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

Title

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

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Description

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.

Identifier

AmesF_01_20190807_C02

Publication Date

8-7-2019

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

Overview; Discovery and Success; Research; MD Anderson History; MD Anderson Snapshot; Joining MD Anderson/Coming to Texas; Personal Background

Transcript

Tacey A. Rosolowski, PhD

Did having that experience have an impact on how you thought about surgery later?

Frederick Ames, MD

It just reinforced it. My gosh it just enhanced it, and I came home for Christmas my second year and my mother told me that Mary Lou Rogge had called. She was the administrative assistant for Dr. White and he wanted to see me, pretty much the end of the discussion, because I went to his office and he invited me, that was it. We didn’t negotiate anything. Interesting thing is the paper I presented to the Society of Surgical Oncology—no, the Head and Neck Society in San Francisco, while I was in the military-- was on melanoma of the head and neck, that I had coauthored with Everett [Sugarbaker] and obviously Jay Ballantine. We were on this panel and I gave my presentation in full uniform, because they paid for me to go out there. Fred Eilber, by the way, was the moderator of that. He and I knew each other because Fred was a fellow at the time I was a rotating resident. I remember when we interviewed, Fritz, some years ago, for a fellowship. He was born in Houston, so he was born while Fred was a fellow. In any event, there was somebody in the back and they had—do you remember the projectors they had then? I mean it was like an aircraft landing, you couldn’t look at it. It was among the first big presentation I’d ever made and I was pretty anxious about it and there was a guy in the back that was asking me all these questions about everything. Fortunately, I was prepared for him and finally Fred said, “Alf—”

Charles Balch, MD

Alf [Alfred] Ketchum.

Frederick Ames, MD

Cut him a little slack, he was actually a pretty good guy.”

Charles Balch, MD

Alf Ketchum was one of my primary mentors.

Frederick Ames, MD

Two weeks later, I got a letter, an invitation, to go visit Miami and of course at the time Everett was there because Everett, Fred had both worked with him. Anyway, it’s very incestuous because at every turn you ran into people who all knew each other. Obviously, you had to make it or break it but the fact is, they were looking at you closely. In any event, I was offered a position here and I took it.

Charles Balch, MD

What was your responsibilities when you first came, this was in 1977, is that right?

Frederick Ames, MD

Correct, August 1, 1977.

Charles Balch, MD

Okay. And how did you fit in? Let me ask you this way. When I was hired, I was a general surgical oncologist. I operated in every body cavity and we did everything. We weren’t organized by organ site, the way people are now.

Frederick Ames, MD

Correct.

Charles Balch, MD

But you had some areas of special interest.

Frederick Ames, MD

Well they sort of evolved.

Charles Balch, MD

Were you a utility person?

Frederick Ames, MD

I was a utility person.

Tacey A. Rosolowski, PhD

What does that mean?

Charles Balch, MD

It means you do everything, you do whatever is asked.

Tacey A. Rosolowski, PhD

And this was at this point, it was the Department or Division of General Surgery, correct?

Frederick Ames, MD

It was the Department of General Surgery.

Charles Balch, MD

Who was the faculty at that time?

Frederick Ames, MD

Well it was Dr. White.

Charles Balch, MD

Who had been the chief from the beginning.

Frederick Ames, MD

And he actually still operated occasionally and I first assisted him. He did only breast and thyroid. Then there was Dr. Martin, there was Dr. Romsdahl, Marvin Romsdahl, they were a squad. There was McBride and McMurtrey.

Charles Balch, MD

I remember Marion McMurtrey.

Frederick Ames, MD

He’s still living by the way.

Charles Balch, MD

Is he?

Frederick Ames, MD

He’s 92 or 93. He had also been trained—

Charles Balch, MD

He did more of the thoracic.

Frederick Ames, MD

He was trained in thoracic surgery in addition to general surgery and actually, when I came onboard, he was still on general surgery. The next person was Ted Copeland, who had his own service and he was really getting famous because of—

Charles Balch, MD

Hyper-alimentation.

Frederick Ames, MD

Right. They needed somebody to manage his service while he was out of town four days a week. They needed somebody --and I was told this to my face-- that they didn’t have to go clean up after or apologize for. So Ted and I became best buddies, as if we weren’t already and for all I know, he may have played a role in my choice as an invited person on the faculty.

Charles Balch, MD

I think you did and we’ll hear from—he’s already—

Frederick Ames, MD

He’s never made any secret that he was very pleased with my work, and as president of the SSO, I was among the few that were mentioned. In any event, of course I was well known to the others, but I think that one of the urges, one of the itches that they needed to scratch was that Ted needed some help on his service.

Tacey A. Rosolowski, PhD

So you fitted the bill?

Frederick Ames, MD

I’ll let others judge that. But he did everything. We also did perfusions, McBride and McMurtrey did perfusions, Ted did perfusions and I did perfusions. Then McMurtrey, the next year, moved to thoracic full-time. And I can’t remember, I may have moved over, I think I moved over. Then was with Charlie McBride, and every six months we would—or three months, we would rotate between. We would carry melanoma with us wherever we went, but we would migrate between GI and breast.

Tacey A. Rosolowski, PhD

So was there good collaboration with people and what was the environment like?

Frederick Ames, MD

Very close-knit. I was obviously the youngest in rank as well as in age, and I was often sent on a mission to go discuss something with the head of anesthesia or this or that or the other. It was remarkable that no one ever gave me any backtalk. Of course they knew that I had been issued my marching orders by Ed White, and he’d been given his by Lee Clark, and everybody knew what the rank order was.

Tacey A. Rosolowski, PhD

Interesting.

Frederick Ames, MD

It was one, two, three, and if you were somebody’s disciple or adjutant, they didn’t question it. They were free to do that but it was pointless to call Dr. White and asked him if he had in fact sent me to do whatever, whoever.

Tacey A. Rosolowski, PhD

Well I guess you could make those assumptions at that time, partially because the institution, it was a small institution at that time.

Frederick Ames, MD

They all knew each other. A very small institution, again we were all in that one little pink building over there and you’ve probably got pictures of that little pink building by itself, surrounded by parking lots and trees.

Tacey A. Rosolowski, PhD

Yeah, I know it’s amazing.

Charles Balch, MD

So Fred, could we go through a synopsis of some of these people, to get your overall impressions. First is Lee Clark as the surgeon. Even though he wasn’t in the operating room, what influence did he have as the so called surgeon in chief, because we have lots of information about him as president but there’s almost nothing written about Lee Clark and his engagement with the surgical faculty, with recruitment. Yet when I read the correspondence, there’s nothing that didn’t go past his desk.

Frederick Ames, MD

My contract, August 1, 1977, signed by Dr. Clark, I’ve still got it. That was his last year as president. He retired at the end of—the fiscal year is you know, the end of August, so at the end of August the next year, he retired. All I know is that they were very close-knit. He gave his thoughts to the people to carry them out, and all I knew was his word, and his rule was law.

Tacey A. Rosolowski, PhD

Did he have an impact on how people undertook surgery at the institution? I remember reading, or hearing from someone, I think you had seconded this but I heard it also from someone else, that really, Dr. Clark wanted to be remembered as a surgeon almost more than as president of MD Anderson.

Frederick Ames, MD

I honestly can’t speak to that because he was completely divorced from clinical activity. I don’t know when it was that he last was clinically engaged, beyond seeing the occasional VIP patient who may have been directed to him and then he lateraled it off, or it some person he may have cared for previously. As I told you before, I remember reviewing charts of interesting cases, one of which was a man who had a chordoma, who came back to the clinic. Because of the pay scale, Fred Eilber and I were assigned to see him. He had a mass, so he was then bumped up and Charlie McBride operated on that patient. But this is a patient that Lee Clark had operated upon a number of years before, because that disease process sometimes takes a number of years to evolve, and that’s where I learned what a Kraske procedure was[GJ1] .

Charles Balch, MD

Yes. So Lee, I’ve gone over all of his records. He talked about international things, the institution, but the one area that he talked about a lot was thyroid disease and thyroid cancer. It was the one thing he was comfortable with talking about outside of his role as president.

Frederick Ames, MD

I don’t remember much about that. I do remember that Dr. White was very deeply involved in thyroid and in fact, I inherited all of his 35 mm slides when he left, and a lot of them were thyroid.

Charles Balch, MD

Do you think that had anything to do with them recruiting Bob [Robert C.] Hickey, who was the president of the Endocrine Society?

Frederick Ames, MD

Later.

Charles Balch, MD

Later on.

Frederick Ames, MD

Later on. You know I honestly don’t know. Dr. Hickey came and went, and so did Marion McMurtrey, he left briefly, to go back to Utah, because he’s Mormon, and he returned only a couple of years later. It didn’t work out for him. I already knew him at that time so when he left and returned, I can’t remember, it may have been when I was finishing my residency. Dr. Hickey was there at that time and then he left and went to Wisconsin and then came back. I think that was when Mickey [Charles A.] LeMaistre [oral history interview] was president, so the dates would show.

Charles Balch, MD

Yeah, yeah.

Frederick Ames, MD

I never really knew much about what Dr. Clark did as a surgeon, except I was struck, he did a presacral chordoma.

Charles Balch, MD

Exactly.

Frederick Ames, MD

That’s big time.

Charles Balch, MD

And he attended all of the surgical meetings: the American Surgical, the Western Surgical, the Southern Surgical. I have letters of him, writing letters of recommendation for a range of surgeons around the country, to join those societies. So he was actively engaged in those surgical societies. So in a sense he—and he carried the title for a long time, of surgeon in chief.

Frederick Ames, MD

Right.

Charles Balch, MD

But the first person who was really the chief of surgery was Ed White, and for what, 30 years, we have the exact dates, he was the person who was really running the department. But even in Ed White’s letters, there’s always a note by R. Lee Clark, even down to approving instruments in the operating room.

Tacey A. Rosolowski, PhD

Interesting.

Frederick Ames, MD

I’m not surprised. It was very, very clear that he was someone, he was the epitome of the CEO who was involved in anything going on, that he didn’t know about.

Charles Balch, MD

Yes. Down to the instruments ordered in the operating room.

Frederick Ames, MD

A fellow who is a few years older than I, who lived down the street and he raced cars and had a hotrod Ford with a big Chrysler motor with a supercharger on it, and when I had just gotten my drivers license, I used to look down the street. He was the son of a local neurosurgeon and I still know him well. One of his best friends was a guy named Randy Clark, who was the son.

Charles Balch, MD

Of course.

Tacey A. Rosolowski, PhD

Oh, okay, yeah.

Frederick Ames, MD

And even when my friend finally moved from Houston, he had a shop in the Heights, with a bed and a kitchen and so forth, where he could work on cars. It was carpeted, and he would build his racecars and stuff. He had the old operating room instruments, you know the overhead lights?

Charles Balch, MD

Yeah. Yeah, yeah.

Frederick Ames, MD

But these go back to, I mean this would have been 1950s stuff that was cast aside.

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

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