline of leaders. She talks about her own strategy for cultivating leadership.
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Chapter 29: Accomplishments, Retirement, and a Love of Cosmology
Alma Rodriguez MD and Tacey A. Rosolowski PhD
Dr. Rodriguez begins by listing her most significant accomplishments: launching the concept of survivorship; imbedding into MD Anderson culture the role of quality officers; integrating Advanced Care Planning into treatment planning; serving as champion for the Physician Assistants Program; helping everyone who has reached out to her as a role model. Next she talks about the interests she plans to pursue in retirement: psychology, art, reading, and cosmology. She notes that she minored in philosophy as an undergraduate and her thinking has been very influenced by process philosophers who believe that reality self-creates. She believes that the Universal Mind is also self-creating and explains that this spiritual component of her belief system helps her cope with change.
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Chapter 01: Multidisciplinary Care at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Rodriguez provides an overview of MD Anderson’s multidisciplinary approach to patient care. She defines the approach and notes that it began with R. Lee Clark’s vision for cancer care. She gives examples of the specialties that collaborate to provide comprehensive management of a patient’s disease throughout treatment. She also offers observations on how the tradition of multidisciplinary care has had an influence on the culture of the institution.
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Chapter 02: The Important of Clinical Leadership at MD Anderson
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Rodriguez about the important role that clinical leadership has played in developing the institution and that it continues to play in the current healthcare environment. She sketches the qualities that leaders must have to steward institutions in the current climate and connects that to the culture of the institution.
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Chapter 03: Leadership in a Period of Change
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Rodriguez comments on the period of change the institution is experiencing, stemming from changes in the healthcare system, financial stressors, and internal turbulence stemming from Dr. Ronald DePinho’s resignation as president in March 2017.
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Chapter 04: Multidisciplinary Care and the MD Anderson Algorithms
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Rodriguez defines the MD Anderson algorithms of care and explains how they were created and are continually evolving, based on current research. She explains how they are connected to multidisciplinary care, and how important they are for standardizing care at MD Anderson’s partner institutions.
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Chapter 05: Envisioning the Next Period of Leadership
Alma Rodriguez MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Rodriguez talks about the qualities that the next president of MD Anderson will need to confront successfully the institution’s fiscal and other challenges. She comments on the stability that MD Anderson’s tradition of physician leadership has provided.
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Chapter 01: Inspired By Work at a Medical Institution
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck explains that he came to work for MD Anderson's Department of Public Information and Education in 1975. (Prior to that he worked in a University of Texas Medical School Information Office that served both the Medical School and MD Anderson.) He then offers some background information, including how he came to spend his "formative years" in Houston. He notes that he spent his undergraduate years at University of Texas at Austin majoring in advertising and journalism. He secured a job in public information at the University of Texas Medical Branch in Galveston after graduation. Seeing the caring dimension of medicine inspired him to continue to work with the medical field, however he was drafted in 1969, going to Vietnam in 1970 as a public information specialist who wrote for the Army until his discharge in 1971. Though he returned to the University of Texas at Austin for graduate work, he left because for a job in the Public Affairs office at the University of Texas Houston.
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Chapter 02: Public Affairs: Working Closely with MD Anderson Presidents
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck describes the work he did promoting awareness of the new medical school (University of Texas Medical School) until 1975, when he was made Director of MD Anderson's Department of Public Information. He explains why the rapidly growing institution needed such a Department at that time and why Dr. R. Lee Clark offered him the job [the letter mentioned is reproduced in Steve Stuyck: The MD Anderson Years]. He talks about Dr. Glen Knots, to whom Mr. Stuyck reported, and the lessons he learned from him about management and leadership. He then explains why, in 1981, Dr. Charles LeMaistre arranged for Mr. Stuyck to report directly to him. He tells a story about a speech he volunteered to write for Dr. LeMaistre when he had to testify in Washington D.C. about the deaths of several patients, and how pleased Dr. LeMaistre was with his work.
Mr. Stuyck explains the particular abilities he was able to bring to MD Anderson and to the institution's presidents. In addition to being a good editor of others' work, Mr. Stuyck describes himself as a strong writer about MD Anderson and about cancer, with a skill to commit issues to paper. He had a special sense of Dr. Charles LeMaistre's way of expressing himself and could capture it. (Mr. Stuyck says that "I could hear him saying the words from the podium.) He notes that the archives have about 700 speeches that he wrote over the course of his career.
Mr. Stuyck describes the exhausting schedule of working with Dr. LeMaistre's speech trips and notes that, when Dr. John Mendelsohn arrived, it was agreed that Mr. Stuyck would not write his speeches.
Mr. Stuyck then tells several anecdotes to demonstrate what he learned about leadership from Dr. Charles LeMaistre. In particular, he mentions Dr. LeMaistre's habit of encouraging people who worked for him.
Mr. Stuyck recalls that Governor Bill Clemmons shouted at him during a visit, and Dr. LeMaistre phoned him later in the evening to tell him not to worry about it. Next he speaks briefly about Dr. John Mendelsohn, noting that he was just what the institution needed at the time. Dr. Mendelsohn promoted Mr. Stuyck to Vice President of Public Affairs.
Mr. Stuyck notes that he had thirty years of working with great bosses and great leaders.
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Chapter 03: Early Developments in the Department of Public Information and Education
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
This chapter opens with the interviewer providing an overview of the three story threads told in Mr. Stuyck's interview: the story of his career, of the Public Affairs at MD Anderson, and a story of what public affairs encompasses.
Mr. Stuyck asserts that he had a direct effect on the broad scope of Public Affairs, citing the gradual absorption of Volunteer Services into the Department.
Mr. Stuyck next explains that he was able to secure a contract to set up the Cancer Information Service in 1974. This was the first NCI-funded initiative to create a public information call-in line, and it was controversial, as most professionals did not believe that laypersons could be sufficiently trained to provide medical information.
Mr. Stuyck explains how he became principle investigator, and what was involved in setting up the service on this grant, which has run for 30 years for a total of twenty-six million dollars. Mr. Stuyck then provides historical context. He notes that the CIS was part of a larger national effort to open up communication about cancer, to develop advocacy for many groups, and to increase the role patients could play in their health decisions. He also notes that the President Nixon signed the National Cancer Act in 1971 and that knowledge in the sciences was growing at a tremendous pace during this time. He also cites the culture of excellence that existed at MD Anderson in the seventies.
Mr. Stuyck gives several examples to demonstrate how far cancer treatment has come since the seventies: the first BCG (Bacillus Calmette-Guerin) trials that required patients to be scarified; "gruesome" chemotherapy treatments; and treatments that required extreme surgical damage to a patient. He also recalls the first outpatient clinic at MD Anderson, which was very primitive by today's standards.
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Chapter 04: The Faculty: The Intellectual Engine of MD Anderson
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck expresses his appreciation for the MD Anderson faculty who are the "intellectual engine" of the institution even though they represent only twenty percent of employees. He says he has always tried to understand faculty issues and "speak their lingo." He traces his support for faculty back to his experiences at University of Texas Medical Branch, where he loved attending Grand Rounds. He sketches how issues have changed for faculty and lists the pressures upon them. He also characterizes MD Anderson faculty as possessing great intellectual curiosity.
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Chapter 05: Expanding the Scope of Public Affairs: Increasing Services for Faculty, Patients, and the Public
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
In this chapter, Mr. Stuyck talks about the expansion of the idea of public affairs at MD Anderson.
Mr. Stuyck explains that after he secured the NCI contract for the Cancer Information Service, "Public Education" was added to the name of the Department of Public Information, going on to detail what education can do for an institution.
Next, Patient Education came under the scope of Public Information, and he explains what sorts of educational materials the department produced. Volunteer Services was next folded into Public Affairs, and Mr. Stuyck explains that he wanted to bring together in one unified division all the functions that would reach out into the public. Next he explains why Public Affairs was sequentially identified as a Department, then an Office, and finally a Division. He comments on the perception of Public Affairs within the institution then goes on to explain some of the many services provided to MD Anderson. He begins by explaining Creative Services then talks about the role Public Affairs played when Dr. Jordan Gutterman [Oral History Interview] and his work on Interferon attracted tremendous media attention. He explains that Dr. Gutterman received 7,000 to 8,000 letters from people begging to participate in his trials. Public Affairs set up a service to answer all of these letters.Mr. Stuyck talks about preparing faculty to deal with media appearances. Then he identifies the sections within Public Affairs and notes that he and his management team produced both monthly and annual reports to document the contributions they made to the institution. At the end of this chapter, Mr. Stuyck notes that MD Anderson has generally received very good press. Most of the negative press has come during the last year.
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Chapter 06: Public Affairs: External Communications
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck explains the changing role of Public Affairs since the seventies. At that time, physicians were not concerned about public relations. He then points to Dr. John Mendelsohn's arrival as a turning point in the institution's dealings with the public: Mr. Stuyck explains how he and others worked with Dr. Mendelsohn to draw greater attention from national and international media, eventually hiring a New York public relations firm, The GabbeGroup (which still works for MD Anderson). He also explains that the single greatest factor to change the institution's media needs was the passing of the self-referral legislation in 1994.
Mr. Stuyck describes the challenges created when the bill went into effect in 1995 and forty percent of patients could suddenly request their own appointments. He explains that the information service, Ask MD Anderson, was created to help patients navigate the complex institution: it takes 100,000 calls per year.
Mr. Stuyck next describes several strategies used to raise the institution's profile. He describes the trips that Public Affairs planned for Dr. Mendelsohn, designing them to create more exposure for cancer and the institution. The GabbeGroup suggested that Public Affairs submit profiles on cancer issues to the US News and World Report website. Public Affairs also published surveys on attitudes about cancer and attitudes about breast cancer in Prevention Magazine.
Mr. Stuyck explains that departments that heavily use Public Affairs services fund positions within the Department. This insures that Public Affairs serves their needs.
Mr. Stuyck points to the important and productive link between Development and Public Affairs. He then identifies some key moments in the institution's relationship to the public: achieving status as a cancer center; the change in the institution's name in the 1980s; the impact of the Internet.
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Chapter 07: Public Affairs: Internal Communications
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
In this chapter, Mr. Stuyck gives an overview of internal communications in the institution. He notes that, in 2001, MD Anderson was at a crisis point in communications and Public Affairs hired the management group, Deloitte &Touche, to analyze the issues. At this time he proposed to the Management Committee of Public Affairs to establish a section for internal communication. As an example of communication difficulties, he talks about the mistrust created by layoffs in the early to mid-nineties, describing the publications created to address the issue. He compares the paper communications of past decades with the online communications of today. He then talks about new technologies that communications specialists must master today, noting that "it's fun to be around" the new media specialists and to strategize how to use new technologies. He notes that Communications has "reinvented itself" six or seven times in the past decades.
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Chapter 08: Public Affairs: Writing the MD Anderson Mission Statement and the Code of Ethics
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
In this chapter, Mr. Stuyck next talks about his work on two key documents: the Vision and Mission Statement and the MD Anderson Core Values. He explains why there was controversy over the core values.
Mr. Stuyck gives an example of why the word "hope" was controversial in the Core Values, saying that he was "never a fan of hope," but other committee members convinced him it was key to MD Anderson. He then talks about the impact of the two documents, citing a survey of employees that revealed almost 100% satisfaction with the institution values. Next Mr. Stuyck briefly compares Public Affairs at MD Anderson to analogous departments at other institutions. He comments on the role of the Management Group within Public Affairs and its strategic work in guiding the departments activities and evolution. He briefly comments on how Public Affairs is working with the current controversies surrounding Dr. Ronald DePinho.
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Chapter 15: A Key Publication: Making Cancer History
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
In this chapter, Mr. Stuyck tells the story of how Making Cancer History, a history of MD Anderson came to be written. Dr. James Olsen, a historian at Sam Houston State University, originally approached Dr. James Bowen with the idea, however the Management Board under Dr. Charles LeMaistre had no enthusiasm for the project.
Mr. Stuyck speculates on why this was the case, then goes on to trace how the Historical Resources Committee was created under Dr. Stephen Tomasovic, with a first goal of producing a history of the institution. He explains the lengthy process of looking for a writer and the eventual hiring of Dr. Olsen, as well as securing Johns Hopkins University Press to publish it.
Mr. Stuyck recalls that he and Stephen Tomasovic [Oral History Interview] both read the manuscript.
Mr. Stuyck says that Making Cancer History is a great book that tells history in a human way. He also talks about his favorite chapter. Next he next talks about what it meant for the institution to have a book that celebrates the culture. He speaks about the number of documents James Olsen reviewed as part of his research, the committee members who worked on it, and what was done to promote it.
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Chapter 16: Changes at MD Anderson
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck gives an overview of the changes he has seen at the institution over the course of his career. He notes that people in the past worked just as hard as they do now, but worked differently. He talks about the dramatic expansions to ambulatory care and patient care in general and the improvement of quality of life issues for patients. He makes some observations on cultural changes and the increasing interest in work/life balance. He then talks about the plan to merge the University of Texas Health Science Center with MD Anderson, a move that was resisted to preserve the institutions mission and resources.
Mr. Stuyck also talks about changes that Dr. John Mendelsohn brought to the institution, particularly the dramatic growth, for which the institution is now paying the price, he says.
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Chapter 17: The Murder of Dr. Fred: A Challenge for Public Affairs and the Institution
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck talks about the day that Dr. Fred G. Conrad, Vice President for Patient Care, was fatally shot (17 December 1982). He recalls Elmer Gilley calling him early Friday morning, and he went to MD Anderson to wait for the police and the coroner and to handle the reporters.
Mr. Stuyck recalls how calmly Dr. LeMaistre handled the situation and helped calm the tension. He then talks about how Public Affairs handled the media, noting that the crisis brought out the best in people at the institution. He describes Dr. Conrad and explains why his murder was a "seminal moment" in the institution. He ends with a story about a woman who had flown into town to be interviewed for a job, arriving at MD Anderson to discover "bedlam" so she returned to New York.
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Chapter 18: Departments Within Public Affairs
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
In this chapter, Mr. Stuyck talks about four departments within Public Affairs: Volunteer Services, the Children's Art Project, Public Education, and Patient Education. He begins with Volunteer Services, a service within MD Anderson that goes back to the 1950s. He then talks about Page Lawson, a director who greatly expanded Volunteer Services in the 1970s. He explains how he came to oversee the Department and tells a story about Tommie Stewart, a volunteer known as "the Hug Lady." He notes that MD ANdserson has 1200 volunteers who contribute the equivalent of 100 full time employees. He mentions the series of directors leading up to Page Lawson, whom he calls "a dynamo." Mr. Stuyck explains the lesson he learned from Page Lawson about remembering the names of volunteers.
Mr. Stuyck next talks about the Department of Patient Education, created by Dr. Charles LeMaistre. He explains how it came from the first patient satisfaction survey conducted in the 1980s. Dr. LeMaistre used the results of the survey to add valet parking, patient advocates, and patient education functions.
Mr. Stuyck explains changes in the reporting structure that came about with these changes, as well as the database that evolved to support patient education activities. He sketches the types of materials produced and who works on them. Next Mr. Stuyck talks about the Children's Art Project, beginning with an anecdote: Page Lawson showed him children's drawings arranged on an ironing board and asked him which ones would make a good card. He talks about his decision to separate the Art Project from Volunteer Services.
Mr. Stuyck describes what the Children's Art Project contributes to MD Anderson. He explains that it gives the institution a chance to talk about its successes. He notes how the Children's Art Project has come to be part of the MD Anderson brand.
Mr. Stuyck then tells the story of how the Public Education Department started. He comments on his colleagues in the Division of Public Affairs. Finally, Mr. Stuyck talks about what the Department of Public Education does for ME Anderson.
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Chapter 19: A Fun Job at an Institution that Inspires Commitment
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck speaks briefly about some constraints he felt for his activities at MD Anderson. He notes the commitment employees at MD Anderson feel for what they do and how much job satisfaction employees have.
Mr. Stuyck speaks briefly about receiving the Anderson Network Award. He also notes that the Division of Public Affairs is one of only three institutions that have twice received recognition as an Outstanding Public Affairs Program. He briefly talks about the book that he received on his retirement, Steve Stuyck, the MD Anderson Years, and clarifies two mysterious references in that book. He then notes that his is most proud to have started the Cancer Information and Public Information services, both of which were groundbreaking at the time. He is also very proud that he engaged the institution's first public relations group. Next Mr. Stuyck talks about what MD Anderson has given him over the years: a rewarding and fun job. At the end of the interview he notes that he gave his job "his all" and hopes that MD Anderson will continue to lift the "huge burden" that cancer represents.
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Chapter 09: Public Affairs at MD Anderson: Supporting Cancer Prevention and Education
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck begins this chapter talking about a joint project between Public Affairs and the Division of Cancer Prevention. He provides context, explaining that Dr. Bernard Levin (Vice President of Cancer Prevention, [Oral History Interview]) was approached by Channel 13 to do a promotion of the new fecal test for colon cancer screening. He explains how the project turned into a research project supported by SmithKline as well as a public service initiative. Nine thousand people participated in a study to compare fecal testing methods. Laboratory Medicine helped, but Public Affairs organized volunteers to read the cards. This study was eventually published.
Mr. Stuyck explains his axiom that "good public education is the best public relations. He then describes how he used that axiom to make decisions about public affairs is
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Chapter 10: R. Lee Clark and Charles LeMaistre
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck notes that MD Anderson has been strong because of the continuity of its CEOs. He notes that the institution's first full-time president, Dr. R. Lee Clark, had a solid public relations staff; he also focused on international activities.
Mr. Stuyck tells an anecdote about accompanying Dr. Clark to a television interview prior to his retirement.
Mr. Stuyck then talks about Dr. Charles LeMaistre [Oral History Interview], noting that he was erudite and chose his words carefully. Dr. LeMaistre also improved the look of MD Anderson and enhanced the clinical environment.
Mr. Stuyck notes that paying patients would go to other institutions, but Dr. LeMaistre's initiatives made MD Anderson more attractive, and turned that around. He says that Dr. LeMaistre was very effective at representing the institution to the public. He also contributed to the institution in many ways. One was by making the controversial move of starting the Division of Cancer Prevention. Dr. LeMaistre also led the initiative to change legislation to patients could self-refer. He explains why attitudes of physicians outside of MD Anderson made self-referral controversial at the time.
Mr. Stuyck notes that the transition to self-referral was very smooth.
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Chapter 11: John Mendelsohn: MD Anderson's Secret Weapon
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck begins this chapter on John Mendelsohn [Oral History Interview] by noting that he was a "dark-horse candidate" for president. He describes the interview process and how administrators were invited to participate. During an interview session, Mr. Stuyck found Dr. Mendelsohn to be very "energetic and wiry." Mr. Stuyck notes that MD Anderson had been ranked second to Memorial Sloan Kettering, but that changed under John Mendelsohn. He says the Dr. Mendelsohn arrived at just the right time in the institution's history: he describes Dr. Mendelsohn as "MD Anderson's secret weapon." He tells an anecdote about giving Dr. Mendelsohn advice"which he ignored.
Mr. Stuyck then talks about Dr. Mendelsohn's difficulties with the media during two conflict of interest cases involving his involvement with Imclone and Enron.
Mr. Stuyck explains how he prepared Dr. Mendelson for interviews with the media. He then describes how Dr. Mendelsohn handled his interview with a reporter from KTRK-TV, Channel 13, Wayne Dolcefino, about expenditures for furniture and art: Dr. Mendelsohn was very forthright and convincing, and the reporter let the story slide without publishing it. He then tells a story about a trip to Washington, D.C. for interviews at the Washington Post and PBS.
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Chapter 13: The Changing Organization of Public Affairs
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
A conversation about Cancer Bulletin, published through Scientific Publications, leads to a discussion of how and why Public Affairs has been reorganized over the years.
Mr. Stuyck says there are rumors that it will be reorganized again, under Dr. DePinho. As an example of reorganization, Mr. Stuyck talks about the Place of Wellness, which he originally managed until he decided he was not in a position to make the necessary medical decisions, so it became the Integrated Medicine Program directed by Dr. Lorenzo Cohen.
Mr. Stuyck also talks about the unique roles of JoAnn Ward and Louise Villejo [Oral History Interview].
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Chapter 14: Public Affairs and Communication Tools
Steve C. Stuyck MPH and Tacey A. Rosolowski PhD
Mr. Stuyck first talks about The Messenger, the first employee communication tool, which has been published for forty years. Next he discusses Conquest, a publication designed to generate awareness of MD Anderson among opinion leaders, donors, and corporate executives.
Mr. Stuyck talks about how Conquest was started and how it tells the MD Anderson story. He tells an anecdote about putting a donor envelope inside of Conquest with no accompanying solicitation for funds: the envelope alone has generated three million dollars (never less than $25,000 per issue). Next Mr. Stuyck talks about Cancer NewsLine, a series of video news releases launched in 1986 to provide media with news about cancer research and treatment. He describes the impact of these on the institution's reputation. He then talks about the Network Newsletter, launched in 1988 and mailed to all former patients ("a lifeline to the institution"), then moves on to the CancerWise Community Speaker's Bureau and MD Anderson Ambassadors programs, through which MD Anderson employees go into the community to talk about cancer issues. He notes that many within higher levels of the institution were at first suspicious of employees going out into the community.
Mr. Stuyck then talks about the "Too Cool to Smoke" program for kindergarten through fourth graders. Lastly he talks about Contributions to Making Cancer History (first published in 2007), launched because Dr. John Mendelsohn wanted to address the frequent question What are specific advances that MD Anderson has made against cancer? Mr. Stuyck explains how the approximately 100 advances were compiled and selected, and how Scientific Publications helped edit it to ensure its credibility.
Mr. Stuyck notes that this is a unique document among academic institutions: the content is now on the website, with about 150 advances included. At the end of this session, Mr. Stuyck tells a story to demonstrate Dr. John Mendelsohn's communication skills.
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Chapter 01: A Child with a Different Perspective
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler talks about her early realization that she had a different perspective on life than other children her age. She talks about her early affinity for nature when was a child in Connecticut, her fascination with questions about the universe and intuitive grasp of non-duality. She tells an anecdote about how her father would joke with her, inadvertently supporting her growing perspective. She then talks about discovering the Daoist koans, yoga and pranayamic breathing.
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Chapter 02: Scoliosis Changes Life and Perspective
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
Ms. Sumler begins this chapter by noting that she initially aspired to be a dancer. She then narrates the progression of her scoliosis through the seventies and after her spine fusion surgery in 1976 and shares several stories of significant physical and psychological events. She talks about the grieving she had to do because of the blow scoliosis dealt to her identity as a dancer and describes her process of coming to accept her new physical state and identity.
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Chapter 03: Exploring Massage and Raja Yoga; Cancer is a New Health Challenge
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
Ms. Sumler begins this chapter by explaining that she became interested in massage during the year she spent in bed after her spinal surgery for scoliosis and was learning about alternative treatments. She also talks about joining a raja yoga community because of her desire to live a spiritual life; her yogi was the source of her name, Sat Siri, and her yoga teaching practice at Yoga Central. She then talks about her diagnosis with melanoma and describes undertaking yogic death practices to confront this challenge.
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Chapter 04: Massage and Cancer Patients: A Contemplative Practice
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
Ms. Sumler begins this chapter describing how she began to practice massage in 1986 and tells stories to illustrate how "massage is artistic expression." She also notes some myths in the massage community at that time, e.g. that massaging cancer patients would spread their disease through their bodies. Ms. Sumler questioned this belief and decided to know more about massage and cancer. At the same time, family and friends were referring clients with cancer to her for massage. She explains technical aspects of her work with cancer patients.
Next, Ms. Sumler explains how she came in contact with Integrative Medicine at MD Anderson. She describes how she felt a "sense of calling" when she was at the institution. She was first invited to come and teach yoga, but that opportunity didn't work out. -
Chapter 05: Bringing Massage to the Place of Wellness and Integrative Medicine
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
Ms. Sumler explains that she eventually was offered a contract position to offer chair massages for "brief relaxation" in patient waiting areas. She explains why the massage was labeled in that way and talks about progress made in creating an inviting space for patients at the Place of Wellness. She also discusses training she received in massage therapy at Memorial Sloan Kettering Cancer Center in 2002.
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Chapter 06: Massage: Benefits to Patients
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler talks about what massage offers the cancer patient and tells several stories about patients' reactions to massage. She also discusses the supportive attitude of many MD Anderson clinicians, particularly in rehabilitative and supportive care. She notes that to document the safety of massage in the first three years of the massage program, she took patients' vital signs before and after massage.
Next, Ms. Sumler talks briefly about the value of yoga for oncology patients. She ends this chapter with comments about how massage makes her contemplative practices manifest. -
Chapter 07: Training Massage Therapists and Building Institutional Acceptance for Massage
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler talks about her work building a training program for massage therapists. She talks about the importance of critical thinking for massage therapists who have been trained to work with healthy populations. She gives examples of how critical thinking comes in to work with cancer patients. She says, "you are not taught what you don't know, and that's what you need to not harm someone."
Next, Ms. Sumler gives examples of how MD Anderson staff have accepted massage as part of a patient's experience and treatment. -
Chapter 08: Patient Acceptance (or Non-Acceptance) of Massage Therapy
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler talks about why patients in general may resist getting massage, and how cancer patients deal with special issues of vulnerability in massage. She also talks about the positive impact of massage on patients, recounting anecdotes to underscore the role of massage in reconnecting patients positively with their bodies. She also discusses how positive personal experiences with massage can lead patients to consider other complementary services, and vice versa.
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Chapter 09: Clinician Acceptance (or Non-Acceptance) of Massage Therapy
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler talks about why clinicians may refuse to send their patients for therapeutic massage, usually out of a lack of information about how specifically this type of massage is tailored to the needs and limitations of patients undergoing specific treatments. She gives examples of how she and others in massage therapy opened communications with clinicians to provide education and overcome resistance.
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Chapter 10: Contributing to Research on the Value of Massage
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler sketches her participation in research into the value of massage for patients with peripheral neuropathy and deep vein thrombosis. She also discusses how her own perspective on massage changed through these collaborations. She explains how one study led to a change in the organization of the scheduling of massage.
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Chapter 11: A Few Words about Yoga and Views on MD Anderson's New Directions
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
Ms. Sumler begins this chapter by speaking briefly about teaching yoga at MD Anderson and how acceptance of that service has grown.
Next, she reflects on the new direction MD Anderson seems to be taking under Dr. Peter Pisters, who became the institution's fifth president after Ronald DePinho's resignation. CLIP She says she feels that "a new light is shining" and she sees a new commitment to the institution's commitment to care and compassion and its mission to support both patients and employees. She has hopes that acceptance of Integrative Medicine will continue to grow. -
Chapter 12: Reflections on Contributions and on the Art of Massage, Meditation, and Teaching
Pamela Sat Siri Sumler and Tacey A. Rosolowski PhD
In this chapter, Ms. Sumler reflects on the contributions that have meant the most to her and stresses that she loves to learn, and will continue to expand her knowledge of therapeutic massage during the rest of her time at the institution. At the end of the interview, she talks about her core identity as a meditation practitioner and an artist. She explains how these two currents combine her view of yoga, teaching, and massage as art forms.
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Chapter 01: The Making Cancer History® Voices Oral History Project
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic provides an overview of the Historical Resources Center –which he founded-- and the Making Cancer History Voices Oral History Project that it oversees.
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Chapter 02: Vietnam Trains an Administrator
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic talks sketches his educational background and describes the significance of his military service. Drafted as a college senior, his service in Military Intelligence during the Vietnam War not only gave him focus for his later graduate studies, but also strengthened specific characteristics and skills that would eventually suit him to a career in administration.
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Chapter 03: Choosing Cancer Research
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic traces the evolution of his interests in graduate school, eventually leading him to focus on cancer research.
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Chapter 04: Joining the Department of Tumor Biology at MD Anderson
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic talks about coming to MD Anderson in 1980 as an Assistant Professor in the Department of Tumor Biology (now Molecular and Cellular Biology). He explains that this was the period when Dr. Charles LeMaistre [Oral History Interview] and Dr. Frederick Becker [Oral History Interview] were bolstering the basic sciences. He explains how he re-evaluated his career, and shifted toward a focus on administration.
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Chapter 05: The Cancer Biology Program
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
Dr. Tomasovic begins this segment with comments on MD Anderson’s perceived weaknesses in basic research. He talks about the important role that graduate students serve in driving research at an institution and how they were integrated into departments at MD Anderson. He then describes his first “forays into leadership”: e.g. during 1986-’88 he created and directed the multi-disciplinary Program in Cancer Biology (first called Interdisciplinary Studies in Cancer Biology) in the Graduate School in Biomedical Sciences.
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Chapter 06: Fostering Innovation and Multi-disciplinary Research
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic talks about how interdisciplinary work –at MD Anderson and in general-- is crucial to treating cancer and fostering creativity in research.
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Chapter 07: Academic Affairs: Administrative Structure and the Role of the Vice President
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic provides an overview of the administrative structure of the Division of Academic Affairs and his responsibilities as Senior Vice President.
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Chapter 08: An Ability to Work With and Within Structure
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic reflects on his leadership style and how this has facilitated his effectiveness. He notes how he came to the attention of James Bowen, then Vice President for Academic Affairs, who worked with him in creating the Faculty Senate (Dr. Tomasovic was the first Chair, ’91-93), and who appointed him Assistant to the Vice President for Academic Affairs (1994). The session closes with a sketch of the institutional flux in play during 1998 when Dr. Mendelsohn [Oral History Interview] assumed leadership of MD Anderson.
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Chapter 09: The MD Anderson Presidents: Continuity of Leadership
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
Dr. Tomasovic begins this segment with the observation that MD Anderson is unusual because of the long tenure of its key leaders and administrators. He characterizes the three presidents and gives examples of how the institution successfully met the managed care crisis. He notes that the institution has faced strong, external financial challenges at the transitions between Dr. LeMaistre and Dr. Mendelsohn and Dr. Mendelsohn and Dr. DePinho.
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Chapter 10: A Lesson About Leadership and an Institutional Blind Spot
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this chapter, Dr. Tomasovic shares a story that taught him lessons about leadership.
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Chapter 11: Institutional Reorganization and Becoming Vice President of Academic Affairs
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
Dr. Tomasovic begins this segment by sketching the administrative restructuring that occurred when Dr. John Mendelsohn arrived as institution president. He also described Dr. Margaret Kripke's [Oral History Interview] plans for restructuring Academic Affairs' and his role in this process. Dr. Tomasovic notes that Dr. Kripke expected him to iron out a range of difficulties arising among faculty.
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Chapter 12: The Education Council, Sister Institutions, and Views On Leading Faculty
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic gives numerous examples of how he has built educational culture at MD Anderson through, for the formation of The Education Council (2001), strengthening faculty development initiatives, serving as Vice President of Extramural Programs (to become Global Academic Programs).
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Chapter 13: The Faculty Senate and a Vision of Faculty Influence
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
Dr. Tomasovic begins this chapter by sketching the history of the Faculty Senate. He discusses term-tenure then expands on the idea that the Faculty Senate was part of a larger vision of building faculty control over the governance of the institution. Dr. Tomasovic also explains how he came to found the Faculty Leadership Academy (1991), devoted to nurturing leadership qualities of faculty.
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Chapter 14: A Mark Left on Education and Faculty Achievement
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
This interview takes place a few weeks before Dr. Tomasovic’s retirement. Dr. Tomasovic closes the session with comments on his hopes that MD Anderson preserves its educational mission, which distinguishes it from other care-delivery institutions. He also hopes that his efforts to foster leadership among the faculty will endure.
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Chapter 15: Serving as Special Assistant to Dr. Oliver Bogler
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic talks about his role as Special Assistant to the Provost. Dr. Tomasovic begins by describing the transition-support role he will serve in the coming year, assisting Dr. Oliver Bogler, who took over Dr. Tomasovic’s position as Senior Vice President of Academic Affairs. He discusses how he and Dr. Bogler are finding ways to link activities in Academic Affairs to the mission of the new MD Anderson president, Dr. Ronald DePinho. He gives examples of how he and Dr. Bogler are streamlining the bureaucracy of Academic Affairs to help faculty and graduate students as well as supporting Dr. DePinho’s mission.
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Chapter 16: Changing Institutional Focus Under a New President
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
Dr. Tomasovic begins this segment by comparing the leadership styles of John Mendelsohn [Oral History Interview] and Dr. DePinho, whose charisma, decisiveness and vision are reminiscent, he feels, of R. Lee Clark. Dr. Tomasovic talks about the impact of Dr. DePihno’s “Town Hall” session on 7 November 2011, when he announced that MD Anderson will now take a Moon Shot approach to curing cancer, focusing on five specific cancers (not yet announced). Dr. Tomasovic speculates on the cultural shifts this focused mission will create, influencing the commitment to global oncology, and educational programs.
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Chapter 17: Academic Programs under a New President
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic notes Dr. DePinho’s commitment to graduate education and research. He describes the many discussions currently taking place in Academic Affairs to insure that all activities are in line with the new directions the institution is taking. He this segment with comments on his optimism that Dr. DePinho will steer the institution in positive directions.
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Chapter 18: Travel, Photography, and a Story about Meerkats
Stephen Tomasovic PhD and Tacey A. Rosolowski PhD
In this segment, Dr. Tomasovic talks about his retirement, noting that he has more energy now that he can spend more time taking care of himself. He talks about getting back into the photography and he has planned several of the eco-travel trips he and his wife enjoy, including a trip to India to see tigers. He tells an amusing anecdote connected to a photo snapped of him during his first trip to Africa: he is reclining in a meerkat colony, with meerkats perched on his hat and hip. He tells of sending that photo for use at the awards banquet when he was elected to the UT Academy of Health Science Education. Popping up amid the formal shots of other awardees, his photo caused a lot of reaction among the attendees. At the interview’s close, he returns to the subject of Dr. DePihno, noting that the focus on institutional growth caused MD Anderson to lose some of its connection to people –a key part of the culture that R. Lee Clark established. Dr. DePinho’s “common touch,” he believes, will help turn the culture of MD Anderson back to those roots. In this segment, Dr. Tomasovic also talks about the human side of R. Lee Clark.
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Chapter 01: An Interest in Moments of Turbulence Feeds an Approach to Leadership
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny begins by explaining that she is in the midst of writing a new job description for herself so she can begin to focus more exclusively on her major interest, leadership development. She mentions author Linda Hill's description of the transition into leadership positions as the equivalent of a big life transition. She goes on to reflect on her own qualities as a leader and an individual who has had to make many transitions, leading her to be "interested in moments of turbulence."
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Chapter 02: Establishing a New Department of Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny sketches how she came to MD Anderson in 1999 to establish a new Department of Faculty Development at a time when there was little research and literature on this new area. She mentions MD Anderson's reputation in the eighties as the "terminal hospital," where patients came to die, a feeling that persisted into the nineties. She sketches the history of unsuccessful leadership development offerings at the institution.
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Chapter 03: The First Successful Leadership Retreat Demonstrates Need for Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny explains that, in 2001, a team was put together to make a "last try" to set up a successful initiative. She discusses how the team went about creating a new faculty leadership program that would prove such an initiative could be effective and relevant to MD Anderson faculty. She sketches the process of finding the Executive Development Group. She explains that the team handpicked the sixteen people who would participate in the first retreat, held in The Woodlands. She notes that the response was immediate and unanimously positive and that the curriculum is still largely the same. She sketches other programs that came from that: the Administrative Leadership Program and the Heart of Leadership Program. Ms. Yadiny also begins to sketch how leadership initiatives at MD Anderson evolve within a politicized environment.
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Chapter 04: Faculty Development in a Politicized Context
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny talks about the political environment in which Faculty Development was established and has evolved. She shares anecdotes to illustrate.
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Chapter 05: Reflecting on Leadership Qualities
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny reflects on her own leadership qualities and discusses leadership in general. She tells another story of Marshall Hicks, head of the Division of Diagnostic Imaging, as an example of someone who has used the coaching services of Faculty Development to help him through leadership transitions and life transitions. She notes that the Executive Coaching service was established in 2008 to support new chairs and that Ethan Dmitrovsky is expanding coaching services. She notes that she earned her coaching certification. She lists her leadership traits (noting that she is a good idea person, "but this doesn't mean I'm a good manager") then talks about models of leadership she has discovered in her reading of literature. Ms. Yadiny then explains that, even though self-reflection is a key element of leadership training, many people "are terrified of it." She tells an anecdote that demonstrates how seemingly small issues can have a big impact on initiatives. Ms. Yadiny then notes that MD Anderson has had a "case study of leadership" over the past years, since Ronald DePinho came on a president. She notes that she would love to have a conversation with him about what he has learned about leadership and shares an anecdote that suggests he has been thinking about the subject.
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Chapter 06: A Wide Range of Interests Leads to Library School
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny talks about her family background and her educational path to Library School at McGill University. She talks about her love of reading, her skills with drawing and sports, and her love of life outdoors. She talks about the interests that led her to study literature at the University of Guelph in Ontario, Canada (BA in 1970) and her decision to go to McGill University in Montreal for her MLS (conferred 1973).
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Chapter 07: International Work and an Interest in Power Dynamics
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny discusses her early jobs with the Royal Society in London, then with the World Health Organization in Geneva, then in Tunisia. She tells anecdotes of the interesting characters she met in London; one of the stories allows her to demonstrate how she became interested in the master/slave relationship and how power factors into communication and power. She notes that she has encountered leaders who can be submissive or sadistic in their relationships with others. She describes the work she did in Geneva with the WHO, the lessons learned from her international experiences, and her reasons for leaving international work.
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Chapter 08: An Evolving Focus on Leadership Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny discusses the series of positions she held that solidified her focus on leadership development. She first talks about her work at the Houston Academy of Medicine in the Texas Medical Center Library ('79 - '90) where she did staff development programming and came to love working with leadership issues. She describes this as a "turning point in her life." She describes the positive work situation and the experience in leadership development she gained. [The recorder is paused.]
Next, Ms. Yadiny talks about her work at the University of Michigan in communications ('90 - '99). She was able to complete a year-long "Planned Change Internship" that enhanced her skills. She talks about meeting Larry Lippitt, whose at the time work provided a basis for the understanding of organization development and how individuals behave within groups. -
Chapter 09: Faculty Development: Offering Support in a Stressful Environment
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny discusses the stressful work culture at MD Anderson and the challenges that leaders face. She tells a story about a department chair who shed tears during a coaching session and a meeting with his department. She notes that the culture makes faculty members feel unsupported, and they come to Faculty Development for support. She also discusses cross-cultural issues that contribute to the stress, touching on issues that international faculty face and also on issues that arise because of U.S. regional, north/south, differences. She notes that the staff wields informal power, and gives examples of faculty women who have problems with staff members, who call them rude and demanding and often raise enough issues that the female faculty member "ends up in front of a Chair or HR." Ms. Yadiny notes that Faculty Development and the institution in general has not done enough to orient faculty to the southern dimensions of MD Anderson culture. She comments on the fact that 70% of employees are female, but MD Anderson "is a male institution." She comments on her own experience of gender issues and the slow progress made on addressing them since she began her professional life.
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Chapter 10: Changes in Academic Medicine over the Past Decades
Janis A. Yadiny and Tacey A. Rosolowski PhD
After reflecting briefly on the discussion in Interview Session one, Ms. Yadiny sketches how academic medicine has changed in the past decades. She notes the increase of expenses, patient volume, and structural changes to the healthcare system as well as the increasing competition for research money. She gives examples of how these contextual issues play out in the lives of faculty and leader. Ms. Yadiny comments on the challenges of mentoring faculty in this environment. She states that Dr. Ronald DePinho has positively "raised the level of the discussion" about research at MD Anderson, noting that this is threatening to those who aren't of the highest caliber. Ms. Yadiny comments on the challenge of balancing a commitment to compassionate care with a forceful pursuit of hard-driving science. She notes that MD Anderson is a unique institution because it is an academic-corporate hybrid.
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Chapter 11: The First Several Years of the Faculty Development Initiative
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny fills in details about the evolution of the Department of Faculty Development. She explains why Margaret Kripke, the VP of Academic Affairs in 1999, supported a leadership development initiative. Ms. Yadiny then talks about her activities as Director of Faculty Development between 1999 and 2001, when the first formal course of the Faculty Leadership Academy was put together by a collaborative committee. Ms. Yadiny explains that in 2001, academic medicine trailed the corporate world by about 15 years in understanding leadership. She explains why leadership is so important and notes that MD Anderson had no succession planning and no real culture of leadership. She explains the success of the Leadership Academy and discusses the coaching sessions that are provided to participants and new leaders.
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Chapter 12: Creating the Faculty Health and Well-being Program
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny recounts the story of how the Faculty Health and Well-being Program was established. She tells the story of the suicide of plastic surgeon, Steve Kroll, in 2001. She notes that when the institution did nothing to address this event, a group of individuals approached then-president John Mendelsohn about doing something for the faculty. This group included: Walter Bayle, MD; Warren Holleman, PhD; Ellen Gritz, PhD; Janis Apted, MLS. This group formed a committee and they set in place a response plan for addressing trauma. Ms. Yadiny next recounts how this initiative evolved into a program. She mentions groundbreaking work the Ellen Gritz and Warren Holleman did on burnout. [The recorder is paused] Ms. Yadiny then talks about several initiatives in Faculty Development. First she talks about Dr. Walter Bayle's use of Interpersonal Communication and Relationship Enhancement to teach communication and leadership. She then talks about Faculty Development's sponsorship of the Houston production of the play, "Wit." Focus groups with clinical faculty related to this production were audio taped and used to produce of the video, "On Being an Oncologist."
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Chapter 13: Preparing for Coming Challenges to Faculty Development
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny briefly comments on the goals she envisioned for Faculty Development when she became Executive Director in 2002. She then sketches the large-scale changes that MD Anderson will face as national demographics and the healthcare system continue to shift. She reflects on working with new staff members. She explains that she went back to school to earn her certification as a coach so she could be a better support to faculty.
Next, Ms. Yadiny lists the faculty's fears and frustrations and notes that most people who need help are not asking for it. -
Chapter 14: An MD Anderson Way of Leadership Training
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny characterizes the "MD Anderson way of leadership training." She explains that in 2002 her office settled on a skill-based approach that differed from the theoretical focus of earlier programs. She notes that Dr. Margaret Kripke advocated adoption of this approach and that the program for women faculty, Executive Leadership in Academic Medicine [ELAM], served as a model and was enthusiastically welcomed by all faculty. She next gives examples of challenging situations that MD Anderson leaders can find themselves in (e.g. emotional blackmail and manipulation). She notes that a psychologist at Rice University introduced her to the idea that transition into leadership is a turbulent process akin to an identity crisis. She talks about the learning curve for developing as a leader and emphasizes that MD Anderson is a very complex culture: some leadership consultants have characterized it as the most challenging and toxic they have encountered.
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Chapter 15: Faculty Development: Directions for Future Growth
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny explains that programs in Faculty Development will increasingly be organized around the idea that transition into leadership catalyzes an identity crisis. She explains a plan to conduct assessments for leadership potential (that could not come to fruition). She discusses motivations that individuals may have for aspiring to leadership roles and notes that most leaders say they get the most satisfaction from training the next generation of leaders or professional in their field. She notes that MD Anderson chair people have demanding roles with more responsibility than their colleagues at other institutions. She explains the growing number of populations that Faculty Development serves at the institution, noting that the faculty is not required to take mandatory classes in leadership (unlike staff people). She discusses preliminary efforts to offer leadership programming for fellows and graduate students. She discusses the advantages of having outside consultants conduct programs and offers a personal anecdote about offering tough feedback.
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Chapter 16: Growth as a Leader
Janis A. Yadiny and Tacey A. Rosolowski PhD
Ms. Yadiny evaluates her own growth as a leader since she "began as a freshman" in Faculty Development at MD Anderson in 1999. In this Chapter she also talks about the importance of emotional intelligence. She begins by discussing what she learned about herself by handling challenging leadership situations. She talks about her (excellent) working relationship with Robert Tillman [Associate Director, Faculty Development] and describes how some problems arose because of her strong working relationship with Janet Simon. She notes a theory that in workplaces, individuals recreate their family of origin around them. Ms. Yadiny then talks about the importance of the emotional brain to leadership development. She notes that she reads a sacred literature to learn more about this and that MD Anderson can "shrink" this dimension of self. She talks about conversations she has with a psychologist who is also a practicing shaman, José Luis Stevens, when she senses distance from her emotional brain. She tells an anecdote about discussing a work challenge with Provost Ethan Dmitrovsky, MD. She lists the serious consequences leaders face if they do not cultivate the emotional dimensions of themselves.
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Chapter 17: Faculty Development: Caring for the Soul of MD Anderson's Faculty
Janis A. Yadiny and Tacey A. Rosolowski PhD
In this chapter, Ms. Yadiny characterizes the essential role of the Department of Faculty Development: to caretake the soul of MD Anderson's faculty. She begins by talking about a retreat held recently to help a department deal with issues of retaliation. She discusses her own experience consulting with this department and recounts an anecdote she heard Bill Johnson (CEO of Heinz) tell about coach.
Next, Ms. Yadiny explains her goals in the years remaining before her retirement: she would like the institution to "understand the full scope of what Faculty Development does." She says that the department is "like a shaman" that brings in the whole person and provides a place of hope for faculty. In the final minutes of the interview, Ms. Yadiny discusses why her work has a spiritual dimension. She acknowledges that she has "played a pretty significant role" at MD Anderson, setting up programs and services to minister to faculty however they require. -
Chapter 01: Education and Family in Hong Kong
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung talks about his family background, education, and the challenges of growing up in Hong Kong during the recovery period in the aftermath of World War II. He first explains that his parents came to Hong Kong from China during the War. He describes the family's financial situation and the strong work ethic he gained by working in his father's business. Dr. Yung explains the educational system in Hong Kong. He talks about the origin and growth of his faith. He talks about meeting his wife, Susie Yung, in high school. Dr. Yung next recounts his early educational experiences under the British style, "pyramid" system education in Hong Kong and notes his transfer from a community school to the Jesuit-run Wah Yen College, a "vigorous" and well-funded school where all the teaching was in English. He notes that he became interested in medicine while he was in high school. Dr. Yung recounts how he came to the United States for college.
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Chapter 02: Medical Education and Laboratory Research Solidifies an Interest in Molecular Analysis
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about his college and medical education and his interest in working at MD Anderson. He begins with his arrival in the United States to attend college at the University of Minnesota (f 1968), a "defining moment" in his life, because of the culture shock. Dr. Yung notes that he began as a sophomore and that his research career began during his undergraduate years as he worked on a project that gave him an interested in cancer: he quantified radiation damage to tissue with different types of radiation.
Next, Dr. Yung talks about how his decision to focus on neurology and attend medical school at the University of Chicago, where he kept working on his own research. He talks about his residency and his fellowship at Memorial Sloan Kettering, where he framed his primary research interests: "How do we go from chromosome analysis to molecular analysis?" -
Chapter 03: Developing a Brain Tumor Clinic at MD Anderson
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about his first impressions of MD Anderson and his early efforts to develop the neurology offerings at the institution. He begins by explaining his decision to come to MD Anderson (in 1981) after his fellowship at Memorial Sloan-Kettering. MD Anderson contacted him because the institution needed a neurologist to handle neuro consults. Dr. Yung describes the neurological complications that he would see normally see during consults and explains why he wanted to start the first designated brain tumor clinic at MD Anderson to treat complications and offer but care for primary tumors. Dr. Yung notes that he wanted to continue his research at MD Anderson. He established his laboratory at the Medical School, but relocated to MD Anderson in 1983.
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Chapter 04: A Reputation For Experimentation and the Impact of Shifting to a Division System in the Eighties
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung connects MD Anderson's reputation for radical research in the 1980s to the move to reorganize the institution by Divisions in order to foster collaboration. He sets context by noting that MD Anderson struggled with a reputation for experimenting on people as well as with limits imposed on its growth. Dr. Yung explains how in 1982 the second president, Dr. Charles LeMaistre, reorganized the institution according to a division system to foster collaboration between departments and services and created a more systematic environment for promoting clinical research. The division system also fostered a more systematic approach to patient care and more structure in services by focusing on disease type. Dr. Yung next explains that, with that administrative reorganization, many new faculty were hired to provide a platform to enhance the quality of research and research driven patient care.
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Chapter 05: Stepping Down as Chair of Neuro-Oncology
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
The recorder is started during a conversation in progress. Dr. Yung offers brief comments on his decision to step down as Chair of Neuro-oncology. (He stepped into the role as interim chair in 1999 and became permanent chair in 2002.)
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Chapter 06: Looking at Chromosomal Patterns in Brain Tumors; Chromosomal Heterogeneity, Chemo-Sensitivity, and EGFR
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
Dr. Yung discusses the evolution of his research, beginning with work on chromosomal patterns at Memorial Sloan-Kettering in the late 70s. He sets this work in the context of the science at that time and its development into the entirely new field of genomic medicine. Next he explains the evolution of his work to include epidermal growth factor receptors (EPGR) and their importance in cells, discussing connections to work of other MD Anderson faculty. He describes the relationship of the gene to kinase and EGFR functions. He then talks about his shift into translational research since 1997. Dr. Yung then sketches the history of translational research at MD Anderson, noting that in the Eighties and Nineties, the institution became a forerunner in applying translational research to clinical questions.
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Chapter 07: Research Pathways and Research Issues that Emerge from EGFR Work
Wai-Kwan Alfred Yung MD and Tacey A. Rosolowski PhD
In this chapter, Dr. Yung talks about the research paths that evolved from his work on EGFR, though he has been unsuccessful so far in discovering how to render glioblastoma sensitive to the receptor. He goes on to describe the lines of research that have opened up and also discusses controversies that have arisen around the issue of sequencing the cancer genome. He notes that MD Anderson is one of the suppliers of tissue to The Cancer Genome Atlas project -and he is involved in this. Dr. Yung also explains how the body of knowledge growing from this project and the International Cancer Genome Continuum has influenced how researchers look at tumors. Dr. Yung explains that the fundamental question is Can we understand the evolution of a tumor? He notes the special technical and ethical difficulties that arise with examining brain tumors.