Chapter 04: Collaborations in the Division of Medicine, Comments on the Needs of Women Faculty, and Final Thoughts on Collaborative Temperaments and Research Culture
Dr. Grimm begins this chapter by mentioning several people she collaborated with when she moved to the Division of Medicine. She and Dr. Balch discuss surgeon, Raphael Pollock, who was the first faculty member to earn a PhD while employed at MD Anderson, and who represented the changing research spirit at the institution. They next discuss the role of women on the faculty, with Dr. Grimm noting the continued need for child care. In response to a question, Dr. Grimm talks about the personal qualities that have enabled her to stay on the cutting edge of translational research. Dr. Balch adds his observations on qualities that enabled her success. He then talks about how her qualities also reflect a commitment to “collective wisdom and collaboration” essential for translational research and team science. Dr. Grimm also notes that she has continuously focused on developing her own independent lines of research, despite changes in administration around her.
The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center
Building the Institution; The Researcher; Overview; Definitions, Explanations, Translations; Multi-Disciplinary Approaches; Growth and/or Change; MD Anderson Culture; Working Environment; Institutional Missions and Values; Experiences Related to Gender, Race, Ethnicity; Gender, Race, Ethnicity, Religion; Leadership; On Leadership
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History of Science, Technology, and Medicine | Oncology | Oral History | Surgery
Elizabeth E. Grimm, PhDYeah, it’s great. I mean, the opportunities here are amazing. I have to say Dick Champlin was here during some of this time.
Charles Balch, MDYes, and Al Deisseroth.
Elizabeth E. Grimm, PhDAnd Al Deisseroth. Those two were translational, and Dick I had known from UCLA, and they set up this phenomenal cytophoresis unit. I still—I have a protocol for sending normal volunteers to get leukaphoresis so we could do our studies, our lymphocyte activation studies. Fifty dollars we paid these people to come in to sit in a machine for three hours and get all their blood circulated through the centrifuge, and we took all the white cells --how we could get the white cells, and that kept us [busy with experiments] for about a week, and we did it again. But because especially Dick setting up this study of lymphocytes in a big way. [Dick and I] had the same background in immunology, he knew me from a distance at UCLA—he was a fellow around the corner on the same hall where I was a grad student. So, anyway, those people were very collaborative, too. Al Deisseroth was wonderful. So there was an undercurrent of that happening.
Charles Balch, MDAnd I want to add, just for the historical context, I think the other change that happened right at this time when Liz and Jack came was recruiting Raph Pollock [Raphael Pollock, MD; oral history interview], who you have an oral history with. While he was on the faculty I agreed with him to take off time and get a PhD with Eva Lotsova, who’s a PhD, on NK cells—
Elizabeth E. Grimm, PhDI remember that.
Charles Balch, MD—and she gave him no extra credit because he was a clinician. He said, “If you’re going to get a PhD, you have to get it because you’re a scientist, not a clinician.”
T. A. Rosolowski, PhDOh, he talked about that. (laughs)
Charles Balch, MDShe was a taskmaster.
Elizabeth E. Grimm, PhDYeah, and Jack talked about that, too.
Charles Balch, MDHe did get that, but that was also part of taking an existing faculty member who did his fellowship here, the first one, to get a PhD, and then have a laboratory research. And I will say Raph even today has a support grant at Ohio State, and so—
Elizabeth E. Grimm, PhDYes, (overlapping dialogue; inaudible).
Charles Balch, MD—it just shows you once you start that change, if you can tap into the right people, get them trained properly, that they can grow and flourish and be first-class clinical scientists.
Elizabeth E. Grimm, PhDI was on his advisory committee for his PhD, and I was in his examining committee, and I was in the room when he defended surgery as immunosuppressive, as I’m remembering this. I don’t think I looked this up.
Charles Balch, MDYes. That was a paper Don Morton wrote many years before.
Elizabeth E. Grimm, PhDOf course, yes. And so I had this background of that. Of course, surgery’s immunosuppressive. But he did it with splenocytes from a mouse model, and proved it with all the controls that only you can do in a mouse; you can’t really do it in a human. But shortly after that he became the youngest, as associate professor, Chairman of Surgery, right? Surgical Oncology. And just was here for a long time, I don’t even remember how many years before he left. But we had lots of collaborations afterwards, too. It was nice to see that happen. Several people have gotten PhDs after their MD, but I think [any of my?] others that were later, not at this time period. But that was great.
Charles Balch, MDLiz, one of the things you touched on that I think is very important historically is the role of women in the faculty, which you’ve had a leadership role in. I wonder if you could just, for the record, talk about how MD Anderson in its evolution, with just a few people at the beginning, has really championed the professional development of women faculty at MD Anderson, and your role in that.
Elizabeth E. Grimm, PhDYeah, well, I think what I’ve done mostly was just by example. I was not ever the leader of the women’s group, and we really have to thank Liz Travis [oral history interview] for taking that on. When I first came, she was already here, and she, on her own time, set up data and analysis to compare salaries of women to men, that kind of thing. So I really appreciated that, and we’ve been good friends ever since. I think that just being present, and having women fellows, and mentoring them, has been a great pleasure.
Charles Balch, MDAnd to succeed.
Elizabeth E. Grimm, PhDAll of them, I think, have done something better, but they were—I mean, they were great students. I had great students, and I’m so proud of all the women that worked in my lab or I mentored otherwise. I’ve been on many committees of those that didn’t even work in my lab. But it was tough, because there was still a change, a society change of the … Some men thought everybody should be home, (laughs) taking care of the kids. I think the one thing I have not solved that probably isn’t good for this institution is that we still have no childcare here, and we lose women faculty, quite honestly. We lose women faculty. They don’t understand you can’t get good help, or how to do it, or they don’t have the finances. They don’t have a surgeon husband. So I think that’s—I have failed to that. I had several times in different instances where I stood up and said, “Here’s—we do a childcare center there. We do a child... Boston has the Longwood Childcare Center, and why can’t we do it?” And it just—we got every excuse.
T. A. Rosolowski, PhDWhat is the obstacle, do you think? Why do the excuses keep coming, and what are they?
Elizabeth E. Grimm, PhDBelieve me, I argued—I couldn’t see them, other than liability was the one, and I think this institution’s kind of been afraid of things over the years, afraid of new things. And they got people onto [administrative] staff that didn’t need that, and that kind of cut out a lot of [faculty] women, and women left. We have wonderful fellows. I think the fellowship classes, at least in medicine now, where I’m mostly—and I don’t know exactly about surgery—but they’re more than half women.
T. A. Rosolowski, PhDYeah. Is it unusual for a cancer center like this not to support the female faculty or parents with a childcare center?
Elizabeth E. Grimm, PhDI think we’re special. MD Anderson is special, because other cancer centers are associated with a university, and they do have childcare centers.
Charles Balch, MDAt the university level.
Elizabeth E. Grimm, PhDAt the university. So once you are brought in to a training position you get access to that. Now, some of our grad students have access to the graduate school housing, but the fellows I don’t think do. They never do. So that’s been a problem.
T. A. Rosolowski, PhDWhat else do you feel needs to move in order to bring the institution forward with women?
Elizabeth E. Grimm, PhDI’d love to see a woman president someday, if someone would like that. More women at the top. We now have less women chairs and full professors. I don’t know the statistics, but we’ve had a little decline. So we haven’t finished the job with respect to that. And with this education level, and the number of graduates from medical schools and PhD programs, with women being 50% in the med school classes now, why are they not here? And it’s been long enough that they should percolate up, and—
T. A. Rosolowski, PhDDo you feel that...? I mean, I know from interviewing Dr. Travis, as well as others involved with women faculty programs—I can’t remember how it’s—the title has evolved now to encompass diversity—
Elizabeth E. Grimm, PhDYes, and minority, and—yeah. (laughs)
T. A. Rosolowski, PhDYes. But there’s been so much effort to educate people, how do we grow people’s careers. Do you feel—do you see that that has taken root, that division heads and department chairs are savvier about supporting people?
Elizabeth E. Grimm, PhDMm-hmm, mm-hmm, the ones I deal with definitely are. Certainly, of course, Charles was the beginning key, yes.
Charles Balch, MDYeah, I think the numbers support that.
Elizabeth E. Grimm, PhDYes, I think they do.
Charles Balch, MDBut it still is unfinished business.
T. A. Rosolowski, PhDRight, there’s a ceiling there.
Elizabeth E. Grimm, PhDYeah, yeah. And we’re getting more women who have come from other cultures, and they want to achieve more, but I think it’s going to be the next generation of some of those, even though the women are physicians themselves. So it’s going to take a little time.
Charles Balch, MDYeah. But—
T. A. Rosolowski, PhDCulture change is tough.
Elizabeth E. Grimm, PhDIt is tough, it is tough, but I have great hope.
Charles Balch, MDElizabeth Grimm, I want to give you credit for 33 years of being here at MD Anderson and still being on the cutting edge of research. The field has transformed. It is totally different than when we started out in 1985, ’86, and that era. It’s transformed, and to keep up on that and contribute original and significant information year after year is something that I give you a lot of credit for. Many PhDs would burn out, because they don’t adopt new technology and new concepts, and the work becomes obsolete. They don’t get grants, and then they go off in to do other things. But you, in turn, have just been remarkable as an investigator and as an educator here at MD Anderson, and I give you a lot of credit for your many, many contributions to the field and to MD Anderson.
Elizabeth E. Grimm, PhDThank you, Charles. That’s wonderful, and it wouldn’t have happened without you. Seriously. It was all possible coming to MD Anderson, because there’s no place like it here, and it’ll always be my home now, even though I was reluctant to come here. (laughs)
T. A. Rosolowski, PhDWhat do you think is it that...? I mean, Dr. Balch was mentioning keeping up with things, and some of that’s energy; some of it is creativity. But those are my words. I mean, what are the personal qualities that you see in yourself that has enabled you to do that? And, of course, we give Dr. Balch credit for having recognized that in you. (laughs) But, I mean, what are those qualities that you...?
Elizabeth E. Grimm, PhDThey’re definitely curiosity, and I have to control that sometimes, because I have to also keep focus, so I don’t have—I mean, I never have enough focus to finish everything I wanted to do. But the curiosity is something that I’ve been able to enjoy. I have so many opportunities here. I can do this and this and this, and find the answer to that, and now with computers we can do even more. (laughs) But we have to keep focused, keep your eye on the goal. So that’s one thing that is probably good. We’re hearing a lot, too, about emotional intelligence, and dealing with other people. I’ll have to say Mickey LeMaistre and Charles Balch are two that had that innate emotional intelligence --just incredible, not only scientists, leaders, surgeons, but gentlemen in every respect to their peers, women, men, whatever. That created the environment that I had no doubt that I was safe and capable of doing what I needed to do and wanted to do, and if I had a problem I was sure they’d tell me I shouldn’t be doing it that way, but it was never any problems here for me. And I just am so grateful for the environment that you nurtured and maintain, and sometimes had to keep at bay, (laughs) so it worked out.
T. A. Rosolowski, PhDBut part of the reason I was asking—
Charles Balch, MDI think you asked a good question. Let me just finish, because I think some other characteristics are being flexible, adaptable, and willing to take on new technology and new concepts, and incorporate them. It’s being a change agent. Most people like things the way they are today, and they’re not as open to making changes, but in our field of research you have to make—you’re constantly about change.
Elizabeth E. Grimm, PhDOh, yeah. It’s what you want to do. You want to do.
T. A. Rosolowski, PhDThat’s right.
Charles Balch, MDAnd if you don’t change, you die.
T. A. Rosolowski, PhDAnd that’s partly a mental and emotional flexibility I think you’ve got.
Charles Balch, MDYeah. So I think these are characteristics that you brought—
Elizabeth E. Grimm, PhDThank you.
Charles Balch, MD—that has allowed you to continue to succeed.
T. A. Rosolowski, PhDOne of the reasons I asked the question is that, as I’ve talked to all sorts of different types of researchers over the years, it’s kind of clear that it takes a particular type of person to dive into these deep collaborations that result in translational work. And so part of—I mean, you were talking earlier about how the General Surgery Department was selecting for a particular type of individual. That helped created the culture of the department. So part of culture change is also deciding what is the skillset, the intellectual/emotional profile of a person that we’re looking for to help maintain our culture. So that’s part of why I was asking that question. What is this new entity that we’re trying to cultivate here?
Charles Balch, MDYeah, and let me add one other thing to these characteristics, and it’s what I call collective wisdom and collaboration. I think that Liz’s personality is that it’s not so egocentric—not it’s going to be my program—but I’m going to create a team, I’m going to collaborate with other people, including clinicians, and that by joining our perspective we can really look at novel and unique things that we couldn’t do before. So I think that whole approach of collaboration and team science is also another reason that both Liz and other people here have succeeded.
Elizabeth E. Grimm, PhDThank you.
Charles Balch, MDThe culture really promotes a collaborative approach. Having been at five other universities, I can say that the barriers for collaboration are lower here than any other place that I’ve worked, and that’s a cultural thing: that you can collaborate across departments between basic scientists and clinical scientists, and so forth. I think that is one of the essential elements in the culture of MD Anderson that’s made it successful.
Elizabeth E. Grimm, PhDTo that point I’ll just add: my lab is in the oldest part of the old hospital building, on the top floor, and it still is, after 33 years. (laughs) It’s probably one of the oldest still running laboratories. But during this time I’ve had seven different chairs, and been in—my primary department has been five different departments. But not once have I changed my focus, what I’ve been doing, what my grants are [addressing]. It’s like the administration sort of swirled around me, and I just kept going with the science, and nobody really had major complaints; mostly it was welcome. But I [kept my secondary affiliation throughout many years as] Surgery, and then I came to be in the Medicine Division but still had the other [five primary] departments, and you remember Mosha Talpez?
Charles Balch, MDYes, yes.
Elizabeth E. Grimm, PhDI was in Biomed Therapy at one point. But I always kept my lab in the same place, my ID could stay the same number, but the title and the appointment, (laughs) I just went from this department to that as chairs left, departments’ names changed. Tumor Biology became Molecular and Cellular Oncology, and then Ki Hong took over, and then this one to that. I mean, I won’t go through all of it, but looking back on that, I’m still here, in the same place, and they’ve all gone. Every one of them except the current chair, and he was an MD PhD student when I came, Michael Davies. He’s now the Chairman of Melanoma Medical Oncology [and my chair]. I remember him walking by, his backpack on his back, and one of my technicians was eying him, like, who’s this guy? Okay, [I’ve got to get the work done?]. But anyway.
T. A. Rosolowski, PhDSo you were really in that deep current of where the institution was going.
Elizabeth E. Grimm, PhDI think so. I just... That was where I wanted to go, too, and I hope I helped it in some way. I hope history will show that... Yeah, it’s been fantastic.
T. A. Rosolowski, PhDWell, you were saying earlier that one of the secrets is being passionate about what you—loving what you do, I think were the words, and so it sounds like—
Elizabeth E. Grimm, PhDOh, yeah, yeah.
Charles Balch, MDYeah, and looking at that list, you have to be flexible and adaptable, also—
Elizabeth E. Grimm, PhDThank you.
Charles Balch, MD—to the currents of the administration.
Elizabeth E. Grimm, PhDCharles has my characteristics. (laughter) I’m going to write this down. Correct, that’s true. Adaptability. Yeah. And I think that goes with this emotional intelligence now that Peter Pisters is talking about, but we had different terms for it, how to keep working with different people and things, so...
Charles Balch, MDAnything else you want to add?
Elizabeth E. Grimm, PhDHmm, hmm, hmm, hmm, hmm... Well, I definitely just want to say how much I appreciate you recruiting us, and for all of the funding, the startup funding that you provided to me, because (laughs) it was a lot.
Charles Balch, MDAnd I think the record will show that half of my resource package from Mickey LeMaistre went to Jack Roth and Elizabeth Grimm. Historically, as we look back, they really had a major role in transforming the institution, in their—by their leadership and by their willing to take the risk to come here and develop new programs, and to bring us where we are today.
Elizabeth E. Grimm, PhDThank you, thank you.
T. A. Rosolowski, PhDCan I ask one final question?
Elizabeth E. Grimm, PhDSure, yes.
T. A. Rosolowski, PhDWhat do you think your impact on Surgery was? Has been?
Elizabeth E. Grimm, PhDWow, wow. Well, I hope that it has educated many other new surgeons to love the laboratory and research, and have research labs. I’ve seen that happen, and that just warms my heart. There’s another generation coming along of translational scientists with clinician degrees, those in the PhD degrees, and also MDs that aren’t surgeons that I have trained and are now leaders in different places. But to see that happening, because I know I just—I can’t keep up with everything, just beyond me to do all the technology these days. That’s probably my major impact, is the training. I still do that, no matter what my time and effort is here. I’m going to be mentoring and helping out. With the next SPORE—I don’t know if you’ve heard—so (inaudible) SPORE for almost 14 years as the overall director, but Patrick Hwu, who’s our Medicine Division Head—he replaced Ki Hong—just this last month got the news and the funding for the Melanoma SPORE, with me as his co-PI, and Jeff Lee is the third co-PI. So Jeff Lee and I are his co-PIs. So that translational component of Medicine and Surgery together from the medicine side, more recently, has been a major contribution. First it was from the surgery side, obviously, because that’s how I came here, but as time went by the other way I did institute that, and I’ll take a lot of credit for that. I remember even having Saturday morning sessions for planning our first P01, because Merrick Ross would not come on a weekday. He would only come on Saturday morning, or for dinner at some steakhouse, and we tried that and he showed up an hour late, so I tried the Saturday. I mean, I hired a babysitter so I could have a meeting so this one surgeon could get there, we could get this P01 planned. As the plans went, we never submitted the P01 because the SPORE solicitation came out. And Merrick was never [directly involved as he really had no time. He was contributing by being an incredibly busy clinical surgeon and making tissues available]. But it was great. It was great. So there were just wonderful opportunities, and working together with people, and also, I think, led to the Moon Shot, as you probably know, and it’s beyond—since Charles left. I was asked to be the first academic officer ad interim under DePinho [oral history interview] for his Moon Shot vision, when he was looking for some outside people. It turned out that I led that for 13 months, and I was still leading the SPORE in my lab and my grants. I think that was a great thing now. It’s beyond what your topic is for this interview, but I just want, since you ask—we’re going to the future. So that wouldn’t have happened if we didn’t have these SPOREs here, and people were already working together. We had the setup. It was the laboratory, the melanoma core laboratory, that Jeff Gershenwald started with a lot of your background from the AJCC data, and tissue collection we did for other reasons that Kyogo was doing. We all grew together with that. But that tissue resource, tissue bank resource, with annotated tissues, peripheral blood lymphocytes preserved, DNA, RNA, all this stuff evolved as the technology got better. I think to get those resources institutional-wide now, almost every disease site, I think were patterned after that.
Charles Balch, MDBut this capsulizes the 34 years of us working together, when, for me, coming here, and Jack Roth as a clinician scientist … We can’t do translational research unless we have PhDs in the laboratory as collaborators who are willing to collaborate with us on clinically-relevant biological research. And Liz brought that. Kyogo Itoh brought that—
Elizabeth E. Grimm, PhDYes.
Charles Balch, MD—in my lab, along with Neal Pellis. It’s that collaboration between the clinician and the basic scientist that really was a cultural change at MD Anderson. And then look at what you just described with the most recent SPORE, is the chair—the Head of the Division of Medicine, the Chair of Surgical Oncology, and Liz, as a PhD, being the leaders of one of the largest SPORE grants in the United States—
T. A. Rosolowski, PhDThat’s a pretty amazing set of bookends.
Charles Balch, MD—in the area of melanoma. So I started out at a lower level, but it’s gotten to a point now that it’s fully embedded into the culture of MD Anderson faculty with this, I think, very important and unique interface between the clinician and the scientist to advance the field of cancer medicine, so that we have innovative therapies in diagnostics to treat our future patients with.
Elizabeth E. Grimm, PhDMm-hmm, mm-hmm, mm-hmm. Absolutely. It’s a struggle still, though. We have many wonderful resources that need to be implemented and coordinated. As new discoveries are made and new technology comes on, it just goes and goes. I mean, training the next generation is the most important thing, to keep those things moving forward, because we know our times are, (laughs) and our energies are getting less and less. We need to have this next generation taking over. I feel that that’s still the greatest contribution we can make, to ensure the future of this field and this institution, that it’s—
Charles Balch, MDYeah, so it’s an important point to emphasize. We not only did the research at our level, but created the training programs and the funding for it so that we could train the next generation, and that was an early strategic agenda.
T. A. Rosolowski, PhDWell, also really key in areas where basically new fields were forming, I mean, and continue to expand.
Elizabeth E. Grimm, PhDTake a little risk that it’s going to work, pay off, but there were people willing to join us in that risk. The fellows were. They were so excited, and they probably saw the future even brighter than we did. I just admire what they’re doing now, many of them, different places. So it’s all good.
Charles Balch, MDOkay, thank you, again, for coming, for kind of recreating some of this history that otherwise would be lost, and we really appreciate your many years of contribution, and your willingness, you and Jack, to come here as first outside recruits during my era, (laughter) when I came here in 1985.
Elizabeth E. Grimm, PhDIncredible. It’s just been wonderful. Thirty-three, almost 34 years, and still going. (laughs)
T. A. Rosolowski, PhDYeah, yeah, amazing.
Elizabeth E. Grimm, PhDSo, anyway, thank you—
T. A. Rosolowski, PhDAbsolutely.
Elizabeth E. Grimm, PhD—and thank you, Tacey. Appreciate it very much.
T. A. Rosolowski, PhDCertainly. My pleasure. All right, and for the record I’ll say I’m turning off the recorder at about 27 minutes after 1:00.
Grimm, Elizabeth A. PhD; Balch, Charles M. MD; and Rosolowski, Tacey A. PhD, "Chapter 04: Collaborations in the Division of Medicine, Comments on the Needs of Women Faculty, and Final Thoughts on Collaborative Temperaments and Research Culture" (2019). History of Surgery - Interview Chapters. 37.
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