WEBVTT - Dr. Selwyn Vickers 0:00:03.520 --> 0:00:05.840 One of everyone's greatest fears that he or she might 0:00:05.840 --> 0:00:08.200 be diagnosed at some point in their life with cancer. 0:00:08.560 --> 0:00:11.160 I recently had a chance of talk to doctor Selwyn Vickers, 0:00:11.360 --> 0:00:14.040 who runs a Royal song Kettering Cancer Center, one of 0:00:14.040 --> 0:00:16.160 the leading cancer centers in the United States, and I 0:00:16.160 --> 0:00:18.000 had a chance to talk with him about the progress 0:00:18.040 --> 0:00:22.240 being made in treating cancer. So today we are about 0:00:22.720 --> 0:00:25.880 I guess, more than fifty years after President Nixon declared 0:00:25.960 --> 0:00:29.360 war on cancer? Have we really made that much progress 0:00:29.400 --> 0:00:31.639 in the fifty years or so since he first declared 0:00:31.720 --> 0:00:32.479 war on cancer? 0:00:32.920 --> 0:00:35.120 Yeah, I think we have the. 0:00:36.720 --> 0:00:41.120 Ability for someone who has a diagnosis of cancer broadly 0:00:41.360 --> 0:00:45.360 thinking about having a chance for cure has significantly improved. 0:00:45.680 --> 0:00:49.240 We've gone from all cancer diagnoses probably around the time 0:00:49.280 --> 0:00:52.560 of that announcement that was around thirty to forty percent 0:00:52.680 --> 0:00:56.240 chance of cure that we're approaching sixty eight to seventy 0:00:56.280 --> 0:01:00.000 percent of patients across the board who get the diagnosis 0:01:00.080 --> 0:01:02.960 of cancer have a chance at five years to being 0:01:03.000 --> 0:01:04.160 told they don't have a tumor. 0:01:04.440 --> 0:01:06.920 So what is the best way to avoid getting cancer? 0:01:06.920 --> 0:01:08.959 I guess that's the question everybody asked, Well, what is 0:01:09.000 --> 0:01:09.760 the answer to that? 0:01:10.040 --> 0:01:13.360 Yeah, I think the best way to avoid it is 0:01:13.480 --> 0:01:19.720 obviously healthy lifestyles, avoid smoking, certainly limit red meat to 0:01:19.760 --> 0:01:22.200 the amount that you eat. Now, all of these statements 0:01:22.240 --> 0:01:24.399 are no guarantee you won't get cancer, but we do 0:01:24.560 --> 0:01:26.839 know to some degree that they probably have a role 0:01:27.280 --> 0:01:31.720 in accelerating or increasing risk. In general, there is no 0:01:31.959 --> 0:01:34.399 actual way to prevent it. There are certainly things we 0:01:34.520 --> 0:01:37.320 do can screen early, and if we catch cancers early, 0:01:37.720 --> 0:01:39.960 we have a really good chance of curing them. 0:01:40.040 --> 0:01:44.800 What extent is environmental factors, What extent is it behavioral factors, 0:01:44.800 --> 0:01:47.360 And what extent is the genetic factors that causes cancer? 0:01:47.800 --> 0:01:52.000 Yeah, so it's a combination. There's a small percentage of 0:01:52.080 --> 0:01:55.880 inherited genes that put you at risk. The most common 0:01:56.200 --> 0:01:58.880 is BRCA one and two for women with breast cancer, 0:01:58.960 --> 0:02:01.720 increasing risk of a varian cancer as well, and one 0:02:01.760 --> 0:02:04.440 or two others those we know and we can detect. 0:02:04.720 --> 0:02:07.600 There's certain other select genes that are passed on that 0:02:07.720 --> 0:02:09.280 significantly increase. 0:02:08.919 --> 0:02:10.400 Your risk, but that's a small number. 0:02:10.960 --> 0:02:15.200 The other genetic aspect are genetic mutations that occur over 0:02:15.320 --> 0:02:19.320 time because of the environment and age. Those somatic mutations 0:02:19.320 --> 0:02:22.600 sometimes caused by viruses, caused by cells that are not 0:02:22.680 --> 0:02:28.120 correcting themselves certainly have a role and actually producing malignant 0:02:28.200 --> 0:02:31.480 cells that grow on control. And then I think there 0:02:31.480 --> 0:02:35.160 are certainly environmental exposures, and we are learning more. We 0:02:35.240 --> 0:02:39.120 know that there are classically ones from multiple chemicals that 0:02:39.200 --> 0:02:41.960 do it, but it's the broad combination. But I would 0:02:41.960 --> 0:02:44.480 say the biggest contributor is our aging. That has a 0:02:44.480 --> 0:02:45.359 big factor in it. 0:02:45.560 --> 0:02:48.280 So what is the most common cancer that humans get? 0:02:48.360 --> 0:02:54.720 Is that lung cancer, breast cancer, pancreatic cancer, brain cancer. 0:02:54.760 --> 0:02:55.640 What is the most common? 0:02:55.720 --> 0:02:59.359 So the most common cancers in America are breast and prostate. 0:03:00.520 --> 0:03:04.400 Three hundred thousand cases of breast, somewhere around two hundred 0:03:04.400 --> 0:03:09.760 and eighty thousand cases of prostate. Lung is arguably one 0:03:09.760 --> 0:03:12.040 of the most if not the number one killer. 0:03:12.200 --> 0:03:13.280 It's about one hundred and. 0:03:13.160 --> 0:03:16.440 Fifty thousand cases, but it is the most lethal large 0:03:16.520 --> 0:03:21.280 number pancre's cancer. The incidence has increased. When I began 0:03:21.440 --> 0:03:24.400 my practice, there was about thirty thousand cases a year 0:03:24.760 --> 0:03:25.360 on average. 0:03:25.400 --> 0:03:27.200 Now there are over sixty. 0:03:26.760 --> 0:03:30.040 Five thousand new cases of pancredit cancer a year, and 0:03:30.160 --> 0:03:33.000 so it's approaching a level where it's going to be 0:03:33.360 --> 0:03:38.320 the second killer, comeless common killer of patients with cancer, 0:03:38.400 --> 0:03:41.440 even though it doesn't have the numbers. Like breast cancer, 0:03:41.760 --> 0:03:44.880 we can cure well over ninety percent of breast cancers 0:03:45.040 --> 0:03:48.120 and well over ninety five percent of prostate cancers are cured. 0:03:48.360 --> 0:03:52.160 And now with prospective prostate cancer there's a PSA which 0:03:52.200 --> 0:03:54.680 is a kind of a blood marker. But we don't 0:03:54.680 --> 0:03:57.880 have those kind of things for brain cancer or or 0:03:57.920 --> 0:03:59.880 for pancreatic cancer, right we don't have a market. 0:04:00.360 --> 0:04:01.800 We don't. 0:04:02.040 --> 0:04:05.560 They are clearly tests that are being evolved based on 0:04:06.200 --> 0:04:10.280 being able to detect circulating tumor, DNA and other markers, 0:04:10.680 --> 0:04:13.720 and our ability to have broader ability to manage the 0:04:13.800 --> 0:04:18.400 data through competition oncology that are giving us gradual insight 0:04:18.680 --> 0:04:22.039 for early detection. It's not as specific as we want 0:04:22.080 --> 0:04:24.680 and it's not completely as accurate. So sometimes if I 0:04:24.720 --> 0:04:27.360 get a positive test, I really don't know which tumor 0:04:27.400 --> 0:04:31.160 to look for. Sometimes it does give directions, but that's evolving. 0:04:31.560 --> 0:04:32.320 But you're right. 0:04:32.520 --> 0:04:36.320 We have PSA, we have mammograms, we have colonoscopy, we 0:04:36.400 --> 0:04:39.880 have cervical screening for certain cancers, and we have CT 0:04:40.040 --> 0:04:44.560 scans for lung but we don't have broad availability of 0:04:44.600 --> 0:04:47.800 screening for the large number of cancers that are still killers. 0:04:47.839 --> 0:04:50.240 Now, the type of cancers that are killers are ones 0:04:50.279 --> 0:04:53.799 where you don't know about them until maybe stage four globlastoma, 0:04:53.920 --> 0:04:58.159 brain cancers, that type, pancreatic cancers, another type, maybe liver cancer. 0:04:58.240 --> 0:04:58.640 That's right. 0:04:59.200 --> 0:05:01.640 How do you know if you have one of those 0:05:01.720 --> 0:05:03.520 kind of cancers? What is the best way to go 0:05:03.600 --> 0:05:05.520 in for an annual cancer checkup or. 0:05:05.520 --> 0:05:05.919 What do you do? 0:05:06.440 --> 0:05:10.719 Yeah, so it's hard, and that's a question that's perplexed me. 0:05:11.160 --> 0:05:12.919 I would love to say, go out and get a 0:05:12.960 --> 0:05:15.479 cat scan for everybody. We can't do that. We don't 0:05:15.480 --> 0:05:17.560 have enough cat scanners to screen. 0:05:18.400 --> 0:05:22.040 We need a better ability to enrich who's truly at risk. 0:05:22.160 --> 0:05:25.880 And recent studies now with AI have been able to 0:05:25.960 --> 0:05:30.039 begin to predict who in the population by virtue of 0:05:30.080 --> 0:05:32.880 a number of things that they pulled together their medical history, 0:05:32.960 --> 0:05:37.120 some blood tests, who's at risk for a pank ratic cancer. 0:05:37.520 --> 0:05:39.960 We do know now if you're a smoker, and if 0:05:39.960 --> 0:05:42.680 you're a certain age or exposed to smoke, you should 0:05:42.680 --> 0:05:44.960 in you over fifty, you clearly should get a low 0:05:45.000 --> 0:05:48.080 dough CT scan, which is proven to have a significant 0:05:48.080 --> 0:05:52.400 difference in outcome and detect early cancers, and yet only 0:05:52.440 --> 0:05:55.440 about six to eight percent of the eligible candidates take 0:05:55.480 --> 0:05:59.440 advantage of that CAT scan. So one, I think it's 0:05:59.480 --> 0:06:02.560 coming day that AI programs looking at our broad array 0:06:02.600 --> 0:06:06.479 of data can enrich the population who we know maybe 0:06:06.520 --> 0:06:10.560 at risk, and then once doing that, probably getting a 0:06:10.680 --> 0:06:13.360 scan MRI, a CT scan is going to be the 0:06:13.400 --> 0:06:15.760 tool which we can't do for everybody, but we can 0:06:15.800 --> 0:06:17.039 do for a select population. 0:06:17.120 --> 0:06:21.000 Now, pancreatic cancer, that's a disease that Ruth Bader Ginsburg 0:06:21.080 --> 0:06:24.280 died from and increasingly many people have it. You don't 0:06:24.320 --> 0:06:27.080 typically know you have until stage four. You are a 0:06:27.120 --> 0:06:30.440 pancredic cancer surgeon. Why didn't you decide to specialize in 0:06:30.480 --> 0:06:31.400 that area? 0:06:32.200 --> 0:06:34.520 You know? One a couple of things. 0:06:34.600 --> 0:06:38.320 Number One, at the time that I trained at Johns Hopkins, 0:06:38.640 --> 0:06:43.440 we were the leading center for treating patients or pancreatic cancer. 0:06:43.800 --> 0:06:47.440 And as you talked about, at that time, the leading 0:06:47.480 --> 0:06:51.240 opportunity to make a difference in somebody's life was surgery. 0:06:51.600 --> 0:06:55.040 So Number one, I felt, I felt I had great 0:06:55.120 --> 0:06:58.640 training and had capacity to make a difference by virtue 0:06:58.680 --> 0:07:00.680 of that skill set. So it was the environment, the 0:07:00.760 --> 0:07:04.800 leaders there who encouraged us to look at difficult problems 0:07:05.080 --> 0:07:07.200 and make a difference. So one it was a skill 0:07:07.240 --> 0:07:09.960 set of training. Two I was at a center where 0:07:10.040 --> 0:07:12.920 we focused on it, and three it was a problem 0:07:12.960 --> 0:07:15.320 that really needed the attention to make a difference. 0:07:15.800 --> 0:07:17.520 I soon learned as a surgeon. 0:07:17.640 --> 0:07:21.480 After I did my first hundred patients for pancredic cancer, 0:07:21.600 --> 0:07:24.920 successfully operating on them, I could count on one hand 0:07:24.960 --> 0:07:27.320 how many were alive at five years, and so I 0:07:27.360 --> 0:07:30.520 knew that was a bigger problem than just my surgical 0:07:30.520 --> 0:07:31.440 skills could resolve. 0:07:31.560 --> 0:07:34.840 Okay, so I'm always worried about pancredic cancer too. What's 0:07:34.880 --> 0:07:37.679 the best sign that I might be having pan credic cancer? 0:07:38.600 --> 0:07:42.680 You know, the signs of cancer are often due to 0:07:42.760 --> 0:07:45.560 something simple. But if you were to think about the 0:07:45.600 --> 0:07:49.880 things that you might worry about, particularly as you get older. 0:07:50.240 --> 0:07:53.320 We don't naturally just lose weight when we get older. 0:07:53.640 --> 0:07:55.360 So one notice that. 0:07:55.480 --> 0:07:58.400 Yes, a sudden Yes, a sudden weight loss. 0:07:58.560 --> 0:08:00.680 So you want to ask the quest question, why am 0:08:00.720 --> 0:08:02.720 I dropping weight even though I've been trying for the 0:08:02.800 --> 0:08:07.240 last five years and nothing's happened. New onset diabetes that 0:08:07.400 --> 0:08:10.600 for some reason now I don't have a history of it. 0:08:10.680 --> 0:08:14.840 I'm over sixty five and I'm developing diabetes that and 0:08:14.880 --> 0:08:19.120 then subtly, although not early on, it's the case where 0:08:19.240 --> 0:08:24.240 either somehow my urine turns dark or I begin to 0:08:24.320 --> 0:08:26.960 have some shades of change and my eyes or my 0:08:27.080 --> 0:08:30.320 thumbnails that begin to look a bit of a yellow 0:08:30.480 --> 0:08:31.440 what we call jarndice. 0:08:31.520 --> 0:08:34.760 Now you've said weight loss is a sign sometimes something 0:08:34.800 --> 0:08:37.880 isn't good, but I know it's not directly in your area. 0:08:37.920 --> 0:08:41.320 But ozempic, which is now a very popular drug to 0:08:41.360 --> 0:08:44.640 produce weight, some people say that it might cause some 0:08:44.720 --> 0:08:48.280 type of tumors. Are you an advocate of ozempic for 0:08:48.360 --> 0:08:49.720 everybody or for some people? 0:08:49.960 --> 0:08:50.240 Yeah. 0:08:50.320 --> 0:08:54.760 I think as the new golp one inhibitors, which are 0:08:55.240 --> 0:08:59.760 these drugs that really affect how we feel about being full, 0:09:00.640 --> 0:09:03.679 become further advanced, I think it's going to be an 0:09:03.760 --> 0:09:08.400 overall sea change for American health care, including cancer, because 0:09:08.440 --> 0:09:12.760 we know obesity over time has a significant impact increasing 0:09:12.840 --> 0:09:16.319 cancer rate and risk. I don't have a strong opinion 0:09:16.320 --> 0:09:19.239 about at this stage whether an ozembic or a manjuro 0:09:19.320 --> 0:09:22.480 would cause a cancer, but I think the global impact 0:09:22.520 --> 0:09:26.200 is one to actually reduce our overall health burden, including cancer. 0:09:26.400 --> 0:09:28.559 Talk about your background. Where were you born? 0:09:29.080 --> 0:09:31.640 So? I was born in Demopolis, Alabama. It's in the 0:09:31.720 --> 0:09:35.560 small town in the black belt of Alabama, a rural 0:09:35.679 --> 0:09:39.679 farming area where my parents were educators. 0:09:39.960 --> 0:09:43.320 Now, your parents were extremely well educated for blacks in 0:09:43.400 --> 0:09:45.520 the South at that time. How did they get so 0:09:45.600 --> 0:09:46.320 well educated? 0:09:46.840 --> 0:09:51.080 Yeah, So on my father's side, it was really a 0:09:51.120 --> 0:09:55.240 parents who themselves had limited education. My grandfather with a 0:09:55.320 --> 0:09:57.760 fourth grade education, who didn't learn how to write and 0:09:57.800 --> 0:10:01.360 read until he was in his forties, who really felt 0:10:01.400 --> 0:10:02.760 his children needed. 0:10:02.520 --> 0:10:03.560 A college education. 0:10:04.200 --> 0:10:08.080 And on my mother's side, her mother in the nineteen 0:10:08.200 --> 0:10:11.960 twenties at the travel two hundred miles to an academy 0:10:12.040 --> 0:10:15.000 to start it by Presbyterians in the southern part of 0:10:15.000 --> 0:10:18.400 Alabama to get her high school degree, and then went 0:10:18.480 --> 0:10:22.640 to summers to get her bachelor's degree. So they had 0:10:23.160 --> 0:10:27.920 foundations of understanding the value of education and the ability, 0:10:27.960 --> 0:10:30.760 particularly for a Nigro in the South, to have a 0:10:30.880 --> 0:10:33.200 chance to advance their lives and careers. 0:10:33.240 --> 0:10:36.440 When you grew up in a segregated environment, isume So 0:10:36.720 --> 0:10:39.080 you were the only child of your parents. Yes, so 0:10:39.160 --> 0:10:41.040 did they say we're putting all our hope in you, 0:10:41.160 --> 0:10:43.280 and we want you to be a pancreatic cancer surgeon. 0:10:43.760 --> 0:10:45.920 No, they had no clue what I might be. 0:10:46.559 --> 0:10:49.240 I think they simply wanted me to do the best 0:10:49.280 --> 0:10:53.120 I could in anything I took my interest in. Clearly, 0:10:53.360 --> 0:10:58.360 achievement in high school and undergrad was really sort of 0:10:58.400 --> 0:11:01.040 the first thing that they looked for and expected of me, 0:11:02.240 --> 0:11:05.440 and I tried to do that because I realized the 0:11:05.559 --> 0:11:10.040 legacy of both grandparents and even great grandparents who studied 0:11:10.040 --> 0:11:13.760 with book A. T. Washington, that I had a significant responsibility. 0:11:13.920 --> 0:11:15.720 So were you a superstar in high school? 0:11:16.440 --> 0:11:19.120 You know, I was a good student. I would say this. 0:11:20.120 --> 0:11:21.920 I grew up in a town called Huntsville. 0:11:22.920 --> 0:11:26.640 It really offered the best education that I could get 0:11:26.679 --> 0:11:29.679 in Alabama at the time. But when I arrived at 0:11:29.720 --> 0:11:33.440 Johns Hopkins, I was probably behind ninety five percent of 0:11:33.440 --> 0:11:34.240 my classmates. 0:11:34.240 --> 0:11:36.080 And what I've been exposed, you must have done okay 0:11:36.120 --> 0:11:38.120 at Johns Hopkins undergrad because you got on the Johns 0:11:38.120 --> 0:11:39.200 Hopkins medical school. 0:11:39.400 --> 0:11:41.400 Yeah, I had to catch up. It took me about 0:11:41.400 --> 0:11:42.600 a year to catch up. 0:11:42.640 --> 0:11:46.559 And you know, there were classes my classmates had who 0:11:46.600 --> 0:11:49.480 went to prep schools I was taking for the first time. 0:11:49.640 --> 0:11:52.080 I hadn't had calculus when I arrived, and they'd all 0:11:52.120 --> 0:11:54.840 had calculus, and so the level loved thing of the 0:11:54.840 --> 0:11:57.400 playing ground took me about a year for that to occur. 0:11:57.559 --> 0:11:58.600 Once the playing. 0:11:58.280 --> 0:12:01.400 Ground became level, I found that I compete just as 0:12:01.480 --> 0:12:02.120 well as they could. 0:12:02.200 --> 0:12:04.440 When you went to Johns Hopkins Medical School, which is 0:12:04.480 --> 0:12:06.600 one of the most famous medical schools in the country, 0:12:06.840 --> 0:12:09.600 up in the world, was it very integrated at the time, 0:12:09.640 --> 0:12:10.560 were mostly white. 0:12:10.679 --> 0:12:13.880 So there was a surgeon there who was from Alabama, 0:12:13.960 --> 0:12:17.320 a guy named Levi Watkins, who became a mentor and friend, 0:12:17.960 --> 0:12:23.760 and he grew up in Alabama where my grandmother and 0:12:23.840 --> 0:12:26.960 my mother went to the college where his father was president, 0:12:27.320 --> 0:12:32.000 and Levi went to Tennessee State, Vanderbilt and then Johns Hopkins. 0:12:32.320 --> 0:12:36.440 Stayed on faculty, but challenged Johns Hopkins that it clearly 0:12:36.720 --> 0:12:39.560 needed to be more diverse. So he wrote all the 0:12:39.600 --> 0:12:43.000 African American medical applicants in the country and encouraged them 0:12:43.000 --> 0:12:46.079 to apply to Johns Hopkins, and he provided a platform 0:12:46.200 --> 0:12:48.800 for people like me to have an interest in going there. 0:12:49.040 --> 0:12:50.360 After you graduated, what did you do? 0:12:50.880 --> 0:12:54.120 So after I graduated, I made the transition to realize 0:12:54.160 --> 0:12:57.040 I wanted to be a surgeon, looked around the country, 0:12:57.040 --> 0:13:00.160 and decided to stay in Baltimore because I thought Hopkins 0:13:00.040 --> 0:13:02.360 had the best surgical training of that time. 0:13:02.440 --> 0:13:04.440 But ultimately you went back to Alabama. 0:13:05.040 --> 0:13:07.720 That was a hard decision. I had an offer to 0:13:07.760 --> 0:13:11.440 stay on faculty at Hopkins. I'd been there for in 0:13:11.480 --> 0:13:15.559 Baltimore for sixteen years, and briefly accepted a job to stay, 0:13:15.600 --> 0:13:19.760 but then change my mind to go to Alabama, in 0:13:19.880 --> 0:13:22.920 part because I felt I wanted to go back home 0:13:22.960 --> 0:13:24.480 into a new environment. 0:13:24.800 --> 0:13:27.640 Now as a great surgeon, sometimes you might say I 0:13:27.640 --> 0:13:30.880 don't need to go be into administrative parts of hospitals. 0:13:31.000 --> 0:13:32.920 I just want to be a doctor, just do surgery. 0:13:33.040 --> 0:13:35.000 What prompted you to want to get out of just 0:13:35.040 --> 0:13:38.240 doing surgery to be an administrator and a hospital leader. 0:13:38.720 --> 0:13:42.920 Yeah, I think it was again watching others who did 0:13:42.920 --> 0:13:43.400 it well. 0:13:43.720 --> 0:13:45.440 I had a. 0:13:44.800 --> 0:13:48.680 Dean who recruited me from Birmingham, Alabama, to Minneapolis, Minnesota, 0:13:49.040 --> 0:13:51.079 which is a big jump to convince me to move 0:13:51.120 --> 0:13:56.640 my family, but she did several things that showed me 0:13:56.720 --> 0:13:59.480 the power of a leader at a significant level to 0:13:59.480 --> 0:13:59.959 affect the. 0:14:00.040 --> 0:14:01.319 Career of other leaders. 0:14:02.040 --> 0:14:05.520 And after I'd helped build a growing Department of Surgery 0:14:05.520 --> 0:14:08.360 at the University of Minnesota. I thought I could serve 0:14:08.440 --> 0:14:13.000 in that role. In particular, I realized over time that 0:14:13.080 --> 0:14:16.440 my training as a surgeon brought a set of credible 0:14:16.520 --> 0:14:20.920 things to the table. One, if surgeons have a measure 0:14:20.920 --> 0:14:24.280 of emotional intelligence, not much of our training reinforces that. 0:14:24.600 --> 0:14:28.760 It reinforces skill, not necessarily emotional intelligence. But if a 0:14:28.800 --> 0:14:32.360 surgeon has some self awareness and emotional intelligence, what they 0:14:32.360 --> 0:14:35.760 bring to the table of leadership are three fundamental things. 0:14:36.160 --> 0:14:41.200 Number One, they do everything in teams, their operations. Their 0:14:41.280 --> 0:14:46.000 patience they see is all team focused. Number Two, they 0:14:46.160 --> 0:14:51.040 value process, but they hold themselves very much accountable to execution. 0:14:51.480 --> 0:14:54.600 They understand that it's good to explore a patient, but 0:14:54.720 --> 0:14:57.040 what really matters is did you take the tumor out? 0:14:57.560 --> 0:15:02.240 And then number three, they make difficult decisions on incomplete information. 0:15:02.840 --> 0:15:05.920 Those things I realized that I could bring to the 0:15:05.960 --> 0:15:08.880 table as a leader if I had a sort of 0:15:08.880 --> 0:15:11.400 a passion for working with people and had some sense 0:15:11.440 --> 0:15:12.200 of self awareness. 0:15:12.200 --> 0:15:14.440 So he rose up in Minnesota. Why did you go 0:15:14.560 --> 0:15:16.800 back to Alabama? Which had racial issues? 0:15:17.400 --> 0:15:18.920 UAB is a unique place. 0:15:19.280 --> 0:15:24.480 It's a bit of an oasis of academic excellence, broad diversity. 0:15:24.840 --> 0:15:28.200 It's the most diverse Carnegie Tier one research university in 0:15:28.200 --> 0:15:32.120 the country. It's done more transplants in African American than 0:15:32.160 --> 0:15:33.920 any hospital in the world. 0:15:34.120 --> 0:15:34.800 So I felt the. 0:15:34.760 --> 0:15:41.040 Compelling opportunity to continually drive the mission of that institution 0:15:41.280 --> 0:15:45.120 in spite of the landscape socially and politically that I 0:15:45.160 --> 0:15:47.760 thought it could have a significant impact on that part 0:15:47.800 --> 0:15:48.520 of the world. 0:15:48.600 --> 0:15:51.240 And how long did you run? UAB So I was 0:15:51.240 --> 0:15:53.480 there for nine and a half years, almost ten years. 0:15:53.560 --> 0:15:56.760 So when Memorial Sloan Kettering approached you, did you say, Look, 0:15:57.120 --> 0:15:59.800 I'm a great surgeon. I got what I want right here. 0:16:00.280 --> 0:16:02.080 This is my native state. I don't need to leave. 0:16:02.640 --> 0:16:06.600 Were you intrigued, No, it was more of the former, 0:16:06.720 --> 0:16:09.200 Like you said, it was I have a good place, 0:16:09.640 --> 0:16:12.680 have a good job, I've built a level of trust 0:16:12.680 --> 0:16:18.000 in the community, i have a compelling mission, and I 0:16:18.040 --> 0:16:20.000 think I need to really think. 0:16:19.920 --> 0:16:21.640 Very hard about leaving it. 0:16:21.800 --> 0:16:24.360 And I would say there are very few places that 0:16:24.520 --> 0:16:28.440 would intrigue you to consider it leaving, and Memorrison Cattering 0:16:28.520 --> 0:16:29.160 is one of them. 0:16:29.240 --> 0:16:32.240 So as you rose from a small town only child 0:16:32.360 --> 0:16:35.280 in Alabama to where you are now, you must have 0:16:35.360 --> 0:16:37.280 encountered a fair amount of racial prejudice. 0:16:37.480 --> 0:16:39.040 Yeah, I had my share of it. 0:16:39.600 --> 0:16:45.320 I learned early on from one of my mentors at 0:16:45.360 --> 0:16:48.440 john Hopkins. He was one of the faculty there, and 0:16:48.480 --> 0:16:53.320 he reminded me that people will often have difficulties with you, 0:16:54.360 --> 0:16:58.920 but don't make their problem your problem. And so one 0:16:59.000 --> 0:17:03.080 of my early experiences of taking care of a patient 0:17:04.040 --> 0:17:07.119 who had a liver cancer or in this case of 0:17:07.160 --> 0:17:11.920 bioduct cancer, they struggled that there was a black surgeon 0:17:12.320 --> 0:17:15.399 saying that they needed half of their liver out. I 0:17:15.480 --> 0:17:19.720 respected that because it was unusual. Even my grandmother had 0:17:19.760 --> 0:17:22.359 not ever seen a black doctor, so that was a 0:17:22.400 --> 0:17:25.880 foreign thing to her. So I respected the understanding that 0:17:25.920 --> 0:17:29.080 what they were going through was not the norm. They 0:17:29.160 --> 0:17:31.960 called back to Johns Hopkins to see if I actually trained, 0:17:33.000 --> 0:17:35.040 and I said, do what you need to do to 0:17:35.040 --> 0:17:36.639 be comfortable with this situation. 0:17:36.920 --> 0:17:39.239 So when you join Memorial Sloan Kettering, what you want 0:17:39.280 --> 0:17:42.000 to do is expand the coverage of moreel Sloan Kettering 0:17:42.040 --> 0:17:44.520 and make sure more people were able to get the services. 0:17:44.640 --> 0:17:46.600 What progress have you made so far in that. 0:17:46.560 --> 0:17:48.959 I have wanted Memorial Sloan Kettering and be a cancer 0:17:49.000 --> 0:17:52.159 center to the world, both culturally, ethnically. 0:17:51.640 --> 0:17:52.600 And geographically. 0:17:53.000 --> 0:17:55.320 And there have been great efforts that have occurred, some 0:17:55.359 --> 0:17:58.080 of them before I got here. One of the efforts 0:17:58.080 --> 0:18:01.439 by our legislative team was to get our state to 0:18:01.960 --> 0:18:07.119 really drive manage Medicaid, manage care in New York, to 0:18:07.240 --> 0:18:11.680 actually negotiate with Morrisloan Kettering so patients with Medicaid broadly 0:18:11.840 --> 0:18:15.600 could access us. We've had that law enacted and patients 0:18:15.640 --> 0:18:18.720 now broadly are able to come to us. Our Medicaid 0:18:18.840 --> 0:18:22.399 service of patients is up by sixty three percent. So 0:18:22.520 --> 0:18:25.679 Number One, we now are getting a broader access to patients. 0:18:25.800 --> 0:18:29.960 Number two, we're partnering with hospitals across New York City, 0:18:30.480 --> 0:18:35.240 Jamaica Queen's Hospital near JFK, which has a tremendously diverse population. 0:18:35.480 --> 0:18:39.120 The most diverse county in America is Queen's. We're partnering 0:18:39.160 --> 0:18:42.000 with them to develop a cancer program. We also work 0:18:42.040 --> 0:18:45.280 with New York Hospital Health and Services also for clinical 0:18:45.280 --> 0:18:48.359 trials and patients access at our RAF Lauren Cancer Center. 0:18:48.840 --> 0:18:52.199 And we've developed a broad strategy around health equity that 0:18:52.280 --> 0:18:55.080 I think will further impact our city and our region 0:18:55.119 --> 0:18:58.080 for making sure everyone has access to the best cancer 0:18:58.119 --> 0:18:58.800 care in the world. 0:18:58.880 --> 0:19:01.440 So, as the head of the Slung Cattering Cancer Center, 0:19:01.480 --> 0:19:04.240 your biggest problem is getting enough money to do the 0:19:04.280 --> 0:19:06.679 research and give the patients the care they want. So 0:19:06.720 --> 0:19:09.640 you're always raising money or that's not your biggest problem. 0:19:10.000 --> 0:19:11.879 You know, it's not my biggest problem, but it is 0:19:11.920 --> 0:19:14.920 a problem. There is no doubt the cost and healthcare 0:19:14.960 --> 0:19:17.760 is significant, not only for our patients, but for the 0:19:17.800 --> 0:19:19.120 science and for the drugs. 0:19:19.480 --> 0:19:21.440 So it is a significant. 0:19:20.800 --> 0:19:23.399 Part of what I do is putting resources on the 0:19:23.440 --> 0:19:27.800 table so that our scientists, our clinical trialists, and our 0:19:27.840 --> 0:19:31.040 physicians are able to do their job and make discoveries. 0:19:31.080 --> 0:19:33.800 So I'm Memorial Sloan Cattering. What it does is it 0:19:33.840 --> 0:19:38.280 does research and then also does patient care. Yes, and 0:19:38.320 --> 0:19:40.520 there's an advantage, you would say, to patient care because 0:19:40.560 --> 0:19:42.360 you have people doing the cutting edge research. 0:19:42.720 --> 0:19:47.200 Yes, cutting edge research that's connected to doctors who are 0:19:47.280 --> 0:19:50.720 looking to answer questions as well as take care of people. 0:19:50.760 --> 0:19:53.600 You also have students at Moral Sloan Cattering. You have 0:19:53.640 --> 0:19:56.359 a graduate school for students, is that right. 0:19:56.240 --> 0:19:58.520 Yeah, So the Gersonal School is really one of the 0:19:58.560 --> 0:20:02.760 outstanding biomedical grad programs in the country. That our students 0:20:02.760 --> 0:20:05.679 are focused in our labs largely on basic science and 0:20:05.720 --> 0:20:10.320 cancer research. We also have almost two thousand fellows and 0:20:10.440 --> 0:20:14.040 residents who rotate the Memorial Hospital, so we have a 0:20:14.160 --> 0:20:17.840 robust educational program, although we don't have a distinct medical school, 0:20:18.200 --> 0:20:22.679 great graduate school, great training programs, nearly one hundred different 0:20:22.680 --> 0:20:23.800 fellowships at Memorial. 0:20:23.840 --> 0:20:27.000 Suppose somebody says they have a cancer that's i'd say, 0:20:27.119 --> 0:20:29.160 not a very good kind of cancer, not that any 0:20:29.200 --> 0:20:31.399 good cancer, not that any cancer is good. But suppose 0:20:31.440 --> 0:20:36.160 you have somebody's very serious stage four gleoblastoma. The advantage 0:20:36.160 --> 0:20:38.399 of coming here is you can really make a difference 0:20:38.440 --> 0:20:39.720 at stage four for somebody. 0:20:40.400 --> 0:20:43.560 Yeah, so the advantage of coming here broadly. So Number one, 0:20:43.720 --> 0:20:46.840 the outcomes are different even at stage one. For coming 0:20:46.840 --> 0:20:50.560 to a Memorial at a stage four, we certainly have 0:20:50.680 --> 0:20:54.560 the better chance of often prolonging life and having a 0:20:54.680 --> 0:20:58.680 chance to getting access to the most novel therapeutics, with 0:20:58.880 --> 0:21:01.200 no guarantee that we're willing to cure you, but we're 0:21:01.240 --> 0:21:03.679