John Laszlo’s dual role: (1) Working to cure childhood leukemia, and (2) Writing the authoritative book on it

His father, Daniel Laszlo, did early work on folate antagonists

When John Laszlo joined the Acute Leukemia Service at NCI in 1956, the field of oncology was nascent—and the cure for childhood leukemia seemed beyond reach. 

“It was a time that these children were just not going to do well. You knew that walking in,” Laszlo, 92, professor emeritus at Duke University Medical Center and a retired national vice president for research at the American Cancer Society, said to The Cancer Letter. “It was very challenging to deal with children who were bleeding from the nose, who were bleeding from the rectum, who were vomiting—and parents were hovering about, very concerned about their children.”

“It’s very gratifying to think about all the progress that’s been made since those early days of taking care of these tiny children who didn’t know what was wrong, why they were there, why their parents were not with them.”

Laszlo worked directly with Emil “Tom” Frei, and Emil J Freireich—early researchers and doctors of childhood leukemia at NCI. Their team tried as best they could to help children as young as three. They stopped the bleeding, gave them antibiotics, and packed their noses.  

“Most of them you couldn’t help at that stage of the game,” Laszlo said. “It’s very gratifying to think about all the progress that’s been made since those early days of taking care of these tiny children who didn’t know what was wrong, why they were there, why their parents were not with them.” 

Laszlo’s book, “The Cure of Childhood Leukemia: Into the Age of Miracles,” is now available for free as a digital download on the Cancer History Project, available as a PDF or eBook.

Based on taped interviews of doctors and scientists whose work led to the cure of childhood leukemia, Laszlo’s book is an essential primary source for anyone interested in oncology and its history. 

Charles Gordon Zubrod, head of the NCI Division of Cancer Treatment (appointed in 1956), who became NCI’s scientific director (1961-1974), described the book as authoritative. “[Laszlo] decided to write up what happened in the cure of leukemia, and I’d suggest you obtain this book from the library,” Zubrod said in an oral history conducted by NCI and made available by the Cancer History Project. 

In “Stairway of Surprise,” Zubrod’s previously unpublished memoir made available by the Cancer History Project, he writes: 

In a conversation with The Cancer Letter, Laszlo also focused on discoveries made by his father, Daniel Laszlo, an oncology pioneer who conducted basic research on folate antagonists.

In 1937, Laszlo’s family fled Vienna as Jewish refugees. His mother, a psychiatrist who trained with Anna Freud, discovered she had breast cancer on the SS Île de France while the family journeyed to America. She died two years later.

His father, Daniel Laszlo, a physician who specialized in cardiovascular physiology, found a job in cancer research at Mount Sinai Hospital.

Daniel Laszlo studied folate antagonists in mice—though folate antagonists hadn’t been characterized yet. One study showed regressions of spontaneous breast cancer in 38 of 89 mice (43%) when treated with folic acid.

“They were working on derivatives of that molecule and were finding some anti-cancer effects in mice,” Laszlo said. “I would go in on weekends and help to change the cages, put the mice in fresh cages, feed them, change the water bottles, and do that kind of thing as a child—in the laboratories at Mount Sinai Hospital.” 

The researchers had discovered what seemed to be a vitamin derivative that would inhibit the growth of cancer, “something that they were surprised at,” Laszlo said.

Daniel Laszlo’s team took the information about folates to experts at Memorial Sloan Kettering Cancer Center.

“They were very interested in it, but didn’t quite believe it, so they asked Dr. Sidney Farber from Harvard to comment on it,” Laszlo said.

Farber’s response?

“He pooh-poohed the whole idea,” Laszlo said. “And then took it over himself.”

Daniel Laszlo’s boss, Richard Lewisohn, a surgeon and director of the laboratory, approached Laszlo one day with a proposal.

Babe Ruth had been admitted to Mount Sinai Hospital with symptoms of throat cancer (later determined to be naso-pharyngeal cancer), and Lewisohn was planning to treat Ruth with drugs that had been shown to reduce cancer in mice. Daniel Laszlo worried about the ethical implications of treating someone with drugs that had not been tested in humans.

“My father said he couldn’t do that because it had never been given to patients,” Laszlo said. “They didn’t know what the dose was, how much to give, how long to give it, and so on. However, the hospital director wouldn’t take no for an answer, even though my father thought it was unethical to do that.” 

And so, Babe Ruth received the drug teropterin, according to The New York Times—resulting in a brief remission. The drug was closely related to methotrexate, which became standard of care for certain cancers.

“The tumor disappeared, and Ruth had come in miserable shape, when he went home feeling just fine, and he stayed in remission for a time,” Laszlo said. 

“My father was very unhappy about being ordered to do something that he felt was unethical, and so he chose to leave Mount Sinai Hospital and was offered an opportunity…to start a new program at Montefiore Hospital in New York, where they had a lot of patients sitting around, taking up hospital beds, and they weren’t doing much for these people,” he said.

In a 1998 news story, a reporter at The New York Times, Lawrence K. Altman, connects the dots in the development of chemotherapy:

[Ruth] joined the often-unaware group of anonymous patients who ushered in the modern era of anti-cancer treatment, which grew out of American research into chemical warfare agents during World War II. In 1942, researchers at Yale University tested one such agent, nitrogen mustard, in a human for the first time. But Government secrecy restrictions prevented publication until 1946, after several hundred patients had been treated.

At the time, a team headed by Dr. Richard Lewisohn, a surgeon at Mount Sinai Hospital in New York City, was experimenting with an anti-cancer drug, teropterin, in mice. There were different teropterins, all extracted from brewers’ yeast, and their effects on mice varied widely with the preparation.

After leaving Mount Sinai, the elder Laszlo started the Neoplastic Disease Division at Montefiore Hospital.

“He took many of these patients and sent them home, because many of them were locals from the Bronx—they could go home and be taken care of at home,” he said. “I occasionally joined my father in making visits to these brownstone houses, and we would walk up two or three or four flights of stairs to see a patient who’d previously occupied a hospital bed, but was now being taken care of at home, and administer what medicine they needed.”   

Laszlo spoke with Alexandria Carolan, a reporter with The Cancer Letter, and Paul Goldberg, editor and publisher of The Cancer Letter.

This conversation is also available on the Cancer History Project podcast, above, and as a video.

Transcript

John Laszlo: Well, I graduated from Columbia College, went to Harvard Medical School, and then took a rotating internship at the University of Chicago, because, although I knew I wanted to go into internal medicine, I needed to know more about surgery and how patients did after surgery, and the preoperative preparations.

For that reason, I took a rotating internship.

After my internship, I went immediately to the National Cancer Institute for my next assignment, which was a two-year assignment in the Public Health Service at the National Cancer Institute.

And after being on the emergency room at the University of Chicago for two days in a row, I drove from there to New York to see my family, and then immediately down to Washington, DC, where I arrived a little bit rattled, not knowing my way around the city, not having a place to stay just yet.

However, I had to start right away at the National Cancer Institute.

I was given my assignment, which was to work on the Acute Leukemia Service. Here I am, having worked with adult patients for years prior, and not having worked with children in a setting like they had at the Cancer Institute.

It was a real challenge, and what was especially challenging was a ward full of children with acute leukemia who were bleeding at the time, who had high fevers, who had headaches, and were generally very uncomfortable.

“We did what we could by stopping the bleeding in the nose, packing the nose, giving antibiotics to children with high fevers, and so on, as best we could. But it was a time that these children were just not going to do well. You knew that walking in.”

I was given some orientation by Dr. [Emil J] Freireich and Dr. [Emil “Tom”] Frei, and then left to my own devices on the children’s leukemia ward.

That was pretty challenging thing for a pretty green doctor who had just finished a rotating internship.

I dove right in. And it was very challenging to deal with children who were bleeding from the nose, who were bleeding from the rectum, who were vomiting—and parents were hovering about, very concerned about their children.

We did what we could by stopping the bleeding in the nose, packing the nose, giving antibiotics to children with high fevers, and so on, as best we could. But it was a time that these children were just not going to do well. You knew that walking in.

You could help some of them, but most of them you couldn’t help at that stage of the game. So, as I look back on it so many years later and think about how 80 plus percent, maybe higher, maybe closer to 90% of these children live a long time after their treatment, presumably cured, it’s very gratifying to think about all the progress that’s been made since those early days of taking care of these tiny children who didn’t know what was wrong, why they were there, why their parents were not with them.

It was very challenging.

JL: That’s right.

JL: Well, actually, I was born in Cologne, because my father—although he studied in Vienna and trained in Vienna—was on a postdoctoral fellowship in cardiovascular physiology in Cologne. So, in 1931, I was dropped off there, and lived there for the first two years of my life before my parents moved back to Vienna.

I left Vienna in 1938—just in time—with my parents, and came to the United States, where my father took a job in cancer research at Mount Sinai Hospital in New York City, where we lived for a period of time.

He was asked to do cancer research, which he had not done before, but he was good in chemistry, and he worked with some wonderful chemists, I believe, at Lederle who were working on folate derivatives, although folic acid had yet to be officially discovered at that time.

But they were working on derivatives of that molecule and were finding some anti-cancer effects in mice. I would go in on weekends and help to change the cages, put the mice in fresh cages, feed them, change the water bottles, and do that kind of thing as a child—in the laboratories at Mount Sinai Hospital.

By the way, the same laboratory area where my father originally worked with mice became Dr. James Holland’s offices years later, when he became director of cancer at Mount Sinai Hospital.

JL: No, as Jews, we were not welcome to stay.

JL: Right. All Laszlos are Hungarian, don’t let them tell you any differently. But yes, I was kicked out of school because I was Jewish, and it was a real struggle for my parents to get the necessary papers to immigrate to the United States.

The U.S. State Department was very, very tough in those days—extremely exclusionary—and a lot of people who would’ve liked to have come were unable to do so. You had to have promise of a job in the United States in order to get papers to come, and then you had to have a backup family who would say, “Yes, we’ll take care of Laszlos, or whoever, in case they lose their job.”

Imagine trying to work from a foreign country, not knowing the language, to get a job, and yet to find another family who would vouch for you and take you in in case of emergency. All of that had to be done before we were able to come to the United States.

JL: Well, the passage was interesting, everything was fine until we got to Manhattan, and then the storm moved in. The biggest hurricane ever to hit New York City prior to that time was on, I think it was September [21], 1938.

There was a famous hurricane that shut down the city, shut down everything in New York. We were not able to land at Ellis Island because the seas were so rough. We were taken in by tugboats and put into a slip in Manhattan.

I had to be carried off the gangplank, with a sailor on either arm who carried me across. And at that time, I asked my parents, “Why would you come to a place like this, with a storm like this?” And, of course, the next morning when I awoke and went downstairs, it was a beautiful sunny day, as though nothing had ever happened.

JL: We were living with this family that agreed to take us in. They were on the Lower East Side, I believe about 12th Street and Second Avenue, and we had a room or so in their apartment, and that’s where we lived probably for two or three weeks until my father was able to locate other arrangements on East 97th Street.

JL: Well, my father immediately went into his job at Mount Sinai. I was only seven years old at the time that we came to the United States.

JL: Absolutely.

But he was incredibly clever and talented, and he made so many contributions to medicine and having found these nutritional aspects of cancer, and this particular kind of substance, which seemed to be a vitamin derivative that would inhibit the growth of cancer, was something that they were very surprised at.

They took the information to other experts at Memorial Sloan Kettering Hospital. They were very interested in it, but didn’t quite believe it, so they asked Dr. Sidney Farber from Harvard to comment on it.

He pooh-poohed the whole idea and then took it over himself.

JL: Well, I didn’t have any expectation to become a physician at that point. I was interested in agricultural science and thought maybe I’d make a career in that. But, somewhere along the way, I guess I was already in college at Columbia, that I decided to go into pre-med, and made a career of it.

JL: Harvard.

JL: Well, it was helped by the fact that I also applied to Yale, and they sent me a telegram that said that they would accept me, but I had to answer in 10 days that I wish to attend Yale.

And so, I contacted Harvard and said, “I’d like a rapid answer as to whether you’ll take me or not,” and they said, “No, we can’t do that,” but then they called me back and said, “Well, we will take you.”

So, the knowledge that Yale was pressing for an answer may have influenced Harvard, I don’t know.

JL: I would presume so.

JL: As a student, you never know what’s on the other side of that curtain that’s called the admitting committee.

JL: When I was an intern, I didn’t know what I was going to do the year after I finished my internship, I didn’t think I wanted to stay at the University of Chicago.

And then a former classmate of mine had called me and said, “There’s this thing called the National Institutes of Health, and that counts as time in the service, because you’re a member of the Public Health Service, and it’s a two-year position, and they have a number of institutes at the National Institutes of Health.” He said, “I’m going into tropical medicine, I want to study tropical medicine. How about you?” And I said, “Well, I’d like to study internal medicine, I’m sort of interested in cardiology.” He said, “Well, go and apply.” I contacted the Heart Institute and they were full for the next year—so what else?

And there was a Cancer Institute and I decided to try that. The nice thing about working in the field of oncology—the word, “Oncology,” hadn’t been invented yet, by the way—my father had, by this time moved to Montefiore Hospital and had started a service called, “Neoplastic diseases,” which was the first ward in a general hospital devoted to patients with cancer.

Anyhow, I applied to the Cancer Institute at the National Institutes of Health, and had an opportunity to speak with Dr. [Charles Gordon] Zubrod, and he said they only had one position left for the following year that I could possibly apply for.

He knew that my father, at this time, was working on breast cancer and anti-hormone therapy, and he had met my father. So, I guess, he liked my credentials and decided to take a gamble on me.

Somehow in the middle of my internship I ended up getting the last position at the National Cancer Institute for July 1.

JL: Yes.

JL: Yeah, he had just gotten the Nobel Prize a year or two earlier, and I had an opportunity to visit with him in his lab. What an interesting fellow he was. You walk into his lab and he said, “Look, Laszlo, there’s a Nobel Prize here.”

He was not a modest man, shall we say, but he was very accomplished, obviously.

I learned a bit from him, although I was not in the laboratory, I was an intern seeing patients. I was inspired by him and also a lot of good doctors who were interested in oncology. I can’t remember them all. [Leon O.] Jacobson was the head of the cancer program there. He had done a lot of work on radiation therapy.

JL: Yes. John Ultmann, I didn’t know there. He might have been a year or so behind me. But you’re right, he was there.

JL: Yes. He had done some work on the folate antagonists, which he didn’t know what folate antagonist exactly was, because it hadn’t been characterized just at that time, it would be in a year or so. At any rate, the work that they did on experimental cancer in mice led to an interesting event. A man was admitted to Mount Sinai Hospital with—I believe it was laryngeal cancer.

JL: Babe Ruth. Thank you. It was Babe Ruth. He was admitted to Mount Sinai Hospital in bad shape. He had been there before, and the hospital director wanted to do something for this famous patient, and they went to the laboratory director who was my father’s boss and said, “I hear you’ve got some interesting chemicals that might be useful.”

Dr. Richard Lewisohn, who was the director of the laboratory, was a surgeon. He said, “Well, Laszlo has these drugs that are doing some things in animals.”

The director called my father in and said, “I want you to give this medicine to Mr. Ruth,” and my father said he couldn’t do that because it had never been given to patients. They didn’t know what the dose was, how much to give, how long to give it, and so on. However, the hospital director wouldn’t take no for an answer, even though my father thought it was unethical to do that.

So, he was ordered to give this to Babe Ruth, who had a brilliant remission. The tumor disappeared, and Ruth had come in miserable shape, when he went home feeling just fine, and he stayed in remission for a time.

At any rate, without divulging his name, he was the subject of a paper given to the Medical Journal of North America—I have to think of the name of it—and there was a meeting in Chicago of a society every year, and this paper was included there, never naming the patient himself.

My father was very unhappy about being ordered to do something that he felt was unethical, and so he chose to leave Mount Sinai Hospital and was offered an opportunity—I don’t know how this came about really—to start a new program at Montefiore Hospital in New York, where they had a lot of patients sitting around, taking up hospital beds, and they weren’t doing much for these people.

They [had] advanced prostate cancer, but they had nothing to do with them, to do for them, so they were lounging there. So, my father went to Montefiore Hospital and started this program for patients with advanced cancer and called it the Neoplastic Disease Division.

And he did something really quite remarkable there, he took many of these patients and sent them home, because many of them were locals from the Bronx—they could go home and be taken care of at home. And he developed his residents to make house calls on them at least on a weekly basis, and he himself made house calls, and I occasionally joined my father in making visits to these brownstone houses, and we would walk up two or three or four flights of stairs to see a patient who’d previously occupied a hospital bed, but was now being taken care of at home, and administer what medicine they needed and so forth.

That’s a whole other story of the start of the home health program, forgotten what it was called, but Dr. Martin Cherkasky, who was hospital director, was very active in forming this new program based at Montefiore Hospital.

So, he then mobilized, as a consequence of rearranging the bedding situation at the hospital, for patients who were not getting active treatment, but could be treated at home.

He then was able to get patients in there that they were actively treating, and he started intensive research on calcium metabolism, started a program with radioactive iodine for thyroid cancer, quite a number of things that were started at Montefiore Hospital.

JL: Well, there were three of us, my father, my grandmother, and I.

My mother had died shortly after coming to the United States. She discovered that she had breast cancer while we were on board the SS Île de France, coming to the United States, and she succumbed about two years later.

There were three of us. My grandmother only spoke German, but my father really only wanted to speak English, and he spoke it quite well. My mother was the linguist in the family, and she was teaching my father how to speak English while we were on the ship coming to the United States, so she started him off.

JL: She was a psychiatrist who trained with Anna Freud.

JL: And she was studying for medical boards while we were on a ship to the United States, preparing to take a medical examination, which she needed to have, which she passed. Of course, she was never able to practice.

JL: I think, 1940. Two years after we arrived.

JL: I don’t think she received anything other than palliative care. I don’t know. I was sort of pushed out, I was sent to a boarding school to study out of town. My father was busy with his job, with taking care of my mother, and with trying to get his parents out of Hungary.

He was very busy, and I would’ve been in the way, so they got me off to a school out of town, which did not work well for me. I was then boarded with old friends of my father’s from Vienna; one was a well-known pathologist, and another was a neurosurgeon who really did some pioneering work in the autonomic nervous system. Anyway, they each took me for some months while my mother was dying.

JL: He was doing studies on breast cancer.

JL: He did some of the early work on treatment of breast cancer with estrogens, B.J. Kennedy, and my father published some papers.

JL: Yes, that’s true.

JL: That’s true. And when I was at the National Cancer Institute, I was confronted by these naysayers very frequently, “You’re wasting your time, Laszlo.”

JL: They were too busy doing their own things to bother about me, what I decided to do.

They were supportive of whatever I wanted. They really were largely surgically oriented, and they wanted me to stay and go into surgery, but I was not interested in that specialty of medicine, except to learn about what they can do for patients and how to prepare patients for surgery, and how to take care of them postoperatively.

And for that, they were superb as far as I was concerned. But I wasn’t interested in learning how to tie knots and do surgical procedures.

JL: Well, I didn’t particularly choose to go into that.

I chose to go to the National Cancer Institute because I didn’t get into the Heart Institute, and I was assigned to the leukemia ward, and a very interesting thing happened while I was on the leukemia ward.

We had a lecture from Dr. Dean Burk, who was a PhD at the National Cancer Institute, and a kind of a contrarian—so, a superb scientist. He would go every summer to work with Farber in Germany, and they worked on both cancer metabolism and photosynthesis, which were their two interests.

And then he would come back for the rest of the year at the National Cancer Institute. He was a basic scientist.

He came to give a lecture one time to our group at the NCI at the invitation of Dr. Zubrod. He talked about how all cancer cells have this unique feature of aerobic metabolism, which distinguishes them from normal cells, which don’t do that kind of thing to raise their ATP.

So, I asked Dr. Burk afterwards if I could meet with him, and I said, “Can we test this out on human cells, leukemic cells?”

He said, “Well, I don’t know how to do that.”

I said, “Well, I can get the leukemic cells if you will help me with the technological aspect,” and he said, “Yes, if you’ll do the work, I’ll help you.”

So, what I would do is, when I had patients who had high blood counts with leukemic cells, I would take a large sample down to Building 6 over to Building 10, and I would go down the hill to his lab.

And then we would separate out the white cells from the red cells and concentrate the cells away from some of the plasma, and then we would incubate those cells the way he would incubate mouse cancer cells in Warburg flasks, on a shaking water bath, if you have ever seen those.

These would be little flasks, and they would be in a large vat of water, and then we would test how much oxygen the cells were consuming, how much CO2 they were producing, and we could calculate how much aerobic glycolysis they were consuming, and how much anaerobic glycolysis they were making.

You can either make glucose in the presence of oxygen, which is aerobic, or in absence of oxygen, which is anaerobic glycolysis.

And I began to get some things that were really quite interesting—some of which followed the Warburg Hypothesis, but some of which were contrary to Warburg’s Hypothesis.

It turns out that myelocytes—they got lots of their ATP from anaerobic glycolysis, but lymphocytes did not—they breathe like normal cells. So, I was able to compare the metabolism of normal leukocytes to leukemic leukocytes, work that was partially done at the NCI, and partly done after I finished at NCI, and went on to Duke.

But we then turned to studying how drugs influence cell metabolism. While I was taking care of patients, I was also working in the laboratory with Dr. Burk.

And as my rotations through the National Cancer Institute continued, and I was assigned a different ward, I still maintained contact with the leukemic service and was able to get samples for our work in the laboratory.

JL: I would have conversations with him about it. He was very interested in it. In fact, he had done a little bit of work in Vienna with a Warburg apparatus and cancer cells, so he was very interested in what I was doing.

But I was full-time to help the Cancer Institute. I didn’t spend much time in New York to actually see him.

He was very busy in New York, taking care of his new division.

JL: It would’ve been 1957.

JL: Yeah.

JL: I didn’t care for the terminology, but yes.

JL: I thought it was a most wonderful opportunity to get started in my life’s career and at the same time meet my service obligations. It was just a wonderful, wonderful thing.

JL: Yeah.

JL: That’s right.

JL: Well, I really cared for the man. He was just a wonderful gentleman. A solid scientific background in clinical research and knew what he wanted and what he expected of people—how to conduct ethical research, taking care not to abuse patients in any way during the course of clinical studies on them.

Tom Frei came before Freireich. That is a very interesting story, which I know you know, since you read the book, how they met. Freireich thinks he’s going into his office, and sees the office where he’s going—and saw the name Emil Frei III. 

He thought they’d misspelled his name and got it all wrong. It was really Emil Freireich, no period. Emil J Freireich. Yeah, that was a very interesting story.

Zubrod was the master architect of this relatively small team of people. They weren’t only working on leukemia. There were others who were working on other things, as well. The real characters were Frei and Freireich, with Freireich being really two standard deviations beyond the mean.

JL: Yes.

JL: I don’t recall discussing malaria with Zubrod. I know he discussed his work on pneumococcal pneumonia at Hopkins and some of the research trials that he set up there. He used that framework for doing some of the studies at NCI with double blind studies and insisting on careful controls.

He imbued Frei and Freireich, although Freireich didn’t always get it, in quite the way in which Zubrod meant. They were a very interesting trio, those people. And Jim Holland had preceded Frei, and really started the leukemia program at the NCI. But he left after a year or so, going back to Columbia.

JL: Yes.

JL: It was very difficult, because you can’t be involved in the care of a three-year-old child who’s bleeding from all orifices without being emotionally involved yourself. Doctors tell themselves that they can leave all this stuff behind them when they go home at night.

I never could do that. I always took those problems home with me, which wasn’t necessarily healthy. But I got support from Tom Frei. I rarely had to go to Gordon Zubrod unless there was a problem with Frei or Freireich.

Freireich was the bigger problem, because he wasn’t quite as imbued with some of the—maybe not fair to say this because it’s a different time—but he wasn’t quite as imbued with the ethics of what you should and shouldn’t do to patients.

He took the point of view, “If they’re going to die, we’ve got to do something now. We can’t just sit around and pretend that everything’s going to be alright.”

So, he was all gung-ho to try drugs that—it was like my father, not wanting to treat Babe Ruth without having studied the drug in normal subjects to find out what the dosages should be.

I think at the time that I was on the leukemia service, Freireich was more of my boss than Frei. I would go back to Frei when I had problems with Freireich, and eventually I felt I could go to Zubrod, but he didn’t want to overrule his young guys, Frei and Freireich, unless there was a real moral dilemma, which…

JL: We tried to keep that to a minimum, I would say. Tried to solve the problems ourselves before they got to that stage.

Oftentimes, Freireich would give ground on it.

He paid good attention to Tom Frei, who was a much more level-headed thinker about patient problems of this kind. 

Freireich was a doer. When he saw the pathway, he wanted to go through that door, whether it was wide open or not. And he wanted to go through that door.

JL: They would interact every day. They would sit down and talk for hours at the end of the day and sort of plan what’s the next step. Get a feel for how the patients were doing. There was a lot of give and take between those two people, and then we participated.

I was one of a number of young doctors like myself. In fact, quite a number of my Harvard medical classmates ended up at the National Cancer Institute at about the same time. David Nathan was with me. David Nathan eventually became head of the Farber Center. He was one.

Tom Waldmann, who you may not have known, was still at NCI until a few years ago when he died, doing brilliant basic science work there. There were a few others. There were a lot of good, young people to interact with Freireich and Frei. They were young themselves. They were only a year or so more advanced than we were in terms of clinical training. Everybody was pretty new at this stuff.

Compared to [William] Dameshek, or some of the other greats in American hematology, who had years of experience taking care of patients with leukemia, we were beginners. They were a bit contemptuous of us because they had never seen anybody do well taking care of patients with leukemia. They were some of our harshest critics, I would say.

They didn’t think much of folks who were inclined to spend time taking care of patients with leukemia. The man who was head of hematology/oncology at the Army Institute in Washington—he was very opposed to what we were doing.

JL: It wasn’t until I decided to look back on this period and write about it that I really sat down with him to talk about his personal development in medicine. And a strange journey it was for him having come from nothing, really, absolutely nothing—no father, a mother who couldn’t speak the language, didn’t know anything about education. They were virtually penniless.

JL: It never even came up.

JL: No.

JL: Right. I didn’t know their personal lives and I was very interested in Freireich’s journey. I mean, when he writes, “I learned to be a mean person when I was an intern at Cook County Hospital.”

He describes how the nurses had a special place in the back of the ward where they put patients who they thought weren’t going to make it. They didn’t even take the doctors to make rounds on them. They just let them die. I didn’t know that story at all until afterwards. 

Or Tom Frei’s interesting story about his family being in the glass-making business.

JL: Is that right?

JL: Well, it was an interesting background. And Zubrod in public health being assigned to a general hospital with 1,000 patients—1,000 patients! And he was, like, the only doctor.

JL: He ended up learning something along the way from every experience that he had. So did these other people, as well.

Some of the basic scientists and their background—Howard Skipper in Birmingham, Alabama. How he supported himself as a football player. He is a very modest guy. He said, “I got hit in the head too many times to remember certain things.”

And Gertrude Elion coming up very poor without much encouragement to go into chemistry. She ended up working for a bakery for a period of time to support herself, and then being picked up by George Hitchings.

I worked very, very closely with Hitchings and Elion when I was at Duke and they were at Burroughs Wellcome. We encouraged them to move from the New York area. They actually brought Burroughs Wellcome down to the Research Triangle Park.

They were being crowded in New York and they needed to move somewhere. Dr. [Wayne] Rundles, who was my boss at Duke, and I, worked on Hitchings showing them the advantages of moving into the Research Triangle area and having any amount of space that they needed. It was a great opportunity, and they made the most of it.

JL: It was a great opportunity for us to work with them, too.

JL: Well, I don’t know. I got to a certain point. I had more time away from patients and was able to look back. I had the opportunity to start the book by interviewing some… I took the opportunity to meet Joe Burchenal and various others, Howard Skipper, and others in my travels when I joined the cancer society. I had the opportunity to become a temporary research fellow with the Rockefeller Association.

My wife and I had something like six or eight weeks at their place.

When it first came out, I would get calls from parents who had children with leukemia and they would write and tell me that this was very helpful to them.

JL: Well, it’s a great subject. I think you can see where I was coming from. I wrote it in the hope that young people would see that this was a career that they could do because the background of the scientists was so ordinary.

It wasn’t that their parents had been great scientists and, therefore, they were destined to become great scientists themselves.

They came from different aspects of the world, and they were driven by their own ambitions and talent. So, I think anybody could do it if they had the ambition and the talent. I was hoping to inspire young people and sorry that didn’t sell more widely than it did. 

But they did their best with it, I think.