Cormac Cullinan

Transcription

WITH DR. STEPHEN CULLIAN AND DR. JAMES GERSTNER. DR. JAMES GERSTNER. NOW, I WANT TO GO BACK TO THE NOW, I WANT TO GO BACK TO THE BEGINNING OF THE TWO OF YOU. BEGINNING OF THE TWO OF YOU. WHEN DID YOU FIRST THINK "HEY, WHEN DID YOU FIRST THINK "HEY, THIS SCIENCE THING WORKS FOR THIS SCIENCE THING WORKS FOR ME?" ME?" >>HIGH SCHOOL. >>HIGH SCHOOL. >>WHO WAS THE TEACHER? >>WHO WAS THE TEACHER? DO YOU REMEMBER THE EVENT? DO YOU REMEMBER THE EVENT? >> I DO. >> I DO. I REMEMBER EXACTLY. I REMEMBER EXACTLY. >>WHAT WAS THAT? >>WHAT WAS THAT? >> THERE WAS A LADY BY THE NAME >> THERE WAS A LADY BY THE NAME OF MRS. YOCUM, WHO WAS MARRIED OF MRS. YOCUM, WHO WAS MARRIED TO ONE OF THE PEOPLE FROM TO ONE OF THE PEOPLE FROM CATERPILLAR WHO WAS DOING A CATERPILLAR WHO WAS DOING A ROTATION AND WAS A PH.D. FROM ROTATION AND WAS A PH.D. FROM TEXAS UNIVERSITY. TEXAS UNIVERSITY. SHE HAD TO DO SOMETHING, SO SHE SHE HAD TO DO SOMETHING, SO SHE THOUGHT, HIGH SCHOOL WITH A THOUGHT, HIGH SCHOOL WITH A MASTER'S IN BIOLOGY. MASTER'S IN BIOLOGY. SHE WAS FANTASTIC. SHE WAS FANTASTIC. >>THAT WAS THE TIPPING POINT? >>THAT WAS THE TIPPING POINT? >> THAT WAS THE TIPPING POINT. >> THAT WAS THE TIPPING POINT. >>STEVE, YOUR ANCESTORS, YOUR >>STEVE, YOUR ANCESTORS, YOUR FATHER, DA CULLIAN AND SON, YOUR FATHER, DA CULLIAN AND SON, YOUR GRANDFATHER STARTED THE BUSINESS GRANDFATHER STARTED THE BUSINESS WITH ONE HORSE, PRESUMABLY. WITH ONE HORSE, PRESUMABLY. HE STARTED DOING CULVERTS AND HE STARTED DOING CULVERTS AND THINGS, AND COMING IN FEBRUARY, THINGS, AND COMING IN FEBRUARY, THE COMPANY WILL BE ONE HUNDRED THE COMPANY WILL BE ONE HUNDRED YEARS OLD. YEARS OLD. THREE GENERATIONS, MY THREE GENERATIONS, MY GRANDFATHER, FOR, AND BROTHER. GRANDFATHER, FOR, AND BROTHER. WHEN DID YOU HIT THE IDEA OF WHEN DID YOU HIT THE IDEA OF MEDICAL SCHOOL VERSE MEDICAL SCHOOL VERSE CONSTRUCTION. CONSTRUCTION. MY NEIGHBORHOOD, THERE WERE MY NEIGHBORHOOD, THERE WERE THROUGH DOCTORS. THROUGH DOCTORS. I USED TO GO DOWN THERE AND TALK I USED TO GO DOWN THERE AND TALK TO THEM, AND THEY EXCHANGED TO THEM, AND THEY EXCHANGED THINGS. THINGS. I USED TO GO TO THE HOSPITAL IN I USED TO GO TO THE HOSPITAL IN PEKIN, AND THEY LET ME WALK PEKIN, AND THEY LET ME WALK AROUND WITH THEM. AROUND WITH THEM. IT WAS VERY INTERESTING. IT WAS VERY INTERESTING. >>YOU WERE IN? >>YOU WERE IN? >> 5TH AND 6TH GRADE. >> 5TH AND 6TH GRADE. YOU NATURALLY MIGRATED INTO YOU NATURALLY MIGRATED INTO SCIENCE. SCIENCE. >>ALWAYS WANT WONDERED. >>ALWAYS WANT WONDERED. >>BIOLOGY AND CHEMISTRY AND THE >>BIOLOGY AND CHEMISTRY AND THE LIKE. LIKE. YOU TWO WENT ON SCHOOL, U OF I, YOU TWO WENT ON SCHOOL, U OF I, AND GRADUATE SCHOOL WAS AND GRADUATE SCHOOL WAS NORTHWESTERN. NORTHWESTERN. >>NORTHWESTERN. >>NORTHWESTERN. >>YOU ENJOYED RELATIONSHIPS >>YOU ENJOYED RELATIONSHIPS ACADEMICALLY, AND ALSO MAYO. ACADEMICALLY, AND ALSO MAYO. WE BOTH DID RESIDENCIES IN WE BOTH DID RESIDENCIES IN DIFFERENT AREAS. DIFFERENT AREAS. STEVE WAS HENRY FORD. STEVE WAS HENRY FORD. I WENT TO UP GUN DER SON IN LA I WENT TO UP GUN DER SON IN LA VOSS, WISCONSIN, WHERE I DID MY VOSS, WISCONSIN, WHERE I DID MY THREE YEAR RESIDENCY UP THERE. THREE YEAR RESIDENCY UP THERE. IT WAS ONLY AFTER THAT, THAT WE IT WAS ONLY AFTER THAT, THAT WE THEN BOTH ENDED UP AT MAYO'S AT THEN BOTH ENDED UP AT MAYO'S AT THE SAME TIME IN THE SAME THE SAME TIME IN THE SAME SPECIALTY BY CHANCE. SPECIALTY BY CHANCE. >>BY CHANCE. >>BY CHANCE. >>BY CHANCE. >>BY CHANCE. >>RIGHT. >>RIGHT. >>TWO GUYS FROM PEKIN, TREMONT >>TWO GUYS FROM PEKIN, TREMONT GOING THROUGH THIS ACADEMIC, GOING THROUGH THIS ACADEMIC, LADDER, IF YOU WILL, ENDING UP LADDER, IF YOU WILL, ENDING UP AT AMOW. AT AMOW. >>THAT IS CORRECT. >>THAT IS CORRECT. WHAT WAS IT LIKE BEING WHAT WAS IT LIKE BEING ASSOCIATED FOR MAYO? ASSOCIATED FOR MAYO? WHAT WAS IT LIKE THEN, JUST FOUR WHAT WAS IT LIKE THEN, JUST FOUR OR FIVE YEARS AGO, THEN, RIGHT! OR FIVE YEARS AGO, THEN, RIGHT! (LAUGHING) HOW MANY YEARS AGO. (LAUGHING) HOW MANY YEARS AGO. >>77, OR 78. >>77, OR 78. >>I WAS '75 TO '77. >>I WAS '75 TO '77. I HAD COME INTEREST A HOSPITAL I HAD COME INTEREST A HOSPITAL THIS DETROIT AND LOOKED AT THIS DETROIT AND LOOKED AT FELLOWSHIPS THIS OTHER PLACES, FELLOWSHIPS THIS OTHER PLACES, CLEARLY THE BEST. CLEARLY THE BEST. NOT ONLY FOR THE TRAINING IN NOT ONLY FOR THE TRAINING IN YOUR SUB SPECIALTY, BULL ALL THE YOUR SUB SPECIALTY, BULL ALL THE PEOPLE, BACK UP, AND IT IS TRULY PEOPLE, BACK UP, AND IT IS TRULY THE LADIES AND GENTLEMEN OF THE LADIES AND GENTLEMEN OF MEDICINE. MEDICINE. IT IS A VERY COLLEGE UAL IT IS A VERY COLLEGE UAL ATMOSPHERE. ATMOSPHERE. I CAN REMEMBER EVEN THOUGH I WAS I CAN REMEMBER EVEN THOUGH I WAS IN THE ONCOLOGY OR CANCER IN THE ONCOLOGY OR CANCER DEPARTMENT, ON THE NOON HOUR, I DEPARTMENT, ON THE NOON HOUR, I COULD GO OVER -- YOU CAN GET AN COULD GO OVER -- YOU CAN GET AN EDUCATION, JUST WALKING DOWN THE EDUCATION, JUST WALKING DOWN THE STREET THERE. STREET THERE. THERE IS ALWAYS SOMETHING GOING THERE IS ALWAYS SOMETHING GOING ON ACADEMICALLY. ON ACADEMICALLY. IT WAS VERY NICE. IT WAS VERY NICE. BEST TWO YEARS IN TRAINING WAS BEST TWO YEARS IN TRAINING WAS SPENT THERE. SPENT THERE. >>YOU WOULD HE ECHO THE SAME. >>YOU WOULD HE ECHO THE SAME. I WOULD HAVE TO SAY EXACTLY THE I WOULD HAVE TO SAY EXACTLY THE SAME. SAME. 30,000 DOCTORS. 30,000 DOCTORS. 30,000 DOCTORS. 30,000 DOCTORS. >>ONE OF THE MOST -- A LOT OF >>ONE OF THE MOST -- A LOT OF TIME DURING TRAINING PROGRAMS, TIME DURING TRAINING PROGRAMS, THE TRAINEES ARE A LEVEL APART THE TRAINEES ARE A LEVEL APART AND IS VERY CLEAR THAT THEY ARE AND IS VERY CLEAR THAT THEY ARE A LEVEL APART FROM THE PEOPLE A LEVEL APART FROM THE PEOPLE WHO ARE TRAINING THEM. WHO ARE TRAINING THEM. THE COLLEGE IAL TY OF THE PEOPLE THE COLLEGE IAL TY OF THE PEOPLE I WORKED WITH AT MAYOS, NOT ONLY I WORKED WITH AT MAYOS, NOT ONLY WAS I LEARNING, BUT WE BECAME WAS I LEARNING, BUT WE BECAME GOOD FRIENDS, AND FRIENDSHIPS GOOD FRIENDS, AND FRIENDSHIPS THAT LASTED, MANY BEING MANY THAT LASTED, MANY BEING MANY YEARS. YEARS. STEVE, YOU MIGRATE BACK TO THE STEVE, YOU MIGRATE BACK TO THE CENTRAL ILLINOIS AREA CENTRAL ILLINOIS AREA SPECIFICALLY PEORIA, AND YOU SPECIFICALLY PEORIA, AND YOU FORM IN 1997 THE THEN ONCOLOGY FORM IN 1997 THE THEN ONCOLOGY ASSOCIATES. ASSOCIATES. >>CORRECT. >>CORRECT. >>YOU JOINED THE GROUP TWO YEARS >>YOU JOINED THE GROUP TWO YEARS LATER. LATER. >>YES. >>YES. >>TODAY, 14 MEDICAL ONCOLOGISTS, >>TODAY, 14 MEDICAL ONCOLOGISTS, THREE GYNECOLOGICAL ONCOLOGISTS, THREE GYNECOLOGICAL ONCOLOGISTS, 16 NURSE PRACTITIONER NERS, AND 16 NURSE PRACTITIONER NERS, AND FOUR RETIREES. FOUR RETIREES. THE TWO OF YOU RETIRED IN 2007. THE TWO OF YOU RETIRED IN 2007. >>CORRECT. >>CORRECT. >>HOW MANY TOTAL EMPLOYEES THEN >>HOW MANY TOTAL EMPLOYEES THEN WHEN YOU RETIRED? WHEN YOU RETIRED? >> I KNOW WHAT THEY HAVE NOW. >> I KNOW WHAT THEY HAVE NOW. >>WHAT DO THEY HAVE NOW. >>WHAT DO THEY HAVE NOW. >>270. >>270. >>I THINK AT THE TIME WE WERE >>I THINK AT THE TIME WE WERE RETIRING, THERE WERE ABOUT 190. RETIRING, THERE WERE ABOUT 190. SO IT HAS CONTINUED TO GROW. SO IT HAS CONTINUED TO GROW. >>WHEN YOU LOOK BACK, TWO GUYS >>WHEN YOU LOOK BACK, TWO GUYS FROM SMALLER COMMUNITIES, YOU FROM SMALLER COMMUNITIES, YOU START A BUSINESS. START A BUSINESS. LOOKING BACK ON IT NOW, WOULD LOOKING BACK ON IT NOW, WOULD YOU EVER THOUGHT YOU COULD HAVE YOU EVER THOUGHT YOU COULD HAVE DONE WHAT YOU DID? DONE WHAT YOU DID? >> I CAN SAY THAT NONE OF US >> I CAN SAY THAT NONE OF US EVER THOUGHT THAT THIS WOULD BE EVER THOUGHT THAT THIS WOULD BE WHAT IT ENDED UP TO BE. WHAT IT ENDED UP TO BE. DID BUT I DO HAVE TO TELL YOU AN DID BUT I DO HAVE TO TELL YOU AN INTERESTING STORY. INTERESTING STORY. BACK, AS WE FIRST STARTED, AS BACK, AS WE FIRST STARTED, AS STEVE HAD BEEN IN PRACTICE, AND STEVE HAD BEEN IN PRACTICE, AND I JOINED HIM, AND HE WAS RUNNING I JOINED HIM, AND HE WAS RUNNING HIS TAIL OFF TRYING TO SEE HIS TAIL OFF TRYING TO SEE EVERYTHING AND GET EVERYTHING EVERYTHING AND GET EVERYTHING DONE. HE SAID "JIM, WHY DON'T DONE. HE SAID "JIM, WHY DON'T YOU LOOK INTO THE BUSINESS, TELL YOU LOOK INTO THE BUSINESS, TELL US WHAT WE NEED TO DO." US WHAT WE NEED TO DO." HE SAID "YOU KNOW ABOUT HE SAID "YOU KNOW ABOUT BUSINESS." BUSINESS." OF COURSE, I KNEW NOTHING. OF COURSE, I KNEW NOTHING. I KNEW ABSOLUTELY NOTHING ABOUT I KNEW ABSOLUTELY NOTHING ABOUT BUSINESS! BUSINESS! >>WHICH MAYBE WAS A GOOD THING! >>WHICH MAYBE WAS A GOOD THING! (LAUGHING). (LAUGHING). >>IN TRYING TO DECIDE WHAT TO >>IN TRYING TO DECIDE WHAT TO DO, I THOUGHT WELL, I WILL ASK DO, I THOUGHT WELL, I WILL ASK SOMEONE WHO KNOWS ABOUT SOMEONE WHO KNOWS ABOUT BUSINESS. BUSINESS. SO I GOT THE PEOPLE FROM PRICE SO I GOT THE PEOPLE FROM PRICE WATER HOUSE TO COME OVER AND WE WATER HOUSE TO COME OVER AND WE TALKED. TALKED. I EXPLAINED TO THEM WHAT WE WERE I EXPLAINED TO THEM WHAT WE WERE DOING IN THE CHEMOTHERAPY DRUGS DOING IN THE CHEMOTHERAPY DRUGS THAT WERE BEING GIVEN AND THAT WERE BEING GIVEN AND EXPECTING AFTER THREE DAYS OF EXPECTING AFTER THREE DAYS OF WORKING WITH THEM THAT THEY WORKING WITH THEM THAT THEY COULD TELL ME HOW MANY PEOPLE I COULD TELL ME HOW MANY PEOPLE I NEEDED AND HOW I COULD APORTION NEEDED AND HOW I COULD APORTION PEOPLE CORRECTLY. PEOPLE CORRECTLY. AFTER THREE DAYS, I SAT DOWN AFTER THREE DAYS, I SAT DOWN WITH THE EXIT INTERVIEW WITH WITH THE EXIT INTERVIEW WITH HIM, AND I SAID, WHAT SHOULD WE HIM, AND I SAID, WHAT SHOULD WE DO? DO? HE SAID, "WELL, I THINK YOU NEED HE SAID, "WELL, I THINK YOU NEED TO GET A SHOE BOX AND PUT ALL TO GET A SHOE BOX AND PUT ALL YOUR RECEIPTS IN THAT. YOUR RECEIPTS IN THAT. AT THE END OF THE YEAR, THEN I AT THE END OF THE YEAR, THEN I WILL MAKE YOUR TAXES." WILL MAKE YOUR TAXES." (LAUGHING). (LAUGHING). I LEARNED ABSOLUTELY NOTHING. I LEARNED ABSOLUTELY NOTHING. HOWEVER, AT THAT POINT, I DID HOWEVER, AT THAT POINT, I DID LEARN THAT FOR MOST OF THE FIRST LEARN THAT FOR MOST OF THE FIRST TWO YEARS, STEVE HAD NOT BILLED TWO YEARS, STEVE HAD NOT BILLED ANYBODY! ANYBODY! (LAUGHING) MADE ME REALIZE THIS (LAUGHING) MADE ME REALIZE THIS IS A 501C3. IS A 501C3. >>IF THEY HAPPEN TO PAY AT THE >>IF THEY HAPPEN TO PAY AT THE DOOR, THAT WAS FINE. DOOR, THAT WAS FINE. IS IT FAIR TO SAY YOU WERE GOING IS IT FAIR TO SAY YOU WERE GOING AROUND THE MIDWEST OR TRI COUNTY AROUND THE MIDWEST OR TRI COUNTY AREA OR LARGER STATES TO MAKE IT AREA OR LARGER STATES TO MAKE IT KNOWN THIS IS WHAT YOU WERE KNOWN THIS IS WHAT YOU WERE DOING, AND SEEKING REFERRALS, IF DOING, AND SEEKING REFERRALS, IF YOU WILL. YOU WILL. THAT'S TRUE. THAT'S TRUE. WE HAD 16 OR 18 SATELLITE WE HAD 16 OR 18 SATELLITE CLINICS. CLINICS. OF THEM BEING I HAVE BEEN TO OF THEM BEING I HAVE BEEN TO EVERY ONE OF THEM WITHIN THE EVERY ONE OF THEM WITHIN THE FIRST TWO TO THREE YEARS FROM FIRST TWO TO THREE YEARS FROM '77 TO ABOUT '80, I HAD BEEN TO '77 TO ABOUT '80, I HAD BEEN TO EVERY ONE OF THOSE PLUS APOLUNE EVERY ONE OF THOSE PLUS APOLUNE BUNCH OF OTHERS, AND JUST MET BUNCH OF OTHERS, AND JUST MET DOCTOR'S THINGS. DOCTOR'S THINGS. A LOT OF WOMEN'S CLUB, BUSINESS A LOT OF WOMEN'S CLUB, BUSINESS MEETINGS, SPEECHES, JAYCEES. MEETINGS, SPEECHES, JAYCEES. >>WERE THERE OTHER ONCOLOGY? >>WERE THERE OTHER ONCOLOGY? >> TWO OTHER FELLOWS. >> TWO OTHER FELLOWS. AND THERE WAS ME. AND THERE WAS ME. HE CAME, AND HE JOINED ME AFTER HE CAME, AND HE JOINED ME AFTER TWO YEARS. WE SAT DOWN, AND HE TWO YEARS. WE SAT DOWN, AND HE SAID "WHAT IS THE CONTRACT SAID "WHAT IS THE CONTRACT HERE." HERE." I SAID "WE ARE PARTNERS." I SAID "WE ARE PARTNERS." I SAID THAT AND THAT WAS IT. I SAID THAT AND THAT WAS IT. WE WERE JUST PARTNERS. WE WERE JUST PARTNERS. >>YOU AND OUR DAD'S KNOW EACH >>YOU AND OUR DAD'S KNOW EACH OTHER. OTHER. YOU AND I KNOW EACH OTHER. YOU AND I KNOW EACH OTHER. >>LET'S TALK ABOUT YOUR DAD'S. >>LET'S TALK ABOUT YOUR DAD'S. INTERESTING PART OF THE INTERESTING PART OF THE RELATIONSHIP. RELATIONSHIP. YOUR FATHERS KNEW EACH OTHER YOUR FATHERS KNEW EACH OTHER VERY WELL. VERY WELL. THEY WERE BEST FRIENDS. THEY WERE BEST FRIENDS. >>BEST FRIENDS. >>BEST FRIENDS. >>HOW DID THEY COME TO KNOW >>HOW DID THEY COME TO KNOW THIS. THIS. >>BOTH OF THEM GREW UP IN >>BOTH OF THEM GREW UP IN TREMONT. TREMONT. AND THEY HAD KNOWN EACH OTHER AND THEY HAD KNOWN EACH OTHER ALL THEIR LIVES, AND AS THEY ALL THEIR LIVES, AND AS THEY WENT OFF TO COLLEGE, MY DAD CAME WENT OFF TO COLLEGE, MY DAD CAME BACK AS THE TREMONT SCIENCE BACK AS THE TREMONT SCIENCE TEACHER. TEACHER. ROY, WENT TO LAW SCHOOL, AND ROY, WENT TO LAW SCHOOL, AND CAME BACK TO WORK IN HIS CAME BACK TO WORK IN HIS FATHER'S BUSINESS. FATHER'S BUSINESS. MY DAD SHORTLY REALIZED IT WAS MY DAD SHORTLY REALIZED IT WAS VERY DIFFICULT BEING A TEACHER VERY DIFFICULT BEING A TEACHER AND ENDED UP BEING THE CHRYSLER AND ENDED UP BEING THE CHRYSLER PLYMOUTH DEALER IN TREMONT. PLYMOUTH DEALER IN TREMONT. WE HAD A CAR DEALER AND A ROAD WE HAD A CAR DEALER AND A ROAD AND BRIDGE CONTRACTOR, NEITHER AND BRIDGE CONTRACTOR, NEITHER ONE OF WHICH HAD ANY BACKGROUND ONE OF WHICH HAD ANY BACKGROUND IN HEALTH CARE. IN HEALTH CARE. >> SO THEN, STEVE, THINKING >> SO THEN, STEVE, THINKING ABOUT THAT, THEIR MEETINGS, THEY ABOUT THAT, THEIR MEETINGS, THEY UNDERSTOOD THEY TENDED TO HAVE UNDERSTOOD THEY TENDED TO HAVE BREAKFAST TOGETHER? BREAKFAST TOGETHER? >> EVERY DAY. >> EVERY DAY. >>SEE THE OTHER THING IS, TOO, >>SEE THE OTHER THING IS, TOO, WE USED TO HAVE GET TOGETHERS, WE USED TO HAVE GET TOGETHERS, AND WE'D HAVE -- AND WE'D HAVE -- >>FAMILIES WOULD GET TOGETHER. >>FAMILIES WOULD GET TOGETHER. >>ALL SORTS OF THINGS. YOU SAT >>ALL SORTS OF THINGS. YOU SAT AND HAD FAMILY THINGS TOGETHER. AND HAD FAMILY THINGS TOGETHER. THIS WAS A NATURAL THING. THIS WAS A NATURAL THING. WHEN THE PARTNERSHIP, I KNOW IT WHEN THE PARTNERSHIP, I KNOW IT CAME, AND AS WE DREW OTHER CAME, AND AS WE DREW OTHER PEOPLE EXTREMELY TALENTED PEOPLE EXTREMELY TALENTED PHYSICIANS FROM ALL OVER THE PHYSICIANS FROM ALL OVER THE COUNTRY CAME WITH US, IT WAS COUNTRY CAME WITH US, IT WAS THAT SAME COLLEGE IAL TY AND THAT SAME COLLEGE IAL TY AND PARTNERSHIP, WE OFFERED A UNIQUE PARTNERSHIP, WE OFFERED A UNIQUE THING YOU COULD BECOME A PARTNER THING YOU COULD BECOME A PARTNER IN ONE YEAR WHICH WAS UNHEARD OF IN ONE YEAR WHICH WAS UNHEARD OF AT THAT TIME IN A MEDICAL AT THAT TIME IN A MEDICAL PRACTICE. PRACTICE. WE JUST ATTRACTED THE RIGHT WE JUST ATTRACTED THE RIGHT PEOPLE. PEOPLE. PART OF THE ACTIVITIES OF YOUR PART OF THE ACTIVITIES OF YOUR OLD GROUP WAS TO CONDUCT TRIALS. OLD GROUP WAS TO CONDUCT TRIALS. IS THAT RIGHT? IS THAT RIGHT? >> YES. >> YES. >>WE ARE REALLY TALKING ABOUT >>WE ARE REALLY TALKING ABOUT RESEARCH. RESEARCH. REALLY TALKING ABOUT RESEARCH. REALLY TALKING ABOUT RESEARCH. REALLY, FROM THE VERY BEGINNING REALLY, FROM THE VERY BEGINNING THAT I THINK WE ALL RECOGNIZE THAT I THINK WE ALL RECOGNIZE THAT MANY OF THE NEW MEDICINES THAT MANY OF THE NEW MEDICINES THAT WERE COMING ALONG WERE THAT WERE COMING ALONG WERE GOING TO BE MEDICINES THAT WERE GOING TO BE MEDICINES THAT WERE NOT AVAILABLE. NOT AVAILABLE. THEY WERE NOT COMMERCIALLY THEY WERE NOT COMMERCIALLY AVAILABLE. AVAILABLE. AND ONLY MEDICINES OF THAT AND ONLY MEDICINES OF THAT VARIETY BE AVAILABLE IF THERE VARIETY BE AVAILABLE IF THERE WERE RESEARCH TRIALS THAT WERE WERE RESEARCH TRIALS THAT WERE ONGOING. ONGOING. THERE WAS A GENTLEMAN BY THE THERE WAS A GENTLEMAN BY THE NAME OF DR. CHARLES MARTELL, NAME OF DR. CHARLES MARTELL, HEAD OF THE ONCOLOGY DEPARTMENT HEAD OF THE ONCOLOGY DEPARTMENT AT MAYO'S. AT MAYO'S. ABOUT THE TIME THAT STEVE AND I ABOUT THE TIME THAT STEVE AND I WERE FINISHING, DR. MARTELL SAID WERE FINISHING, DR. MARTELL SAID I AM TRAIN ALL YOU YOUNG MEN TO I AM TRAIN ALL YOU YOUNG MEN TO GO OUT AND DO WORK AND ALL THE GO OUT AND DO WORK AND ALL THE THINGS THAT WE DO HERE. THINGS THAT WE DO HERE. HE SAID, WITHIN AND AS THAT HE SAID, WITHIN AND AS THAT HAPPENS, WE ARE GOING TO HAVE HAPPENS, WE ARE GOING TO HAVE FEWER PATIENTS COMING TO MAYOS FEWER PATIENTS COMING TO MAYOS BECAUSE SO MANY WILL BE DONE IN BECAUSE SO MANY WILL BE DONE IN YOUR HOME TOWNS. YOUR HOME TOWNS. IN ORDER TO DO GOOD CLINICAL IN ORDER TO DO GOOD CLINICAL RESEARCH, WE NEED TO HAVE RESEARCH, WE NEED TO HAVE NUMBERS OF PEOPLE INVOLVED. NUMBERS OF PEOPLE INVOLVED. MAYBE IT WOULD BE A GOOD IDEA IF MAYBE IT WOULD BE A GOOD IDEA IF WE GET TOGETHER AND TRY TO HAVE WE GET TOGETHER AND TRY TO HAVE INVOLVEMENT WITH BOTH THE PEOPLE INVOLVEMENT WITH BOTH THE PEOPLE IN THE COMMUNITIES AS WELL AS IN THE COMMUNITIES AS WELL AS HERE IN ROCHESTER TO DO HERE IN ROCHESTER TO DO CONTINUED CLINICAL TRIALS." CONTINUED CLINICAL TRIALS." >>STEVE, TELL ME TODAY, THE MOST >>STEVE, TELL ME TODAY, THE MOST RECENT ARTICLE IN "PEORIA RECENT ARTICLE IN "PEORIA JOURNAL STAR" 12-72012, SAID JOURNAL STAR" 12-72012, SAID ILLINOIS CANCER CENTER IS THE ILLINOIS CANCER CENTER IS THE NINTH LARGEST IN TREATMENT AND NINTH LARGEST IN TREATMENT AND CANCER CONTROL, THOSE CANCER CONTROL, THOSE PROCEDURES, RANKING ABOVE MAYO PROCEDURES, RANKING ABOVE MAYO CLINIC OF JACKSONVILLE, FLORIDA, CLINIC OF JACKSONVILLE, FLORIDA, THE CLEVELAND CLINIC AND THE THE CLEVELAND CLINIC AND THE UNIVERSITY OF IOWA. UNIVERSITY OF IOWA. SO THE RESEARCH THAT YOU FOLKS SO THE RESEARCH THAT YOU FOLKS EN GENDERED PUT YOU NINTH IN THE EN GENDERED PUT YOU NINTH IN THE NATION ABOVE CLEVELAND CLINIC NATION ABOVE CLEVELAND CLINIC AND THE UNIVERSITY OF IOWA. AND THE UNIVERSITY OF IOWA. >>WE ARE VERY PROUD OF THE >>WE ARE VERY PROUD OF THE INVOLVEMENT THAT WE HAVE HAD IN INVOLVEMENT THAT WE HAVE HAD IN THE RESEARCH, BUT A LARGE PART THE RESEARCH, BUT A LARGE PART OF THAT, AND PARTICULARLY IN THE OF THAT, AND PARTICULARLY IN THE EARLY YEARS HAS TO GO TO THE EARLY YEARS HAS TO GO TO THE ORGANIZATIONAL CAPABILITIES OF ORGANIZATIONAL CAPABILITIES OF MAYOS. MAYOS. THE OTHER THING THAT MEDICAL THE OTHER THING THAT MEDICAL ONCOLOGY OR CANCER AND BLOODY ONCOLOGY OR CANCER AND BLOODY CEASES IS, AS EVERYBODY KNOWS, CEASES IS, AS EVERYBODY KNOWS, RAPIDLY EVOLVING. WE RECOGNIZED RAPIDLY EVOLVING. WE RECOGNIZED WHEN WE CAME OUT IN PRACTICE, WE WHEN WE CAME OUT IN PRACTICE, WE HAD TO WRITE THE PAPERS BECAUSE HAD TO WRITE THE PAPERS BECAUSE YOU COULDN'T READ THEM BECAUSE YOU COULDN'T READ THEM BECAUSE YOU WOULD ALREADY BE OUT OF YOU WOULD ALREADY BE OUT OF DATE. DATE. IT ALLOWED US TO GET THE NEWER IT ALLOWED US TO GET THE NEWER AGENTS. AGENTS. BY THE TIME THEY WERE AVAILABLE, BY THE TIME THEY WERE AVAILABLE, WE HAD LARGE EXPERIENCE, AND WE HAD LARGE EXPERIENCE, AND ACTUALLY PARTICIPATED AND WROTE ACTUALLY PARTICIPATED AND WROTE SEVERAL OF THE MAJOR PAPERS. SEVERAL OF THE MAJOR PAPERS. YOU CO-AUTHORED OR AUTHORED OVER YOU CO-AUTHORED OR AUTHORED OVER 30. 30. >>YEAH, WHEN THE RESEARCH >>YEAH, WHEN THE RESEARCH STARTED BACK IN 1978 OR '79, STARTED BACK IN 1978 OR '79, THAT THERE AT THAT TIME WERE TEN THAT THERE AT THAT TIME WERE TEN PEOPLE THAT WERE INVOLVED IN PEOPLE THAT WERE INVOLVED IN KIND OF GETTING THINGS STARTED. KIND OF GETTING THINGS STARTED. THOSE TEN PEOPLE HAVE NOW THOSE TEN PEOPLE HAVE NOW EVOLVED IN OUR RESEARCH GROUP TO EVOLVED IN OUR RESEARCH GROUP TO SLIGHTLY MORE THAN 700 PEOPLE. SLIGHTLY MORE THAN 700 PEOPLE. >>IS ALL? >>IS ALL? >> YEAH. >> YEAH. SO THE NORTH CENTRAL CANCER SO THE NORTH CENTRAL CANCER TREATMENT GROUP WHICH IS ANOTHER TREATMENT GROUP WHICH IS ANOTHER NAME FOR THE MAYO CLINIC. NAME FOR THE MAYO CLINIC. >>AFFILIATE. >>AFFILIATE. >>ALL THE AFFILIATES. >>ALL THE AFFILIATES. >>HOW MANY CITIES ARE THEY IN >>HOW MANY CITIES ARE THEY IN NOW? NOW? >> 44 DIFFERENT GROUPS, AND SOME >> 44 DIFFERENT GROUPS, AND SOME 200 CITIES INVOLVED IN THE. 200 CITIES INVOLVED IN THE. >>IT IS ENORMOUS. >>IT IS ENORMOUS. >>INVOLVED IN THE PROGRAM. >>INVOLVED IN THE PROGRAM. >>THE GENESIS WAS MAYOS. >>THE GENESIS WAS MAYOS. >>YES, IT WAS. >>YES, IT WAS. >>BUT YOU GUYS ARE THE LARGEST >>BUT YOU GUYS ARE THE LARGEST PERHAPS OF ALL AFFILIATES? PERHAPS OF ALL AFFILIATES? >> NO,. >> NO,. >>THERE ARE LARGER ONES. >>THERE ARE LARGER ONES. SOME HAVE BEEN BROUGHT IN. SOME HAVE BEEN BROUGHT IN. AT THE TIME, ACTUALLY AT THAT AT THE TIME, ACTUALLY AT THAT TIME THAT WAS THE ACTUALLY THE TIME THAT WAS THE ACTUALLY THE TEMPLATE FOR COMMUNITY CANCER TEMPLATE FOR COMMUNITY CANCER ORGANIZATIONS WAS THE NORTH ORGANIZATIONS WAS THE NORTH CENTRAL GROUP. CENTRAL GROUP. EVERYBODY ELSE MAT EARNED IT AND EVERYBODY ELSE MAT EARNED IT AND WANTED TO JOIN IT. WANTED TO JOIN IT. IN FACT, BIG NATIONAL MEETINGS, IN FACT, BIG NATIONAL MEETINGS, THERE IS A THING CALLED PLENARY THERE IS A THING CALLED PLENARY SESSION. SESSION. THEY PICKED THE TOP FIVE PAPERS. THEY PICKED THE TOP FIVE PAPERS. ONE OF THOSE CAME FROM NORTH ONE OF THOSE CAME FROM NORTH CENTRAL GROUP OF WHICH JIM AND I CENTRAL GROUP OF WHICH JIM AND I PARTICIPATED IN THAT PAPER WHICH PARTICIPATED IN THAT PAPER WHICH WAS REALLY QUITE AFFECT R FOR US WAS REALLY QUITE AFFECT R FOR US AT THE TIME. AT THE TIME. BUT IT WAS STILL THE IDEA WAS BUT IT WAS STILL THE IDEA WAS THAT YOU STILL WERE ABLE TO THAT YOU STILL WERE ABLE TO BRING THE BEST AND BE PART OF BRING THE BEST AND BE PART OF THE BEST. THE BEST. OTHER THING, WHEN YOU GO TO THE OTHER THING, WHEN YOU GO TO THE MEETINGS, PEOPLE WOULD TALK TO MEETINGS, PEOPLE WOULD TALK TO YOU. YOU. YOU WOULD TALK TO THEM AND BE ON YOU WOULD TALK TO THEM AND BE ON THE SAME PLANE. THE SAME PLANE. >>THE SAME MISSION, DO WHATEVER >>THE SAME MISSION, DO WHATEVER YOU CAN TO STOP THE SPREAD OF YOU CAN TO STOP THE SPREAD OF CANCER OR PERHAPS CURE IT. CANCER OR PERHAPS CURE IT. NUMBERS, IT SEEMS TO ME THAT THE NUMBERS, IT SEEMS TO ME THAT THE WORLD OF RESEARCH IS NUMBERS, WORLD OF RESEARCH IS NUMBERS, STATISTICS. STATISTICS. AND THE CHANGE FROM THE DAYS OF AND THE CHANGE FROM THE DAYS OF MARTIN ARROW SMITH OF SINCLAIR MARTIN ARROW SMITH OF SINCLAIR LEWIS, TO TODAY IS THE LEWIS, TO TODAY IS THE APPLICATION OF NUMBERS, APPLICATION OF NUMBERS, STATISTICAL ANALYSIS OF GENETICS STATISTICAL ANALYSIS OF GENETICS MORE LIKELY TO OCCUR WITH MORE LIKELY TO OCCUR WITH MR. "A" VERSUS MR. "B" AND MR. "A" VERSUS MR. "B" AND RESEARCH FEEDS INTO THAT, IS RESEARCH FEEDS INTO THAT, IS THAT RIGHT. THAT RIGHT. >>ABSOLUTELY. >>ABSOLUTELY. YOU NEED NUMBERS. YOU NEED NUMBERS. >>RIGHT ON. >>RIGHT ON. AND YOU CAN PRETTY MUCH PREDICT AND YOU CAN PRETTY MUCH PREDICT WHO IS MORE LIKELY TO CONTRACT WHO IS MORE LIKELY TO CONTRACT THAT DREADED DISEASE. THAT DREADED DISEASE. >>NOT ONLY WHO IS GOING TO BE >>NOT ONLY WHO IS GOING TO BE MORE AT RISK, BUT THE PEOPLE MORE AT RISK, BUT THE PEOPLE THAT DO DEVELOP IT, I THINK WE THAT DO DEVELOP IT, I THINK WE ARE INDIVIDUALIZING TREATMENTS A ARE INDIVIDUALIZING TREATMENTS A GREAT DEAL MORE. GREAT DEAL MORE. >>SPECIFIC APPLICATION. >>SPECIFIC APPLICATION. >>THE SYSTEMS YOU ARE LOOKING >>THE SYSTEMS YOU ARE LOOKING AT, KNOWLEDGE ABOUT MALIGNANCY, AT, KNOWLEDGE ABOUT MALIGNANCY, NOT JUST MALIGNANCY IN GENERAL, NOT JUST MALIGNANCY IN GENERAL, BUT INDIVIDUAL'S MALIGNANCY, BUT INDIVIDUAL'S MALIGNANCY, WHAT DRUGS MAYBE DRUGS THAT ARE WHAT DRUGS MAYBE DRUGS THAT ARE GOING TO BE THE MOST LIKELY TO GOING TO BE THE MOST LIKELY TO WORK, IN THAT PARTICULAR WORK, IN THAT PARTICULAR CUSTOMIZE TREATMENT. CUSTOMIZE TREATMENT. ALSO, OVER THE YEARS WHAT WE ALSO, OVER THE YEARS WHAT WE HAVE SEEN EVEN MORE SO IS THAT HAVE SEEN EVEN MORE SO IS THAT THE CANCER IS NOT A DISEASE THE CANCER IS NOT A DISEASE TREATED WITH ONE TYPE OF TREATED WITH ONE TYPE OF THERAPY. THERAPY. IT IS A MULTI MODALITY, SURGERY, IT IS A MULTI MODALITY, SURGERY, RADIATION THERAPY, RADIATION THERAPY, IMMUNOTHERAPY, CHEMOTHERAPY, ALL IMMUNOTHERAPY, CHEMOTHERAPY, ALL OF THOSE, AND IN ANY ONE OF THOSE, AND IN ANY ONE PATIENT, ALL OF THEM MAYBE USED PATIENT, ALL OF THEM MAYBE USED AND HOW BEST TO USE THEM, AND AND HOW BEST TO USE THEM, AND HOW TO COMBINE THEM AND TIME HOW TO COMBINE THEM AND TIME THEM. THEM. THOSE ARE ALL MORE RESEARCH. THOSE ARE ALL MORE RESEARCH. >>TURNING BACK, '97, WHEN YOU >>TURNING BACK, '97, WHEN YOU STARTED, THE DIFFERENCES WERE STARTED, THE DIFFERENCES WERE SO, SPEND THE REST OF THE DAY TO SO, SPEND THE REST OF THE DAY TO TALK ABOUT THOSE, BUT THE MOST TALK ABOUT THOSE, BUT THE MOST PROMINENT DIFFERENCE, '97, PROMINENT DIFFERENCE, '97, SEEING FIRST, SECOND, OR THIRD SEEING FIRST, SECOND, OR THIRD PATIENT, VERSUS WHAT IT IS LIKE PATIENT, VERSUS WHAT IT IS LIKE IN 2007, WHEN YOU RETIRED. IN 2007, WHEN YOU RETIRED. >>I THINK HE TOUCHED ON A LOT OF >>I THINK HE TOUCHED ON A LOT OF THAT. THAT. THIS WAS -- YOU KNOW, THERE WAS THIS WAS -- YOU KNOW, THERE WAS THE ERA OF SURGERY, ERA OF THE ERA OF SURGERY, ERA OF RADIATION THERAPY. RADIATION THERAPY. AT THAT TIME IN THE 70'S, IT WAS AT THAT TIME IN THE 70'S, IT WAS THE ERA OF DRUGS OR THE ERA OF DRUGS OR CHEMOTHERAPY. CHEMOTHERAPY. A LOT OF DRUGS USED, PEOPLE MAY A LOT OF DRUGS USED, PEOPLE MAY FIND US, WE NEVER TOTALLY FIND US, WE NEVER TOTALLY UNDERSTAND HOW THEY WORKED. UNDERSTAND HOW THEY WORKED. THEY WORKED, BUT NOW WE ACTUALLY THEY WORKED, BUT NOW WE ACTUALLY UNDERSTAND HOW THINGS WORK. UNDERSTAND HOW THINGS WORK. AND I SAID THE OTHER THING, AND AND I SAID THE OTHER THING, AND WE HAVE MORE PANELS TO LOOK AT. WE HAVE MORE PANELS TO LOOK AT. IT WASN'T JUST EXECUTIVE RAY AND IT WASN'T JUST EXECUTIVE RAY AND LOOK UNDER THE MICROSCOPE. LOOK UNDER THE MICROSCOPE. YOU HAVE GENETIC MARKERS, TUMOR YOU HAVE GENETIC MARKERS, TUMOR MARKERS, ENZYME MARKERS, AND IT MARKERS, ENZYME MARKERS, AND IT IS PROLIFERATING AT EXPONENTIAL IS PROLIFERATING AT EXPONENTIAL RATE. RATE. DRUGS WOULD COME OUT, I REMEMBER DRUGS WOULD COME OUT, I REMEMBER IN THE EARLY 70'S, ABOUT I WAS IN THE EARLY 70'S, ABOUT I WAS IN DETROIT BEING THAT'S HOW IN DETROIT BEING THAT'S HOW BECAME INTERESTED, THERE WAS A BECAME INTERESTED, THERE WAS A NEW DRUG EVERY SIX TO EIGHT NEW DRUG EVERY SIX TO EIGHT MONTHS. NOW, THERE ARE DRUGS MONTHS. NOW, THERE ARE DRUGS COMING OUT WEEKLY. COMING OUT WEEKLY. YEAH, IT IS -- YEAH, IT IS -- >>HOW DO YOU KEEP UP? >>HOW DO YOU KEEP UP? HOW DOES ONE, ACTIVE AND KEEP HOW DOES ONE, ACTIVE AND KEEP UP? UP? >> WITH DIFFICULTY. >> WITH DIFFICULTY. >>HOW DO YOU HAVE TIME FOR YOUR >>HOW DO YOU HAVE TIME FOR YOUR FULL DAY JOB, FOR YOUR FAMILY, FULL DAY JOB, FOR YOUR FAMILY, FOR YOUR OTHER INTERESTS? FOR YOUR OTHER INTERESTS? NOW YOU DO HAVE SINCE YOU BOTH NOW YOU DO HAVE SINCE YOU BOTH RETIRED, BUT THEN HOW MANY HOURS RETIRED, BUT THEN HOW MANY HOURS WOULD YOU DEVOTE TO YOUR WOULD YOU DEVOTE TO YOUR PROFESSION? PROFESSION? HOW MANY OF THE 24 HOURS WOULD HOW MANY OF THE 24 HOURS WOULD YOU NOT DEVOTE TO YOUR YOU NOT DEVOTE TO YOUR PROFESSION. PROFESSION. >>I USED TO MEET JIM AT 5:30 IN >>I USED TO MEET JIM AT 5:30 IN THE MORNING AT THE HOSPITAL. THE MORNING AT THE HOSPITAL. >>AND FREQUENTLY WITH EACH OTHER >>AND FREQUENTLY WITH EACH OTHER AT 8:00 AT NIGHT. AT 8:00 AT NIGHT. >>YOU WERE A YOUNG PERSON AT >>YOU WERE A YOUNG PERSON AT THAT TIME, AND TWO GUYS WHO THAT TIME, AND TWO GUYS WHO REALLY LIKED WHAT THEY DID, REALLY LIKED WHAT THEY DID, WANTED TO DO IT, AND YOU WERE WANTED TO DO IT, AND YOU WERE ABLE TO DO IT, JUST LIKE SO MANY ABLE TO DO IT, JUST LIKE SO MANY PEOPLE IN OTHER FIELDS. PEOPLE IN OTHER FIELDS. YOU WORKED HARD, BUT IT WASN'T YOU WORKED HARD, BUT IT WASN'T HARD WORK. HARD WORK. YOU KNOW, IT WAS SOMETHING YOU YOU KNOW, IT WAS SOMETHING YOU ENJOYED. ENJOYED. WE WERE IN A FIELD THAT WAS WE WERE IN A FIELD THAT WAS RAPIDLY DEVELOPING. RAPIDLY DEVELOPING. WE HAD THE EXPERTISE OF MAYO WE HAD THE EXPERTISE OF MAYO CLINIC HELPING US. CLINIC HELPING US. THAT'S WHY WE ARE VERY LOYAL. THAT'S WHY WE ARE VERY LOYAL. AND THE OTHER THING THAT WAS AND THE OTHER THING THAT WAS WONDERFUL IS THAT AS WE STARTED WONDERFUL IS THAT AS WE STARTED TO EXPAND THE PRACTICE, WE WERE TO EXPAND THE PRACTICE, WE WERE ABLE TO ATTRACT VERY TOPNOTCH ABLE TO ATTRACT VERY TOPNOTCH DOCTORS FROM FIRST CLASS DOCTORS FROM FIRST CLASS INSTITUTIONS, HARVARD, INSTITUTIONS, HARVARD, VANDERBILT, U.C.L.A., UNIVERSITY VANDERBILT, U.C.L.A., UNIVERSITY OF IOWA. OF IOWA. >>ACTUALLY WE TRIED TO ATTRACT >>ACTUALLY WE TRIED TO ATTRACT PEOPLE FROM DIFFERENT PEOPLE FROM DIFFERENT INSTITUTIONS. INSTITUTIONS. THERE WERE, LIKE EVERY PLACE, THERE WERE, LIKE EVERY PLACE, THERE WERE CERTAIN STRENGTHS AN THERE WERE CERTAIN STRENGTHS AN INSTITUTION MAY HAVE, AND BRING INSTITUTION MAY HAVE, AND BRING THOSE IN THE PEORIA AREA AS PART THOSE IN THE PEORIA AREA AS PART OF OUR PRACTICE WAS THE INTENT, OF OUR PRACTICE WAS THE INTENT, AND IT WORKED VERY WELL. AND IT WORKED VERY WELL. >>YOU WERE LEASING SPACE, ST. >>YOU WERE LEASING SPACE, ST. FRANCIS, HOW MANY SQUARE FEET FRANCIS, HOW MANY SQUARE FEET ARE THERE IN THE CURRENT ARE THERE IN THE CURRENT FACILITY? FACILITY? DO YOU RECALL. DO YOU RECALL. >>NO, BECAUSE THEY KEEP ADDING >>NO, BECAUSE THEY KEEP ADDING TO IT! TO IT! (LAUGHING) IT IS A MOVING (LAUGHING) IT IS A MOVING TARGET. TARGET. >>IN 2007? >>IN 2007? >> THERE WERE AT THAT TIME ABOUT >> THERE WERE AT THAT TIME ABOUT 90,000,. 90,000,. >>PROBABLY OVER 150,000. >>PROBABLY OVER 150,000. >>WHEN IT STARTED, ONE DOCTOR, >>WHEN IT STARTED, ONE DOCTOR, TWO NURSES AND TWO OFFICE TWO NURSES AND TWO OFFICE ASSISTANTS, AND TWO EXAM ROOMS. ASSISTANTS, AND TWO EXAM ROOMS. >>I REMEMBER THE DOCTOR'S ROOM, >>I REMEMBER THE DOCTOR'S ROOM, WAS ACTUALLY -- IT WAS A CLOSET WAS ACTUALLY -- IT WAS A CLOSET THAT HAD TWO SHELVES IN IT, AND THAT HAD TWO SHELVES IN IT, AND TWO STOOLS. TWO STOOLS. STEVE AND I WOULD GO INTO THE STEVE AND I WOULD GO INTO THE CLOSET TO DO OUR DICTATION AND CLOSET TO DO OUR DICTATION AND WORK AND PUT THE CHARTS ON THE WORK AND PUT THE CHARTS ON THE SHELVES. SHELVES. THAT WAS AT THE BEGINNING. THAT WAS AT THE BEGINNING. >>DO YOU HAVE TO PINCH YOURSELF >>DO YOU HAVE TO PINCH YOURSELF NOW, AND SAY "GEE, WHIZ, THIS IS NOW, AND SAY "GEE, WHIZ, THIS IS LIKE A NEW WORLD." LIKE A NEW WORLD." >>IT IS ASTONISHING. >>IT IS ASTONISHING. >>CHANGES HAVE GONE ON. >>CHANGES HAVE GONE ON. THERE HAVE BEEN SO MANY THERE HAVE BEEN SO MANY ADDITIONAL THINGS, NOT ONLY IN ADDITIONAL THINGS, NOT ONLY IN MEDICINES AND TECHNOLOGY, BUT MEDICINES AND TECHNOLOGY, BUT WHOLE CONCEPTS, THE HOSPICE WHOLE CONCEPTS, THE HOSPICE PROGRAM DIDN'T EXIST WHEN WE PROGRAM DIDN'T EXIST WHEN WE FIRST CAME. FIRST CAME. WE ALL TAKE THAT FOR GRANTED, WE ALL TAKE THAT FOR GRANTED, AND AS A SOURCE AND THE PEOPLE AND AS A SOURCE AND THE PEOPLE WHO CAN'T BE CURED OF THEIR WHO CAN'T BE CURED OF THEIR MALIGNANCY TO HELP WITH MALIGNANCY TO HELP WITH SYMPTOMS, THAT DIDN'T EXIST WHEN SYMPTOMS, THAT DIDN'T EXIST WHEN WE FIRST CAME. WE FIRST CAME. HOW TO EVEN GET IV'S IN PEOPLE, HOW TO EVEN GET IV'S IN PEOPLE, SOME OF THE PEOPLE WHO HAD HAD SOME OF THE PEOPLE WHO HAD HAD VERY DIFFICULT VEINS, WE HAD NO VERY DIFFICULT VEINS, WE HAD NO WAY TO GET INTO THOSE VEINS. WAY TO GET INTO THOSE VEINS. THERE ARE OTHER TECHNIQUES AND THERE ARE OTHER TECHNIQUES AND PORTS TO IMPLANT WE CAN ACCESS PORTS TO IMPLANT WE CAN ACCESS WITHOUT DIFFICULTY. WITHOUT DIFFICULTY. ALL OF THESE THINGS WERE ALL ALL OF THESE THINGS WERE ALL DURING OUR WATCH. WE GOT TO SEE DURING OUR WATCH. WE GOT TO SEE IT ALL. IT ALL. >>STEVE, WHY ARE YOU SO >>STEVE, WHY ARE YOU SO PASSIONATE ABOUT THAT, THAT PASSIONATE ABOUT THAT, THAT WHOLE AREA OF ONCOLOGY? WHOLE AREA OF ONCOLOGY? WHY WERE YOU SO PASSIONATE FROM WHY WERE YOU SO PASSIONATE FROM '97 TO '07. '97 TO '07. WHAT DROVE YOU TO DO WHAT YOU WHAT DROVE YOU TO DO WHAT YOU WERE DOING? WERE DOING? ACTUALLY IT STARTED WAY BACK ACTUALLY IT STARTED WAY BACK WHEN I WAS INTERN IN DETROIT, WHEN I WAS INTERN IN DETROIT, HENRY FORD IN DETROIT WHICH WAS HENRY FORD IN DETROIT WHICH WAS A HUGE CONTRIBUTOR TO AT THAT A HUGE CONTRIBUTOR TO AT THAT TIME THE NEW DRUGS. TIME THE NEW DRUGS. AS A YOUNG FELLOW, I LOOKED AT AS A YOUNG FELLOW, I LOOKED AT THIS AND SAID, "BOY, WHAT AN THIS AND SAID, "BOY, WHAT AN EMERGING FIELD." EMERGING FIELD." NOBODY WANTED TO GO INTO IT A NOBODY WANTED TO GO INTO IT A LOT AT THAT TIME. LOT AT THAT TIME. >>WHY? >>WHY? >> BECAUSE IT WAS DISCOURAGING >> BECAUSE IT WAS DISCOURAGING AT TIMES, AND IT CAN BE. AT TIMES, AND IT CAN BE. BUT YOU COULD SEE THAT THE BALL BUT YOU COULD SEE THAT THE BALL WAS ROLLING. WAS ROLLING. THERE WAS A REAL LOT OF THERE WAS A REAL LOT OF INTEREST. INTEREST. THERE WAS A LOST MOMENTUM, AND THERE WAS A LOST MOMENTUM, AND AT THAT TIME I BELIEVE THE AT THAT TIME I BELIEVE THE PRESIDENT AND CONGRESS REALLY PRESIDENT AND CONGRESS REALLY PUT MUSCLE BEHIND IT, NOT ONLY PUT MUSCLE BEHIND IT, NOT ONLY ADMINISTRATIVELY, BUT ADMINISTRATIVELY, BUT FINANCIALLY TO REALLY LOOK AT FINANCIALLY TO REALLY LOOK AT THIS. THIS. THE THING WAS YOU COULD SEE SOME THE THING WAS YOU COULD SEE SOME OF THE DRUGS THAT CAME OUT, OF THE DRUGS THAT CAME OUT, REALLY MADE A DIFFERENCE. REALLY MADE A DIFFERENCE. I CAN JUST REMEMBER IN DETROIT I CAN JUST REMEMBER IN DETROIT WHEN THEY HAD DRUG CALLED WHEN THEY HAD DRUG CALLED ADRIMICIN CAME OUT, AND PEOPLE ADRIMICIN CAME OUT, AND PEOPLE WITH DISEASE DIDN'T WORK. WITH DISEASE DIDN'T WORK. YOU GAVE IT TO THEM, AND THEY YOU GAVE IT TO THEM, AND THEY GOT UP AND LEFT THE HOSPITAL GOT UP AND LEFT THE HOSPITAL FOUR DAYS LATER. THAT'S REALLY FOUR DAYS LATER. THAT'S REALLY INTERESTING AND THAT MADE A INTERESTING AND THAT MADE A DIFFERENCE. DIFFERENCE. IT WAS UNBELIEVABLE. IT WAS UNBELIEVABLE. IT WAS ASTONISHING, LIKE IT WAS ASTONISHING, LIKE LAZARUS. LAZARUS. THE OTHER THING, WE RECRUITED THE OTHER THING, WE RECRUITED WONDERFUL COLLEAGUES WHO BROUGHT WONDERFUL COLLEAGUES WHO BROUGHT DIFFERENT VIEWS AND THINGS. DIFFERENT VIEWS AND THINGS. I THINK NOW A LOT OF DOCTORS IN I THINK NOW A LOT OF DOCTORS IN THE PRACTICE ARE SUB THE PRACTICE ARE SUB SPECIALIZING IN CERTAIN SPECIALIZING IN CERTAIN DISEASES. DISEASES. BECAUSE I THINK YOU BROUGHT UP A BECAUSE I THINK YOU BROUGHT UP A GOOD POINT. GOOD POINT. IT IS VERY HARD TO KEEP UP WITH IT IS VERY HARD TO KEEP UP WITH ALL OF THIS, IF YOU TREAT LUNG ALL OF THIS, IF YOU TREAT LUNG CANCER AND BREAST CANCER AND CANCER AND BREAST CANCER AND SOME OF THESE. SOME OF THESE. IT IS JUST THE FIELD IS GROWING IT IS JUST THE FIELD IS GROWING AT SUCH EXPONENTIAL RATE. AT SUCH EXPONENTIAL RATE. THANK GOODNESS. THANK GOODNESS. >>IF I ASKED YOU THE SAME >>IF I ASKED YOU THE SAME QUESTION, HOW WOULD YOUR QUESTION, HOW WOULD YOUR RESPONSE DIFFERENT FROM THAT OF RESPONSE DIFFERENT FROM THAT OF STEVE'S? STEVE'S? WHY ARE YOU SO PASSIONATE ABOUT WHY ARE YOU SO PASSIONATE ABOUT WHAT YOU DID? WHAT YOU DID? >> I THINK PATIENTS WERE, FOR >> I THINK PATIENTS WERE, FOR ME, THE DRIVING PART. ME, THE DRIVING PART. THE DOCTOR-PATIENT RELATIONSHIP, THE DOCTOR-PATIENT RELATIONSHIP, THE FACT THAT I MIGHT HAVE THE FACT THAT I MIGHT HAVE SOMETHING THAT COULD HELP THOSE SOMETHING THAT COULD HELP THOSE PATIENTS. PATIENTS. PART OF THE WHOLE REASON FOR PART OF THE WHOLE REASON FOR GETTING INTO THE RESEARCH GETTING INTO THE RESEARCH PROGRAM WAS TO HAVE THINGS PROGRAM WAS TO HAVE THINGS AVAILABLE FOR MY PATIENTS HERE. AVAILABLE FOR MY PATIENTS HERE. PART OF OUR REASON FOR STARTING PART OF OUR REASON FOR STARTING OUT OUTREACH CLINICS SO WE COULD OUT OUTREACH CLINICS SO WE COULD GET TO OUR PATIENTS WITHOUT SOME GET TO OUR PATIENTS WITHOUT SOME OF THE PROBLEMS AND DIFFICULTIES OF THE PROBLEMS AND DIFFICULTIES THAT BACK IN THOSE DAYS WHEN THAT BACK IN THOSE DAYS WHEN THERE WAS A VERY POOR MEDICINES THERE WAS A VERY POOR MEDICINES TO HELP WITH NAUSEA AND VOMITING TO HELP WITH NAUSEA AND VOMITING AFTER CHEMOTHERAPY. AFTER CHEMOTHERAPY. TO HAVE SOMEONE DRIVE AN HOUR TO HAVE SOMEONE DRIVE AN HOUR AND A HALF TO SEE US AND DRIVE AND A HALF TO SEE US AND DRIVE BACK AND HAVE VOMITING FOR AN BACK AND HAVE VOMITING FOR AN HOUR AND A HALF IN THE CAR WAS HOUR AND A HALF IN THE CAR WAS NOT NICE. NOT NICE. SO IF WE COULD GET OUT TO THEM, SO IF WE COULD GET OUT TO THEM, AND BE ABLE TO TAKE CARE OF THEM AND BE ABLE TO TAKE CARE OF THEM AND THEIR HOME COMMUNITY, TAKE AND THEIR HOME COMMUNITY, TAKE OUR MEDICINES TO THEM AND AVOID OUR MEDICINES TO THEM AND AVOID ALL OF THAT PROBLEM FOR THEM. ALL OF THAT PROBLEM FOR THEM. REPUBLICAN YOU MAKING A REPUBLICAN YOU MAKING A SIGNIFICANT DIFFERENCES OF SIGNIFICANT DIFFERENCES OF LIVING OR DYING, WHAT COULD BE LIVING OR DYING, WHAT COULD BE MORE SIGNIFICANT? MORE SIGNIFICANT? >> PEOPLE PUT THEIR ULTIMATE >> PEOPLE PUT THEIR ULTIMATE TRUST IN. TRUST IN. BECAUSE -- WE KNOW MALIGNANCY, BECAUSE -- WE KNOW MALIGNANCY, WHEN PEOPLE HEAR THAT WORD, THEY WHEN PEOPLE HEAR THAT WORD, THEY THINK OF FINALITY. THINK OF FINALITY. NOW, WHEN YOU BROUGHT UP THE NOW, WHEN YOU BROUGHT UP THE THING ABOUT CURE, DO WE CURE THING ABOUT CURE, DO WE CURE MANY DISEASE? MANY DISEASE? NO, WE CONTROL THEM. NOW YOU NO, WE CONTROL THEM. NOW YOU HAVE A LOT OF DISEASES THAT ARE HAVE A LOT OF DISEASES THAT ARE PROLONGED CURE -- PROLONGED PROLONGED CURE -- PROLONGED CONTROL WHICH IS EQUAL OR CONTROL WHICH IS EQUAL OR TANTAMOUNT TO CURE BECAUSE SOME TANTAMOUNT TO CURE BECAUSE SOME OF THESE DISEASES HAVE BECOME OF THESE DISEASES HAVE BECOME CHRONIC DISEASE. CHRONIC DISEASE. >>THEN I THINK ONE OTHER THING >>THEN I THINK ONE OTHER THING IS WE BEGAN TO SEE THAT CERTAIN IS WE BEGAN TO SEE THAT CERTAIN TREATMENTS COULD MAKE PEOPLE TREATMENTS COULD MAKE PEOPLE WITH ADVANCED DISEASE WITH ADVANCED DISEASE TEMPORARILY BETTER, THAT THE TEMPORARILY BETTER, THAT THE CONCEPT THEN BECAME IF WE CAUGHT CONCEPT THEN BECAME IF WE CAUGHT SOMEONE EARLY WITH THEIR SOMEONE EARLY WITH THEIR DISEASE, WHO WAS PERHAPS NO DISEASE, WHO WAS PERHAPS NO EVIDENCE OF WIDESPREAD PROBLEMS, EVIDENCE OF WIDESPREAD PROBLEMS, BUT WE KNEW THAT STATISTICALLY BUT WE KNEW THAT STATISTICALLY THE RISK WAS HIGH. THE RISK WAS HIGH. WE COULD USE THOSE TREATMENTS AT WE COULD USE THOSE TREATMENTS AT AN EARLIER POINT, AND THOSE AN EARLIER POINT, AND THOSE PEOPLE BE ABLE TO CURE A LARGE PEOPLE BE ABLE TO CURE A LARGE NUMBER OF PEOPLE. NUMBER OF PEOPLE. THAT HAS BEEN A PHILOSOPHICAL THAT HAS BEEN A PHILOSOPHICAL POINT THAT HAS CONTINUED TO POINT THAT HAS CONTINUED TO CARRY ON THROUGHOUT. CARRY ON THROUGHOUT. AS WE HAVE BETTER DRUGS, MORE AS WE HAVE BETTER DRUGS, MORE SPECIFIC DRUGS FOR CERTAIN KINDS SPECIFIC DRUGS FOR CERTAIN KINDS OF MALIGNANCIES OR SOMEBODY'S OF MALIGNANCIES OR SOMEBODY'S PARTICULAR MALIGNANCY, THE PARTICULAR MALIGNANCY, THE EARLIER THEY MAY BE TREAT WHAT EARLIER THEY MAY BE TREAT WHAT WE CALL ADJUTANT FASHION, WE CALL ADJUTANT FASHION, SOMEONE HAS COLON CANCER SOMEONE HAS COLON CANCER REMOVED, BUT THEY HAD LYMPH REMOVED, BUT THEY HAD LYMPH NODES AND WERE AT HIGH RISK FOR NODES AND WERE AT HIGH RISK FOR DEVELOPING WIDESPREAD DISEASE, DEVELOPING WIDESPREAD DISEASE, IF YOU TREAT THEM RIGHT THEN, WE IF YOU TREAT THEM RIGHT THEN, WE ARE GOING TO HAVE ABOUT A 30% ARE GOING TO HAVE ABOUT A 30% IMPROVED CURE RATE FOR THOSE IMPROVED CURE RATE FOR THOSE FOLKS. FOLKS. >>HOW DO YOU HANDLE THIS "DEAR >>HOW DO YOU HANDLE THIS "DEAR JOHN, WE ARE DOING THE BEST WE JOHN, WE ARE DOING THE BEST WE CAN, BUT I SHI WE SHOULD GOAT CAN, BUT I SHI WE SHOULD GOAT YOUR AFFAIRS IN ORDER. YOUR AFFAIRS IN ORDER. " STEVE, HOW MANY TIMES A WEEK " STEVE, HOW MANY TIMES A WEEK WOULD YOU DO THAT, I AM NOT WOULD YOU DO THAT, I AM NOT SAYING ALL YOUR PATIENTS, BUT A SAYING ALL YOUR PATIENTS, BUT A FAIR NUMBER CAME IN TOO LATE, FAIR NUMBER CAME IN TOO LATE, AND THERE WASN'T TOO MUCH OF A AND THERE WASN'T TOO MUCH OF A CURE OPPORTUNITY. CURE OPPORTUNITY. HOW DO YOU GET UP FOR THAT EVERY HOW DO YOU GET UP FOR THAT EVERY DAY? DAY? >> I WOULD HAVE TO SAY FOR THOSE >> I WOULD HAVE TO SAY FOR THOSE PATIENTS, EACH ONE WAS PATIENTS, EACH ONE WAS INDIVIDUAL. INDIVIDUAL. THE OTHER THING, TOO, BECAUSE WE THE OTHER THING, TOO, BECAUSE WE WERE CLOSE AND WENT OUT TO WERE CLOSE AND WENT OUT TO COMMUNITIES, WE ACTUALLY GOT TO COMMUNITIES, WE ACTUALLY GOT TO KNOW A LOT OF THESE FOLKS DURING KNOW A LOT OF THESE FOLKS DURING THEIR DISEASE PROCESS AND THEIR DISEASE PROCESS AND THINGS. THINGS. I WISH -- I DON'T THINK THERE IS I WISH -- I DON'T THINK THERE IS REALLY A PROTOCOL OR A WAY OF -- REALLY A PROTOCOL OR A WAY OF -- HERE IS A GUIDELINE FOR YOU OR HERE IS A GUIDELINE FOR YOU OR ANYTHING. ANYTHING. BECAUSE AS JIM SAID, WHAT YOU BECAUSE AS JIM SAID, WHAT YOU REALLY LIKE IS SOME OF THE REALLY LIKE IS SOME OF THE PERSONALITIES OF THE PEOPLE. PERSONALITIES OF THE PEOPLE. I -- A LOT OF PEOPLE, A LOT OF I -- A LOT OF PEOPLE, A LOT OF PATIENTS GAVE BACK MORE TO ME PATIENTS GAVE BACK MORE TO ME THAN I COULD GIVE TO THEM. THAN I COULD GIVE TO THEM. THEY HAVE COURAGE, THEIR THEY HAVE COURAGE, THEIR DETERMINATION, AND JIM, I WILL DETERMINATION, AND JIM, I WILL SAY FROM -- I SAW THINGS WHERE I SAY FROM -- I SAW THINGS WHERE I THOUGHT PEOPLE WERE NOT GOING TO THOUGHT PEOPLE WERE NOT GOING TO DO VERY WELL AT ALL, AND THEY DO VERY WELL AT ALL, AND THEY DID REMARKABLY, UNBELIEVABLE, DID REMARKABLY, UNBELIEVABLE, ASTONISHING. ASTONISHING. AND PEOPLE I THOUGHT WOULD DO AND PEOPLE I THOUGHT WOULD DO VERY WELL, AND THEY DID NOT. VERY WELL, AND THEY DID NOT. THAT WAS A VERY HARD THING. THAT WAS A VERY HARD THING. I THINK THE HARDEST THING, AND I I THINK THE HARDEST THING, AND I CAN SAY TO THIS DAY, IT WAS THE CAN SAY TO THIS DAY, IT WAS THE HARDEST THING FOR ME TO SIT HARDEST THING FOR ME TO SIT THERE AND TELL SOMEBODY, YOU THERE AND TELL SOMEBODY, YOU KNOW, THE DISEASE, HAS REACHED KNOW, THE DISEASE, HAS REACHED OUR -- OUR TREATMENTS REACHED OUR -- OUR TREATMENTS REACHED POINT OF MAXIMAL BENEFIT, AND POINT OF MAXIMAL BENEFIT, AND THEY ARE NOT GOING TO HELP ANY THEY ARE NOT GOING TO HELP ANY MORE. MORE. IT IS HARD FOR ANYBODY TO ADMIT IT IS HARD FOR ANYBODY TO ADMIT AS A PHYSICIAN OR ANYTHING WE DO AS A PHYSICIAN OR ANYTHING WE DO IN LIFE, WHATEVER WE HAVE DONE, IN LIFE, WHATEVER WE HAVE DONE, IT IS JUST NOT GOING TO BE IT IS JUST NOT GOING TO BE ENOUGH. ENOUGH. THERE IS TOO MUCH. THERE IS TOO MUCH. AND I CAN TELL YOU I STRUGGLED AND I CAN TELL YOU I STRUGGLED WITH THAT, AND IF ANYTHING I WITH THAT, AND IF ANYTHING I CRITICIZE MYSELF, IT WAS VERY CRITICIZE MYSELF, IT WAS VERY HARD TO SAY THAT TO PEOPLE. HARD TO SAY THAT TO PEOPLE. NONE OF US, AS STEVE SAID, NONE NONE OF US, AS STEVE SAID, NONE COULD PREDICT EXACTLY WHAT WAS COULD PREDICT EXACTLY WHAT WAS GOING TO HAPPEN FOR ANY ONE GOING TO HAPPEN FOR ANY ONE INDIVIDUAL. INDIVIDUAL. BUT I THINK ONE OF THE THINGS BUT I THINK ONE OF THE THINGS THAT WE LEARNED EARLY WAS THAT WE LEARNED EARLY WAS HONESTY, THAT YOU HAD TO BE HONESTY, THAT YOU HAD TO BE HONEST WITH YOUR PATIENT. THEY HONEST WITH YOUR PATIENT. THEY WANTED HONEST ANSWERS SO THEY WANTED HONEST ANSWERS SO THEY COULD MAKE THEIR PLANS. COULD MAKE THEIR PLANS. IF THINGS DEPARTMENT LOOK LIKE IF THINGS DEPARTMENT LOOK LIKE THEY WERE GOING TO GO WELL, THEY THEY WERE GOING TO GO WELL, THEY NEEDED TO KNOW THAT. NEEDED TO KNOW THAT. THEY NEEDED TO BE PREPARED. THEY NEEDED TO BE PREPARED. THEIR FAMILY, THEIR SPOUSE THEIR FAMILY, THEIR SPOUSE NEEDED TO BE PREPARED. NEEDED TO BE PREPARED. OFTEN THEY HAD CHILDREN THAT OFTEN THEY HAD CHILDREN THAT NEEDED TO HAVE CONSIDERATION NEEDED TO HAVE CONSIDERATION BROUGHT IN. BROUGHT IN. SO I THINK HONESTY WAS THE ONE SO I THINK HONESTY WAS THE ONE VALUE THAT WAS REALLY IMPORTANT VALUE THAT WAS REALLY IMPORTANT IN DEALING WITH PATIENTS WHO IN DEALING WITH PATIENTS WHO HAVE THIS KIND OF ILLNESS, AND, HAVE THIS KIND OF ILLNESS, AND, YET, BEING ABLE TO SAY-SO IN A YET, BEING ABLE TO SAY-SO IN A WAY THAT WAS NOT GOING TO HIT WAY THAT WAS NOT GOING TO HIT THEM OVER THE HEAD, AND, YET, BE THEM OVER THE HEAD, AND, YET, BE SURE THEY UNDERSTOOD THE SURE THEY UNDERSTOOD THE INFORMATION. INFORMATION. >> ALL OF US ARE DIFFERENT >> ALL OF US ARE DIFFERENT STROKES FOR DIFFERENT FOLKS. STROKES FOR DIFFERENT FOLKS. A LOT OF PEOPLE YOU REALLY LIKE A LOT OF PEOPLE YOU REALLY LIKE THEM VERY MUCH. THEM VERY MUCH. I LIKED THE PATIENTS I HAD. I LIKED THE PATIENTS I HAD. WHEN IT CAME TO THINGS THAT WERE WHEN IT CAME TO THINGS THAT WERE VERY DIFFICULT, OR YOU KNEW VERY DIFFICULT, OR YOU KNEW THERE WASN'T ANYTHING, IT WAS THERE WASN'T ANYTHING, IT WAS VERY HARD. VERY HARD. YOU WOULD FEEL VERY BAD THAT YOU WOULD FEEL VERY BAD THAT THERE JUST WASN'T -- BUT I HAVE THERE JUST WASN'T -- BUT I HAVE TO SAY AS THE YEARS HAVE GONE TO SAY AS THE YEARS HAVE GONE BY, THINGS GOT BERT. BY, THINGS GOT BERT. TREATMENTS GOT BETTER. TREATMENTS GOT BETTER. >>YOU COULD DELIVER MORE GOOD >>YOU COULD DELIVER MORE GOOD NEWS THAN BAD NEWS. NEWS THAN BAD NEWS. >>YEAH. >>YEAH. >>THIS HAS BEEN MY PRIVILEGE, >>THIS HAS BEEN MY PRIVILEGE, GENTLEMEN. GENTLEMEN. CONTINUE WITH WHAT YOU ARE CONTINUE WITH WHAT YOU ARE DOING. DOING. THANKS A LOT. THANKS A LOT. >>THANKS FOR HAVING US. >>THANKS FOR HAVING US. >>