When a colleague’s misconduct is discovered, Fisher is forced to resign from the NSABP and becomes the subject of a Congressional investigation. As the walls close in, Fisher fights back. He spends the rest of his life trying to restore his reputation.
Less Radical is the story of Dr. Bernie Fisher, the surgeon-scientist who not only revolutionized breast cancer treatment, but also fundamentally changed the way we understand all cancers. He was an unlikely hero—a Jewish kid from Pittsburgh who had to make it past antisemitic quotas to get into med school. And the thanks he received for his discoveries? A performative, misguided Congressional hearing that destroyed his reputation and haunted him until his death.
Over six episodes, radiation oncologist Dr. Stacy Wentworth will take you into operating rooms, through the halls of Congress, and into the labs where breakthrough cancer treatments were not only developed, but discovered.
If you or someone you know has had breast cancer, Bernie is a part of your story—and you’re a part of his.
For photos, recommended readings, and show notes, visit Dr. Wentworth’s Substack, Cancer Culture.
Transcript
[THEME MUSIC IN]
STACY WENTWORTH: There are a lot of metaphors you can reach for when you’re trying to sum up the career of Bernie Fisher. One big one is Prometheus. Writers apply this to scientists a lot. It’s the central metaphor of Robert Oppenheimer’s biography. Prometheus gave man fire and was punished by the gods for eternity.
There’s also Icarus. He flew too close to the sun. His rise was his downfall.
And then, there’s that saying about the perils of success, “The nail that rises up gets hammered down.” Bernie sometimes pointed at a picture of a turtle on his desk and said, “You know what happens when you stick your neck out.”
But Bernie wasn’t a nail or a turtle. He wasn’t a figure from mythology. He was a real man. And there’s a very real, relatable metaphor we can use here instead. While Bernie was walking tall, on top of the world, potentially bound for a Nobel and all other kinds of accolades, there was a piece of gravel in his shoe.
That bit of gravel was one of the doctors he recruited for the B-06 trial—Dr. Roger Poisson, in Montreal, who signed up so many women for Bernie’s studies, and contributed so much to changes in cancer treatment. There was a problem with his data. A problem of falsification. Fudged numbers. Bad records. And it would soon be a very public problem.
Bernie Fisher, who had never backed down from a fight, was in for the fight of his life.
I’m Dr. Stacy Wentworth and this is Less Radical.
[SHOW OPEN MONTAGE]
NANCY DAVIDSON: Bernie was changing everything.
BERNIE FISHER: At that time the treatment was draconian, to say the least.
DANIEL KEVLES: Dingell was a very shrewd politician.
VINCENT DEVITA: He leaned across the table, you know, stuck his nose almost in my nose, and he said, “Don’t ever cross me because I always get my man.”
EDWARD LEVINE: Frankly these guys were driven.
DAVID BALTIMORE: I could stand up to him, and I paid a heavy price for that.
BERNIE FISHER: But one thing I feel confident is that we have the great possibility of eliminating the need for surgery as we know it today for the treatment of breast cancer.
VINCENT DEVITA: You could see where they hated him because he wouldn’t give in.
[END SHOW MONTAGE]
[THEME MUSIC OUT]
SPEAKER 2: The 1985 Albert Lasker clinical medical research award winner is Dr. Bernard Fisher, who is professor of surgery, University of Pittsburgh, School of Medicine.
STACY WENTWORTH: In 1985, Bernie Fisher won the Lasker Prize. The prize was created in the 1940s by Albert and Mary Lasker, philanthropists who spent millions to raise the profile of the National Institutes of Health. The prize is nicknamed “America’s Nobel.” It goes to doctors who make breakthroughs in research. And Bernie won it in 1985 for his work on breast cancer.
SPEAKER 2: Dr. Fisher is a renowned scientist and surgeon, and he’s done more than any other single individual to formulate the modern concepts that underlie current therapy for cancer of the breasts. In the laboratory, his pioneering work has given us a new understanding of metastases and the biology of breast cancer. And in the clinic, he has established the large-scale, prospective randomized trial as a legitimate instrument for reshaping and improving the treatment of breast cancer.
STACY WENTWORTH: The next year, the prize went to Dr. Robert Gallo, a researcher at the National Cancer Institute. I’m going to take a little detour here to tell you a bit about Gallo and a chapter of his life, because the road leads back to Bernie.
[MUSIC]
STACY WENTWORTH: Gallo was also working on a pressing medical issue—AIDS. Gallo identified the virus that causes AIDS in 1984. It was a breakthrough in the race to diagnose and treat a disease that was killing thousands of Americans. Despite proof that this new, deadly epidemic was spreading, a lot of officials looked the other way. There was also a large racial disparity, with Black Americans having higher infection rates than white. Officials were slow to take it seriously. Some, including then-President Ronald Reagan’s staff, even joked about it.
The 1980s were an era of AIDS activism. Groups like ACT UP fought constantly to get the government to even recognize that HIV/AIDS was a problem, let alone fund research into treatments or a cure. Reagan appeared to be ignoring the problem, only acknowledging the epidemic in 1987, six years after the first AIDS cases were identified in the US.
PRESIDENT RONALD REAGAN: Our battle against AIDS has been like an emergency room operation. We’ve thrown everything we have into it. We’ve declared AIDS public health enemy number one. I’m determined that we’ll find a cure for AIDS.
STACY WENTWORTH: Despite the rhetoric, the Reagan administration’s recommendations for testing and prevention had little impact. It’s a shameful history that cost an unknown number of lives.
What did have an impact was the work of activists. The organized “die-ins,” where demonstrators would lay as if dead outside the government buildings. Their work eventually led to increase government funding for AIDS research. By 1991, ten percent of the National Institutes of Health budget was spent on AIDS research. That same year, the National Breast Cancer Coalition formed. Inspired by AIDS activists, these women saw an opportunity to push for government funding to find a cure for breast cancer.
Dr. Susan Love, a surgeon, breast cancer research advocate, and a contemporary of Bernie’s in the ‘80s and 90s, reflected on these efforts in an interview a few years ago with The Cancer Letter.
SUSAN LOVE: Having a group of educated women who were educated in breast cancer and in the science, was really important. And then we were demanding more research money, and so we demanded that we get it from the Department of Defense. We said, enough money has gone to war and fighting it. We need money to actually fight breast cancer.
STACY WENTWORTH: Advocates like Dr. Love wanted more than just awareness—more than wearing pink shirts or red ribbons. Government funding for research for a cure was essential. Love also spoke about the synergy between AIDS and breast cancer advocacies in the ‘80s.
SUSAN LOVE: This whole breast cancer movement, just along with that, the AIDS movement really changed how we look at diseases, and how we look at trying to get more research and trying to get more people involved in it. And so now you see people who are involved with all kinds of diseases, from, you know, multiple sclerosis to something to AIDS. You’ve got a whole, you’ve got people who get a disease, always, a percentage of them will end up trying to make it better, trying to figure it out. And this idea that regular old people, or people with a disease could be responsible for figuring it out and maybe ending it was really started with AIDS and with breast cancer.
STACY WENTWORTH: Government spending on cancer research also helped Gallo’s work on AIDS—the NCI is where most of the virus experts like Gallo worked.
But with government money comes government oversight. Of course there needs to be routine and careful monitoring of how taxpayer money is spent. In the 1980s, congressional oversight undercovered many egregious examples of improper use of government funds, including Army contractors charging hundreds of dollars for a hammer, and Stanford University using research money to buy fresh flowers and offset the cost for a 72 foot yacht.
With research grants, it’s in everyone’s interest to make sure the money is well-spent because it’s in everyone’s interest to make medical breakthroughs and cure diseases. But the methods of scientists and politicians couldn’t be farther apart. Science is based on trial and error. The kind of massive clinical trials Bernie had helped popularize involve placebos and disproven theories. Money has to be spent proving an idea is wrong if it’s going to be spent proving an idea is right. But to a politician, money spent on a failed hypothesis may seem like waste.
So, back to Robert Gallo. Throughout the late ‘80s, there had been some dispute with a French lab over Gallo’s findings, largely over who deserved the patent for the HIV test the NIH later developed. But then, in November 1989, The Chicago Tribune ran a fifty-thousand word story suggesting misconduct on Gallo’s part.
Because Gallo was a researcher at the National Cancer Institute, and because he had used National Institutes of Health money, Congress got involved. Specifically, Michigan Representative John Dingell.
DANIEL KEVLES: Dingell was head of the Energy and Commerce Committee, but also head of a subcommittee that was in charge of the National Institutes of Health.
[MUSIC]
STACY WENTWORTH: Dr. Daniel Kevles is a historian of science who wrote a book about another one of Dingell’s investigations.
DANIEL KEVLES: Dingell was a very shrewd politician, was responsible for vetting about 40% of the legislation that went through the Congress at that time.
STACY WENTWORTH: Dingell presented himself as a crusader against scientific fraud. The brave and bold Congressman, fighting to protect the American taxpayer from the jargon-spewing eggheads in the lab. Any scientist with federally funded research was fair game to Dingell. As soon as there was one hint of a mistake, Dingell followed it like a shark smelling blood in the water.
DANIEL KEVLES: And so Dingell saw a political opportunity, but he also saw a need for giving a wake up call to the American biomedical community, certainly, and the American scientific community in general, to the need for policing itself better than it had been policing itself.
And also, this was a time in the 1980s following in the wake of Vietnam and Watergate, when there was enormous distrust of public institutions and the Watergate and the war in Vietnam had established that distrust in a general way, it persisted.
STACY WENTWORTH: Sometimes Dingell’s investigations became more about public shaming than rooting out corruption. He once said, “When we do these things, we try to see to it that the pain and suffering goes on for a greater period of time, until the abuse that is obvious is taken care of.” He liked heads on platters. If anyone was going to walk out of one of his hearings, they were going to walk out embarrassed. Dingell bragged about seeing wet spots on chairs when witnesses left the room.
When Dingell called witnesses in for one of his hearings-turned-shaming sessions, he insisted they testify under oath. Not all congressional hearings require people to be sworn in, but this way, Dingell held the threat of a perjury trial over all his witnesses. When his staff worked with one witness ahead of his testimony, they told him his statement didn’t “have enough groveling.”
In Dingell’s memoir, his wife, Congresswoman Deb Dingell, said even she was afraid of him. She called him “a towering large man with an ability to ask questions that could literally destroy someone’s career.”
VINCENT DEVITA: When I met John Dingell, I had lunch with him. He leaned across the table, you know, stuck his nose almost in my nose. And he said, “Don’t ever cross me because I always get my man.”
STACY WENTWORTH: Dr. Vincent DeVita led the National Cancer Institute for most of the 1980s.
VINCENT DEVITA: He was obsessed as an investigator that he always won didn’t make any difference. In other words, you could present him the cure for cancer. And if he was after you, he’d be after you.
STACY WENTWORTH: By 1990, Dingell was after Robert Gallo for rumored misconduct in his AIDS research. He dove into the investigation. Headlines soon called it a “war” against Gallo. Dingell held hearings and threatened criminal charges.
But for all the bluster, Gallo didn’t face criminal charges, and the final NIH report found no intentional wrongdoing on Gallo’s part. But the investigation nearly destroyed his reputation and his career.
Dingell, however, maintained his image as a crusader. And Gallo wasn’t the only scientist to suffer through these fruitless hearings. In the late ‘80s, a researcher at MIT alleged that two scientists—Dr. David Baltimore and Dr. Thereza Iminishi-Kari had fabricated data in a paper they published. Since their study was funded by the NIH, it was fair game for Dingell.
The case was practically tailor-made for Dingell’s committee. Baltimore had won a Nobel Prize at age 37—he was exactly the kind of high-minded scientist that the congressman loved to paint as a leech on the taxpayers’ pockets. Dingell brought in Secret Service investigators to study Iminishi-Kari’s notes—a move that is just as over-the-top as it sounds. Here’s Daniel Kevles explaining the strategy behind that move.
DANIEL KEVLES: There was no contesting the Secret Service because, again, nobody had the opportunity to cross examine them, to look into their procedures. So that’s how the Secret Service got into it, because Dingle wanted to bolster the case.
STACY WENTWORTH: Dingell fought hard and pulled the scientists through the mud. Baltimore’s career was nearly ruined, just like Gallo’s.
DANIEL KEVLES: He had been appointed, I think, in November 1990 to the presidency of Rockefeller University. His presidency was thrust into doubt when you have The New York Times saying, this is a scientific Watergate and David Baltimore is at the center of it, refusing to do the right thing, to compromise, to admit wrongdoing, and so on.
STACY WENTWORTH: Iminishi-Kari was banned from receiving government funding for a decade. And it took a decade for her name to be cleared. And just like with Robert Gallo, Dingell’s investigation turned up nothing.
DANIEL KEVLES: The case lasted 10 years, believe it or not, until the appeals panel ruled that she was not guilty on all counts. That was May 1996. In that time she was in a very beleaguered state. And then, when she was exonerated in the appeals hearing, Tufts immediately reinstated her, promoted her full professor, and she went on with her career.
STACY WENTWORTH: Of course, by the time the case settled, Congress, the press, and the public had all moved on. There were a lot of headlines about accusations of scientific fraud. But not as many about those accusations being false.
[MUSIC]
STACY WENTWORTH: So, back to Bernie. In 1991, Bernie should have been on top of the world. He reinvented treatment for breast cancer. He helped make randomized clinical trials part of the modern medical research process. He won many of the major awards in his field. He put an end to the idea of the knife as the cure. He took on the surgical establishment, fought hard, and won. And now, in his 70s, he was embarking on his most ambitious project yet—testing whether the drug tamoxifen could prevent breast cancer in high-risk women.
Behind the scenes, though, there was a problem. A little over a year earlier, one of the NSABP auditors did a routine review of paperwork for Bernie’s trial on lumpectomies. You heard about this study, called B-06, in the last episode. The auditors found a discrepancy in some forms from Dr. Roger Poisson, the head of breast surgery at St. Luc’s Hospital in Montreal. Remember, this is the guy Bernie recognized for his success in recruiting hundreds of women for Bernie’s studies—the guy who called Bernie a father figure.
On one form, a woman’s surgery date was June 19th. On another, it was June 29th. Ten days might not seem like a lot, but timing is essential in clinical trials. The women recruited needed to have surgery within thirty days of a biopsy. Depending on which date was accurate, the woman may not have been eligible for the trial.
NSABP researchers went to Montreal to investigate. They looked over Poisson’s paperwork and found more duplicate forms—this time, they found problems in the consent forms, the papers women signed when they agreed to enroll in the study. Some patients had one form in English, and one form in French. The English forms all had dates that made the women eligible for the studies. The French forms however, did not.
The investigators told Bernie about these discrepancies in the fall of 1990. He talked to Poisson and Poisson’s wife, who was also a surgeon at St. Luc’s, and told them there needed to be a more thorough audit. Poisson was outraged at his hero’s accusations and felt there must be some mistake. He welcomed a full audit. And that’s when it went from bad to worse.
During this more intense audit in late January 1991, one of the investigators opened a patient’s chart and found two duplicate forms with a label on each. One label said “vrai” and the other said “faux.”
That’s French for true and false.
When he heard about Poisson’s blatantly false double record keeping, Bernie was furious. He sent a letter to Poisson demanding an explanation and banning him from entering patients into NSABP studies. Bernie remembered telling his wife the whole ordeal “would come back to haunt us.”
This time, Poisson was quick with his explanation and confession. In a long letter, he wrote to Bernie:
ROGER POISSON (TRACKED): I always feel sorry for a nice case to be denied the right to enter into a good protocol just on account of trivial details.
STACY WENTWORTH: But the “trivial details” included dates of surgeries, pathology results, and more. Poisson was fudging his documentation to get more women into trials, even if they weren’t eligible. In February 1991, Bernie reported the issue to the Office of Scientific Integrity, a government body that investigates misconduct. They were mad that Bernie had seemingly taken eight months to report the problem, but Bernie hadn’t just been waiting around. He’d only learned about it himself in November, and he sent a team to investigate it in January.
As the Office of Scientific Integrity began an investigation into Poisson, Bernie’s latest trial was also running into trouble. Tamoxifen, the drug he was testing as a potential breast cancer prevention medication, was causing concerning rates of blood clots, strokes, cataracts, and uterine cancer. Some advocacy groups felt the risks of the trial outweighed the benefits, and that women who enrolled in the trial had not been properly warned of these possible side effects.
Bernie wasn’t used to being challenged. He said the consent forms made the risks clear, and he wasn’t going to change course based on non-scientific opinions. He would wait for the final data, just like he had in the past 40 years.
When Fisher began studying breast cancer in 1958, the concept of cancer prevention was considered science fiction. But now, preventing it was within his grasp and he would not let go. He called the prevention study “the capstone of my career.” Pugnacious Bernie Fisher had often warned his students and colleagues to stay away from people he called “baps” —bureaucrats, administrators, and politicians. But now, he was running afoul of all three.
The government investigation into what was, behind the scenes, called “l’affaire Poisson,” found more falsified forms in Poisson’s files. This didn’t look good for the research. Poisson was one of the leading recruiters for B-06. So in the wake of these findings, Bernie’s team and outside auditors tossed out Poisson’s data and re-analyzed the results—they were the same.
EDWARD LEVINE: You know, the NSABP, they went back and pulled out the Montreal data and reanalyzed anything and if you’ve seen the papers, I mean, there’s no question. These studies are rock solid.
STACY WENTWORTH: Dr. Edward Levine is a professor of surgery at Wake Forest School of Medicine. He’s designed and led clinical trials in cancer for over 30 years. He also put hundreds of women on NSABP trials.
But remember, scientists and politicians operate differently.
[MUSIC]
STACY WENTWORTH: While the investigation into Bernie’s research was underway, everyone involved was told to keep it quiet. This could not go public. It especially didn’t need to reach John Dingell.
Even though the results of Bernie’s studies hadn’t changed after removing Poisson’s data, investigators asked him to write a new manuscript explaining what happened and the results without Poisson’s patients. By then, however, the prevention study was gaining traction—despite concerns with tamoxifen, women at risk for breast cancer were desperate to sign up. Updating old papers to say that nothing had changed wasn’t a priority. This miscalculation would be Bernie’s downfall.
During the Gallo and Baltimore cases, the Office of Scientific Integrity was led by a woman named Suzanne Hadley. By 1993, she was working for Dingell. One night in December, she met up with an old colleague who mentioned some frustration with a long-running case at the Office of Scientific Integrity. They’d found that a published science study contained fraudulent data, but the authors hadn’t published an update yet. “Which case?” Hadley asked. The colleague replied, “Roger Poisson.”
Hadley was shocked. She knew about this case. She’d been involved in the investigations three years earlier. She shared this news with Dingell’s investigators. They looked into it and found that it had been over a year since Bernie was asked to publish the new analysis, and he had yet to comply.
Still, the story stayed quiet, until March 1994. John Crewdson, the same Chicago Tribune reporter who broke the Robert Gallo story, had a new scoop. The headline—“Fraud in Breast Cancer Study: Doctor Lied on Data for a Decade.”
Crewdson reported that Fisher and colleagues privately assured the National Cancer Institute that the falsified data had not changed the “direction” of the study. But still, there had been no public notice of either the fraud or the re-analyzed data. The inference was clear: What was Fisher hiding?
[MUSIC]
STACY WENTWORTH: As soon as the story hit, all hell broke loose. Because the University of Pittsburgh handled grants for Bernie’s research, university officials got involved. The NCI’s director, Dr. Sam Broder, ordered a re-evaluation of the data with more outside investigators.
On March 29th, Pitt’s lawyers advised Bernie to take a leave of absence. Six days later, The Chicago Tribune reported that Bernie had been forced to resign due to “serious management and scientific deficiencies” and a “lack of judgment.”
All this might have been prevented had Bernie just published the update sooner. And it had been in the works—he wanted to talk over the situation with his colleagues at the NSABP during their spring meeting. And he was busy with the tamoxifen study. Plus, the findings were still the same, so no one’s health was at risk. As The Cancer Letter reported, Bernie said, “When you get no change in the results, you don’t call up the New England Journal of Medicine and say guess what, nothing happened.”
VINCENT DEVITA: I didn’t think it was a big deal at all, frankly.
STACY WENTWORTH: Dr. Vincent DeVita again.
VINCENT DEVITA: It was kind of a…it was somebody’s looking for something they can cause trouble with.
STACY WENTWORTH: Dingell and the press weren’t Bernie’s only concerns. DeVita says his successor leading the NCI, Sam Broder, wasn’t a fan of Bernie’s demeanor.
VINCENT DEVITA: Sam Broder did not support Bernie, you know, and the reason he didn’t support Bernie is again Bernie, Broder said something about Dr. Fisher’s study, and Bernie, I was there, Bernie turned around and said, “Look, I was doing these things when you were in knee pants.” And Broder disliked Fisher from that point on. And [it] goes very deep
STACY WENTWORTH: Broder demanded that Bernie resign from the NSABP, the organization he helped found with his old mentor Dr. Ravdin nearly forty years earlier. Bernie had been chair for nearly 30 years. He’d grown the organization from a dozen surgeons meeting in his living room to five thousand doctors across North America. And now Bernie left in disgrace.
EDWARD LEVINE: And he and his buddies, who put the NSABP together and changed the way cancer care was done were being hopelessly slandered in the press.
STACY WENTWORTH: Ed Levine again.
EDWARD LEVINE: I mean, it was, you’ve seen these things, really ugly things about fraud and deception and stealing money from cancer care, on and on.
STACY WENTWORTH: The NCI soon ordered an audit of every facility that had contributed to Bernie’s groundbreaking lumpectomy study. His prevention study was paused, along with a slew of other NSABP work. Fifty-six NCI staffers, and dozens of contractors joined the investigation. Teams of eight to ten people were dispatched to institutions across the country. Two weeks later, the report came in to NCI headquarters: no evidence of systemic fraud could be found.
[MUSIC]
STACY WENTWORTH: Despite this exoneration, Pitt’s lawyers told Bernie to stay quiet. He watched the news as reporters accused him of fabricating data. The boring fact that the results remained the same without Poisson’s data didn’t get the same attention as sensationalized falsified documents. Everyone hoped it would all blow over. And for a while it looked like it might.
And then came a subpoena from John Dingell. Bernie would later tell The Cancer Letter that he’d never heard of John Dingell, didn’t know anything about him. But after he heard about what happened at Dingell’s other hearings, Fisher began to feel real fear.
Bernie had never shied away from a fight. He’d fought his own colleagues, sometimes bordering on physical violence, for years. He’d always triumphed using data and research. He wasn’t a performer, and he was used to being right. He couldn’t stand talking to the press—it required too much simplification. Science is complicated and difficult to explain in a soundbyte. All that to say, he wasn’t likely to do well going head-to-head with Dingell on Dingell’s turf. This wasn’t a lab or a medical conference—it wasn’t even a long recorded interview with a newspaper writer—it was a show put on to embarrass the people Dingell wanted to embarrass. On the first day of hearings, Dingell’s committee arranged for breast cancer survivors to react and say how they felt wronged. They had opted for lumpectomies or other treatments based on data that the news kept saying was false. Bernie wasn’t there. On the advice of his lawyers from Pitt, he said he was sick.
In that hearing, no one stopped to explain that the results of the study hadn’t changed. No one reviewed the steps that Fisher and the OSI took over two years of their investigations. No one emphasized that it was Bernie’s team who uncovered the fraud and reported it. No one mentioned that a plan was in place for publication of the results, even if it was late. At every turn, the witnesses blamed Bernie. And no one credited Bernie with conducting trials that could withstand even this level of fraud.
EDWARD LEVINE: And, frankly, these guys were driven.
STACY WENTWORTH: Ed Levine again.
EDWARD LEVINE: These guys were like, monks. They were dedicated to what they were doing almost to a religious fervor. And to see their entire careers going up in flames for something stupid that somebody in Montreal did. It was heartbreaking. And these guys were well known, very well respected surgeons and that respect was well earned over decades of hard work dedicated to cancer care, and it was going up in flames.
STACY WENTWORTH: Bernie technically remained on faculty at Pitt, but he lost all his power and positions. Pitt’s lawyers had guided Bernie through this process. But that support ended, too. Stripped of his titles, his positions, his reputation, and now his institutional protection, Bernie appeared before Dingell’s committee in a followup hearing on June 15th, 1994.
Bernie was alone. Pitt had provided his attorney, but was now using the same lawyer to run a misconduct investigation against him. Bernie had no support, while Dingell had a committee and dozens of staff. And like he was with Robert Gallo and David Baltimore, Dingell was out for blood. The hearing opened with a three page monologue in which Dingell repeated false statements and made Bernie out to be an absentee leader at best, and a corrupt scientist at worst. We don’t have recordings of this, but we’ll post the transcript in the Cancer Culture Substack. It’s brutal.
This hearing wasn’t about the women, it wasn’t about the data, it wasn’t about the research. It was about theater and power. Bernie didn’t stand a chance. He was tired and poorly prepared. The New York Times reported that he “gave vague answers, failed to provide specifics and stammered.” What he did not do, however, was grovel.
After Bernie’s disastrous testimony, NCI director Dr. Sam Broder took the stand. He put the blame for any wrongdoing directly on Bernie’s broad shoulders. It was disingenuous. Again, the only thing Bernie “did wrong” —and I’m using air quotes here—was not publish sooner. Broder knew about Bernie’s data and his reasons, and he didn’t say anything about it. Broder had even taken the unprecedented step of confiscating an independent researcher’s data and re-analyzing it. I know we hear the word unprecedented a lot lately, but I can’t tell you how shocking that is. A government agency taking scientific data and re-analyzing it because one bureaucrat doesn’t like the conclusions? That’s some shady stuff. Broder defended his actions and said he would not hesitate to do it again to any researcher. That, he told Dingell, was the price of accepting public funding. Scientists watching the hearing were outraged at this threat of government overreach.
Finally, officials from Pitt took the stand. Dingell didn’t put any blame on them. Playing the populist, he blamed the “culture of deference” in academia that discouraged anyone from challenging Bernie. Acutely aware of the multi-million dollar NSABP grant dangling over their heads, Pitt’s representatives offered no defense of their most loyal, profitable, and esteemed faculty member. The man who had brought the NSABP to Pittsburgh. A native son of the city, now disavowed by his alma mater. The only academic home he’d ever known. Ed Levine remembers it this way.
EDWARD LEVINE: It was absolutely heartbreaking. And just frankly to see some of these guys who were my mentors or models, in terms of what you could potentially do, were absolutely being just lambasted and destroyed. And for something they didn’t do.
STACY WENTWORTH: A while later, Bernie got a package from his friend Helene Brown, a cancer activist who he met while they were both on the board of the American Cancer Society. Inside was a giant screw encased in clear epoxy mounted on a wooden base. A plate on the front said: “Bernie, you’re a gentleman, but you got screwed.”
[MUSIC]
STACY WENTWORTH: We can’t end things like this. And, fortunately, this story didn’t end here. Bernie’s friend Peter Safar was still working at Pitt. Dr. Safar is known as the father of CPR. He built the first intensive care unit in the United States at Pitt. And he used his influence to push the university to do right by Bernie. He made his case in private letters and in public editorials in the local Pittsburgh papers.
TRACKED LETTERS VOICE 1: A society that allows just anybody to assassinate creative leaders will destroy itself. Shame on politicians and bureaucrats who are arrogantly ‘re-investigating’ the data of a very difficult, unique, multi-center clinical study mechanism.
STACY WENTWORTH: And his neighbors in Squirrel Hill didn’t forget Bernie either. Letters from local residents and former patients also appeared in the papers. One wrote:
TRACKED LETTERS VOICE 2: No credible scientist has negated or in any way impugned the results of the study. Mean spirited people, headline hunting politicians and misguided or irresponsible media are out to destroy someone’s reputation. The flags of our city should be displayed at half staff.
STACY WENTWORTH: The Cancer Letter editorialized Bernie’s choice to take a stand.
TRACKED LETTERS VOICE 3: He remained faithful to the principles of academic freedom and due process when people around him were urging him to cave, compromise and apologize.
STACY WENTWORTH: Despite immense pressure, Bernie Fisher still hadn’t groveled.
Instead, Bernie fought back. After his disastrous hearing in front of Dingell, Bernie hired his own lawyer. Despite his distrust of the media, he called a press conference in July 1994 and stated that he had been wrongfully dismissed from the NSABP and Pitt. He pointed out how Pitt’s lawyers had advised him, then abandoned him and ultimately worked against him. Three years later, during jury selection for the case, Pitt and the NCI admitted Bernie had done nothing wrong, formally apologized, and agreed to a settlement of nearly three million dollars.
And in the meantime, public officials began to push back against John Dingell’s cruelty. In 1996, a former NIH director who had also been grilled before Dingell’s committee, wrote an op-ed in The New York Times questioning the congressman’s persistent brutality towards these scientists. Maybe this sounds like inside baseball, but this was a huge deal. Today’s parallel would be like Francis Collins writing an op ed about Lindsay Graham.
David Baltimore did an interview for an MIT history project in 2010. The interviewer asked him if all these years later, he had a sense of what Dingell’s hearings were actually about. I think his answer is worth hearing in full.
DAVID BALTIMORE: No, I had a sense then of what it was about and I haven’t changed my mind. And it was about political power, it was about John Dingell and the way he could exercise unilateral political power in the U.S. House of Representatives through his stewardship of the Energy and Commerce Committee. He was a bulldog, he was a bully, he was out to aggrandize himself as the center focus of the Congress. And he was using this particular controversy to prove that NIH didn’t know how to govern itself, and therefore had to answer to him. And it was awful. When I talk to members of the MIT corporation about it, many of them said we have been in the same situation in relation to John Dingell, but because we were public corporations, we couldn’t stand up to him. I could stand up to him and did. And I paid a heavy price for that, but I’m proud that I did it. And I think it was the right thing to do. And I actually diminished a little bit of his power, but more important I stood up for some principles that were important and that he was not going to be the arbiter of how science was done. But that took 10 years.
STACY WENTWORTH: Dingell’s victims weren’t just the scientists and administrators he dragged to Washington.
EDWARD LEVINE: It also had a very chilling effect on cancer research.
STACY WENTWORTH: Dr. Ed Levine again.
EDWARD LEVINE: There were years if you take a look, at the years after even after the NCI reopened everything, and everything was cleared, the number of patients that went on trials from the NSABP was down for it took some years to get back to where they were. The public had lost faith in it. You’ll hear the accusation, but when you were cleared of charges, the presses, you know, it’ll be on page 27 of the newspaper, you know, so it doesn’t have anywhere near the impact.
STACY WENTWORTH: It’s also heartbreaking that for years, whenever anyone looked up any of Fisher’s papers, they all had “SCIENTIFIC MISCONDUCT” in big letters across them. Those labels are gone now, but Bernie lost years of finding better ways to cure cancer because he was fighting to regain his reputation. And we’ll never know how many women’s lives were lost or permanently altered because of it.
Still, Bernie kept working, in whatever capacity he could.
VINCENT DEVITA: The last time I spoke to him, I think was his 99th birthday.
STACY WENTWORTH: Dr. Vincent DeVita.
VINCENT DEVITA: But he wrote a very lovely paper on breast cancer, a year or so before he died. So his brain was still working pretty well. I have been very fortunate to be around people like that, who I saw, I know they were right. I heard the reason why they believed the way they did. And it made sense to me. And I found that good, and I saw them take terrible chances with their careers, to make sure that the right thing was done. Obviously, I’m very fond of him. And I enjoyed working with him. And I wish we had about 100 More Bernie Fishers.
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STACY WENTWORTH: Bernie Fisher died in Pittsburgh in 2019, at age 101.
He didn’t live to see the massive political fight against public health and science that would come the following year. I thought about him a lot though, when I watched the hearings, or saw politicians attacking scientists, floating conspiracy theories, refusing to understand—or pretending not to understand—the facts that were before them.
And for as gruff as he could be, and as much as he avoided press and politicians, Bernie was passionate and curious. He loved science, discovery, the possibility of finding a better way. The Bernie I like to remember isn’t the one who appeared in front of Dingell. It’s Bernie who testified before the House Select Committee on Aging in 1992. The video is on C-SPAN—we’ll link to it in the show notes. There he is with his big glasses and gray hair, sitting at the witness table. He starts by looking back at his career, and the history of science itself.
BERNIE FISHER: It’s 25 years or so since a man landed on the moon We’ve had space exploration. Is there anybody that we know who can predict where we will be 500 years from now relative to that? And so it goes with research, and research in breast cancer. When I started my research 35 years ago, I was interested in one thing—the biology of how tumors spread. I had no interest really in breast cancer, per se. But we did know as was mentioned, when a woman had a breast cancer 35 years ago, she had a radical mastectomy, she was in a hospital for two weeks, she was sent home and told to come back if she had any more trouble. And that was the total extent of the management of a woman with breast cancer.
STACY WENTWORTH: He ended that practice. He put the Halsted radical mastectomy to rest. He pioneered the types of studies that would lead to breakthroughs in all areas of medicine. But he wasn’t at that hearing to talk about his biography. The Bernie Fisher in that hearing isn’t a man in his 70s resting on his laurels. It’s a scientist who is more excited for what’s to come. A future where even the treatments he pioneered would be as out of date as the Halsted.
BERNIE FISHER: In 1958, when I started to look at metastasis, I had no idea where we were getting at or where this would go. And now we’re getting to the point where we’re realizing that the molecular biologic changes in the breast are where the next frontier is, where the next outer space is.
I’ve always been excited about what was always looked upon as a new contribution or a new pathway to take. And I’m not one much for hyperbole, or false promises. But I really honestly believe that we are now entering a new approach. And I think I can make the promise very reasonably strong, that by the year 2000, or the year 2010, I’m not sure we’re going to cure breast cancer completely. But one thing I feel confident is that we have the great possibility of eliminating the need for surgery as we know it today, for the treatment of breast cancer.
STACY WENTWORTH: We didn’t quite get there on that timeline. And mastectomies are even on the rise. Very often, a patient will come into my office and say about her breasts “just cut them off.” We still want to use the knife as the cure. But as Bernie Fisher found—the problem with breast cancer is not in the breast. And no surgery, no matter how radical, can remove fear.
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STACY WENTWORTH: The “magic bullet” for fear is understanding.
Sometimes it’s easy to feel like we’re on the verge of going backward when we see politicians notching victories against scientists, and members of Congress demanding prosecutions of public health officials like Dr. Anthony Fauci. It can be demoralizing to watch as women lose their bodily autonomy, scientists fear for their research, and public health suffers from decisions made in Congress or the Supreme Court.
It’s easy to think that the only reason we don’t have a cure for cancer is because scientists haven’t figured it out. But it’s not that simple. There are politics and all kinds of machinations that stall progress.
When a politician declares “war on cancer,” it’s like with any other war—they expect to win. And when the war doesn’t end in a few years, the politicians blame the generals—in this case, the doctors. They want cures. They want magic bullets shot into the bullseye of the target. They don’t want to hear about Western blot assays and experiments with rats. They want a big breakthrough, not small steps. But small steps are what lead to breakthroughs.
When powerful politicians try to break the medical research system that WE fund and WE need, it’s all of our jobs to hold them accountable. Doctors like Bernie Fisher are not supposed to be bullied, threatened, and intimidated. They’re not supposed to be scared away from their focus on curing the cancer that may affect you, me, or someone we love. The backlash that comes from any attack on our scientists should not be borne by the scientists, but by the politicians who create false scandals to further their personal political goals or to settle old scores.
I’m not saying that scientists are always above reproach—just look at some of the history we’ve covered in this show! But if we want cures and treatments, then we need to recruit, train, and support people of character who enter a long, arduous and sometimes soul-sucking career in cancer care and research. We need oversight, but we also need to give scientists all they need to discover the cure for cancer faster. We need to clear real hurdles and not suspect that every dollar spent is a dollar lost.
Prior authorization forms from insurance companies delay care and hamstring treatment decisions. Systemic misogyny, xenophobia, and racism have been pervasive in medical culture since the beginning. Nearly two hundred hospitals have closed in the past twenty years, mostly in rural areas, due to financial instability and high operating costs. That limits who has access to cancer screening and treatment. And despite being the world’s largest source of cancer research funding, the NCI budget shrunk in 2024, at a time when inflation means research dollars don’t go as far.
And grandiose metaphors like “battle” and “war” make the small, necessary steps of science seem insignificant—but you need doctors who will be willing to sit in their labs performing test after test, studying x-rays and rats to see how cells behave.
So if we can take a lesson from Bernie Fisher, it’s to keep going forward. Keep fighting for understanding and advancement, no matter how difficult it gets.
As a doctor who treats breast cancer, I think we’re close to realizing Bernie’s dream of nonsurgical treatments. Through immunology and gene editing, we can work with our bodies rather than against them.
This will take courage and hope, both of which are difficult. Thinking about cancer isn’t something most people want to do until it’s absolutely necessary. I get it. But when it’s me and a newly diagnosed breast cancer patient sitting across from each other discussing treatment, I want all the tools in front of me. Tools that will help cure the cancer AND let someone return to normal life afterwards. Cancer doesn’t stop when you ring that bell after your last treatment. In fact for some patients now, cancer is incurable but treatable.
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STACY WENTWORTH: Through science and innovation, some forms of cancer have become a chronic disease like diabetes or high blood pressure. One that we can’t cure but we can treat.
Bernie buried the radical, knife-wielding surgeons in the past, and it’s okay for us to leave them there. To find better, more personalized, more specific ways to cure this disease. We call it all cancer, but really, as Bernie repeatedly told us, it’s “a heterogeneous disease in a heterogeneous group of women treated by heterogenous doctors.” One size scalpel does not fit all. The most aggressive treatment does not always provide the best chance of cure. Sacrificing your body is not always required.
But this is the next part of the journey that Dr. Bernie Fisher began when he reluctantly went to that first task force meeting in 1957. We have to be brave enough to believe in science and take the next step. And then the one after that and the one after that.
We can work together to make the future of cancer…less radical.
Thank you for joining me this past month. I’ve been obsessed with Dr. Bernie Fisher for years now, and it’s meant so much to me to share his story with you. And if it meant something to you, too, I’d love to hear from you.
This is the end of Dr. Fisher’s story, but the conversation is just beginning. If there’s someone you know whose had cancer, or been affected by it, please help get the word out and share the podcast with them. And if you leave us a five-star review in your podcast app, that also helps others find the show.
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STACY WENTWORTH: Less Radical is produced by me, Stacy Wentworth, and the team at Yellow Armadillo Studios: Melody Rowell, Gabe Bullard, and Sam Gebauer.
Fact checking is by Ryan Alderman. Our artwork is by Arianna Egleston. We get marketing support from Tink Media. And music is from Epidemic Sound.
Special thanks to Dr. Daniel Kevles, Dr. Vincent DeVita, Dr. Ed Levine, Kyle Daley, Alison Blackwell, Veronica Penuotu, Tony Indavina, Paul Goldberg and The Cancer Letter, Katie Goldberg and The History Project, and The Squirrel Hill Historical Society.
If you want to share your reactions to today’s episode and continue the conversation, join me in the discussion thread for this episode at cancerculture.substack.com. There, you can also see extensive show notes for Less Radical, including photos and links to read more about Bernie Fisher and the history of breast cancer. It’s at cancerculture.substack.com. And you can follow me on Instagram at drstacywentworth.
Thanks for listening.
