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

Title

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

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Description

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.

Identifier

ByersR_01_2019014_C12

Publication Date

10-14-2019

Publisher

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

City

Houston, Texas

Topics Covered

The Univeristy of Texas MD Anderson Cancer Center - Institutional Mission and Values; Professional Values, Ethics, Purpose; Critical Perspectives; MD Anderson Impact; Institutional Mission and Values; Growth and/or Change; Research; Care; MD Anderson in the Future; Leadership

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History | Surgery

Transcript

Robert Byers, MD

All the back table was being ultraviolet while they’re waiting, whatever they needed or something back there.

Charles Balch, MD

So in these final moments are there some things you want to put on the record that we haven’t talked about?

Robert Byers, MD

Well, how did the past be prologue to the future? And I think the past has been ignored to a certain extent and everything is quote moon shot. And I think the research has always been MD Anderson Cancer and Tumor Institute. And I think the time that they brought the two together has always created somewhat of a competition. And I think the research now has dominated to some extent the clinical. And you can see what happened with DePinho and now Peter.

Charles Balch, MD

Peter Pisters.

Robert Byers, MD

Pisters, yes. So I think Clark was the past, but he was a clinician. Crucial. The president. Clinician, not research. And I think it’s beared fruit now.

Charles Balch, MD

I think this is very important. Even Lee Clark said, “Our mission is patient care, research, and education,” but he always put patient care first.

Robert Byers, MD

He always did. And the same with—it changed a little with LeMaistre.

Charles Balch, MD

That’s the central mission.

Robert Byers, MD

And it really changed with Mendelsohn and then we need not go any further. But yes, Clark emphasized the patient care. And not just the technical academic interest in the patient. But the personal.

Charles Balch, MD

And I think the reason to make that as an important point, a lot of heroes who took care of thousands of patients are not so well known because they were busy taking care of patients but they didn’t necessarily publish what they did or participate in clinical trials. And yet they set the foundation for this institution and standards of excellence in their trainees that went all over the country. And that’s why having these oral histories so that people like you can talk about those heroes who are not as well known today. Oscar Guillamondegui. Bill MacComb. Ed White. Dick Martin. Felix Rutledge.

Robert Byers, MD

Doug Johnson.

Charles Balch, MD

Doug Johnson of course.

Robert Byers, MD

Awesome in urology. Whitmore up there at Memorial, he was a competitor with him. I mean and he was world-famous urologic cancer surgeon.

Charles Balch, MD

So part of the reason for doing this is so that we can tell the story about those individuals who richly deserve to be recognized for their contributions but aren’t as well known because they didn’t publish 50 or 100 papers. But they contributed to the standards of care in the evolution of cancer surgery that we enjoy today. And you are one of those pioneers.

Robert Byers, MD

I tried to have the three legs of the stool. The research I did was protocol research or whatever kind of thing I did with the young patients and all that. But basically it revolved about you have to publish because Anderson needs to be promoted in the world, and you can’t do it by just the unknowns working like a Trojan in the institution. Those people needed to be producing publications. And I think it sort of got to the researchers being so dependent upon getting money for what they were doing for research. They had to have money for that.

And I think things got out of kilter. I think the people who were doing the research were not worried about the people who were doing the clinical because there was no bench to bed. Bench to bed concept got fuzzy. We can study sea urchins because we want to study sea urchins. Come on, guys. We got problems with nerve invasion. How do we treat nerve invasion? You guys need to tell us why one tumor invades nerves and one doesn’t.

Charles Balch, MD

So Bob Byers, I want to tell you how much respect I have for you as part of the legacy and the history of MD Anderson’s Surgery Department.

Robert Byers, MD

That’s kind.

Charles Balch, MD

And your contributions. So I really appreciate you spending the time and documenting your historical perspective on this great institution.

Robert Byers, MD

I appreciate you asking me, Charles. Asking me. Because I thought there might be some animosity between us but I can tell you from my side—

Charles Balch, MD

None at all.

Robert Byers, MD

—if there was it’s gone. OK?

Charles Balch, MD

OK. And we’ll end this session now. Thank you.

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

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