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Interview Profile

 

Submitted: 2012

 

Interview Information:

One interview session: 10 May 2012
Approximate duration: two hours
Interviewer: Tacey A. Rosolowski, Ph.D. 

 

For supplementary materials:

Please contact, the Historical Resources Center, Research Medical Library:

Javier Garza, MSIS, jjgarza@mdanderson.org

About the Interview Subject:

Marilyn Stovall, PhD (b. 1931, Galveston, Texas) was hired as a radiation technologist at M.D. Anderson Hospital in 1951. Dr. Stovall shifted focus to epidemiology over the course of her employment and went on to earn her Ph.D. in Epidemiology in 1996.  She is known for her work on the late effects of radiation therapy.  At the time of the interview she was Director of the Late Effects Studies Group at MD Anderson.

 

Major Topics Covered

Personal background and education

Memories of the early years of MD Anderson

Contributions to radiation therapy

Effects of radiation on long-term cancer survivors

A portrait of Dr. Robert Shalek, former Director of the Radiation Physics Center  

 

A note on transcription and the transcript:

This interview had been transcribed according to oral history best practices to preserve the conversational quality of spoken language (rather than editing it to written standards).

The interview subject has been given the opportunity to review the transcript and make changes: any substantial departures from the audio file are indicated with brackets [ ].

In addition, the Archives may have redacted portions of the transcript and audio file in compliance with HIPAA and/or interview subject requests.

 


 

Table of Contents

 

Interview Session One: 10 May 2012

 

A Career in Radiobiology at MD Anderson
Chapter 01 / MD Anderson Past

 

Developing the First Computer Programs to Calculate Radiation Dosages
Chapter 02 / Devices, Drugs, Procedures

 

Studying Late Effects of Radiation Therapy
Chapter 03 / The Researcher

 

Investigating the Effects of Radiation on Long-Term Survivors
Chapter 04 / The Researcher

 

Technology in Radiation Therapy and Fee-For Service Activities
Chapter 05 / Devices, Drugs, Procedures

 

Radiation Physics and Institutional Growth
Segment 6 / An Institutional Unit

 

Research Opportunities; Appreciating MD Anderson’s Reputation Abroad
Chapter 07 / View on Career and Accomplishments

 

Passing on Lines of Research and Opportunities to Young Faculty and Staff
Chapter 08 / A View on Career and Accomplishments

 

 


 

Chapter Summaries

 

Interview Session One: 10 May 2012 (listen/read)

 

Chapter 00A
Interview Identifier (listen/read)

 

Chapter 01 (MD Anderson Past)
A Career in Radiobiology at MD Anderson (listen/read)

 

Topics Covered

  • Character, Values, Beliefs, Talents
  • Personal Background
  • Professional Path
  • Inspirations to Practice Science/Medicine
  • Influences from People and Life Experiences
  • Joining MD Anderson
  • Overview
  • Definitions, Explanations, Translations
  • MD Anderson Impact
  • Institutional Processes
  • Devices, Drugs, Procedures
  • Institutional Mission and Values
  • MD Anderson Culture
  • Human Stories
  • Offering Care, Compassion, Help
  • Patients

Dr. Stovall first sketches her background and then describes her role as a radiation technologist and her working relationship with Dr. Shalek when she first came to MD Anderson.  She shares memories of Gilbert Fletcher.  She describes the value of radiation therapy to patients and illustrates with an anecdote about cancer of the tongue.  She also recalls treating prisoners, brought to MD Anderson in shackles (some of whom escaped and had to be caught not only for legal reasons, but to retrieve the radioactive implants) and other patients of very limited means treated at MD Anderson During this section she offers many impressions of MD Anderson and the strong ethic in the Department of Radiation Therapy that the patient always comes first.

 

Chapter 02 (Devices, Drugs, Procedures)
Developing the First Computer Programs to Calculate Radiation Dosages (listen/read)

 

Topics Covered

  • MD Anderson History
  • MD Anderson Snapshot
  • MD Anderson Impact
  • Devices, Drugs, Procedures
  • Contributions
  • Overview
  • Definitions, Explanations, Translations

In this segment, Dr. Stovall describes how, in 1956 or ’57, the Department began to use computers to calculate dosages and beam strengths (the first in the country to use computers in this way).  Dr. Stovall wrote some of the earliest versions of the programs, which she had to run at night on the computer in the billing/accounting department.  (One calculation might take four or five nights to complete.)  Sometime in the late fifties, the Department of Radiation Physics acquired its own computer.  Dr. Stovall notes that she is very proud of her contributions to the use of the computer for these dosing calculations and recalls that the Department gave the program away to other services free of charge.  She also underscores the need to check computer calculations, both then and today, noting several consequences of mistakes in calculations.

 

Chapter 03 (The Researcher)
Studying Late Effects of Radiation Therapy (listen/read)

 

Topics Covered

  • The Researcher
  • Professional Path
  • Overview
  • Definitions, Explanations, Translations
  • Professional Practice
  • The Professional at Work
  • Collaborations
  • Discovery and Success

Dr. Stovall talks about her career shift to epidemiological work on the late effects of radiation on cancer survivors (20 minutes).  This began in 1960 when she worked on a study that showed that patients irradiated as children had increased risk of secondary tumors of the thyroid, findings that led radiation therapists to begin protecting the thyroid and testing cancer survivors for late-effects of radiation.

Dr. Stovall then describes her work with several late-effects studies, many conducted in Scandinavian countries, and explains why retrospective studies were easier to conduct there than in the U.S.  She notes the surprising results of one study that revealed no fertility problems in adults who were treated with radiation as children. 

 

Chapter 04 (The Researcher)
Investigating the Effects of Radiation on Long-Term Survivors (listen/read)

 

Topics Covered

  • Professional Path
  • On Mentoring
  • The Researcher
  • Discovery and Success
  • MD Anderson Culture

Dr. Stovall describes her graduate education, taking seven or eight years to earn her Masters in Public Health while working full time, and ten years to complete her Ph.D.  She needed more education to pursue the late effects studies, and she goes on to describe studies of breast cancer and her work with the Children’s Cancer Survivor Study (funded by NCI), an 18-year study (to date) that is projected to follow patients throughout their entire lifetimes.  She also discusses the WECARE study [Women’s Environment, Cancer, Radiation Epidemiology].  She underscores that these studies have put physicians and radiation therapists on alert for late-effects of radiation, so cancer survivors are offered adequate testing.

 

Chapter 05 (Devices, Drugs, Procedures)
Technology in Radiation Therapy and Fee-For Service Activities (listen/read)

 

Topics Covered

  • Definitions, Explanations, Translations
  • The Business of MD Anderson
  • Devices, Drugs, Procedures
  • MD Anderson History
  • Understanding Cancer, the History of Science, Cancer Research
  • The History of Health Care, Patient Care
  • Multi-disciplinary Approaches

In this segment, Dr. Stovall talks about technology in radiation therapy.  She describes wax avatars (called “The Phantom Family”; see attached printout of PowerPoint presentation) used to estimate beam position and size.  She describes an NCI funded a program in which the Department of Radiation Physics checked radiation therapy machines for other Texas hospitals.  This program was so successful that when it ended (in 1965?), the Department continued it as a fee for service program.  Dr. Stovall talks about the types of equipment they test and some of the miscalibrations they have discovered.  She speaks briefly about the American Association of Physicists in Medicine and MD Anderson’s acquisition of the first Cobalt-65 unit in the United States.  Dr. Stovall then talks about advances in shaping a radiation beam to match a tumor size and shape and notes the symptoms of doses that are too high.  She describes techniques to avoid overtreatment.

 

Chapter 06 (An Institutional Unit)
Radiation Physics and Institutional Growth (listen/read)

 

Topics Covered

  • MD Anderson History
  • Growth and/or Change
  • The Patient

In this segment, Dr. Stovall first speaks about the growth of the Department of Radiation Physics.  She comments on the growth of MD Anderson as a whole.

 

Chapter 07 (View on Career and Accomplishments)
Research Opportunities; Appreciating MD Anderson’s Reputation Abroad (listen/read)

 

Topics Covered

  • Personal Background
  • This is MD Anderson
  • Personal Reflections, Memories of MD Anderson
  • MD Anderson Past
  • Gender, Race, Ethnicity, Religion
  • Character, Values, Beliefs, Talents
  • Evolution of Career
  • The Researcher

Dr. Stovall begins by observing that she never felt as though she was treated differently from male employees. She reflects on her own growth as a professional, saying that she is committed to accuracy in her work and that she carries on Dr. Shalek’s traditions of checking work and putting the patient first.  She also explains that her work on the late effects of radiation therapy has taken her overseas.  During the late 60s and early 70s she did a “Grand Tour” to collect patient data.  She recalls how warmly she was welcomed because she represented MD Anderson, seeing first hand the affects of the institution’s reputation.  In the seventies she spent time in Vienna, working through the International Atomic Energy Agency to help developing countries establish radiation therapy facilities.

 

Chapter 08 (A View on Career and Accomplishments)
Passing on Lines of Research and Opportunities to Young Faculty and Staff (listen/read)

Topics Covered

  • The Researcher
  • Professional Practice
  • The Professional at Work
  • Beyond the Institution
  • Career and Accomplishments

In this final segment, Dr. Stovall discusses how important it is to pass on her late-effects work to someone else. She notes her efforts to help younger people break into the work, as so many people helped her along the way.  She again mentions her work with the Children’s Cancer Survivor Study, and underscores that such late-effects work provides a real service to cancer survivors.

Original Profile 

This two-hour interview with epidemiologist Marilyn Stovall, Ph.D. (b. 1931, Galveston, Texas) is conducted on 10 May 2012 with Tacey A. Rosolowski, Ph.D. as the interviewer.  The interview takes place in Dr. Stovall’s office at MD Anderson’s El Rio Street complex in Houston, Texas.

Dr. Stovall was hired as a radiation technologist at M.D. Anderson Hospital in 1951, after receiving her B.S. in  Zoology and Mathematics from Baylor University.  Dr. Stovall shifted focus to epidemiology over the course of her employment and in 1979 earned her MPH at the UT Health Science Center School of Public Health.  IN 1996 she was awarded her Ph.D. in Epidemiology from the same institution and was made a Professor of Radiation Physics that year.  Dr. Stovall has over 40-years of experience with the late effects of radiation therapy and has collaborated with the Radiation Epidemiology Branch at the NC Institute for over two decades.  She is Director of the Late Effects Studies Group at MD Anderson.

During this interview, Dr. Stovall offers memories from her many years at MD Anderson, discusses contributions she made to radiation therapy, and gives insight into her work with the effects of radiation on long-term cancer survivors.  She is able to give a vivid portrait of Dr. Robert Shalek, who served as Director of the Radiation Physics Center from 1968 to 1985. 

In the opening five minutes, Dr. Stovall sketches her background and recalls that she “always wanted to work in a hospital.”  She tells about volunteering at John Sealy Hospital in Galveston as a teenager and rubbing ointment on pediatric burn patients.  She describes answering an ad in the Houston Chronicle for a position at M.D. Anderson Hospital and her interview with Robert J. Shalek, Chief of Physics, whom she came to admire greatly and credits with spurring her to develop her career.  During the next five minutes, she describes her role as a radiation technologist, which involved performing calculations to determine the position and strength of radiation beams over the course of a patient’s treatment: she notes that Dr. Shalek and she always checked each other’s work.

Dr. Stovall next (ten minutes) gives a brief overview of radiation therapy and talks about Dr. Gilbert Fletcher, the first radiation therapist (whom she describes as a “wild man”).  She often worked in the operating room with Dr. Fletcher and recalls his insistence on the early use of radiation therapy (as opposed to treating all cancer with surgery).  She demonstrates its value to patients with an anecdote about cancer of the tongue.  She also recalls treating prisoners, brought to MD Anderson in shackles (some of whom escaped and had to be caught not only for legal reasons, but to retrieve the radioactive implants).  She also recalls a family whose members had retinoblastomas (a genetically linked disease) and who were so poor they lived in their car.  During this section she offers many impressions of MD Anderson and the strong ethic in the Department of Radiation Therapy that the patient always comes first.

During the next ten minutes, Dr. Stovall describes how, in 1956 or ’57, the Department began to use computers to calculate dosages and beam strengths (the first in the country to use computers in this way).  Dr. Stovall wrote some of the earliest versions of the programs, which she had to run at night on the computer in the billing/accounting department.  (One calculation might take four or five nights to complete.)  Sometime in the late fifties, the Department of Radiation Physics acquired its own computer.  Dr. Stovall notes that she is very proud of her contributions to the use of the computer for these dosing calculations and recalls that the Department gave the program away to other services free of charge.  She also underscores the need to check computer calculations, both then and today, noting several consequences of mistakes in calculations.

Next Dr. Stovall turns to the shift in her career from radiation therapy to epidemiological work on the late effects of radiation on cancer survivors (20 minutes).  This began in 1960 when she worked on a study that showed that patients irradiated as children had increased risk of secondary tumors of the thyroid, findings that led radiation therapists to begin protecting the thyroid and testing cancer survivors for late-effects of radiation.  She undertook this project reluctantly, but discovered she loved the work.  Dr. Stovall then describes her work with several late-effects studies, many conducted in Scandinavian countries, which offer centralized computer records of individuals’ medical histories, therefore making retrospective studies much easier than they are in the U.S.  She notes the surprising results of one study that revealed no fertility problems in adults who were treated with radiation as children.  Dr. Stovall then describes her educational track, taking seven or eight years to earn her Masters in Public Health while working full time, and ten years to complete her Ph.D.  She needed more education to pursue the late effects studies, and she goes on to describe studies of breast cancer and her work with the Children’s Cancer Survivor Study (funded by NCI), an 18-year study (to date) that is projected to follow patients throughout their entire lifetimes.  She also discusses the WECARE study [Women’s Environment, Cancer, Radiation Epidemiology].  She underscores that these studies have put physicians and radiation therapists on alert for late-effects of radiation, so cancer survivors are offered adequate testing.

During the next twenty minutes Dr. Stovall talks about technology in radiation therapy.  She describes wax avatars (called “The Phantom Family”; see attached printout of PowerPoint presentation) used to estimate beam position and size.  She describes an NCI funded a program in which the Department of Radiation Physics checked radiation therapy machines for other Texas hospitals.  This program was so successful that when it ended (in 1965?), the Department continued it as a fee for service program.  Dr. Stovall talks about the types of equipment they test and some of the miscalibrations they have discovered.  She speaks briefly about the American Association of Physicists in Medicine and MD Anderson’s acquisition of the first Cobalt-65 unit in the United States.  Dr. Stovall then talks about advances in shaping a radiation beam to match a tumor size and shape and notes the symptoms of doses that are too high.  She describes techniques to avoid overtreatment.

For about ten minutes, Dr. Stovall then speaks about the growth of the Department of Radiation Physics.  She comments on the growth of MD Anderson as a whole, noting that one has to see that growth from the perspective of both an employee of the institution and as a patient.

In response to a question about being a woman at MD Anderson, Dr. Stovall says she never felt as though she was treated differently from male employees.  In this fifteen-minute section, she notes her naiveté when she arrived and the kindness that Paul Yoder, Head of Personnel, showed by taking her around to find a place to live after her interview.  She reflects on her own growth, saying that she is committed to accuracy in her work and that she carries on Dr. Shalek’s traditions of checking work and putting the patient first.  She also explains that her work on the late effects of radiation therapy has taken her overseas.  During the late 60s and early 70s she did a “Grand Tour” to collect patient data.  She recalls how warmly she was welcomed because she represented MD Anderson, seeing first hand the affects of the institution’s reputation.  In the seventies she spent time in Vienna, working through the International Atomic Energy Agency to help developing countries establish radiation therapy facilities.

During the interview’s final fifteen minutes, Dr. Stovall discusses how important it is to pass on her late-effects work to someone else. She notes her efforts to help younger people break into the work, as so many people helped her along the way.  She again mentions her work with the Children’s Cancer Survivor Study, and underscores that such late-effects work provides a real service to cancer survivors.