Dr. Folkman’s War
Wow. I’m kind of floored right now. Judah Folkman died last night. Orac has written up a nice piece about his death here and here, and while his praise for him is rather lofty, it is all absolutely, 100% deserved—perhaps even too muted. Alex Palazzo also linked to a great NOVA piece about him and his life’s work. The guy was without question a legend in cancer research and nothing short of a paradigm changer in areas not limited only to cancer research.
For instance, in the course of his life’s work, he invented a new technique for repairing patent ducti arteriosi and presented it to the American College of Surgeons while a freshman medical student; made significant contributions to the development of the implantable cardiac pacemaker; happened upon the concept of slow-release drugs; became the first-ever instructor of surgery to be promoted directly to professor of surgery and the youngest-ever professor of surgery in the history of Harvard, having been appointed surgeon-in-chief of Children’s Hospital in Boston at the age of 34; made one of the first huge public collaboratory agreements with a biotech company (forcing Harvard as an institution to reconsider the way it interacts with such an industry); and pioneered the successful culture of previously “impossible-to-culture” endothelial cells, which was seminal to any subsequent study of vascular biology; among many, many other landmarks. Absolutely incredible.
As it happens, you may have noticed that I’d been reading a book chronicling his life and research, Dr. Folkman’s War by Robert Cooke, which I actually just finished this afternoon. While it started off slowly, it turned out to be a very good book about a truly great physician and scientist. I am still amazed by all the things this guy did, the breadth of his work and vision, the work ethic by which he worked, and the sense that he had about research. A few choice quotes:
To reach his goal, Folkman had made a career of learning whatever he could about blood vessels. He liked to say that he hoped to someday put himself out of business. The only way to do that, he imagined, was to persist in his work, no matter the odds. It was a fine line, he knew, between being persistent and being stubborn. And the difference, in the end, was in results: ‘If your idea succeeds everybody says you’re persistent. If it doesn’t succeed, you’re stubborn.’ …he was ready to live up to this, his father’s private admonition: ‘Be a credit to your people.’”
One of the fundamental lessons Judah Folkman passed on to young people joining his laboratory was that success can often arrive dressed as failure. Success is great—satisfying, good for the ego, capable of bringing reward and prosperity—but doing experiments that invariably bring the expected results may mean the questions aren’t tough enough. To fail, then struggle to understand why, may offer more insight and greater learning. Asking ‘Why not?’ is often an important and productive stop on the way to learning ‘why.’”
One reason Folkman was able to persist so long, and remain on the staff at Children’s Hopsital and on the Harvard Medical School faculty, despite so much controversy and criticism, was his consummate skill as a physician, teacher, and pediatric surgeon. Critics had always sniped at his ideas and his style as a researcher, but there was never any question about Folkman’s skill as a physician and teacher. Year after year Folkman won medical students’ votes as one of the best teachers on the Harvard Medical School faculty. He was regularly tapped to lecture first-year medical students on what it means to be a doctor, occasions on which he emphasized over and over again the importance of being alert and alive to the patients’ feelings. He repeatedly argued that a physician’s bond with his or her patients should be so close that it transcends a strictly professional relationship. When you walk into the hospital room when your patient’s family is visiting, he lectured the medical students, the patient should immediately say to his relatives, ‘I want you to meet my doctor.’ If they don’t, something’s wrong.”
‘You are their doctor,’ Folkman tells he students. ‘There’s a certain point at which the begin to trust you, and you won’t abandon them. You won’t go on vacation and disappear. Or they can’t reach you. They’re scared to begin with, and if they get that sense, then they’re very scared. Folkman would never have his patients feel disconnected from their doctor. He always made sure they had his home telephone number…When young residents in training objected to that idea, groaning about never having any time of their own or about being awakened late at night, Folkman’s answer was blunt: ‘You chose medicine. It’s a service career. Long hours are part of the job. If you want a different kind of life, think about becoming a banker.’”
Snap.
