Knowing Lee Clark

By Bryant Boutwell and Charles M. Balch

MD Anderson’s first president, Dr. R. Lee Clark, was a visionary who made a lasting impression on all who met him. Co-authors Dr. Charles Balch and Dr. Bryant Boutwell were fortunate to have known the iconic man who is the subject of this series. Balch shared a special bond with Clark after Clark’s successor, Dr. Charles LeMaistre, appointed him chair of Surgery. Balch was the fourth head of surgery following Drs. Clark, Edgar White and Richard Martin. He frequently visited Clark at the Anderson Mayfair apartments (replaced by the hospital’s Jesse H. Jones Rotary House International in 1993) and noted that he was “always gracious, humble and full of sage advice.” Boutwell was a summer communications intern in 1974 working in MD Anderson’s public information office, part of the president’s office on the ninth floor of the old Prudential Insurance Co. Building. Below he offers three personal anecdotes to provide an added dimension rarely found in newspaper accounts and boxes of archived documents.

Collect the stories

The old Prudential Building (Houston Main Building) is long gone to demolition in 2012. Yet the building lives on in the memories of many. Working there as a summer intern in 1974, I had no guarantee of a permanent job at MD Anderson. Thankfully, Clark approved a full-time appointment at summer’s end. I typed copy on an IBM Selectric typewriter with correctable tape. Yes, typewriters and carbon paper back then. I no longer needed White Out…or Blue Out, given MD Anderson memos required blue stationery at the time. 

Life was good as I leaned back in my office chair one morning. Through frosted glass I caught a glimpse of someone headed for my door. Could it be? It was. Lee Clark was in my office and holding a piece of copy before me — my copy, and there were red markings across the top. I gulped. Perhaps I had given away the White Out too soon. With both hands he leaned on the wide, granite windowsill and gazed nine floors below to the pool. The old Prudential Building had a pool, employee library and free cafeteria for Prudential employees who still occupied the building. MD Anderson IDs didn’t work. I tried.

It turned out his suggestions on the copy were minor, but his advice was lifechanging. “You’re from Mississippi,” he informed me. “Born in Hattiesburg but a Texan by age 5,” I replied, to which he volleyed, “A Mississippi writer (pause) that makes you a storyteller. I want you to collect the stories around here ‘cause you’re going to meet a lot of interesting people.” The good news was that he had read my one-page resume. The bad news was all he seemingly got from it was Mississippi. Later I learned he had lived in Mississippi in the early 1940s as a young surgeon.

Then he said it. “You need to go back to school.” I was speechless, having just finished five years at The University of Texas at Austin for degrees in journalism and biology. “You have to know what a ‘p-value’ is so you can tell reporters about significant research around here,” he added. To that I asked, “What’s a p-value?”  He grimaced, “Go over to the School of Public Health and talk to Dean Stallones. They’ll teach you.”

In a matter of minutes Lee Clark had redirected my life. I would collect the stories of the Texas Medical Center for the next four-plus decades and in time migrate over to the School of Public Health. It was then a small glass building (where the UTHealth School of Nursing building is today) housing the Graduate School of Biomedical Sciences and a small group of public health faculty. There I learned p-values are statistical probabilities supporting research findings based on solid design and statistical rigor. 

To this day I treasure Dean Reuel Stallones’ handwritten acceptance letter. 

There’s a lesson in leadership here. Clark came into my office with a much bigger plan in mind than his comments on a one-time writing assignment. He saw my future. I was not the first employee he guided along the way.

Knowing the score

Early in my second year Dr. Clark’s office called to ask if I would like a ticket to the UT-A&M Thanksgiving football game in Austin. That sold-out game was the game of the year. “Yes,” I responded, trying to disguise my excitement.

Days later I was in Austin sitting on the 50-yard line of UT’s Memorial Stadium. Coach Darrell Royal’s wife was two rows behind me, and a serious gentleman was behind her wearing a three-piece, burnt-orange suit with matching hat, tie and socks. This was Longhorn country.

The two seats beside me were empty as the Longhorns kicked off. The Aggies fumbled and UT ran it in. The Aggies got the ball and passed. The Longhorns ran it in. The Aggies’ coach was chewing on his clipboard as UT scored again. Ten minutes in and it was 21-0. Then I spotted Clark and Dr. Gilbert Fletcher trudging up the steps to the empty seats beside me. “What happened?” he asked, with a bit of shock in his voice as he took his seat. I quickly did a play-by-play, realizing that telling Lee Clark the score in Austin was a rare event. After all, he was a master at telling Texas Legislators the score on health care and gaining their support.

I included every detail, to which he reached in his pocket and pushed a dollar bill into my hand. I was horrified. My play-by-play was darn good, but no tip was required. As I stared at the dollar, Clark pointed to the concessions vendor about to pass our row. “Don’t let him get away. Get me a Coke.” I was greatly relieved and Clark soon refreshed. As the game proceeded, his eyes rarely left the scoreboard. I wondered why. His gaze was intent.

Years later I came to understand the double meaning of that moment. The scoreboard had just been named for a beloved Longhorn football star named Freddie Steinmark, a patient at MD Anderson who succumbed to osteosarcoma on June 6, 1971. 

Looking at the Freddie Steinmark scoreboard that day, Clark was likely reliving the amputation of the young football star’s leg, something all desperately hoped could be avoided. As a UT student in Austin I had lived in the same dormitory as Freddie. The football elite and we common students shared Jester, a dorm named for a former Texas governor who had helped Clark with budget needs in the late 1940s. 

Freddie entered our dorm cafeteria on crutches some weeks after surgery to be swarmed by well-wishers. He was a wakeup call that life is precious, and we hoped beyond hope he would live forever. 

While the Steinmark scoreboard showed a win for the Longhorns, it also served as a reminder to Clark that cancer had taken Freddie at an all too young age. Clark was more interested in the bigger story that day. There was much more work ahead to find cures and save future Freddie Steinmarks. Like the dominating UT football team on the field that fall afternoon, his UT team would build a strong offense against cancer.

Back in the days when MD Anderson was operating out of temporary facilities at the Oaks, the former Baker estate, so little was known about the biology of the disease. Dr. Ernst Bertner had borrowed four basic research scientists from The University of Texas Medical Branch at Galveston. Clark had hired Gilbert Fletcher and unleashed radiotherapy on cancer. Yet there was much work ahead to understand its biology and the mechanisms of metastasis. He had already started by hiring department heads in key basic science departments like Drs. A. Clark Griffin (hired in 1954 to head Biochemistry), Leon Dmochowski (1954, Virology) and Felix Haas (1956, Biology). 

In 1965, Clark brought two all-stars, Drs. Emil Freireich and Emil “Tom” Frei III, to Houston from the National Cancer Institute to start a chemotherapy program. Freireich wrote the textbook on treating childhood leukemia using combinations of powerful chemotherapeutic drugs. Childhood leukemia outcomes went from nearly hopeless in the 1950s to the current 90% five-year survival rate for children with acute lymphocytic leukemia. The Developmental Therapeutics program Freireich and Frei started became a model for others. 

To this day I can see Clark staring intently at that Freddie Steinmark scoreboard, deep in thought and pondering all that he and future MD Anderson presidents must do to push further and save more lives from cancer. I thought I had told him the score. Little did I know he had a much different score in mind, and it was much bigger than a football game. In that moment, his UT offense was making great progress, but there was much more work to be done. If only Lee Clark could see where we are today.

Dedicating the Clark Clinic

Clark retired after more than three decades (1946-1978). LeMaistre took the reins in 1978 and served the next 18 years. I was honored to write the dedication remarks for the R. Lee Clark Clinic building, which was formally dedicated on Nov. 19, 1987. LeMaistre enhanced my words (as LeMaistre could do so well) and delivered a wonderful tribute. Barely able to speak due to the effects of his stroke, Clark stood before an overflowing crowd that day and thanked all in attendance. Tears flowed. Clark, who always did his homework, worked with his speech therapist for weeks to perfect his remarks. His mouth no longer wanted to provide the seamless flow of words that seemed trapped in his brilliant mind.

It was a great MD Anderson moment frozen in time for me. I can see him now, slowly approaching the podium as LeMaistre steps aside. The auditorium thunders with applause. His unsteady gait and strained smile quiet the room a bit, but that sparkle in his eyes is there. Tears flow again. Despite hours of practice, he looks uncertain. The auditorium goes silent. Then, like a flickering lightbulb suddenly shining brightly, his words of appreciation come to him and are greeted by a sea of standing applause, cheers and love. 

Today, when I drive by the R. Lee Clark Clinic, I see much more than bricks and mortar. I see Lee Clark’s face filled with pride on that dedicatory day so long ago, and beside him all those early recruits. They came to support his vision to improve cancer care and make a difference. And what a difference they made.

Next article: Transforming cancer care