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  Chapter 01: Medical Training, the Military, and a Fellowship at MD Anderson

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Dr. Ames begins this chapter by sketching his training at University of Texas Medical Branch in Galveston and St. Joseph Hospital in Houston and his fellowship at MD Anderson. He talks about the environment for surgical practice at MD Anderson at that time and some technical aspects. Next he talks about his service as a Major and Chief of General Surgical Services in the Army (7/1975-7/1977). He talks about how the carefully selected group of skilled surgeons with whom he served.

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  Chapter 02: On Faculty in General Surgery at MD Anderson and Thoughts about R. Lee Clark

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Dr. Ames begins this chapter with the story of he joined the faculty of MD Anderson in the Department of General Surgery after his military service (1977). He notes that his research on melanoma was gaining recognition. He lists the major figures in the Department at that time. He then notes that he began to work closely with Dr. Edward Copeland (Surgery collection interview]. Next, Dr. Ames shares some memories of Dr. R. Lee Clark, who served as Surgeon in Chief as well as president of the institution. He explains that he had an opportunity to review charts of patients that Dr. Clark had treated, and they had very good outcomes.

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  Chapter 03: Dr. Edward White: Impact on the Department and Breast Cancer Treatment

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  In this chapter, Dr. Ames talks about Dr. Edward White, who became department chair when he joined the faculty of General Surgery in 1977. He first notes that Dr. White as very dedicated to patients and highly regarded by the institution. Dr. Ames next explains that Dr. White supported multi-disciplinary approaches and worked closely with radiation oncologists in developing treatment protocols for breast cancer. He goes on to discuss innovations on the breast service and tells stories about John Stehlin and Eleanor Montague. He talks about how the treatment of breast cancer evolved through the work of all these individuals, leading to more conservative surgery. Next, Dr. Ames lists the departments included under General Surgery and how the department was restructured when Dr. Charles LeMaistre became the second president.

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  Chapter 04: The Impact of R. Lee Clark, MD and Richard Martin, MD

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Dr. Ames begins this chapter explaining that R. Lee Clark knew many of the first surgeons he recruited to MD Anderson from his time in the Air Corps. Dr. Ames notes that this group functioned very harmoniously and reflected a type of personality, establishing come of the foundations of the culture of surgery at the institution. Next, he talks about Dr. Richard Martin, who was much less visible in the institution, but nonetheless had a great impact on the practice of surgery. Dr. Ames describes him as a "gentleman’s gentleman" who was innovative in multiple areas of practice. He tells the story of a controversial randomized trial to determine the relative value of limb amputation and limb salvage. He reflects on Dr. Martin as a teacher and mentor, and his habit of recruiting humble people, with further influence on the culture of surgery. Dr. Balch and Dr. Ames then discuss the importance of MD Anderson’s single plan, established by R. Lee Clark on the model of the Mayo Clinic to encourage collaboration for the benefit of patient care and innovation.

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  Chapter 05: Key Figures in Surgery in the Seventies through Early Nineties

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  In this chapter, Dr. Ames provides his perspective on several key surgeons who had an impact on the culture and practice of surgery and surgical oncology: Charles McBride, Marvin Romsdahl, Everett Sugarbaker, David Ota, and Eva Singletary.

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  Chapter 06: From General Surgery to Surgical Oncology; on Edward Copeland, MD and Others; Reflections on the Division System

  Frederick Ames MD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Dr. Ames begins this chapter with several stories that demonstrate how surgeons in the department were shifting to a surgical oncology perspective (from a reactive surgery perspective), an evolution reflected in the department’s change of name. He notes that he was the first Chief of the Breast Section and worked with Eva Singletary, MD, the first woman to have a titled role in the Department and a very successful and well-thought of surgeon.Next, Dr. Ames talks about the impact of Dr. Edward Copeland (History of Surgery interview]. He notes that Drs. Copeland, Mendelsohn, and Balch were all finalists for the position of MD Anderson’s third president. He also explains that Dr. Copeland brought an academic research perspective to the department with his landmark work on hyper-alimention. Dr. Ames then talks about political struggles when Dr. Balch arrived to head the Department and form the Division of Surgery. Dr. Ames talks about his own aspirations as a surgeon, his feelings for the institution, and the relationship of surgery to patient care.

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  Chapter 03: Dr. Byers’ Training and Decision to Join MD Anderson

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers talks about his his training by, and admiration of, surgeon Dr. Robert Buxton while working as a general surgeon residency at The University of Maryland Hospital in Baltimore. He then discusses joining MD Anderson in 1970 as a general surgeon, recruitment a year later to Head & Neck Surgery by Section Chief Dr. Richard “Dick” Jesse, and work with Dr. William “Bill” MacComb.

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  Chapter 05: Discussion of Dr. Richard H. Jesse, Department Chief of Head & Neck Surgery, MD Anderson

  Robert Byers MD and Charles M. Balch MD

  Discussion of the philosophy, work and life of Dr. Richard “Dick” H. Jesse, who served as Chief of the Department of Head and Neck Cancer during Dr. Byers’ career at MD Anderson.

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  Chapter 06: Overlapping Medical Specializations, Different Cancer Treatment Approaches, and Surgical Challenges With Thyroid, Parathyroid and Other Neck Components

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers talks about Thyroid and Parathyroid lobectomy “totals” versus just lobes, conflicting views of radical surgery versus combination cancer treatments, and his his “less than the radical neck” treatment “forte.” He then covers surgical proficiencies needed for neck procedures, assessments of different medical specializations involved in the treatment of head & neck cancers, and challenges he faced as a head & neck surgeon doing Parathyroid surgery.

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  Chapter 07: Dr. R. Lee Clark, Surgeon & Chief, MD Anderson Cancer Hospital

  Robert Byers MD and Charles M. Balch MD

  Thoughts on the Dr. R. Lee Clark’s reputation, area of expertise, and degree of control over surgical practices at MD Anderson. Dr. Byers talks about how Dr. Edgar “Ed” White, Chief of Surgery, came to MD Anderson, his role and area of practice.

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  Chapter 08: The Head & Neck Department, its Leadership and Politics

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers recalls the doctors considered to succeed Dr. Richard Jesse as Department Chief of the Head & Neck Surgery, the appointment of Dr. Helmuth Goepfert to that position, the arrival of Dr. Raphael Pollock who became Head of Surgery, and politics within the institution throughout that period.

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  Chapter 09: Differences Over Surgical and Radiotherapy Treatment Approaches in the Head & Neck Department

  Robert Byers MD and Charles M. Balch MD

  Concerning treatment options for head & neck cancers, Dr. Byers talks about Dr. Oscar M. Guillamondegui and his surgical approach to minimize adverse treatment side affects observed with radiotherapy, and his role developing the modified neck dissection surgery. He discusses the competing radiotherapy approach supported by Dr. Gilbert H. Fletcher, who expressed concerns that incoming patients were not meeting with radiotherapists. Byers then talks about Dr. Randal “Randy” S. Weber’s initial work at, and then return to MD Anderson as Chairman of the Head & Neck Department.

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  Chapter 10: MD Anderson Head & Neck Surgery Advances with Dental Oncology, Plastic Surgery and Neurosurgery

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers talks about the role of dental oncology under Dr. Joe B. Drane, Head of UT Dental Branch/Dental Oncology, and the work done by Drs. James (Jim) C. Lemon and Jack W. Martin in managing dental problems with radiotherapy patients and fabrication of dental prostheses (ears, noses, dentures, swallowing apparatus). He then discusses the “free flap” plastic surgical method, and ENT/plastic surgery doctors Stephen S. Kroll, Mark A. Schusterman, Geoffrey L. Robb and David L. Larson who performed the surgery. Finally he mentions the role of neurosurgery, praises Neurosurgical Drs. Milam Leavens and Ray Sawaya, and finally discusses the Head & Neck department’s prominence in terms of MD Anderson case admission volume.

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  Chapter 11: Unique Anesthesia Challenges with Head & Neck Cancer Surgery, Anesthesiology Staff Composition, and Sterilization Methods in the 1970’s

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers relates the practice of anesthesiology in the 1970’s, unique head & neck cancer patient airway problems to overcome, and anesthesiology staff composition. He then talks about the use of ultraviolet (UV) and flash instrument sterilization methods, and the latter’s introduction to MD Anderson by Dr. R. Lee Clark.

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  Chapter 12: The Competing Priorities of Patient Care and Research in the Past and Future of MD Anderson, and the Unsung Hero Clinicians at MD Anderson

  Robert Byers MD and Charles M. Balch MD

  Dr. Byers gives his perspective on the priority of personal patient care in MD Anderson’s past, Dr. R. Lee Clark’s emphasis on it relative to research, the trend of its deemphasis under subsequent MD Anderson presidents, and the necessity for its reemphasis in the future. Dr. Balch and Dr. Beyers then name the unsung heroes, who “did not publish 50 or 100 papers” or participate in clinical trials, MD Anderson clinicians: Drs. Oscar M. Guillamondegui, William “Bill” MacComb, Edgar “Ed” White, Richard “Dick” G. Martin, Felix N. Rutledge and Douglas E. Johnson. Dr. Byers talks about his pursuit of the “3 Legs of the Stool” (research, publishing, and clinical work), acknowledged the role of publishing to fund MD Anderson research, but emphasized the need for “bench to bed (bedside)” direct application of research to patient care.

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  Chapter 01: Introduction

  Robert Byers MD, Tacey A. Rosolowski PhD, and Charles M. Balch MD

  Summary of Dr. Byers’ titles & responsibilities at MD Anderson and interviewer outline of subjects to be covered.

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  Chapter 02: Recruitment to MD Anderson and Dr. R. Lee Clark, the “Visionary”

  Robert Byers MD, Tacey A. Rosolowski PhD, and Charles M. Balch MD

  Dr. Byers relates influences on his decision to join MD Anderson, political considerations in building MD Anderson, and others who joined MD Anderson who worked in, or in concert with, the new field of Head & Neck Surgery. Finally, Dr. Byers gives examples of Dr. R. Lee Clark being a “visionary.”

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  Chapter 04: The Evolution of the Head & Neck Surgery Department at MD Anderson, and the Evolving Field of Head & Neck Surgery

  Robert Byers MD, Tacey A. Rosolowski PhD, and Charles M. Balch MD

  Dr. Byers reviews factors leading to his promotion to Assistant Professor in 1972, the growth of the Head & Neck Surgery department at MD Anderson, and touches on different perspectives of the evolving practitioner roles within the field of head & neck surgery.

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  Chapter 01: R. Lee Clark's Recruitment and The Attraction of MD Anderson in the Seventies

  Edward Meadors Copeland III, MD; Charles M. Balch MD; and Tacey A. Rosolowski PhD

  Dr. Copeland begins this chapter talking about how R. Lee Clark, MD was recruited to be MD Anderson’s first full-time president from private practice with a clinic led by Dr. Harvey Johnston in Jackson, Mississippi. He notes that this was a “stellar” practice.Dr. Copeland next sketches his intent in coming to MD Anderson to do a fellowship in Head and Neck surgery.He then continues with the topic of Dr. Clark’s recruitment and also reflects on the career of Edgar White, MD.

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  Chapter 02: The Department of Surgery in the 1970s

  Edward Meadors Copeland III, MD; Charles M. Balch MD; and Tacey A. Rosolowski PhD

  In this chapter, Dr. Copeland provides an overview of the Department of Surgery during his fellowship year (1971) and early years as a faculty member. He notes that Dr. Arlando Ballantyne was not a proponent of radiation therapy and then traces the increasing use of such treatments as their success was demonstrated. He notes the inauguration of the first mammograms as well as Eleanor Montague’s role in organizing breast conferences. Next, Dr. Copeland talks about his own collaborations with Dr. Frederick Ames to document the effectiveness of radiation therapy on breast cancer patients. He also discusses his work with Dr. Stanley Dudrick and Bruce MacFadyn on uses of hyperalimentation for cancer patients. He explains that some of his research was conducted in a dog laboratory that R. Lee Clark had established following the model of the Mayo Clinic research, where he had trained. Next, Dr. Copeland explains the connection between MD Anderson and the medical school in the 70s, noting that the latter paid his salary while he was effectively MD Anderson faculty.

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  Chapter 03: Portraits of MD Anderson Surgeons in the Seventies-Eighties: Part I

  Edward Meadors Copeland III, MD; Charles M. Balch MD; and Tacey A. Rosolowski PhD

  In this chapter, Dr. Balch asks Dr. Copeland to talk about surgeons who were clinically excellent, but generally unrecognized because they did not publish. Dr. Copeland notes that Dr. Edgar White was Chair of the Department of Surgery and not operating when he arrived in 1971 as a fellow. He lists the faculty members at that time, noting that all the surgeons operated three days a week, rotating among the oncologic services. Next, Dr. Copeland notes that the idea of doing limb salvage surgery originated at MD Anderson. He describes an early procedure developed by Martin and Herman Suit to use post surgery radiation to save limbs. By 1986, limb salvage was a regular procedure, based on an NIH study that documented positive outcomes. Next, Dr. Copeland explains that he worked with Renilda Hilkemeyer, RN [oral history interview], head of the Division of Nursing, on his work on hyperalimentation. He then gives his impressions of Dr. Richard Martin.

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  Chapter 04: Portraits of MD Anderson Surgeons in the Seventies-Eighties: Part II

  Edward Meadors Copeland III, MD; Charles M. Balch MD; and Tacey A. Rosolowski PhD

  In this chapter, Dr. Copeland and Dr. Balch continue their review of excellent clinicians who were “under the radar” in the Department of Surgery in the seventies through eighties. Dr. Copeland begins with a discussion of Eva Singletary, MD, the first woman to join the surgical faculty (1986). He then discusses Dr. Frederick Ames, Dr. Charles McBride, Dr. Marvin Rhomsdahl, David Ota, Kim Jessup. Next, Dr. Copeland lists his roles with professional organizations while he was at MD Anderson. He also talks about his work furthering the careers of young faculty members.

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  Chapter 05: Candidates for President, The Legacy of the Division System, and Final Thoughts on Surgery's Evolution at MD Anderson

  Edward Meadors Copeland III, MD; Charles M. Balch MD; and Tacey A. Rosolowski PhD

  Dr. Copeland and Dr. Balch [oral history interview] begin this chapter with comments on the fact that they both were candidates to be president of MD Anderson when Dr. Charles LeMaistre [oral history interview] stepped down, noting Dr. John Mendelsohn’s [oral history interview] suitability for the position. Next, Dr. Copeland comments on Dr. Balch’s impact on the institution, pointing to the role Dr. Balch served in building research and formalizing the disease-oriented approach to treatment. They discuss turbulence in the Division of Surgery when Dr. Mendelsohn stepped down as president. Next, Dr. Balch talks about organizing a committee in 1992 to create a strategic plan to develop research at MD Anderson. In the final moments of the interview, Drs. Copeland and Balch talk about the value of collecting the interviews, the origin of the idea for a cancer center like MD Anderson, and early classifications of patients according to their ability to pay. They discuss lessons about healthcare to be learned from the institution in the 40s and characterize surgeons as visionaries and risk-takers who laid the foundation for the institution.

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  Chapter 01: Leaving the NIH for a New Research Opportunity

  Elizabeth A. Grimm PhD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Drs. Balch and Grimm begin this chapter by sketching how they first met in the 1970s and the affinity of the immunology-focused research they were both conducting at that time. Dr. Grimm notes that she had first considered a position at MD Anderson in 1984, explaining the reasons why she turned it down, then explains why she accepted an offer for a joint appointment the Departments of Tumor Biology and of Surgical Oncology when Dr. Balch recruited her and her husband, Jack Roth, MD, in 1986 She explains how the research environment provided possibilities to positively develop her career through work on human tissue and collaborations with clinicians. She compares the working environments of the NIH and MD Anderson. She also comments on the fact that she was the only woman in her departments, and describes the freedom she felt to assert herself. Dr. Balch explains his commitment to furthering women’s careers.

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  Chapter 02: Impressions of MD Anderson Culture: Old Guard versus New Risk Takers

  Elizabeth A. Grimm PhD, Charles M. Balch MD, and Tacey A. Rosolowski PhD

  Dr. Balch begins this chapter by commenting that he hired Dr. Grimm and Dr. Roth because they were risk takers and then sketches his vision for the growth of research in the Division of Surgery and at MD Anderson. Dr. Grimm confirms the alignment of her vision with his, and goes on to sketch some research successes. She discusses her receipt of a training grant for a fellowship program in Cancer Biology, notes that she received the first SPORE in melanoma in 2012, and describes her early translational research activities at MD Anderson. Next, Drs. Grimm and Balch talk about differences in attitudes toward research expressed by the older members of the faculty and the newer hires. Dr. Grimm explains her sense of responsibility to conduct research advancing oncology treatments and care of the citizens of Texas.