Podcasts about mopp

In episode 50 of the MOPP we are chatting with one of the biggest winners in online poker, high-stakes PLO cash-game player Grazvydas Kontautas. Grazvydas shares his journey from starting poker young to becoming a pro, discussing mindset, game selection, and self-criticism in his growth. He explores the balance between poker and personal life, risk management, and insights from game theory. The conversation covers transitioning from No Limit Hold'em to PLO, common mistakes, strategy creation, and the role of coaching. Grazvydas highlights the importance of feedback, community, and unorthodox strategies for maximizing EV. He reflects on poker's future, lifestyle factors, and the lessons learned, offering advice for aspiring players on finding balance and success in the game.

In episode 51 of the MOPP we chat with american high-stakes cash-game player Armin "AbsoluteTopUp" Amini. We dive deep into his journey, mindset, and experiences at the World Cash Game Championships. We discuss the highs and lows of battling the best, dealing with massive swings, and the lessons he's learned along the way. Armin shares how he transitioned from gaming to poker, refined his study process, and developed the mental resilience needed to compete at the top. We also explore key poker concepts, from understanding blockers to balancing exploitative and solver-based strategies. Plus, he reveals the biggest mindset leaks holding players back and the traits required to reach high stakes. If you're serious about improving your game and mastering the mental side of poker, this episode is a must-watch.

In episode 52 of the podcast, Casimir Seire shares his incredible journey from aspiring footballer to professional poker player. He opens up about the mental resilience gained from his time in the military, the thrill of tournament play, and how he balances ambition, preparation, and emotional control in poker. We dive into the challenges of variance, the importance of structure in poker and life, and how to navigate the emotional rollercoaster of high-stakes games. Casimir also discusses risk management, avoiding burnout, and the key traits necessary for long-term success in poker. If you're looking for practical strategies, mindset shifts, and inspiration to improve your poker game (and life), this episode is for you!

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Management of Postpartum Preeclampsia and Hypertensive Disorders (MOPP): Postpartum Tight vs Standard Blood Pressure Control

In episode 49 of the MOPP, we invited recently crowned cash-game champion Owen "PR0DIGY" on to make his second appearance on the channel. Owen shares what he has been up to since we last spoke reflects on his recent cash-game world championship win over at coinpoker. We will chat about the thrill of competition, mental challenges, and the balance between technical skill and psychological resilience. He shares insights on adapting to opponents, game plans, and balancing instinct with strategy. The conversation delves into player dynamics, overcoming personal weaknesses, thriving under pressure, and navigating perfectionism. Owen also offers advice for aspiring players, emphasizing thoughtful decision-making, learning, and maintaining top-level performance.

In episode 45 of The Mechanics of Poker podcast, we dive into the fascinating journey of Yolan, a world record holder in memory turned high-stakes poker player. Learn about the techniques he used to master memory, his insights into effective learning, and the strategies that helped him transition into poker. Yolan shares his approach to balancing life and poker, building resilience, and overcoming burnout. Discover the lessons he's learned from mistakes, his thoughts on decision-making, and the habits that have driven his success. Whether you're looking to improve your memory, level up your poker game, or gain inspiration from a unique story of growth, this episode has something for everyone. Don't miss the key takeaways and advice Yolan offers to help you achieve your goals!

In episode 46 of The Mechanics of Poker podcast Marc Goone will reveal the to mastering live poker as he shares his journey from musician to high-stakes player and coach. We dive into the mindset shifts, strategies, and common pitfalls that separate the top 1% from the rest. Learn how to build confidence in your exploitative strategy, dissolve your ego, and set realistic goals for success. Whether you're transitioning between live and online poker or aiming to refine your skills, this conversation is packed with insights to elevate your game. Plus, Marc reveals the biggest lessons from his coaching journey and what the future holds for him. Enjoy!

In episode 47 of The Mechanics of Poker podcast, we dive deep into the journey of Felix "GWValuetown" Maierhofer, an inspiring poker player who rapidly climbed the stakes with remarkable success. We explore his unique approach to studying, overcoming challenges, and developing a winning mindset. Felix shares insights into the importance of reflection, discipline, and passion, while also discussing his strategies for maintaining focus, navigating downswings, and mastering the mental game. Felix shares stories about his personal growth, life philosophy, and approach to building a supportive peer group, this episode is packed with valuable lessons for anyone who is interested in becoming a better poker player. Enjoy!

In episode 48 of the MOPP, we dive deep into the poker journey of Belgium high-stakes MTT player, Pieter Aerts, a seasoned pro with 16+ years of experience. From starting out on his dad's account as a teenager to mastering the transition between different poker formats, Pieter shares how he overcame early struggles, dealt with tough competition, and climbed the ranks to success. We explore critical topics like bankroll management, overcoming downswings, leveraging GTO tools, and balancing poker with life, relationships, and long-term goals. Pieter also reveals mental frameworks, lessons from rock-bottom moments, and strategies that helped him stay ahead in a rapidly evolving game. This episode is packed with insights, inspiration, and practical advice to help you navigate your own journey. Enjoy, like & subscribe!

In episode 44 of the Mechanics of Poker podcast we have a chat with high-stakes cash-game player Samu Alto, a veteran who has thrived at the tables for over 15 years. Samu shares insights into the evolution of poker strategies, the impact of solvers, and the skills and habits that have fueled his longevity in a highly competitive field. We discuss his early career, the challenges of adapting to new metas, and the delicate balance between theory and exploitative play. Samu also opens up about his journey through highs and lows, the lessons learned from setbacks, and the routines that keep him sharp and motivated.

In episode 42 of the Mechanics of Poker podcast we dive deep into the journey of high-stakes cash-game player Mateo "schyllae" Urretavizcaya, exploring his early beginnings in poker during the pandemic and how his background in engineering helped shape his learning process. We discuss his competitive nature, transitioning from semi-professional basketball to poker, and the challenges he faced, including busting his bankroll twice and dealing with his worst downswing. Mateo shares insights on bankroll management, handling pressure, and channeling aggression strategically. We also touch on his self-development journey, mindset shifts, and balancing theory with exploitative strategies. Tune in for valuable lessons on poker, mindset, and performance at the highest levels!

In episode 43 of the Mechanics of Poker podcast, we dive deep into the inspiring journey of Mario, who started playing poker at the young age of 13. Mario shares his unique strategies for bankroll management, how he handled the pressures of high-stakes poker, and the pivotal moments that shaped his career, including his first big win and the shocking realizations about his game. We also discuss the personal side of Mario's life—why he decided to leave professional football, the challenges of separating his identity from his former career, and his views on long-term success in poker and beyond. We cover the role of networking in poker, the darker side of being a high-performer, and his approach to creating a more sustainable and enjoyable poker journey. Finally, Mario reveals his thoughts on transitioning into the business world, the lessons learned from working with solvers, and how his poker skills have translated into new ventures.

In episode 40, we chat with high-stakes MTT player Alexandros "Pwndidi" Theologis about his transition from gaming to poker. Alex discusses how gaming prepared him for poker's challenges, including managing variance and expecting worst-case scenarios. He shares his disciplined approach to bankroll management, studying, and dividing grinding and study days efficiently. We delve into his experiences with BitB, handling mistakes, and recording sessions for improvement. Alex also provides insights on PKO tournaments, moving from mid to high stakes, and his study guidelines. Tune in for Alex's valuable advice on managing emotions, understanding poker statistically, and maintaining a love for the game. Enjoy!

In episode 41 of the pod we chat with high-stakes cash-game player Chris "Lukabrate" Nguyen. We will explore his rapid rise to high-stakes which only took him three years. Chris shares insights on balancing math and creativity in poker, the role of empathy, and the dangers of relying too much on solvers. We also discuss his journey from university to full-time poker, the impact of his father's confidence, and the mindset shifts that helped him excel. Whether you're new to poker or a seasoned player, this episode offers valuable lessons and inspiration for your own journey.

In Episode 39 of the podcast, we chat with Finnish high-stakes cash-game player Severi "TheIPoker" Palmu. In this episode, Severi shares his journey, which started by playing conservatively at 2NL, grinding his bankroll all the way up to playing 10KNL. We touch on how Severi keeps up with the ever-evolving poker world, his biggest strengths as a player, the best and worst advice given in today's poker industry, being curious, self-critical, and the most important things to factor into your decision-making. We close off with various lessons learned while reflecting on his 8-year journey. Enjoy!

In Episode 38 of the podcast, we chat with the 2022 Main Event champion, Espen Uhlen Jørstad. In this episode, we discuss the biggest contributors to Espen's success in poker, as well as the unforeseen struggles that came with winning the main event. Espen shares stories from his childhood and how they have shaped his current behavior. Other topics we touch on include competing at the highest level in Triton events, the motivation for continuing to play poker at a high level after winning the main event, how to perform at your best, and mental health and loneliness in poker. Packed with wisdom as always! Enjoy!

In episode 36 of the MOPP we chat with hungarian high-stakes poker player Laszlo "Lackoo87gcb" Molnar. Throughout the episode, Laszlo shared valuable advice based on his 15 years of experience playing poker, offering insights into skill development, study techniques, and managing motivation in the game. Laszlo shares his motivation for pursuing a career in poker, his background in competitive gaming, the upsides and downsides of risk-taking, the importance of finding useful information in poker, and the role of habits and routines in performance. Additionally, we dive into topics such as the power of critical thinking, the dangers of survival bias, the significance of working with coaches, and the keys to longevity in poker. Enjoy!

In episode 37 of the MOPP we chat with long-time finish high-stakes MTT player Samuel "€urop€an" Vousden. In this episode european delves deep into the mindset, habits, and strategies that have propelled him to the top of the game. From insights on staying at the peak of your performance, the importance of being and remaining curious, creating an enviroment in which your creativity and style of playing can flourish, to managing mindset and energy, this conversation is packed with invaluable lessons which can help boost your poker career. Enjoy and like this video if it helped you in any way.

In Episode 33 of the MOPP, we chat with long-time high-stakes MTT pro and holder of the number one spot on the Germany all-time money list, Fedor Holz. In this episode, Fedor shares insights into his journey, why he decided to quit poker and pursue other opportunities in business and investing, and why he decided to make his comeback on the poker scene. Next to that, Fedor discusses handling success, imposter syndrome, and the pitfalls of the poker world. He delves into the mechanics of his Pokercode program, his views on data analysis, and his role in ensuring fair play on GGPoker. Plus, learn Fedor's strategies for staying at the top and his philosophy on efficient learning. Don't miss out on this fascinating conversation with one of poker's brightest minds!

In Episode 34 of the MOPP, we chat with high-stakes cash-game player Sergii Levchenko better known as Jayser1337 online. Discover the mindset, strategies, and breakthroughs that propelled Sergii from $100 NL to $1K NL and beyond. Delve into the psychology behind success, the art of reflection, and the drive to be the best. Join us as we explore Sergii's highs, lows, and the invaluable lessons learned along the way. From battling cognitive biases to building a resilient belief system, this episode offers a roadmap to mastering both the game of poker and the game of life. Tune in for insights, inspiration, and actionable advice from Sergii's journey.

In episode 35 of the MOPP we chat with one of the biggest volume grinders out there, Frank "Mr Builderman, aka Mayothedon". In this podcast discover how Frank recognized his talent, embraced high-volume play, struggled with adiction, and navigated through the ups and downs of being an online poker pro. Gain valuable lessons on resilience, self-awareness, and finding balance amidst the grind.

In episode 32 of the MOPP, we chat with the number 1 on the all-time money list, Bryn Kenney. Bryn shares with us why he likes to take on a lot of risk and how to deal with million-dollar swings, even going broke several times in the process. We will touch on mistakes players make who just look at the solver and the endless realm of possibilities poker strategy has to offer if we give ourselves permission to be creative. Enjoy!

In episode 30 of the MOPP we will have a chat with high-stakes poker player Kayhan “Kayhanmok” Mokri. In this episode we will explore strategies, experiences, and insights in to making it to the top. Whether you're a seasoned poker pro or just starting your poker journey, this episode is packed with valuable insights you won't want to miss. Tune in and make sure to subscribe for all the poker wisdom coming your way!

In episode 31 of the MOPP, we will have a chat with high-stakes poker player Nikolai "Dyrdom1" Evdokimov. Nikolai will share with us his journey, going from speedcubing and sports betting into poker, and all the perspectives he has learned throughout this journey. Enjoy!

In episode 29 of the MOPP we chat with poker player, coach, strategy creator Patrick Howard. In this episode we discuss Patrick's inspiring poker journey, the importance of work ethic, structured learning approaches, adapting to player pool tendencies, battling downswings and mental hurdles, coping with burnout and anxiety, mental health struggles, the significance of reaching out for help, poker's isolation challenges, and much more. Whether you're a poker enthusiast or looking for insights into mental resilience, this podcast has something for you. Don't miss out!

In episode 27 of the MOPP, we chat with high-stakes PLO player and enterpeneur Fernando "Jnandez87" Habegger. Discover what attracted Fernando to poker and why he invested $2500 in a PLO strategy book. Learn about the entrepreneurial spirit that led him to view poker as a thriving business opportunity. Fernando shares how he leverages his unique skill sets, embraces risk, uses data, making a difference in poker and life and offers invaluable advice on skill development and strategic game selection.

In episode 28 of the MOPP we chat with high-stakes cash-game player Owen “PRODIGY” Messers. In the pod we discuss his recent 100k HU match against Doug Polk and dive deep into his poker journey, discussing challenges, strategies, and his transition from international-level chess. Unpack the psychology behind decision-making, understand the mechanics of poker, and discover how to optimize your game with solvers. Owen also touches on the balance of talent vs. hard work and shares invaluable lessons he's learned along the way. Don't miss Adam and Rene's main takeaways at the end!

In episode 26 of the MOPP, we will chat with israelian all round high-stakes NLH player Barak Wisbrod. Barak shares his journey from starting as a degenerate gambler to becoming a high-stakes pro. Discover how he overcame the hurdles of going broke multiple times, transitioning from MTTs to cash games, and finding his place among poker's elite. Barak's story is a testament to the power of resilience, embracing pain, and evolving one's approach to achieve success. Gain insights into the mindset and strategies that separate mid-stakes players from high-stakes contenders. From handling massive swings to building a high-stakes network, this episode is packed with practical wisdom and inspiration

In episode 25 of the MOPP, we will chat with one the biggest american online cash-game winners Matt "ILuvAvrilLavigne91" Marinelli's. From deciding to pursue poker full-time to finding a supportive poker tribe, Matt shares his experiences and the biggest mistake he overcame by implementing simplified strategies. Matt's transformation from 100NL to 5KNL, overcoming downswings, and shaping a winning mindset are truely inspiring. Tune in for an in-depth look at poker success, self-belief, and the mindset of a true champion. Don't miss the key takeaway towards the end Matt wants you to walk away with!

Junge Junge, 4 Monate nix...und jetzt nix Gescheites. Aber wenigstens was. Da werden alle Erlebnisse aus dieser langen Zeit aufgearbeitet und verwurstet. Der Greis hat schon wieder ein neues Mopp und der Stricher frisst Hirn in Shanghai. Das wars. Viel wichtiger ist, das die beiden in die Kathedrale rülpsen und sich die passende Groupie-Strategie für das bevorstehende Konzert überlegen. Eins ist klar....wer gut schmiert der gut fährt. Juffta....

In this episode we chat with brazilian high-stakes cash-game player Matheus "Xpl01t4bl3" Pinheiro. Matheus reflects on the importance of presence, the drive to push beyond comfort zones, and his struggle with setting goals. We explore his transition to professional poker, facing setbacks, anxiety attacks, and the power of therapy. Matheus shares insights on self-care and his experiences with coaches. From coping with downswings to mindset shifts, he offers valuable lessons and reflections on his career. Don't miss Adam and Rene's summary at the end!

In todays episode we talk with dutch high-stakes MTT pro Jans "Graftekkel" Arends on the back of his Triton wins in Vietnam where he took home close to 1.5 milion dollars. We cover the road he had to walk in order to get himself in the position to compete daily in some of the thoughest fields in the world. Enjoy!

The early 1970's saw the start of the medical specialty we now know as oncology. How does one create standards and practices for patient care during that time? Dr. John Glick is a pioneer during the dawn of oncology. He says that early work involved humanity, optimism, and compassion, all of which were the foundation of his career. Dr Glick describes the clinical experiences that drove him to oncology (4:28), his rapport with patients, which was portrayed in Stewart Alsop's book Stay of Execution (9:21), and his groundbreaking work developing the medical oncology program at the University of Pennsylvania (12:22). Speaker Disclosures Dr. David Johnson: Consulting or Advisory Role – Merck, Pfizer, Aileron Therapeutics, Boston University Dr. Patrick Loehrer: Research Funding – Novartis, Lilly Foundation, Taiho Pharmaceutical Dr. John Glick: None More Podcasts with Oncology Leaders    Oncology, Etc. – In Conversation with Dr. Richard Pazdur (Part 1) Oncology, Etc. – HPV Vaccine Pioneer Dr. Douglas Lowy (Part 1) Oncology, Etc. – Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 1)  If you liked this episode, please follow the show. To explore other educational content, including courses, visit education.asco.org. Contact us at education@asco.org.   TRANSCRIPT Disclosures for this podcast are listed in the podcast page. Pat Loehrer: Welcome to Oncology, Etc. This is an ASCO education podcast. I'm Pat Loehrer, Director of Global Oncology and Health Equity at Indiana University. Dave Johnson: And I'm Dave Johnson, a medical oncologist at the University of Texas Southwestern in Dallas, Texas. If you're a regular listener to our podcast, welcome back. If you're new to Oncology, Etc., the purpose of our podcast is to introduce listeners to interesting people and topics in and outside the world of oncology. Today's guest is someone well-known to the oncology community. Dr. John Glick is undoubtedly one of oncology's most highly respected clinicians, researchers, and mentors. I've always viewed John as the quintessential role model. I will add that for me, he proved to be a role model even before I met him, which hopefully we'll talk about a little bit later.   To attempt to summarize John's career in a paragraph or two is really impossible. Suffice it to say, he is to the University of Pennsylvania Cancer Center what water is to Niagara Falls. You can't have one without the other. After completing his fellowship at NCI in Stanford, John joined the Penn faculty in 1974 as the Ann B. Young Assistant Professor. Some five decades later, he retired as the director of one of the most highly respected comprehensive cancer centers in the nation. Among his many notable accomplishments, I will comment on just a few. He established the Medical Oncology program at Penn and subsequently directed the Abramson Cancer Center from 1985 to 2006. Interestingly, he established the Penn Medicine Academy of Master Clinicians to promote clinical excellence in all subspecialties across the health system. He's been a driving force in philanthropy at Penn Medicine, culminating in his role as Vice President Associate Dean for Resource Development.  Over the past several decades, he has helped raise over half a billion dollars for Penn Med. We need you on our team, John. As a clinician scholar, John's research has helped shape standards of care for both breast cancer and lymphomas. For example, he pioneered the integration of adjuvant chemotherapy and definitive breast irradiation for early-stage breast cancer. In 1985, he chaired the pivotal NCI Consensus Conference on adjuvant chemotherapy for breast cancer. He also was a driving force in a clinical landmark study published in The New England Journal some 20 or so years ago about the role of bone marrow transplant for advanced breast cancer. Most impressive of all, in my opinion, is John's legacy as a mentor to multiple generations of medical students, residents, and fellows.   So, John, we want to thank you for joining us and welcome. Thought we might start by having you tell us a little about your early life, your family, your parents, where you grew up, and how you got into medicine. Dr. John Glick: Well, thank you for having me on the podcast, Pat and David, it's always a pleasure to be with you and with ASCO. I grew up in New York City in Manhattan. My father was a well-known dermatologist. He was my role model. And from the age of eight, I knew I wanted to be a doctor. Nothing else ever crossed my mind. But having seen my father's many interests outside of medicine, I realized from very early that there was much more to medicine than just science. And that really induced me, when I went to college, to major in the humanities, in history, art history, and I actually took the minimum number of science courses to get into medical school. That probably wouldn't work today, but it was the start of my interest in humanism, humanities, and dealing with people outside of the quantitative sciences.  Dave Johnson: So that's reflected in how we all view you, John. You're one of the most humanistic physicians that I know personally. I wonder if you could tell us about your interest in medical oncology, and in particular, as one of the pioneers in the field. I mean, there wasn't really even a specialty of medical oncology until the early 1970s. So, how in the world did you get interested in oncology and what drew you to that specialty? Dr. John Glick: Well, I had two clinical experiences that drove me into oncology. The first, when I was a third year medical student at Columbia PNS, my first clinical rotation in internal medicine, I was assigned a 20-year-old who had acute leukemia, except he was not told his diagnosis. He was told he had aplastic anemia, receiving blood and platelets, and some form of chemotherapy. And I spent a lot of time just talking to him as an individual, not just taking care of him. And we became friends. And he was then discharged, only to be readmitted about two weeks later. And in the elevator, the medical assistant had his admission sheet, and unfortunately, it was facing the patient, and it had his diagnosis, acute leukemia. So he came into the ward and he confronted me. "Why didn't you tell me I had acute leukemia?" Well, I couldn't say the attendees forbade me to do that. So I took what today we would call ‘the hit', and apologized. But it stimulated me to reflect that honesty with patients was extremely important, and that oncology was just in its infancy. We knew nothing about it. It was not considered even a specialty. I don't think we used the word "oncology."  But that inspired me to take an elective in my fourth year at PNS, at an indigent cancer hospital called the Francis Delafield Hospital. It only took care of indigent cancer patients, and there were wards, twelve patients in a ward, six on each side, and nobody would go see the patients. It was almost as if they were afraid that if they were to touch the patient, they would get cancer. And I started talking to the patients, and they were human beings, but nobody had told them their diagnosis. Nobody had told them if they were terminal. And there were a few patients who were getting a new drug at that time for multiple myeloma called melphalan, and they actually had relief of some of the symptoms, of their bone pain. But I realized that there was a huge void in medicine that I could possibly help to fill.  And that was the era of Vietnam, and so I applied to the National Cancer Institute to become a commissioned officer in the Public Health Service to avoid the draft, to be on a service with, at that time, some very notable oncologists Vince DeVita, Ed Henderson, Paul Carbone. I had read some of their papers, and I was lucky to be accepted. And I was a clinical associate at the National Cancer Institute. And that was life-changing because there every patient was considered to be potentially curable. The advances at that time using MOPP for Hodgkin's disease, C-MOPP for lymphoma, some treatments for leukemia. George Canellos pioneered the use of CMF for metastatic breast cancer. It was an amazing, amazing experience. That was in 1971 to ‘73. Oncology did not become a true specialty till ‘73, but my two years at NCI were formative.  However, I realized that there was something missing in my training. Everybody was considered curable, but I had never seen a patient with metastatic colon cancer, metastatic lung cancer. The radiotherapists there did not like to teach clinical associates, and I knew that there was a place called Stanford. And Stanford had Saul Rosenberg in medical oncology for lymphomas and Henry Kaplan in radiotherapy. So, everybody was going to California, and my wife and I packed up and went to California and spent a year at Stanford, which, combined with my training at the NCI, led me to the principles that guided my career in oncology; humanity, optimism, reality, compassion, and a love for clinical trials.  I was very, very fortunate to be there at the dawn of medical oncology shortly after I decided to go to Penn, which at that time did not have a medical oncologist. In fact, I was the only medical oncologist at Penn for four years and did every consult in the hospital for four years, much to the chagrin of my wife. But I was fortunate to have great mentors in my career: Paul Carbone, Vince DeVita, Saul Rosenberg, Henry Kaplan, among many, many others. And that impressed me about the importance of mentorship because my career would never have been where it was or is without these mentors. Pat Loehrer: John, just to echo what Dave said, you've been such a tremendous mentor for us. Dave and I particularly, you took us under your wings when you didn't know who we were. We were people in the Midwest. We weren't from any place shiny, but we really appreciate that. Dave Johnson: So, John, I mentioned at the very beginning that I met you before I met you, and the way I met you was through Stewart Alsop's book, Stay of Execution. He portrayed you as an extraordinarily caring individual, and it tremendously impacted me. It was one of the reasons why I chose oncology as a specialty. I realize it's been 50 or more years ago and most of our listeners will have no idea who Stewart Alsop was. And I wonder if you might share with us a little bit of that experience interacting with someone who was particularly well-known in that time as a columnist for The New York Times.  Dr. John Glick: His brother Joe Alsop and Stu Alsop were two of the most famous columnists at that time. Joe Alsop was a hawk right-winger who lived in the Vietnam War. Stewart was charming, was a centrist Democrat, wrote the back page for Newsweek for years. He and I had very similar educational backgrounds and interests. And we functioned on two different levels—one as a physician-patient, and then we became friends. And he and his wife adopted us into the Georgetown set.  And I received a lot of criticism for socializing with a patient. But over the years, I've been able to become friends with many of my patients, and I've been able to compartmentalize their medical care from our friendship. And I use the analogy if I was a doctor in a small town and I was the only doctor,  I'd be friends with people in town, with the pastor and likely the mayor. But I have always believed that patients can become your friends if they want it and if they initiated it.   Taking care of Stewart Alsop was an amazing, amazing experience. We didn't know what he had. People initially thought he had acute leukemia. In reality, he had myelodysplastic syndrome, but that hadn't been described yet. He had a spontaneous remission, which I rarely see, probably due to interferon released from a febrile episode, all his blasts went away in his marrow. One of my children's middle name is Stewart. But professionally and personally, it was an incredible experience. It taught me the importance of being available to patients. They had my home phone number. We didn't have cell phone numbers in those days. We had beepers, but they didn't work. And from that point on, I gave my home phone number to patients, and I actually trained my children how to answer the phone. “This is Katie Glick. How can I help you? My father's not home. You need my father? Can I have your phone number? I'll find him and he'll call you back.” Patients still remember my children and their way of answering the phone. Pat Loehrer: One of the things you did do is create this medical oncology program at Penn, which has graduated some incredible fellows that have become outstanding leaders in our field. But can you reflect a little bit about the process of creating something that was never created before, like a medical oncology program? Dr. John Glick: Well, I came to Penn, my first day. Person who recruited me was on sabbatical. I asked where my office was and there was no office. There was an exam room. There was a clinic for indigent patients which we scrubbed by hand. There was another office for patients who paid. Within two months, I had abolished that. We had one– I hate to use the word clinic, people still use the word clinic today, but one office that took care of all patients, irregardless of means.   I saw every oncology consult in the hospital for four years. But I had a mentor, not only Buz Cooper, but fortunately, Jonathan Rhoads was Chairman of Surgery, and he was also Chairman of the President's Cancer panel. And what he said at Penn in surgery became the law. And then when we introduced lumpectomy for breast cancer and radiotherapy, he endorsed it immediately. All the other surgeons followed suit. I don't think there's any hospital in the country that adopted lumpectomy and radiotherapy for breast cancer as quickly. And the surgeons were instrumental in my career.  Now, I was taking care of gliomas, head and neck cancers, and it was difficult. If I had a colorectal patient, I'd call Charles Moertel at Mayo Clinic and say, “What do I do?” I was there when Larry Einhorn in 1975 presented his data on testicular cancer with the platinum. Unbelievably inspiring, transformational. It also showed the importance of single-arm studies. You didn't have to do randomized studies because the results were so outstanding. And so in my career, I did both single-arm studies, proof of principle studies, and then many randomized trials through the cooperative groups.  But the first four years were very difficult. I didn't know what the word ‘work-life balance' meant in those days. If somebody was sick, I stayed and saw them. It was difficult introducing new principles. When I first mentioned platinum after Larry's presentation, I was laughed out of the room because this was a heavy metal. When patients were dying, they died in the hospital, and I wanted to hang up morphine to assist them. The nurses reported me to the administration. I had to fight to get the vending machines for cigarettes out of the hospital. So there were a lot of victories along the way and a lot of setbacks.  It took me several years to have an oncology unit of six beds, and now I think we have 150 or 160 beds and need more. So it was an interesting and, in retrospective, a wonderful experience, but I didn't know any better. Fortunately, I had a great wife who was working at Penn and then at Medical College of Pennsylvania, and she was incredibly understanding, never complained. And I think my kids knew that on Tuesdays and Thursdays, don't bring up anything difficult with dad because he's had a really tough day in clinic. Dave Johnson: We were not in that era, but we were very close. And many of the struggles that you had were beginning to dissipate by the time we were completing our training. But it was still a challenge. I mean, all those things. I gave my own chemotherapy for the first few years I was in practice. I don't know that our colleagues today who have trained in the last, say, 10 or 15 years, actually realize that that was what we did. Most of the chemo was given in the hospital. It was not uncommon in the early days to have 20, 30, 40 inpatients that you would round on because there just wasn't an outpatient facility. But the corporate mind made a big difference, allowing us to give drugs like platinum in the outpatient arena. You span all of that era, and so you've seen the whole panoply of change that has taken place.  John, the other thing you did that has impressed me, in part because of my time as a Chair of Medicine, is you created this Academy of Master Clinicians. Can you tell us a bit about that and what was the motivation behind that?  Dr. John Glick: Ben had a strategic plan, and one of the pillars was talking about valuing clinical medicine and clinical excellence. But there was no implementation plan. It was sort of just words and left in the air. And I was no longer director of the cancer center, and I realized we had a lot of awards for research, awards for education, and no awards for clinical excellence. So I created the idea of having an academy and master clinician spend six months talking to all constituencies, chairs of various departments, directors of centers to get a buy-in. Wrote a three-page white paper for the dean, who approved it immediately. And then, as typical at Penn, I raised all the money for it. I went to one of my patients who was an executive at Blue Cross. I said I need $500,000 to start this program. And then subsequently, I raised $4 million to endow it. Today, it is the highest honor that a Penn clinician can receive.  You could be on any one of our multiple tracks. You have to see patients at least 60% of the time. You not only have to be a great doctor, you have to be a humanist. So the world's best thoracic surgeon who has a demeanor in the operating room that is not conducive to working with a nurse as a team doesn't get in. We emphasize professionalism, mentorship, citizenship, teaching, national reputation, local reputation, and clinical excellence. And so we've elected over 100 people, maybe 3% of the Penn faculty. We give an honorarium. We have monthly meetings now by Zoom. We have monthly meetings on various topics. We never have a problem getting any dean or CEO to come talk to us.  We were the first to do Penn's professionalism statement. The school subsequently adopted, and it's become the highest honor for a Penn clinician. It's very competitive. It's peer-reviewed. The dean has no influence. And we're very proud that 40% of the members of the academy are women. We have a high percentage of diversity compared to the numbers on our faculty, but you really have to be elected on merit, and some people that you might expected to be members of the academy aren't. It's one of the things I'm proudest of. It will go on in perpetuity because of the money we've raised. I think many of my accomplishments as a researcher will fade, as they typically do, but I'm very proud of the Academy, and I'm very proud of the people that I've mentored. Dave Johnson: It speaks to your values, John, and I think it's one of the reasons why you're so widely admired. Thank you for creating that. It proved to be a model for other institutions. I know that for a fact. One would think that valuing clinical care would be preeminent in medical schools, but in fact, it's often ignored. So again, I know that your colleagues at Penn appreciate your efforts in that regard.  Tell us a little about your term as ASCO president. What are you most proud about and what were your most difficult challenges? Dr. John Glick: Well, the most difficult challenge was that ASCO was in transition. I had to fire the company that ran the meeting. We had to decide that ASCO was going to hire a CEO. We hired John Durant, made a small headquarters, tiny staff, and did a lot of the work as being chief operating officer myself. It was the year that email was just getting started, and ASCO wasn't using it. So every Saturday from 8:00 to 6:00, I came into the office and my secretary wrote letters inviting people to be on the program committee or various committees. But it was a society in transition. The growth of membership was huge. The meeting sites had to be changed. We emphasized science. Some of the things that we did are still in existence today.  We formed the ASCO ACR Clinical Research Methods course. It's still given. That's one of our real highlights. We forged relationships with other societies, the National Coalition for Survivorship. We made the ASCO guidelines much more prominent. And I remember that we were going to publish the first guidelines on genetic testing for breast cancer, and the MCI went up in absolute arms, so I arranged a meeting. I was at the head of the table. On my right were Francis Collins, Richard Klausner, Bob Wittes, and a few other people. Then the ASCO people who wrote the guideline were on the left, and they didn't want us to publish it. They thought it was premature to have a guideline about genetic testing. And what I learned from that meeting is that you can agree to disagree with even the most prominent people in oncology and still maintain those relationships. But we did what's right, and we published a guideline on the JCO. There were so many wonderful things that happened at ASCO that I can hardly restate all that happened I guess 27 years later. It was exciting. ASCO was still young. There was a lot we had to do, and we could do it. You could just go ahead and do it. It was exciting. It was gratifying. It was one of the most fun years of my life. Dave Johnson: I mean, that transition from an outside company in many respects, controlling the premier activity of ASCO, its annual meeting to ASCO, taking that on, that defined ASCO, and that's what I remember most about your time as president. It was a bold move, and the hiring of John Durant was brilliant. I mean, he was such an incredible individual, and it was great that you guys were able to pull that off. Pat Loehrer: Thank you for what you've done.  You've had a number of your mentees if you will, and colleagues that have gone on to prominent positions, including, I think, at least three directors of NCI Cancer Centers. Can you just talk briefly how you would describe your mentoring style because you've been so successful? Dr. John Glick: First, there are two aspects. One is when people come to you, and then when you go to people, you sense they're in need. The key aspect of mentoring is listening. Not talking, listening. Looking for the hidden meanings behind what they're saying, not telling them what to do, presenting options, perhaps giving them clues on how to weigh those options in pros and cons, being available for follow-up. Mentoring is never a one-time exercise. Not criticizing their decisions. You may disagree with their decision, but it's their decision, especially if they've considered it. Being proud of the mentee, being proud of their accomplishments, following them over the years. And when they've gotten in trouble or failed to get the job that they wanted, always be there for them, not just in the good times, but in the times that are difficult for them professionally. I think that's one of the most important things.  Even today, I mentor three or four clinical department chairmen, and people ranging from full professors to newly appointed assistant professors. Now that I'm retired, mentoring is the one activity that I've really retained. It's extraordinarily satisfying, and I'm proud of the people that I've mentored. But it's their accomplishments, and the key aspect of mentoring is never to take credit. Dave Johnson: I'll give you credit for mentoring me, and I appreciate it. You were very instrumental at a very decisive point in my career when the old Southeast Cancer Group disbanded, and we were looking for a new cooperative group home. And you were instrumental in helping my institution come into the ECOG fold, and not just as a very junior member, but really as a player. And I'll never forget that, and we'll always appreciate that very much. Pat Loehrer: Ditto on my side, too. Dave Johnson: John, you mentioned that you're retired. What do you like to do in your "free time” if you're not mentoring? Dr. John Glick: Life is good. My daughter says I have a disease, O-L-D. My grandson says, “He's not old; he's almost 80. Look how well he's done.” “Here's $20.” I'm having fun. We are fortunate to have homes in different places. We spend the summer up in the Thousand Islands on the St. Lawrence River, spring and fall down in Charleston, then lots of time in Philadelphia. We travel. I play golf poorly. I'm getting a chance to read history again, go back to one of my great loves. I'm with my children and grandchildren more. I lost my first wife. I've been remarried for about twelve years, and I'm enjoying every moment of that. I'm not bored, but I do wake up in the morning with no anxiety, no realization that I have to herd sheep or herd cats. I have no metrics, I have no RVUs,  not behind of the EMR.  Dave Johnson: You're making it sound too good, John.  Dr. John Glick: We're having fun. And I have not been bored. I've not been down in the dumps. Each day brings a different aspect. We see a lot more of our friends. I exercise. I deal with the health problems that people get when they get older, and I have plenty of those. Seeing doctors takes a lot of time, but I'm grateful that I'm having these few years of retirement. I'm one of the people who is most fortunate to have attained everything they wanted to do in their professional life, and now I'm trying to do some of the same in my personal life. Dave Johnson: John, Pat and I both love to read. We love history. You mentioned that you're reading some history. Is there a book that you've read recently that you might recommend to us? Dr. John Glick: “the Last of the Breed” {With the Old Breed} It's about a private in the Pacific campaign who was not a commissioned officer; it's just a grunt on the ground. It brings the horrors of the Pacific island campaigns to life. But there's a huge number of books, some historical fiction. I'm a great fan of Bernard Cornwell, who's written about the Medieval times, Azincourt, 1356. I'll read two or three books a week. I'm devoted to my Kindle. Dave Johnson: If you could go back in time and give your younger self a piece of advice, what would that advice be?   Dr. John Glick: Try and achieve more of a work-life balance. I didn't have any choice. If I didn't do the consult, it didn't get done. That's not the situation today. But I have a second piece of advice, don't treat medicine as a 9 to 5 job. If a patient is sick, stay with the patient. Give the patient your home or cell phone number. Remember, medicine is not just a profession, but it can be a calling. Too few of our physicians today regard medicine as a calling. And even if you're employed, as most of us are by an academic or other institution, do what's right for the patient, not just what's right for your timesheet or the EMR. Remember that the patient is at the center of all we do and that medicine is a calling for some people, as it was for me. Dave Johnson: Great advice, John. Great advice.  Well, I want to thank Dr. Glick for joining Pat and me. This has been a delight. You're one of our role models and heroes.  I want to thank all of our listeners of Oncology, Etc., which is an ASCO educational podcast where we will talk about oncology medicine and other topics. If you have an idea for a topic or a guest you'd like us to interview, please email us at education@asco.org. To stay up to date with the latest episodes and explore other educational content of ASCO, please visit education.asco.org. Thanks again. Pat, before we go, I've got an important question for you. I've been trying to school you recently, and you've failed miserably. So I'm going to ask you, why is it that McDonald's doesn't serve escargot? Pat Loehrer: I can't do it. I don't know. I give up.  Dave Johnson: It's not fast food. Pat Loehrer: I like that. It's good.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experiences, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    

If you thought or think that poker is dead, Josef is here to show you otherwise. He started taking poker seriously during covid and has since then reached the 10KNL online cash-games. You will learn about the power or perspective, tips to study and approach the game more effectively and why players are stuck and how to make that jump up in stakes. We are sure you are going to enjoy this conversation as much as we did!

In this episode, we will chat with Andrew "LuckyChewy" Lichtenberger. Andrew has been in poker for a long time and has reinvented himself many times over. We will talk about how he has changed his views on life, career, money, and health while constantly developing his poker game to keep up with modern-day strategies. We will discuss the hardest moments he had to overcome in his career and what he learned by going through these periods, and relive his high points. Another episode packed with wisdom to learn from, enjoy!

In todays episode we have a chat with high-stakes MTT player Ben Heath. Ben gives us an insight about the mentality one needs to have in order to play super high-rollers. Learn about the road Ben took in order to reach these super high-stakes, and the obstacles he had to overcome to become one of the best MTT players in the world.

Guess what's back, back again, Nicknames is back, tell a friend...And by golly, by gosh...you definitely wanna listen to these!See omnystudio.com/listener for privacy information.

In this episode we speak with high stakes cash game crusher Naoufel "Bonk30" Smires in one of his rare public appearances. He shares with us how he uses poker as a path to personal growth, including using meditation and breath work as performance enhancing tools. You will learn how his holistic approach to poker gives him an edge in some of the biggest online games around and how he was able to play a ridiculous 1 million hands at 500NL Zoom in one year when he transitioned to online poker

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In this episode, we will chat with long-time high-stakes poker player Matt Berkey. Matt will share his 20-year journey in poker, which found him reflecting on if this is something worth pursuing ten years after having gone broke several times. At some point, he was down $5,000,000 playing 300/600/1200 in Ivey's room while simultaneously dealing with a personal loss. In the pod, he will share with us the mindset and technical abilities he had to develop to turn things around. Enjoy!

Yes, that is how Donald G. “Skip” Mondragon describes himself. Skip has served as an internal Medicine physician in the Army rising to the rank of colonel.   Throughout much of his life, Skip has also been a wrestler competitor, and he has been good at the sport.   In 2014 Skip discovered that he was suffering from a deep depression. As he worked through his condition and emerged from it he also wrote his Amazon Bestselling book entitled Wrestling Depression Is Not For Wimps.   I very much enjoyed my interview with Skip Mondragon and I sincerely hope that you will as well and that Skip's conversation and stories will inspire you.   About the Guest: Donald G. “Skip” Mondragon, MD is a transformed tough guy. Since recovering from depression in 2014, he's been on a quest to help ten million men struggling with depression, one man at a time. He's practiced Internal Medicine for over thirty years. Colonel Mondragon is a twenty-six-year Army veteran, spent eighteen months in combat zones, and is a national wrestling champion. Skip's book Wrestling Depression Is Not for Wimps! was published in February 2020 and is the author of Inspired Talks Volume 3, an Amazon International Bestseller. He's spoken on different stages, including at TEDXGrandviewHeights in December 2021. Skip's true claim to fame is his five independent and gainfully employed children, his four amazing grandchildren, and especially his wife Sherry. She's a fellow author and a tough Army wife. Sherry has endured raising teenagers on her own, a variety of moves to new duty stations, and far too many of Skip's idiosyncrasies for forty-one years of marriage.   Skip can be reached at: Email: skipmondragon@transformedtoughguys.com Website: www.transformedtoughguys.com Book: www.amazon.com/author/skipmondragon LinkedIn: www.linkedin.com/in/skip-mondragon-66a-2b436 Facebook: https://www.facebook.com/SkipWNW/ Twitter: https://twitter.com/SkipWnw   About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog.   Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is an Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards.   https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/   accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/       Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below!   Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app.   Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.     Transcription Notes* Michael Hingson  00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i  capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us.   Michael Hingson  01:21 Good morning or afternoon wherever you happen to be and welcome to unstoppable mindset. Today, our guest is Donald  “Skip” Mondragon. I met Donald not too long ago, actually at podapolooza. And we've talked about that before. It's an event where podcasters would be podcasters. And people who want to be interviewed by podcasters all get together. Sometimes one person has all three at once. But I met Skip. And we talked a little bit and I said would you be interested and willing to come on the podcast? And he said yes. So now he's stuck with us? Because here we are. Skip. How are you?   Donald G. “Skip” Mondragon  01:58 I am doing great. Michael, delighted to be here.   Michael Hingson  02:02 Now where are you located?   Donald G. “Skip” Mondragon  02:04 I am in the Dallas Fort Worth area.   Michael Hingson  02:06 So there you go two hours ahead of where we are and any fires nearby? Hopefully not. No, sir.   Donald G. “Skip” Mondragon  02:14 Thank you, Lord,   Michael Hingson  02:15 right now us the same way. And we're, we're blessed by that. But it is getting hot in both places, isn't   Donald G. “Skip” Mondragon  02:22 it? Oh, yes, indeed.   Michael Hingson  02:25 Well, tell me a little bit about you, maybe your early life and so on. And you know, we'll kind of go from there.   Donald G. “Skip” Mondragon  02:31 Yes, sir. And the third of eight children born of Hispanic parents, but meager means but born in Denver, Colorado. My father went to the Korean War, and came back a broken man. The man that went to war was not the man that came home. He suffered, I'm convinced with bipolar disorder, PTSD, and he was an alcoholic. And when my dad drank, he was violent. My sister, my eldest sister, Roma tells us that when my dad would come home, we would run and hide, because we didn't know which dad was coming home. The kind, gentle, fun loving dad for the angry mean, violent dad. So this was my early childhood. I actually don't have memories before the age of seven, other than a couple little fleeting memories. So I don't remember a lot of that I get history really from my sister, my older sister,   Michael Hingson  03:33 I help that because he's just blocked it out or something worse.   Donald G. “Skip” Mondragon  03:37 Yes. It's it's gone. Those I just don't have those memories are not accessible. But that was my early childhood. It was chaotic. It was. It was chaotic. It was traumatic. But I came from very loving family. Eight, you know, seven siblings were all close in age. 10 years separate us. We're still close to this day enjoy being together with one another loud, boisterous. Or they're very affectionate. No. My siblings are in Texas. I have a brother in the Baltimore area, Maryland, one in Raleigh, North Carolina. I'm here in Texas. The others are all in Colorado.   Michael Hingson  04:20 So I guess with a number in Colorado, that's the meeting place.   Donald G. “Skip” Mondragon  04:25 Yes, sir. Between my wife and I, my mother is the only living parent. And so we go back home as we call it to his in Colorado. Yes.   Michael Hingson  04:36 Well, there's nothing wrong with that. Indeed. So you grew up? Did you go to college?   Donald G. “Skip” Mondragon  04:45 Yes, sir. tended start my college career at the University of Notre Dame ROTC scholarship, left there, in my fifth semester confused, not quite sure what I was going to do. There's this tug, am I going to go into ministry or says medicine I was pre med at the time I left school I was out of school for three plus three and a half years trying to decide what I was going to do. And then I transferred into all Roberts University where I finished my undergraduate work for Roshan first in Tulsa, Oklahoma. And their I went to medical school and it's there for you that I met my sweetheart sherry. And this year we celebrated our 41st wedding anniversary,   Michael Hingson  05:30 Pierre just ahead of us by a year and a half, I guess because we will, our 40s will be in November. No congratulation, which is great. Now, we knew the marriage was gonna last I'm, I'm gonna get shot for this, I'm sure but we knew our marriage was gonna last because the wedding was supposed to start at four in the afternoon on Saturday, the 27th of November of 90. Yes, and the church was not filled up like it was supposed to be at four o'clock. And it got to be an I remember it well for 12 Suddenly, the doors opened and this whole crowd of people came in. And so we started although it was 14 or 12 minutes late, or 15 by the time they got in chair. And it wasn't until later that we learned that everyone was out in their cars until the end of the USC Notre Dame game. Being here in California, my wife getting her master's from USC, oh my gosh, we knew the marriage was gonna last when we learned that not what USC want the snot out of Notre Dame that   Donald G. “Skip” Mondragon  06:45 we took some weapons from USC, I'll be it you back. I was at Notre Dame that year that we we beat them and went on to win the national championship and 73. So that that was a turn of events, if you will, after taking some real whippings the years preceding that from USC.   Michael Hingson  07:07 I you know, I gain an appreciation for football and all seriousness. When it was a couple of years later, I was in Los Angeles and I had a meeting. And somebody was listening on the radio and keeping us apprised the fact that at the end of the first half Notre Dame was leading USC 24 to nothing. And then I got in the car and we started going home. And USC started scoring and scoring. It was with Anthony Davis and man who know about that game, and by the time it was over was 55 Switch 24 USC. But it's a great rivalry. And I'm glad it exists.   Donald G. “Skip” Mondragon  07:50 Right. I think the next year is when they came to South Bend. And they hug hug him in effigy. So I remember they had this thing there. And it's   Michael Hingson  08:00 like the USC, USC, don't let him run against us like that again.   Michael Hingson  08:09 What makes it fun? And as long as it's a game like that, and people view it that way. It's great.   Donald G. “Skip” Mondragon  08:16 There you go. It's a game. That's all it needs to be. Don't   Michael Hingson  08:19 take it too seriously by any means. No, sir. But it's a lot of fun. So, after Oral Roberts and so on you you went off and had some adventures?   Donald G. “Skip” Mondragon  08:32 Yes, sir. What kind of happen next? Well, I went to do further training, internship and residency and Canton, Ohio. And there was a turn of events I had expected I was going to do a military internship and go on and complete my residency with the military. But I received this Dear John letter, approximately six weeks before the interview season was going to close the army telling me I did not receive an army internship and I had to pursue a civilian internship, I think and are you kidding me? I was supposed to be in the Army next year, I hadn't even looked at civilian internships. And so I was scrambling. This was a day maybe days before the internet. You had to go to the library, look up programs, phone numbers, call them find out what they needed. So you could apply to that program what documents they needed send to each program individually, the documents the letters, arrange a flight. Now they have a centralized application system. So you complete one application, your letters of reference are all uploaded there. Then you decide which programs you want the sent to wait. So I'm doing this video post taste. Making this application season is ending Christmas is going to be approaching and then there's nothing going to get done. So I gotta get this done. And it was it was hectic ended up in Canton, Ohio. And it was fabulous. I had the best of both worlds great academics, fabulous clinical teaching. And it just so happened. The new program director was retired brigadier general Andre J. Augmentee. And he scared the snot out of us.   Michael Hingson  10:22 What year was this? What year did this take place?   Donald G. “Skip” Mondragon  10:26 I arrived there in 1985. Got it.   Michael Hingson  10:29 So he scared the snot out of you. Oh   Donald G. “Skip” Mondragon  10:31 my gosh, we call them Dr. Rowe, the big O or the Oh. And when he was when he was coming, we were like, Oh, no deals coming Fall, we'd be at Morning Report, we'd be talking about new cases that were admitted the night before. And he'd asked me to present the case or ask questions. And I would feel like I I felt like the voices on Charlie Brown. Go home and I tell my wife, oh, I can't seem to answer one interview. Question intelligently. When he is around, he must think I'm the stupidest intern he has ever seen. I I just get so flustered when he was around. I went down in a few months them because I was planning on doing physical medicine rehabilitation. But I had really fallen in love with internal medicine. Because my first few months were on the general internal medicine wards, and then a month in the internal or the intensive care unit. And I really fell in love with internal medicine, went to them and talk and said Dr. Rowe, I I'd like to talk to you. I am interested in drone medicine. But I don't know that I could be a good internist, I remember him looking at me and say, Skip, you could be a good interest. In fact, you could be a very good internist. And we'd love to keep you in the program. I could write letters that are permanent, so you can stay on the program and train here. That was a turning point for me. You away. He actually became very good friends. My last year, he actually asked me to be the chief president. I didn't accept because we were expecting our third child at that time preparing to move to join the army and I just couldn't put that pressure on my wife at that time. But we're still good friends to this day. Yes, wife. So it went from being that Bumbly Ugg boots, intern to a competent senior resident to friendship as the years went on.   Michael Hingson  12:49 So he figured you out and obviously saw something you and you kind of figured him out a little bit it sounds like oh, yes,   Donald G. “Skip” Mondragon  12:57 sir. Yes, sir.   Michael Hingson  12:59 Where is he today?   Donald G. “Skip” Mondragon  13:01 He is here in Texas. He is outside of San Antonio. He and his wife Margaret. A little   Michael Hingson  13:06 bit closer than Canton, Ohio.   Donald G. “Skip” Mondragon  13:09 Oh yes sir.   Michael Hingson  13:11 Well, that's great that you guys are still friends and you can see each other that is that is the way it ought to be. In the end, it's it's always great when you can establish a relationship with the teacher. You know, I wrote thunder dog the story of a blind man his guide dog in the triumph of trust at ground zero when I talked in there about Dick herbal Shimer, my geometry teacher. And to this day, we are still friends and chat on the phone on a regular basis.   Donald G. “Skip” Mondragon  13:41 That reminds me of my junior high wrestling coach John Gregerson. We were great friends to this day. And we hadn't seen one another for almost 1015 plus years. I'd seen him at the I think it was the 1992 1994 NCAA Wrestling Championships division one in North Carolina, and hadn't seen him to till 2000. Approximately 2015, something like that, when seen one another, but got in touch with him because he had moved back when he retired from teaching there in Colorado. He moved to Wyoming, then moved back to Colorado, gotten in touch with him said to get in touch with you, John, we met when another talks just just like we hadn't been apart. And I remember upon leaving, talking Adam say, John, I love you. And he looked at me and says, I love you too. And a great man, great relationship. And there's so much affection in my heart and appreciation for that man. The things he taught me.   Michael Hingson  14:56 So wrestling is a part of your life, I   Donald G. “Skip” Mondragon  14:58 guess. Oh my goodness. It's in my blood.   Michael Hingson  15:03 Well tell me about that a little bit.   Donald G. “Skip” Mondragon  15:05 Please. Oh, yes, I, I was miserable at sports any sport. Growing up, I didn't know how to throw I didn't know how to catch. I don't know how to kick. I didn't know how to run. I failed that tetherball. Okay. So I didn't know the skills, I wasn't taught the skills. So wrestling was the first sport that went out for an eighth grade that I thought after if you practice, I think I can be good at this. And IBM think i think i could be really good at this. That was the first time that I wasn't having to compete against boys that were a lot bigger than I was. Because I was typically the smallest kid in my class. And so I was wrestling in the 85 pound weight class in eighth grade, good lowest weight class. I was having good success. Only eighth grader on the varsity team. I didn't win a match that year. But I learned lots I gained a lot of confidence. The next year come in and the rest of the room. I'm the best wrestler in that wrestling. But I get so worked up before a match. I couldn't sleep a wink all night long. So I'd go into that match utterly exhausted mentally and physically. underperform. However, the summer afterwards, I won my first tournament I entered was a state freestyle wrestling tournament, one of the Olympic styles. When my first match, my second, my third match, win my fourth match. Now I'm wrestling for the championship. And I went after that my coach asked me, you know who this guy was you're wrestling have no idea coach. And he said that guy won this tournament last year. And that further cemented my love for this sport went on. He was a two time district champion in high schools, state runner up and honorable mention All American. So I had a lot of success. Moreso in freestyle wrestling a lot of state tournaments I won many state tournaments placed into Nash national wrestling tournaments as a high schooler and then after. After that, I've wrestled some in college and some in freestyle also. But last time it competed was in 2012 and 2013. In the veterans nationals.   Michael Hingson  17:33 How did that go?   Donald G. “Skip” Mondragon  17:35 Oh, how did that go? It went great. I had been wanting to compete again. At ba I still had that bug. Oh, I'd like to do this. The dates the training. I couldn't work that in. But I'm sitting up in the stands watching the state finals of the of the Georgia state finals with my youngest son Joey, he had completed his wrestling career had he not been ill and injured. He would have been wrestling on that stage that night. He was one of the best hunter and 12 pounders in the state of Georgia, but being ill and injured, he wasn't there wrestling that night. So we're watching this I had this wrestling magazine. I think it was USA Wrestling and I'm looking at these dates. Veterans national so it's gonna be held in conjunction with the senior nationals and I'm looking at this. Tucson, Arizona, May 5, and sixth I say Joey, she'll train with me. I'd like to compete. Well, my 18 year old son looks and he goes, Okay, Dad, you're gonna have to do everything I tell you. So Joey became my training partner, my trainer and my manager retrained hard, very hard. So this was mid February. And at first week in May, we're going out to Tucson. Those first six weeks and I was in great shape. I mean, I trained worked out like a fanatic, but those first few weeks, you know, oh my gosh, you know, I'd come home from practice. Oh, my wife and go Have you had enough old man. I think I'm gonna go soak in the tub, honey. I'd sit on the couch with ice on a shoulder or knee or elbow or sometimes all of those week. By week, my body toughen and there was the day I got up. Because I added an early morning workout in addition to my afternoon workouts, bring my weight down help a little bit with the conditioning. And my feet hit the floor. I got out to do my workout. I thought Oh, am I feeling good? I thought Joey, you better bring your A game today because your man is feeling good. So we went out to Tucson won a national championship. And we're sitting there taking this picture with the stop sign of a trophy. Now that I got here, it's big that Joey asked me Dad, was it worth it? All those hot baths, all those ice packs? And I look at him and grin. I say, Yes, it was worth. I had a blast. The next year was a national runner up. So those were the last times I competed, but I've coached I've been around the sport. My sons all wrestled my four sons, my brothers. For my four brothers. They're all younger. They all wrestled my brother in law wrestled my father in law was a college wrestler. Wrestling is in my blood. In fact, my kids call me a wrestling groupie. Because I collect wrestling cards. I get wrestling card sign, I get poster side I mug with all these wrestling greats have friends with World Champions and Olympic champions. That's my blood.   Michael Hingson  20:56 What's the difference between the Olympic style wrestling and I guess other forms like freestyle wrestling, and so on?   Donald G. “Skip” Mondragon  21:02 Okay, so freestyle and Greco Roman are the two Olympic styles. primary difference in those two styles is in Greco Roman, you can't attack the legs. That's the difference in those two. Now, the difference in our style, whether we call school boy or sometimes it's called catches catch can is you also have what we call a a Down and up position that are done differently the way that is in the scoring. To score for instance, a takedown when you take them to the mat, you have to have more control in freestyle is much faster or in in Greco you don't have to show the control, you just have to show the exposure of the back. Plus, you can get a five point move with a high flying exposure, the back or if you take a patient or a an opponent from feet to back in freestyle Aggreko, you can get four points for I said, if it's high flying five points, potentially. Whereas in freestyle, our in our style Americans out, it's two points for a takedown doesn't matter. Take them straight to the back, you could get additional points by exposing the back, if you help hold them there long enough, we'll call a nearfall. And then there's writing time. So if you're on the top position, and you control that man for a minute or longer, you're getting writing time. So there's those factors that that you have. So it's it's and the rules are, are somewhat different. So those are the basic differences in our style and the freedom and the Olympic styles.   Michael Hingson  22:41 But wrestling scoring is pretty much then absolutely objective. It's not subjective. It's not an opinion sort of thing. There are specifics,   Donald G. “Skip” Mondragon  22:51 there are specifics, but then you get into those subjective things. Yeah, it's a caution. It's a stall. It's it's this and you're saying, Are you kidding me? Or they say that's not a takedown you're going What? What do you mean, that's not a takedown? You gotta be blind not to call that thing. So there's still some subjectivity to it. Sure. There is, you know, are they miss? They miss something, the ref misses something in your thing. And you got to be blind dude, you know, that was   Michael Hingson  23:17 a tape. That's an answer. No, no, no. No, here's, here's my question. Is there ever been a time that both wrestlers go after the riff? You know, just check in?   Donald G. “Skip” Mondragon  23:29 I have never seen I have seen some, some, some come off there and give up. You know, escaping something. Yeah, you do to me, your GP and we have to say though, never leave it in the hands of the ref. Never leave it in the hands of the ref. And you you don't want to leave a match in the hands of the ref that don't let it come down to that. Wrestle your match. So there's no question.   Michael Hingson  23:55 Well, so you have wrestled a lot. You went from Canton then I guess you joined the army.   Donald G. “Skip” Mondragon  24:02 Correct? joined the army. Uh huh.   Michael Hingson  24:05 Well, if you would tell me a little bit about about that and what you did and so on.   Donald G. “Skip” Mondragon  24:10 1989 Our first duty station, Lawton, Oklahoma Fort Sill out there on this dreary day, January 3, I believe is gray, dark, you know, overcast, cold, only new to people. My sponsor and his wife. They were the only people we knew when we arrived. I had gone earlier to rent a home for us. And then we were waiting. We our household goods were arriving. Got there. We had three young children. Adam was for Christmas too. And Anjali was four months old. We get there we're moving in. getting settled. I'm in processing to the arm mean, everything's new to us. And then I start practicing as a doctor had two colleagues and internal medicine, within six months of me joining the army or if you will come in on active duty, I shouldn't say joining I had already been on inactive status in the army, going through school and training, but getting their report sale, they turn around and say, well, you're one colleague, like Keith conkel, was named. He's going to do a fellowship, infectious disease. And then my other colleague, Lee selfmade, or senior colleague in internal medicine was chief of the clinic chief of the ICU, he decided very abruptly to get out and do a nephrology fellowship, civilian fellowship, so he was getting out of the army. Now they say, well, you're now the chief of the internal medicine clinic, you're the medical officer, the chief of the intensive care unit. And guess what? You're the only internal medicine physician we're going to have for the summer. Have a good summer. Well, it was worse summer I've ever had in my life. Miserable Oh, it was horrible.   Michael Hingson  26:20 So I was so   Donald G. “Skip” Mondragon  26:21 busy there with with patients and care and responsibilities there and having to tell some patients I'm sorry, we don't have capacity for you're going to have to be seen in the civilian sector. Now, mind you, when my two new colleagues came, we had all these patients screaming back saying please, please, please, may I come back, because they knew the care we rendered was superior to what they were getting the care they were receiving in the civilian sector. But it was it was such a demanding physically and emotionally and timewise. spending enormous amounts of time at the clinic and hospital.   Michael Hingson  27:06 So what does Internal Medicine take in   Donald G. “Skip” Mondragon  27:09 internal medicine, we are specialists for adults, you think of the gamut of non surgical diseases. We take care of adults 18 to end of life. And so our training entails taking care of the common cold, a community acquired pneumonia, that you can treat as an outpatient, to taking care of a patient that's in the ICU, hooked up to life support. That's the scope of what we're trained in. So if you think of the common diseases of adults, high blood pressure, diabetes, heart disease, lung disease, arthritis, gastrointestinal problems, this is the Bailiwick of an internal medicine physician.   Michael Hingson  27:59 Our biggest exposure to that for Well, first of all, my sister in law was a critical care unit and ICU nurse for a lot of her life. And, and then retired. But anyway, in 2014, my wife contracted double pneumonia, and ARDS, ARDS, oh my gosh. And she ended up in the hospital on a ventilator. And what they were trying to constantly do is to force air into her lungs to try to push out some of the pneumonia. They actually had to use and you'll appreciate this, a peeps level of 39 just to get air into her lungs. They were so stiff. Yeah, they were so stiff. And no one at the hospital had ever seen any situation where they had to use so much air pressure to get air into her lungs to start to move things around and get rid of the pneumonia. Everyone came from around the hospital just to see the gauges.   Donald G. “Skip” Mondragon  29:02 And your they probably told you this risks injuring her lungs because the pressures are so high. But without the weather, we're not going to be able to oxygenate her.   Michael Hingson  29:15 Right. And what they said basically was that if she didn't have pneumonia, her lungs would have exploded with that kind of pressure. Exactly. Because what the average individual when you're inhaling is a peeps level of like between two and five. So 39 was incredibly high.   Donald G. “Skip” Mondragon  29:33 Oh, yes, absolutely. But she's glad she recovered.   Michael Hingson  29:37 She did. We're we're glad about that. She was in the hospital for a month and and she was in an induced coma using propofol and when my gosh when she came out of all that I asked her she dreamed about seeing thriller and bad and all that. I was mean. But but no she ordeal, wow. Well, and that's what eventually caused us to move down here to Southern California to be closer to relatives. But I really appreciated what the doctors did for her. And we're, we're very grateful and fully understand a lot of what goes on with internal medicine and she has a good doctor now that we work with, well, who I both work with, and so on. You're very pleased with that. But you say you're in charge of Internal Medicine. And how long did that last at your first station,   Donald G. “Skip” Mondragon  30:39 first duty station, we arrived in 89. We were there till 92 till summer of 92. So arrived in January 89. I graduated off cycle. And Canton, arrived in, left in summer of 92 went to Walter Reed Army Medical Center. But while I was at Fort Sill was first time I deployed to Operation Desert Shield Desert Storm, my first deployment and it was found out just days, like the week before, that my wife was expecting our fourth child or son Jonathan got home in time, for 11 days before his birth. Thank you, Lord. But that was my first deployment. And that was harrowing in that we were the first major medical group in theater, 47 filled hospital. And we knew that Saddam had chemical weapons, and that is Scud missiles could reach where we were at in Bahrain. So it was it was some harrowing times with that, getting our hospital set up. And knowing that we were well within range of Scud missiles, the alarms that go off and we'd be throwing on our protective gear we call our MOPP gear, our masks and our other other protective gear and these outrageous high temperatures. You know, within a couple of minutes, you were just drenched with sweat pouring off of you. In those those heat in that heat until you'd hear their alarms go off again and all clear. Thankfully, we never were bombed with the Scud. But we were well within the range. And we knew we had used chemical weapons, and we knew they certainly were in this arsenal. So we that was my first deployment. And then Walter Reed where I did a fellowship two years there in Washington, DC, and then we are off to Brooke Army Medical Center. And that was San Antonio, one of my favorite cities, that Fort Sam Houston. And we we were there for four years. And on the heels of that, I was deployed to Haiti for seven months, the last months that we live there, so I've gone I'm just redeploying returning home. And we're in the process of moving. Now we're moving to Fort Hood, Texas. There we spent, actually eight years at Fort Bragg. And there I was, again, chief of the Department of Medicine at Fort Hood, had amazing staff, great people that I worked with wonderful patients everywhere I went this wonderful patients to take care of. And then I was deployed during that time to Operation Iraqi Freedom was, Oh, if one Operation Iraqi Freedom one 2003 2004, stationed up in Missoula, treating caring primarily for the 100 and first Airborne Division aerosols. Major General David Petraeus was a division commander at that time, I got to work closely. My last few months, I was the officer in charge of the hospital, 21st combat support hospital and got to work closely interact with John Petraeus and his staff. Amazing man, amazing staff. incredible experience. Then from there after fort Fort Hood, we went back to Fort Sill, which was an interesting experience because then I was the deputy commander of Clinical Services, the Chief Medical Officer of the hospital. So first time I was there, I was a newly minted captain, new to the army, you know, expect you to know much about the army. Now I go to back to Fort Sill, I'm in the command suite on the Chief Medical Officer of the hospital now as a colonel, they expect you to know air everything. So it was it was interesting. Now, one of the first few days I was there, they give me a tour around to various places and the record group and we're talking and the the records lady, one of the ladies talking to us, telling us about different things and that she She says, You remind me of you remind me of Dr. Longer God, Dr. Monder. God, she had been there the first time I had been there, because we'd have to go down and review our charts and sign our charts on a regular basis. It was, it was amazing. But just some great people that I got to work with over the years, and that our last duty station was in Augusta, Georgia, at the Eisenhower Army Medical Center, where I was again, Chief of Department of Medicine, worked with great people helped train some amazing residents and medical students, PA students.   Donald G. “Skip” Mondragon  35:39 Just some great experiences. And while I was at Eisenhower Army Medical Center, I deployed for the last time to Iraq for another year 2010 to 2011.   Michael Hingson  35:50 How did all of the deployments and I guess you're 26 years in the military in general, but especially your deployments? How did all of that affect you in your life in your family,   Donald G. “Skip” Mondragon  36:02 it gives you a much greater appreciation. Well, a few ways. Certainly a much bigger appreciation for your your family and your time with your family, I lost over three and a half years, 37 months out of the life of my family. And you don't get that time back. No, you don't get that back. So all major these major events that go on your life, seeing things with your children happening. There are no do overs with that that's time last. So you get a better appreciation for that, you also get a better appreciation for the freedoms, the opportunities we have in this nation, when you go to some of those countries realize, you see what poverty can be like, you see how certain citizens are treated, you see women who are treated like cattle, in some cases like property, that the lack of rights, you see these people who want to be able to vote, that it's not just a rigged election, but they actually have a say, in their country's democratic process. The appreciation, and one of the things that was so poignant to Michael was the fact that these so many people, every place I've been whether that's on a mission trip to Guatemala, whether that's in Iraq, whether that was in Bahrain and other places that have been there, how many people would come and say My dream is to go to the US and become a US citizen, I heard that over and over and over again. And when I would get back home, I would feel like kissing the ground. Because I realized, by virtue of being born American, the privileges, the opportunities that I have, are so different than so many people around the world. So gave me appreciation for that. But being deployed, you get to see Army Medicine, practiced in the in the field, because Army Medicine is world class medicine, but you get to see it in the field practice again, in a world class way. It's, it's really mind boggling. Some of the things that we do in a field setting in a combat zone, taking care of soldiers, taking care of other service members, the things that we do, literally world class, not just back in brick and mortar facilities. But they're in the field. Unbelievable. And again, working with great colleagues, amazing staff that I had there, the 21st cache and other places that I've worked. So that appreciation and that idea that you're working for a cause so much greater than yourself, that brotherhood that you have. Now, when you've deployed with people and you've been in combat zone with people, let me tell you, you build some strong bonds.   Michael Hingson  39:15 And it's all about really putting into practice what most of us really can only think about is theory because unless we've been subjected to it and need medical help, or have been involved in the situations like you, it's it's not the same. We're not connected to it. And it's so important, it seems to me to help people understand that connection and the values that you're exactly what you're talking about.   Donald G. “Skip” Mondragon  39:46 Yes, yes. You were asking about the impact on my family. Well think about that. My first time employee My wife has three young children. Adam was six Chris was four. Anjali It was too, and she's expecting our fourth. We're deploying to this war zone that's very uncertain knowing he's got Scud missiles, he's got chemical weapon arsenal, that he's used this. And you're going into this very uncertain war zone. Not knowing when you're coming back home, or even if you're coming back home, all of this uncertainty. The night they announced that, okay, the war had started, that that officially had kicked, kicked off there, that hostilities it started, it was announced on TV. And the kids were at a swimming lesson at the pool, I believe. And somebody came running through some young soldier or something,   Michael Hingson  40:59 the war started, the   Donald G. “Skip” Mondragon  41:00 war has started. And the children all started bawling. And so Sherry's trying to gather them up and she's thinking, What are you doing, you know, trying to gather up the the kids and get them home. But she didn't allow them to listen to any reports do anything. Thankfully, we didn't have a TV at that time by choice. We didn't have a TV for many years. But she didn't allow him to listen to any reports, because she didn't want them to hear these things. But you can think about the uncertainty, you think about missing the events, you think about a spouse having to manage everything at home, taking care of the family, taking care of all the other things there that are involved in managing a household. That's what's left with that, that spouse and then them carrying on without you. So adjusting without you. And then as those children are a different ages, again, all of that, your spouse taking care of that. And your family, adjusting without you. Now if people don't realize they see these idyllic, idyllic reunions, oh, it's great look at they're coming home, and they're hugging and kissing and crying and looking at how wonderful that is. Well, yes, it is wonderful. It's magnificent. You can't believe the elation and the relief. But there's a short little honeymoon phase, if you will. But then the real work begins reintegrating into your family, finding that new normal, how do I fit back into this, they've done with it. They've been without me for several months, or even up to a year. My kids have changed. I've changed Sherry's changed, our family has changed. So how now do we find that normal? And I think that's what a lot of people don't understand that there is that work that needs to be done. And there's a lot of work that needs to be done after it. service members returned home from a deployment, that it's not easy. And it takes its toll. And I don't think that people realize the sacrifice when service members been gone. for months and months at a time years at a time, the sacrifice of that service member the sacrifice of their fam, with every promotion, every award that I received, I used to tell people, my wife, and my kids deserve this a lot more than I do.   Michael Hingson  43:50 And another thing that comes to mind in thinking about this back in the time of Desert Storm, and so on and maybe up into Iraqi Freedom, I would think actually is how were you able to communicate with home.   Donald G. “Skip” Mondragon  44:07 Oh, with your family. And in Desert Storm is primarily snail mail. We did have the occasional call that we can make. Now, as the theater matured and they moved us out of living in tents. We got to move into hardened structure in there. I could make a regular phone call when we got to if there we could, I could send e mail and that became snail mail. And e mail were the primary ways that we connected. The last time I was in Iraq 2010 and 2011. Again, it was email but I could also I had a car that I could charge minutes to that I can Make through an international calling system that I can also place telephone calls. But the primary way became again, snail mail and email to communicate with my family. Today, is   Michael Hingson  45:13 there additional kinds of ways of communicating like zoom or Skype? Yeah.   Donald G. “Skip” Mondragon  45:18 Oh, yes. Oh, yes. Now you're right. They can do face to face zoom. FaceTime there they have, they have their cell phone. So if they're not restricted from using their cell phones, and can even get the international plan and call, we weren't able to do those kinds of things. Yeah. There. Now we did have one thing when I was in Haiti, where it could go into a room. And you could do a as via satellite, it was on a monitor that I could speak to, and they were in this special room there that it was big monitor. But it was a very limited time. And that when that time ended, boom, the screen would just freeze. And the first time it ended like that the kids action starts, started crying because I'm in mid sentence saying something, and I freeze on the screen. And the kids didn't understand what was going on. Yeah. And they was so abrupt that Sherry told me later, can start crying when that happened,   Michael Hingson  46:25 cuz they didn't know they didn't know whether suddenly a bomb dropped or what?   Donald G. “Skip” Mondragon  46:29 Right, right. Yes. It's shocking to them.   Michael Hingson  46:33 Well, all of this obviously takes a toll on anyone who's subjected to it or who gets to do it. And I guess the other side of it is it's an honorable and a wonderful thing to be able to go off and serve people and, and help make the world a better place. But it eventually led to a depression for you, right?   Donald G. “Skip” Mondragon  46:55 Yes, yes. I ended up with major depression. And it culminated on April 17 2014, where I was curled up in a fetal position under the desk in my office. They're laying on that musty carpet. I had gone to work as I normally did, like, get to my office that day early, as was my custom. Nobody else on the whole floor. I locked my office turned on the lights, step inside. And everything just came crashing down on me. I was beat up, beaten down and broken. Should behind me lock the door, turned off the lights, close the blinds. And I crawled under that desk. And then for four hours. I'm asking myself skip, what are you doing? Skip? Why are you here? What happened? You're a tough guy. You're a colonel. You've been in combat zones for over 18 months. Your National Wrestling Champion, you're a tough guy. What happened? Then very slowly, looking at that, and scenes and memories colliding, looking at things, promise, difficulties, and I began to put the pieces together. And finally began to understand the symptoms I was having the past nine months, insomnia, impaired cognition is progressively moving these negative thoughts it just pounded the day and night. You're a fake. You don't deserve to be a colonel, you let your family down. You left the army down, who's gonna want a higher loss of confidence in decision, loss of passion and things that I normally have no interest in resting. Joy, no joy in my life. It's like walking through life in black and white. My body old injuries. Overuse injuries, the osteoarthritis body just a make it even worse. My libido my sex drive was in the toilet. Now you talk about kicking the guy when he's down. And I finally began was able to put those pieces together after four hours. Now I was finally able to understand, said scale. You're depressed? Go get help. And I crawled out from under that desk with a flicker of hope. And later that afternoon, I've seen a clinical psychologist to confirm the diagnosis of major depression.   Michael Hingson  49:25 How come it took so long for you to get to that point? Do you think   Donald G. “Skip” Mondragon  49:30 it was my tough guy mentality? This idea that you just keep pushing through that tough guy identity is like a double edged sword. That tough guys just keep pushing through. There was a lot of things colonel, combat that physician wrestler. So I took on this tough guy persona. And we even have a term for it in wrestling. We call it gutting it out. No matter how hard your lungs and what your lungs burn how much your muscles say, no matter how hard this is, you're just going to keep pushing and pushing. So that was my, that was my modus operandi. That's what I how I operated in my life. You just keep pushing hard and hard and pushing through these difficulties. With it, I couldn't see step back far enough to see what was going on. I knew it felt horrible. I couldn't sleep. I felt badly. I didn't want to be around people. I was withdrawn. But I couldn't step back even as a physician, and put these together to say, Oh, I'm depressed. It's just Oh, keep pushing. And the harder I push, the worse I got. So it was that blindness from that tough guy identity. That there probably some denial going on perhaps. But even as I look back retrospectively, that tough guy mentality just didn't help me. Allow me to see that until it got so crucial where I was just totally depleted. Ended up under that desk.   Michael Hingson  51:11 So how would you define being a tough guy today, as opposed to what you what you thought back then?   Donald G. “Skip” Mondragon  51:20 Yes, yes. Well, there are two sides to a tough guy, Michael, I see a tough guy. Certainly one aspect of the tough guy as that provider protector, that decisive individual, that decisive man that can do things that need to be done now, and can make those tough decisions, no matter what. That's one aspect of so yeah, but that other aspect to hit balances is. So we think of that one tough guy, you might say that's your impart your rugged, individualistic guy that you see that module, tough guy, that the screen portrays at least aspects of that. But then you see this other aspect of that tough guy, this is the individual that has, can be in touch with his emotions, can understand and able to dig there into that and say, Oh, I'm feeling sad. You know, what, somebody what you just said, really hurt. That's, I'm disappointed with that. I'm able to shed tears open, I'm able to show that tenderness that love very openly, but to balance it between the two sides appropriately. That's what I see as a true tough guy. It's not just the one or the other. It's that blend of both that we need in our lives to make us a tough guy. And if you have only one or the other, you're you're not a tough guy. You only have the tenderness and the warmth, and the gentleness and the ability to share your emotions. Well guess what? You're going to be a tough time you're going to run over people can take advantage of they're not going to be much of a protector for those you need to protect. But if you only have that other side of you. You're very limited. You're not going to be able to function in the full array of what we're meant to function in as men or women. Nor women. Absolutely. It's not just restricted to one sex. Absolutely. You're right, Michael.   Michael Hingson  53:51 So you wrote a book wrestling? Depression is not for tough guys. Right? Not for wimps. Yeah, not for wimps. I'm sorry. Wrestling. Depression is pretty tough guys. Wrestling depression is not for wimps. Tell us about that and how it affected you and your family writing that?   Donald G. “Skip” Mondragon  54:11 Well, that book, the genesis of that book came about about six weeks into my recovery, but still struggling. And throughout the time that I was sinking down deeper and deeper into the depression and the first several weeks in my recovery. My prayers had been lowered lower, please, please deliver me from this darkness. But six weeks into my recovery. My youngest brother Chris calls me he had been at a Bible study with Franklin Graham, son of Billy Graham. In Franklin talked about the suffering of Christ. And the gist of what was if Christ suffered so brutally upon that cross why as Western Christians do we think we should be immune from suffering. And over the next two days, the birth that kept coming to my mind was from Philippians. To 13 Paul writes, oh, that I know him, and the power of his resurrection and the fellowship of His sufferings. I knew that verse I knew well, I'd prayed that verse hundreds of times in my walk with Christ, but in the midst of my suffering, I wanted deliverance. But over two days, my prayer shifted from Lord, please, please deliver me, the Lord. What would you have me learn? And how might I use it to serve others. And at that point, I knew I was going to have to share my story. I didn't know how, when but I knew I must share my story. So I began to note what lessons I had learned and what lessons I was learning with the intent of sharing those first time I got to do that was at a officer Professional Development Day, there at the hospital at Eisenhower Medical Center, our session, the morning, our session, the afternoon, and the hospital auditorium. And that became the genesis for my book, I want a writing contest in 2015, your have to retire from the army. And with that came a contract to have my book published. And then it was the process of going through the whole process of writing the book, editing the book, selecting the book, cover, all the things go into book, writing, that book was life transformed. It was transformational to me. And so I learned so many things about myself writing this book.   Michael Hingson  56:41 Did you have fun writing it,   Donald G. “Skip” Mondragon  56:43 I had fun at times. Other times, it was a grind, almost chickened out at the point where we had everything finished. It was ready to go to the publishers and I was I was I was on the cliffs, so to speak. i The book midwife as we called her, the lady is working with Carrie to read love the love with the lady with the company, their Confucian publishing is now called used to be transformational books. I called her and I said, Carrie, I don't know. I think I need to scrap this whole book. I think I need to start over. I can write a much better book. And she goes, No skip. This book is ready. We need to get it birth, we need to extend it to the publisher. And I'm thinking oh, no, no, no, I, I just can in Nice, I need to rewrite this whole thing. I can do a bunch better. This after working. You know, we've been working on this thing for two and a half years getting this thing ready. And I prayed about I'm talking about and then later I called her back in a day and a half and say, okay, Sherry talked me off the cliff. We're gonna send this book forward. But with that, learn things about yourself, going through that access some memories that I hadn't thought about, and some things, some promise that occurred that affected me in profound ways that I didn't realize how much of an impact that had on my life, and for how long that have an impact on my life. Case in point. I lost the state wrestling championship as a senior in high school by two seconds of writing time. Meaning my opponent, Matt Martinez, from greedy West High School knew Matt. There. He beat me by controlling me when he's on the top position for two seconds. He had two seconds more writing time controlling me on that map that I escaped from him three seconds earlier, you wouldn't have any writing time. And we had gotten into overtime. And I believe I would have beat Matt in overtime because nobody, nobody could match my conditioning. But it didn't get to them. So I really that that match. That was probably 10s of 1000s. But what it did is it it really devastated my confidence. And that carried on into my first couple years of college, the College wrestling. Just a lot of things about me. And what I didn't realize it took three and a half years. No, actually five, five years 73 It was 78 and spring of 78 when I was finally healing from that, regaining my mojo. And I didn't realize that until I was writing this book, that profound impact that loss had and the RIP holes, the effects that went on for those successive years there, the profundity of that. And there were other things that I came to light. So there'd be times I'd be laughing. There'd be times I'd be crying. There'd be times I'd be like, Whoa, wow. So it was an amazing experience.   Michael Hingson  1:00:23 So what are some tips that you would give to anyone dealing with depression today?   Donald G. “Skip” Mondragon  1:00:29 Yep. Thank you for asking that. Michael, first and foremost, men, or anybody if you're struggling, don't struggle. One more day in silence, please, please, please go get help to remember, you're never, never, never alone. Three, keep your head up. And wrestling, we talk about this, keep your head up, instill this in our young wrestlers. Why because if they're on their feet, and they drop their head, and get taken down to the mat, if they're down on the mat, the opponent's on top of them and drop their head, they can turn over and pin. But that's also figurative, and emotional, keep your head up. Keep your head up. And I needed people speaking into my life, like my wife, my family, my friends, my therapist, others speaking into my life, it's a skip, keep your head up. Psalm three, three says the Lord is our glory, and the lifter of our heads. So I tell people, you're never ever, ever alone. third, or fourth, I would say attend to the basics, sleep, healthy nutrition. And some regular activity. Those basics are the basics for good reason. And I call them the big three. And probably the most important of all of those, if you're having dysregulation of your sleep is get your sleep back under control. The last few that I'm sorry, go ahead. And then the last few that I would say is make sure you've got a battle buddy. Make sure you have somebody that you can turn to somebody that you can confide in somebody that, you know, would just listen and walk this journey with you and a prescription. And there's many other things that I talked about in my book, but a prescription that I have left with 1000s and 1000s of patients. I've written this on prescription pads. And I've shared this with patients and I say this medication has no bad side effects. This medication has no drug to drug interactions, and you cannot overdose on this medication. So I want you to take this medication liberally each and every day. Proverbs 1722 says A merry heart doeth good, like a medicine. broken spirit. Drive up the boats. When I was depressed, I had a broken spirit. So lack is good nets. So I say each and every day, laugh and laugh hard to find something that you can laugh about. It's goodness.   Michael Hingson  1:03:40 Oh, whenever I want to laugh, all I have to say is I wanted to be a doctor but I didn't have any patients. See?   Donald G. “Skip” Mondragon  1:03:55 Oh, that's great.   Donald G. “Skip” Mondragon  1:03:59 Well, I tell people, in retrospect, I say, gee, if I had only been my own doctor, I would have diagnosed myself sooner. See, well wait, I am a doctor.   Michael Hingson  1:04:15 Or you know what the doctor said Is he sewed himself up Suit yourself. Yeah. I got that from an old inner sanctum radio show. But anyway. Last thing, because we've been going a while and just to at least mention it. You have been a TD X speaker.   Donald G. “Skip” Mondragon  1:04:33 Yes, sir. I was a TEDx speaker. Indeed.   Michael Hingson  1:04:36 I got it that went well. Oh,   Donald G. “Skip” Mondragon  1:04:39 it was amazing. Was a TEDx speaker in Vancouver, in December of 2021. My talk is entitled tough guys are an endangered species. And standing up there on the TEDx phase and stage was a common addition of almost nine months of preparation, our mentor, Roger killin tremendous in helping prepare, myself and some colleagues for this, with the help of his sidekick, Dorthea Hendrik, just lovely, lovely people. But to stand on that stage, and deliver my talk, which is about 12 and a half minutes, started off in about six and a half 17 minutes, get cutting down, cutting it down, cutting it down, but stand there and deliver this message directed to tough guys talking about emotions, and the inability that men often have an accessing our emotions because of the way we've been conditioned, the way we've been raised the expectations placed on us. In fact, there's a medical term that was coined, that's masculine, Alexei timea, which means he leaves without words, and how that then sets men up, that I don't, I'm okay, I don't need help. I don't need to share my feelings and we lose contact with our feelings. Men don't seek medical care as often as women in general, much less when they're struggling with mental health issues, that denial, that tough guy, and now they seek it in maladaptive behaviors. I talked about that. But the ultimate behavior becoming suicide,   Michael Hingson  1:06:39 which is why you have given us a new and much better definition of tough guy. Yes, sir. In the end, it is very clear that wrestling depression is not for wimps. So I get it right that time. There you go. Well, I want to thank you for being here with us on unstoppable mindset. Clearly, you have an unstoppable mindset. And I hope people get inspired by it. And inspired by all the things you've had to say if they'd like to reach out to you. How might they do that?   Donald G. “Skip” Mondragon  1:07:14 The easiest way for them to reach out Michael is go to my website. w w w dot transform, tough guys.com W, W W dot transform Tough guys.com. And there, you could send me a message.   Michael Hingson  1:07:35 Send you a message looking at your book. Are you looking at writing any more books?   Donald G. “Skip” Mondragon  1:07:39 Yes, sir. I am looking to write another book. And still in the making. But I think the next book, maybe wrestling movies is not for wimps.   Michael Hingson  1:07:53 There you go. Well, we want to hear about that when it comes out. And so you have to come back and we can talk more about it.   Donald G. “Skip” Mondragon  1:07:59 Yes, sir. Well, thank   Michael Hingson  1:08:01 you again, skip for being with us on unstoppable mindset. I appreciate it. I appreciate you. And it's easy to say you inspire me and and all that. But I seriously mean it. I think you've offered a lot of good knowledge and good sound advice that people should listen to. And I hope that all of you out there, appreciate this as well. And that you will reach out to www dot transform, tough guys.com and reach out to skip. Also, of course, we'd love to hear from you feel free to email me at Michaelhi at accessibe.com or go to www dot Michaelhingson.com/podcast or wherever you're listening to us. Please give us a five star rating. We appreciate it. We want to hear what you think about the podcast. If you've got suggestions of people who should be on and skip Same to you if you know of anyone else that we ought to have on the podcast would appreciate your, your help in finding more people and more insights that we all can appreciate. So again, thank you for you for being on the podcast with us   Donald G. “Skip” Mondragon  1:09:08 there. My pleasure, Mike. Thank you.   Michael Hingson  1:09:10 Pleasure is mine.   Michael Hingson  1:09:16 You have been listening to the Unstoppable Mindset podcast. Thanks for dropping by. I hope that you'll join us again next week, and in future weeks for upcoming episodes. To subscribe to our podcast and to learn about upcoming episodes, please visit www dot Michael hingson.com slash podcast. Michael Hingson is spelled m i c h a e l h i n g s o n. While you're on the site., please use the form there to recommend people who we ought to interview in upcoming editions of the show. And also, we ask you and urge you to invite your friends to join us in the future. If you know of any one or any organization needing a speaker for an event, please email me at speaker at Michael hingson.com. I appreciate it very much. To learn more about the concept of blinded by fear, please visit www dot Michael hingson.com forward slash blinded by fear and while you're there, feel free to pick up a copy of my free eBook entitled blinded by fear. The unstoppable mindset podcast is provided by access cast an initiative of accessiBe and is sponsored by accessiBe. Please visit www.accessibe.com. accessiBe is spelled a c c e s s i b e. There you can learn all about how you can make your website inclusive for all persons with disabilities and how you can help make the internet fully inclusive by 2025. Thanks again for listening. Please come back and visit us again next week.

In todays podcast Viktor “Enlightq aka Zas” Kudinov walks us through his journey towards poker successer success. He grew up in a hard environment and saw being competitive in sports and games as a way towards a better life. He shares how he uses anger as a competitive driver to put in insane amounts of volume both on the tables and in the lab. This drive also has it's dark sides as he overdid it and ended up burning out. He then had to redevelop his strategy and refound his motivation for the game and is currently playing the highest stakes in online cash-games and in live MTTs

In this episode we switch to what some people call the great game of Pot-limit Omaha. We will have a chat with Gruffudd "d.apollo777" Jones who is known as one of the best HU PLO cash-game players on the internet. Gruffudd shares his road to the highest stakes and how he has always looked to poke at players first to see if they are really that good instead of putting them on a pedestal before having even played them. With this approach he has left many battles as the winner while others as the person who learned a lot preparing him better for future opposition.

Freude schöner Götterfunken: Joy (Jennifer Lawrence) ist vom Erfindungsgeist geküsst. Die Frau aus der Lower Middle-Class entwirft einen revolutionären Mopp. Doch der Weg zum Teleshopping-Olymp ist beschwerlich, erst recht mit einer dysfunktionalen Familie am Bein. De Niro spielt einen Rabenvater, also solcher hatte er in SILVER LININGS aufhorchen lassen. Vadder & Sohn erfreuen sich am vertrauten Team - denn wo Lawrence und De Niro sind, dürfen Bradley Cooper und Regisseur David O. Russell natürlich nicht fehlen. Doch hält der Film, was der deutsche Untertitel verspricht?

In this episode we speak with $100KNL superstar Sergey “MunEZ_StaRR” Nikiforov about his journey to playing the nose bleeds. He shares with us how he was able to keep moving up stakes, the challenges he faced trying to break into $2KNL and why a lot of $100KNL regs are scared money.

Today we hear a Combat Story from a long-time Combat Story listener Christian Holloway, a former Marine who was part of the initial invasion into Iraq, fought in both Fallujah I and II, and was one of the first Marines in what we now know as Marine Special Operations Command or MARSOC. [Support us on Patreon and get exclusive content and insights at www.patreon.com/combatstory] Christian was just 18 years old when he crossed the line of departure into Iraq for the initial invasion alongside M1A1 tanks in his Marine Amphibious Assault Vehicle (AAV).He was then clearing buildings on foot in Fallujah alongside his Marine brothers, was among the first to see the effects of IEDs and what later became a very common and lethal enemy TTP, and was then in the elite special operations community training foreign militaries as a force multiplier. Since leaving the military, Christian continued to train service members in Survival, Evasion, Resistance, Escape (SERE) as a contractor and now hosts a financial information program on YouTube.This is a great Combat Story that follows the path from the tactical perspective of the Marine infantryman to the strategic MARSOC operator and I hope you enjoy his humble insights as much as I did. Find Christian Online: -YouTube https://www.youtube.com/channel/UCs1jwxG_W_NAVVX8KlZ-Mig-Instagram @chris.holloway_fi https://www.instagram.com/chris.holloway_fi/ Find Ryan Online: - Ryan's Linktree https://linktr.ee/combatstory- Merch https://www.bonfire.com/store/combatstory/- Instagram @combatstory https://www.instagram.com/combatstory- Facebook @combatstoryofficial https://fb.me/combatstoryofficial- Send us messages at https://m.me/combatstoryofficial- Email ryan@combatstory.com- Learn more about Ryan www.combatstory.com/aboutus- Intro Song: Sport Rock from Audio JungleShow Notes:0:00 - Intro 0:44 - Guest Introduction (Christian Holloway) 1:59 - Interview begins 2:40 - Growing up in Texas 7:31 - Why Marine Corps and recruitment story 10:44 - Training and preparing for deployment only 4 months after after boot camp and school of infantry 17:13 - Preparing for first deployment invading Iraq at only 18 years old 20:48 - MOPP levels and the nuclear, biological and chemical threat 24:53 - Combat Story - Engaged by an artillery unit and the invasion of Iraq33:10 - Combat Story - An armor to armor engagement 55:27 - Combat Story - 48 hour engagement 1:18:01 - almost dying in Baghdad from celebratory fire 1:21:03 -Fallujah 1 fighting the insurgency and the first in incorporation of IED tactics 1:35:52 - Combat Story - a very persistent engagement 1:56:24 - Joining what would later be known as MARSOC and the intense training course 2:24:42 - Transition to contractor 2:27:42 - Refelctions on being in combat at 18 years old2:30:45 - Personal Finance YouTube channel 2:37:19 - What did you carry into combat?2:39:08 - Would you do it again? 2:40:21 - Listener comments and shout outs

In this episode, we talk with high stakes player Jose “JMBigJoe” Jimenez about his 12-year journey to playing the biggest online poker games. Jose is obsessed with growing in all areas of his life, and he shares with us the profound impact of silent retreats, spending time in nature and being structuring his days has had on his poker success.

In today's podcast, we will have a chat with Julian "JVL_Starrrr69" Schultheis. Julian has been playing online poker professionally for over 12 years and plays high stakes cash-games. He has credited a big part of his success to his work ethic which he learned when he was younger being competitive in both video games and football. Being a professional player has made him develop a stoic mentality which next to technical poker wisdom he will share with you in this episode.

In this episode we speak with the 2021 MTT Player of The Year Pedro ‘Pvigar' Garagnani, who has been one of the most consistent online winners in the last few years. In this wide-ranging conversation, we discuss how he is able to deal with extreme downswings, why emotions are a big part of poker and the skills that you need to develop to have poker success in the modern game.

In this episode, we speak with exploitive wizard Uri Peleg, whose out-of-the-box thinking has earned a host of admirers from some of the world's best players. He talks about the pros and cons of playing exploitative poker, why he thinks GTO is an easy way to justify a bad play and why he adopts the mindset that all his opponents are fish even in high-stakes games.

In this episode we speak with the charismatic High Roller Johan “YoH ViraL” Guilbert. He walks us through his journey from losing his bankroll trying to play like Tom Dwan, to later playing against Dwan in some of the world's biggest cash games. Johan shares with us his unique Micro and Marco strategies that poker players at all levels can apply to progress with their poker careers.

Akkuwischer sollen Eimer, Mopp und Besen überflüssig machen und verheißen blitzblanke Böden. Aber wie sauber putzen Akkuwischer wirklich? Die Stiftung Warentest hat sieben Geräte in die Labore geschickt und sie einem Praxistest unterzogen. Die Ergebnisse offenbaren, ob sie Schlieren vermeiden, wie leicht sie durchs Zimmer gleiten und wie lange Akkus und Wassertanks halten. Wir sprachen mit Daniel Kastner von der Stiftung Warentest über die Ergebnisse.

In this video, we speak with NL5K regular Luke “Clanty” Johnson about his meteoric rise to the high stakes. He shares with us how he instills confidence when moving up stakes, the importance of thinking in EV, and how he has built his game around GTO using creative solver approaches.

In this episode, we speak with high stakes crusher Tobias “Dudd1” Duthweiler who shares his unique journey which took him from working with mentally disabled children to beating the highest online poker games. Tobias walks us through what it really takes to make it to the top, how he recovered from going broke and building an unshakable confidence.

Consolidation, innovation, and perspective all need to work together in government IT according to Eric Trexler, VP of Global Governments and Critical Infrastructure Sales at Forcepoint. IT acts as an enabler of business in the challenging landscape of government technology. Listen in to find out what Eric believes the United States IT space should be focusing on in order to stay ahead of the adversaries. Episode Table of Contents[00:25] All About Innovation with Eric Trexler [10:39] An Enabler of the Business [18:27] We Haven't Seen Consolidation [21:37] Choosing Fiefdom Over Consolidation and Innovation [27:49] The Commercial Component of Innovation [32:32] There Are Productivity Gains Out of Innovation Episode Links and Resources All About Innovation with Eric TrexlerCarolyn: Today, our guest is Eric Trexler, Vice President of Global Governments and critical infrastructure at Forcepoint. Eric is an expert in the technology industry with more than 25 years of experience with both the public and private sectors. And Eric and I used to host To The Point Cybersecurity podcast together. So today is actually a real treat for me to see your face again, Eric. So, good morning. Eric: Good morning. And it's bizarre being back on the air with you, Carolyn. Carolyn: So, today, we're going to talk about the perplexing and growing cost of cybercrime and how we can shift the paradigm. But before we jump into that, Eric, you have actually a pretty fascinating background. So, can you just tell us a little bit about your journey? Eric: My journey in IT? Or where would you like me to start? Carolyn: Let's not go all the way back to birth. Let's start at your Airborne Ranger days. How about that? And then how you got to where you are today. So yes, technology. Eric: So, I was an aimless kid at about 17 with no potential to pay for college. No easy path at the time. And I said, I'm joining the army against my mother's wishes to become an Airborne Ranger. The Requirement to Be a Navy SEALCarolyn: At 17? Eric: Yes. She had to sign the paperwork so I could join the delayed entry program. The military throws at you when you have a high ASVAB score, that's the entrance. And I had a high ASVAB score. So, I saw the Navy and they wanted me to be a nuclear engineer. And I just wanted to be a Navy SEAL back in the day before people knew what the Navy SEALs were. But you had to pick a rating, I believe they call it in the Navy. So, I'm sitting in front of the recruiter, and he's like, "Okay, but what do you want to do?" And I'm a dumb kid, I'm 17 years old. "I want to be a Navy SEAL." "Well, you can't do that. You have to have a rating. You have to have this skill at trade." And nothing, absolutely nothing was interesting to me. So, I left. I went to the army recruiter and enlisted. Because they'd let me be an airborne, I was unassigned airborne, technically. How I became an Airborne Ranger? I didn't want to be normal and I was in jump school and talked to a gentleman and I didn't want to wear chemical gear. This was right at the end of the first Gulf War, and everybody was running around in MOPP suits. If you remember that MOPP suits? Hot, heavy, you can't see. MOPP GearMark: You can't breathe. Eric: Same reason I didn't want to be in a tank or a ship or a plane. I wanted to be on my feet and I wanted to be able to move. And I was like, "I don't want to wear MOPP gear." The guy said, "Here's what you do." And that's what I did. So, I literally made the choice because I did not want to wear a helmet and I didn't want to wear MOPP gear. Carolyn: You sound like my six-year-old niece, how she chooses what she wants to do is whatever that doesn't require shoes. Eric: I was probably about as evolved at that point in time. Mark, you know what it's like to be a 17-year-old boy. I mean, you're really pretty low on the intelligent decision-making maturity scale, right? Mark: Maturity scale. Eric: I mean, you're just not there. It was...

In this episode, we speak with the number 1 ranked online tournament player in the world Patrick “Pads1161” Leonard. You will learn how his passion for the game, combined with his intense work ethic has allowed him to stay at the very top of the MTT world for the past 8 years.

In this episode, we speak with Brazilian high stakes cash and BrPC stable co-owner Matheus 'Zinhao' Moraes. He's one of the most successful players in Brazil and today he shares with us where his competitive drive comes from, common mistakes players make when using mass data analysis, and the character traits that have allowed him to be a successful high stakes crusher.

In this episode, we speak with all-round NLH crusher Steffen ‘Go0se.core' Sontheimer who shares with us his journey to the highest stakes in both cash-games and tournaments. We will learn how being competitive from a young age and always looking to play in games where he has an edge has increased the chances of him succeeding in poker. But maybe even more important, he shares with us valuable knowledge on value based decision making so you can succeed in life based on your definition of success. We also talk about his approach to the current games he is playing, his coaching philosophy, and why players get stuck at mid-stakes.

In this episode, we speak with $500 Zoom regular Jarretman who shares with us his long 9-year journey to become a successful poker player. He shares with us key approaches to learning poker that he wishes he knew sooner, the biggest mistakes players make transitioning from online to live poker, and how he plans to break into the $2K NL games in the near future.

In this second episode, Ben 'BenABadBeat' Raven is sharing a lot of good insights. He explains what poker was like for him before and after he discovered psychotherapy. And he reveals his favorite book that helped him the most.

Ein weiߟer Mopp auf dem Kopp ist jetzt nicht gerade ein Zeichen von Würde. Erst recht, wenn das Ding nie gewaschen wird und voller Flöhe ist. Es gab einmal eine Zeit, da waren genau solche Perücken aber total angesagt. Die Frage ist nur: Warum?Mit Fabian und ThandiDirekter Link zur Audiodatei

In this very first Mechanics of Poker episode, we have a special guest from The Netherlands. Joris ''BillLewinsky'' Ruijs talks openly about his recent health issues and burnout. Find out how he dealt with this new situation and with the ''dark side'' of poker.

Dr. Lindsay Morton of the National Cancer Institute at the National Institutes of Health reflects on research findings by Øvlisen et al that leverage large-scale linked registries in Denmark to suggest that improvements in both chemotherapy treatments and assisted reproductive technologies have made it possible for more survivors of Hodgkin lymphoma to become parents.   TRANSCRIPT This JCO podcast provides observations and commentary on the JCO article “Rates and Use of Assisted Reproduction Techniques in Younger Hodgkin Lymphoma Survivors: A Danish Population-Based Study of 793 Patients and 3965 Matched Comparators” by Øvlisen and colleagues. My name is Lindsay Morton, and I am a Senior Investigator and Deputy Chief of the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, at the Intramural Research Program of the National Cancer Institute at the National Institutes of Health. I am trained in epidemiology, and my oncologic specialty is in hematologic malignancies and cancer survivorship research. I have no relevant conflicts to disclose. The adverse effects of treatment among patients with Hodgkin lymphoma have long been at the forefront of oncology research. In the late 1960s, patients with Hodgkin lymphoma were some of the first to receive combination chemotherapy with a four-drug regimen called “MOPP,” consisting of mechlorethamine, vincristine, procarbazine, and prednisone. MOPP resulted in dramatic improvements in patient outcomes following diagnosis with Hodgkin lymphoma. But in subsequent decades, the toxicities of MOPP came to be understood, including both acute toxicities – most notably myelosuppression – as well as longer-term toxicities such as second cancers and sterility, especially in males. Around the same timeframe, long-term toxicities of radiotherapy also were increasingly recognized, which set off a search for effective Hodgkin lymphoma treatment approaches with fewer short- and long-term toxicities. I often think of how research on adverse effects in patients with Hodgkin lymphoma has been at the vanguard in cancer survivorship: this focus has helped to drive development of new therapies and changes in clinical practice. This has occurred in part because Hodgkin lymphoma is frequently diagnosed in early adulthood and patients now have such a good prognosis; this means there is a longer window in which to experience any long-term effects of cancer treatments, and patients face unique issues, such as impacts on fertility, which aren't relevant for older cancer patients. In the paper accompanying this podcast, Øvlisen and colleagues present novel data on parenthood rates and use of assisted reproduction techniques in Danish patients with Hodgkin lymphoma. Importantly, the results of this study are very relevant to current patients because all the patients in the study were treated between 2000 and 2015 using standard treatment approaches that are still frequently used today. About one-third of the study population received radiotherapy plus 2-4 cycles of the combination chemotherapy regimen called “ABVD,” which consists of doxorubicin, bleomycin, vinblastine, and dacarbazine, and is the preferred front-line therapy approach for Hodgkin lymphoma patients in the United States. Another third of the study population received 6-8 cycles of ABVD, while in the remaining third, about half received either “BEACOPP” (a seven-drug regimen, which includes bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, and which is commonly used in Europe) or some other chemotherapy regimen. In this study, the authors compared the rates of parenthood in patients with Hodgkin lymphoma to individuals in the general population who were matched to the patients by age, sex, and parenthood status. Overall, the news was good: both male and female survivors of Hodgkin lymphoma had similar parenthood rates as the matched individuals from the general population. But the details of this bigger picture finding are really worth understanding because of their important impact on patients. In particular, a larger number of patients with Hodgkin lymphoma than the comparison individuals from the general population used assisted reproductive technology in order to become parents. Specifically, nearly 22% of male and 14% of female survivors of Hodgkin lymphoma used assisted reproductive technology compared with only about 6% of those in the general population. When the authors looked at various predictors of parenthood in subgroup analyses, one other finding stood out: male survivors of Hodgkin lymphoma who had received BEACOPP therapy had about half the rate of parenthood compared with other Hodgkin lymphoma survivors and the general population. In contrast, for female survivors, parenthood rates were similar among the different treatment groups, but the numbers of female survivors treated with BEACOPP was small, so we should be cautious about drawing conclusions for females. The results from Øvlisen and colleagues seem to reflect two important changes from previous studies, most of which included patients who were treated with older chemotherapy regimens, like MOPP. First, Hodgkin lymphoma treatments have continued to evolve, and adverse effects on fertility seem to be declining for the newer regimens. Second, of course, there also have been important advances in assisted reproductive technology, so that individuals who have trouble with conception initially can be helped by these technological advances. In addition to hearing this good news for patients with Hodgkin lymphoma, the way the authors collected the information for this study was also exciting because it was large-scale, long-term, and systematic. Most of the data on fertility in patients with Hodgkin lymphoma previously has come from clinical trials. Those data have been invaluable, and in fact, provided some of the first signs several decades ago that patients with Hodgkin lymphoma treated with MOPP could face fertility issues. But we also know that clinical trials often have incomplete information on outcomes that occur more than a few years out, which raises some questions about the validity or generalizability of the study results for those outcomes. In this report, the authors collected information on patients with Hodgkin lymphoma and the matched individuals from the general population from nationwide birth and patient registries. In countries like the United States, this study design would be virtually impossible because our healthcare system is fragmented – patients receive different types of care, like their cancer treatment and fertility treatments, in different places, and there is no easy way to link information on these different types of care for a specific individual. In this Danish study, the authors were able to leverage the centralized nature of the healthcare system in Denmark to capture not only all the information on the Hodgkin lymphoma treatments but also the birth registries and use of assisted reproductive techniques – connecting this information from different sources for all the individuals in the study. Because of the linkages that are possible among all these different sources of data, we are confident that the study provides complete, unbiased information even on longer-term outcomes. While this study demonstrates both the importance of long-term patient follow-up and the power of registries, it also highlights the need to continue efforts to reduce toxicities and improve outcomes in patients with Hodgkin lymphoma, particularly those diagnosed in childhood, adolescence, or young adulthood. Fertility is just one aspect of quality of life that may be impacted by cancer treatment, and the more high-quality data we bring to bear on cancer survivorship, the better we will be at not just treating cancer but also taking care of the whole patient for the many years they have ahead of them. This concludes this JCO Podcast. Thank you for listening.

Dr. Hayes interviews Dr. Norton.   TRANSCRIPT SPEAKER 1: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   [MUSIC PLAYING]   DANIEL F. HAYES: Welcome to JCO's Cancer Stories, the Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content, and offering enriching insights into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org.   [MUSIC PLAYING]   Dr. Norton has stock and other ownership interest in Samus Therapeutics, Codagenix Inc, Martell Diagnostic, and Medaptive Health Inc. He's received honoraria from Context Therapeutics, Prime Oncology, the Sarah Lawrence Lecture, Context Advisory Board, Oncology Pioneer Science Lecture Series, Sermonix Pharmaceuticals, the Cold Spring Harbor advisory board, Codagenix, Agenus, and the Cold Spring Harbor external advisory board.   He has served as a consultant or provided advice to Context Therapeutics, Prime Oncology, the Context Advisory Board, Oncology Pioneer Science Lecture, Martell Diagnostic, Sermonix, Codagenix, Agenus, Medaptive Health, and the Cold Springs Harbor Laboratories. He has received expense reimbursement for travel and accommodations from the Oncology Pioneer Science Lecture Series, the BCRP Programmatic Review Meeting, the Breast Cancer Research Foundation, the American Association of Cancer Research, and Cold Spring Harbor Laboratory.   [MUSIC PLAYING]   Today my guest on the podcast is Dr. Larry Norton. Dr. Norton has been instrumental in so many facets of oncology it's hard to go through, but particularly, in breast cancer, and especially related to applying mathematical models of cancer kinetics that he developed with Richard Simon at the National Cancer Institute, and applying them really, to dose density strategies for chemotherapy and breast cancer, which we'll discuss. Dr. Norton was raised in suburban New York.   He received his undergraduate degree at Rochester University, his medical degree at the Columbia University College of Physicians and Scientists. And then he did his residency at Einstein Associated Hospitals in the Bronx. He then went on to complete a medical oncology fellowship at the National Cancer Institute from 1974 to 1976 and stayed there an extra year. And then he returned to New York and joined the faculty at Mount Sinai in 1977, where he stayed for about a decade.   He then moved to Memorial Sloan Kettering, where I think most of us think he was born and raised and lived his whole life. He's held many positions there. And particularly, he was responsible for really building the breast medical oncology service and starting the Evelyn Lauder Breast Center. He now sits in the Norman S Seraphim-- did I pronounce that correctly, Dr. Norton?   LARRY NORTON: Yes, you did.   DANIEL F. HAYES: Chair in Clinical Oncology, he's authored over 450 peer reviewed papers. He's won too many awards for me to list, as have most of my guests on this program. But in particular, he's won the triple crown, in my opinion. And that's the Karnofsky, the McGuire, and the Bonnadonna awards.   At least those of us in breast cancer would strive to win all three of those. And importantly to this series, he served as president of ASCO from 2001 to 2002, has served many roles at ASCO and has had a major footprint in where ASCO is today. Dr. Norton, welcome to our program.   LARRY NORTON: Great pleasure to be here. Thank you, Dan.   DANIEL F. HAYES: So we'll start with some of the origin stories. I know you weren't bit by a radioactive spider and got spidey powers. But I've known you for a long time.   And I know, really, your first love was music and that you started out to be a professional musician. Can you give us some background? What were your instruments? I know you went to Rochester specifically to be in music. And feel more than free to do some name dropping, because I think some of the people in music are people we'd all recognize.   LARRY NORTON: Well, I don't know whether that would be totally right. I've known a lot of people in music. My first love was music.   I grew up in Long Island, was able to commute in with one bus and one subway to Greenwich Village in the '60s, which was, really, the hotbed of much of what was going on in music to this day. I didn't even realize it was a golden age. I remember all the giants, Bob Dylan, when he was a very young kid in town, in small coffee houses.   But it was also in close proximity where a lot of the jazz scene was happening, and just to take the A Train would be very easy to get up into Harlem, where there's a lot of jazz things going on. Like a lot of kids growing up on Long Island, I had some musical education. I started off with the clarinet, went quickly into saxophone in terms of music. But I played a whole variety of instruments.   Like everybody else, I play guitar. I played percussion. I played bongos behind beat poets and was very excited to be really part of that scene.   I think one of the major turning points for me, actually, was the Vietnam War. Because like a lot of people of my generation, it did not seem to be reasonable war. And even McNamara wrote a book later saying, yep, sorry, it was a mistake. We were looking for things that could interest us and also help us serve our country in ways other than sacrificing our lives in Vietnam.   That's how medicine got into my life. It seemed to be the right compromise. Fortunately, starting off in Rochester which had the Eastman School of Music, which was a great influence on me, and a fantastic school, and has evolved continuously to be an even better school now.   It has a very active jazz program now, which didn't exist at that time. We had to do jazz on the sly, which was very easy to do, because there are a lot of jazz clubs in Rochester at that time. And it was really very easy to play jazz all night and then to play classical music all day. And that was totally, totally a great experience.   We were young. We didn't have to sleep at all. But I hankered to get back into New York. When the opportunity arose to go to medical school, I was fortunately chosen to go to Columbia, where I actually was able to play music and at the same time go to the medical school. But after a while, as all of us in medicine know, it becomes all consuming.   And so the medicine part of it just slipped. When it came to a lot of my friends from the old days up until the present day, very little performing, I've done a couple of benefits. I'll do the one namedrop with Elton John, because he's been so terrific at raising money for breast cancer research through the Breast Cancer Research Foundation. I had the great honor of being able to play with him twice--   DANIEL F. HAYES: How did you meet Elton John? I mean, it's not like you walk down the street and say, oh, hi, I'm Dan Hayes.   LARRY NORTON: Mutual friends, mutual friends in the arts, basically, one of our closest friends, close friend of his, close friend of mine, someone named Ingrid Sischy was a fantastic writer and editor, very involved with Andy Warhol in the beginning, and then continued a career in art criticism and art writing. And she was a friend of everybody and a close friend of Elton's and a close friend of mine. And so I think she made the original introduction. And he's really been terrific.   But the music is put aside, although I do play every day. I still keep that as a very important part of my zen escape from other stresses of life. Although, music itself has its own stresses.   The good thing about jazz is improvisation. So it's an immediate feeling, no such thing as a wrong note. You hit a wrong note, and you play around it. And it becomes a right note. And so music is still a very important part of my life.   DANIEL F. HAYES: That's terrific. Actually, I interviewed Hyman Muss a few weeks ago. And he and some others have introduced me to tying flies for fly fishing.   And it's sort of the same thing. I can take 15 minutes and tie a fly. I'm not sure it looks like anything official-like. But it's not medicine for a while, and that's good.   LARRY NORTON: Yeah, but medicine--   DANIEL F. HAYES: The other thing--   LARRY NORTON: I want to get back to this for a second, because I mean,   DANIEL F. HAYES: Yeah.   LARRY NORTON: It's not a separate thing. I mean, music and-- especially my early music education just taught me a lot that's really helped me in my career in medicine. I think it's very important for people to know. The talent for music is a talent to practice.   Essentially, anybody who can speak can-- has enough control of tones that they can actually do something with music. I'm not sure how much is really inborn ability. I'm not sure there is such a thing as a talent in that regard. But some people can practice for long hours successfully. And some people can't.   And I think that that's something that may be inborn. I don't know. I'll leave that to the developmental psychologists. But that is a very important trait, obviously, in medicine.   You have to spend a long time studying. You have to learn a lot. You have to concentrate a lot. You have to be able to concentrate on individual patients, when you're taking care of them. And that's been very important, but it's also empathy.   Music teaches you to feel what other people are feeling. You're not going to be a good musician unless you know how you're affecting your audience in a profound way. And you can sense when you're losing your audience, and you can change the direction you're going in. And when you hit something right, you can play it.   And that ability to feel what other people are feeling, I think, is really essential to be a good clinician. And music teaches you that. I think arts in general teach you that.   DANIEL F. HAYES: Actually, I hadn't thought about it. Do you think that your music and your mathematic leanings are tied together too?   LARRY NORTON: There is a tendency for mathematicians to be musicians, not true quite vice versa. Although they are-- good musicians really are mathematicians. But they don't know it.   A lot of people think math is the written equation, and it's not. It's a certain approach toward nature. Thinking in spatial ways, for me, thinking of shapes, and the way shapes form, the way shapes move over time and space, then you learn the tools for being able to write it down which is the actual mathematical notation.   DANIEL F. HAYES: Yeah.   LARRY NORTON: And the same thing with music, I mean, music isn't the notes on the page. I mean, that's a very poor reflection of what sounds you're making. It's the sounds. It's the sounds, and they go up and then down. That's spatial, and they go forward in time.   And so they're temporal, and they have meaning. It's not just random sounds. They have meaning. They connect to each other, and they tell a story, as we say in the jazz world. And the notes are a poor reflection of that.   Some of the best musicians I know can't read music. And as a matter of fact, it used to be said that if you want to be good jazz musician, you shouldn't learn to read. Because if you learn to read, you'll cheat. And you should be able to play by ear. And that's what's going to make you a better musician.   So I think math and music are very closely aligned. You have a problem to solve, when you think about it, and in novel ways that are not verbal. And the non-verbal way of thinking in music and in math are very similar, I think.   DANIEL F. HAYES: So let me segue onto how you changed paths. I know that it was-- I've heard you talk about it was a discussion with Dr. Ron Bloom, who I think has remained a good friend of yours, and then in association with Dr. Regelson at Roswell Park. Can you tell us about that?   LARRY NORTON: Well, Ron got me-- I mean, Ron, great, great oncologist, retired now, and his wife Diane also very, very important in the cancer world through her leadership of organizations. They both went to University of Rochester same time I did. I was actually perplexed at the end of one semester.   So both Ron and Diane were at the University of Rochester, the same I was. And I was perplexed at the end of one semester, because I had several opportunities to do things in the summer coming forward. One of which was very music oriented, and it was a very exciting possibility. But I was at that time considering a change in direction very strongly.   Math was one of the things that was drawing me. The question, should I become a professional statistician? That was the course that was turning me on mostly at that time. I thought physics was an incredible art form and was intrigued to that.   But I also had music that was drawing me. And also the question, of what could keep me helping people, and helping my nation, and keep me from necessarily bearing arms in Vietnam was a big concern. And I met Ron on the stairs of the Rush Rhees Library at the University of Rochester, a famous library, that by the way, has a famous ghost associated with it. That's a whole different story.   He said that he had this unbelievably wonderful experience the previous summer by working at Roswell Park Memorial Institute in Buffalo, New York State Cancer Research Institute, particularly under a guy named William Regelson who was just totally inspirational to him. And that was one of his major motivations to spend his career in cancer medicine, which I didn't even know it. I had another connection to Bill Regelson is that my father and his father actually knew each other. Because they were in businesses that touched.   His father ran a Catskills resort. And my father was a professional writer and travel editor at The New York Post. And so that there was that connection. So that when I relayed the story to my parents, they said, oh, we know Regelson.   So well, one thing led to another. And on a cold and rainy night, I took a bus into Buffalo, New York. And I met Bill Regelson in the laboratory at Roswell Park Memorial Institute.   It was late at night, and it was freezing rain, kind of miserable night. And he asked me a lot of very tough questions and was not very pleasant toward me. But the end of the interview, he says, I like the way you think. And I'd like to offer you an opportunity to work with me this summer.   And I jumped at that opportunity. And it was really, truly the turning point in my life in many ways. Because I, eventually, many years later ended up marrying Bill Regelson's daughter. My current wife--   DANIEL F. HAYES: I was not aware of that.   LARRY NORTON: Yeah. Rachel, the love of my life, it was an extraordinary experience, because I got very close to family. And she was in New York at Columbia, at Barnard, the same time that I was in medical school. And so that's how it all came about.   But anyway, Bill was really an inspirational character for many people of my generation who were in contact with him. Because he was just filled with enthusiasm, and energy, and optimism. You remember, the early days of oncology were very special. And by the way, if you want to catch a glimpse of that, it tends to be this book, The Death of Cancer. I'm giving it a big plug, fantastic book that captures the whole history of his life and cancer.   But the early days is very important for people to recognize what it was like in those early days. It was just an enormous challenge just to get people to pay attention. The possibility that drugs could actually be useful in the treatment of cancer, and it was often ridiculed. I can tell you a little story later about my early experiences when I came to New York in that regard.   DANIEL F. HAYES: So did you know you were going to be an oncologist when you went to med school? Or did that--   LARRY NORTON: I'll tell you two of the turning points in that regard that I think are particularly interesting. One is, at the very beginning of that summer, Bill Regelson brought me-- in those days, the labs were right next to the clinic, the inpatient service. And he brought me right from the lab a few steps in to see a patient who was admitted to the hospital with a pelvic tumor.   I don't know what type, didn't register in my mind at that time, but a pelvic tumor that had grown very large. And it actually had eroded out into the skin and was large, and infected, and bleeding, and just awful. And the patient was in terrible pain.   And he said, we're going to treat this patient with a new drug that I think is going to help her. And it's called methotrexate. And he treated with methotrexate, and I saw the I saw the medicine go into her arms.   And over the next few weeks, during that summer, I saw this tumor shrink down. I saw the skin heal over. I saw the pain go away. And it was, I'm seeing this monster eating this woman from the inside out. And I'm seeing just this yellow chemical going in there, and the monster being defeated.   It was like magic. It was something just beyond conception that, actually, you could take something that awful and that terrible, and actually give it medicine, and actually make it go away. And I said, this is a world I can't turn my back on. This is a world I have to be in.   This is just a magical, wonderful world, where you can actually heal things that couldn't be healed by other ways, I mean, totally beyond surgery, totally beyond radiation. And here's medicine going in. So that hooked me.   But at the very end of the summer, and toward the very end of my time there, another thing happened which would be a good segue. But also very important is the real person running medicine A at Roswell Park at that time was this person named Jim Holland. And Jim Holland was not there all summer, because he was riding a horse. And he had his daughter, one of his daughters on the horse.   And the horse was acting very, very jittery. And he was a little afraid of what the horse would do. So he went close to a fence, where he could actually unload the daughter, so she can grab on to the fence. And the horse didn't bolt and crushed his hip against the fence.   And so he was out with a fractured hip or pelvis the entire summer. But he was well enough toward the end of the summer to come in and speak to the summer students. And he came in, and he sat in a chair in the middle of the room. And all the summer students who gathered around him-- if I thought Bill Regelson had energy, to see this tornado of a personality in the room, with his loud booming voice and his probing questions, his clear intelligence and enthusiasm for his field and dedication to it was just inspirational.   And so it was a crescendo of a summer for me. And that was it. The experience of Bill Regelson, the experience of Jim Holland, I knew that I was stuck. And even though other things were attracting my attention, nothing was going to capture my life as much as the medical oncology.   DANIEL F. HAYES: You went on then to work with him for 10 years at Mount Sinai.   LARRY NORTON: Right.   DANIEL F. HAYES: In addition to what you've said, his obnoxious ties also always stood out for the rest of us. But those 10 years must have been unbelievable. Because the guy never quit thinking, at least in my experience with him.   LARRY NORTON: I mean, there's so much to say about Jim Holland. I had the honor to speak his funeral, the sadness to speak at his funeral, but it was the honor to speak at his funeral related some of the stories. But there's so much to talk about him that it's actually worth a whole book, even an opera, with the bigger than life personality he was.   But he captured something that I think was very important. And some of the early pioneers that we were talking about before really captured which is, I mean, these were real pioneers. I'll just give you a little side story. I mean, I came into grand rounds once, when I was working with him late, as I usually am to pretty much everything.   But nevertheless, I came in a few minutes late, and everybody was gathered around. And I remember it was a thoracic specialist, a pulmonologist, who was actually conducting grand rounds. And as I walked in the door, he says, how come you're late, Larry? Were you out there saving lives?   And everybody roared into uproarious laughter. Because medical oncology was the last step before the cemetery. Hopeless situations would all come to us. And then we'd give them drugs and not help people whatsoever.   And of course, I felt this deep humiliation. I was a young doctor at the time, and all these great, senior people, great luminaries were arrayed around. But that was the attitude of a lot of people in medicine at that time is that hopeless situations, send it to them, they'll take care of it. They'll hold hands, whatever.   And to see where we are today, and how many cases we cured, and how many patients we've cured, and how well we managed things, certainly, we don't cure enough. And you and I and our whole community is working hard on that. But we do cure a whole lot of people, and we do help their lives.   And we do keep them functioning for a longer period of time with the medicines. So the people that went into the field at that time and actually established the field of oncology, medical oncology, at that time were really had to have a real pioneering spirit. And so Tom Frei obviously pops to mind in that regard, and many others. I could give a long list--   DANIEL F. HAYES: Well, I should say, I had the great privilege of training with Tom Frei and the pleasure of interviewing Dr. Freireich who, sadly, passed away a few weeks ago. I did not get to interview Dr. Holland. But because of his friendship with Dr. Frei, Dr. Holland adopted me as well, even though I was never working with him directly.   And the three of those guys, I think our listeners need to understand, they were really cowboys. And they did things that we would now just, I think, repel, just have you can't do that sort of thing. But they did it, because they had to. As you said, there was nothing else to do. It took a special personality.   LARRY NORTON: Totally-- I mean, everything you're saying is-- I agree with. But also, that's why we are where we are today is because they took chances, because they had a vision, and they attacked that vision very, very aggressively. And I'll do one more namedrop in music that is one of my and still friend is Quincy Jones.   And Quincy Jones had this wonderful phrase in terms of jazz improvisation that was really very important to me. Sometimes, Larry, you have to jump without a parachute. And how do you get into an improvisation? You just start.   And then it has a life of its own. And the better you get, the more experience you get, the better you start it, and the better you're going to develop it. But you just got to start. Hit the first note, doesn't matter what it is.   And that kind of spirit of jumping in into it was really, very important. And I think that's something I really miss from modern oncology. If we're going to talk about where we are now compared to where we are then, a lot of things have changed that are very positive.   Obviously, the amount of science that we have to draw from now is just astronomically greater than what we had in the early days, when we're talking about very primitive things. The whole Norton-Simon thing was all about attacking cell division, the best way of attacking cell division. We're so far beyond that in so many ways. That's one of the bigger changes.   Our access to information, I mean, I had a question. I have to go to the library and got to cart catalogs, and pull books off the shelf, and open them up, and spend hours and spend days finding out one piece of information that now I can find out in about 15 seconds, if my fingers are slow on the keyboard, 15 seconds. And so that's it.   But one of the major things is that it was all about concepts then. It was all about principles. The principle that antimitotics could actually make tumors shrink and could be beneficial. That's a principle.   Combination chemotherapy is a principle. Dose dense sequential therapy, if you take it into further development of my area as a principle. And the overarching concepts on patient centrality of it also is that the early clinical trials were very small trials. Because each and every patient was a valuable piece of information.   They were almost collections of anecdotes. And obviously, we've evolved way past that in very positive ways. But what you learned from the individual patient was extremely important to that generation of pioneers rather than large numbers. And I think we moved away from that.   DANIEL F. HAYES: Actually, I'm going to interrupt you, because I think almost everybody I've interviewed has stories like you started out with. I saw a patient who I couldn't believe responded to X or Y. And I have the same stories.   And I'm hoping our young folks still believe that's as important as filling out the meaningful use things on their documentation. I told my own son, I want him to be a doctor and not a documenter. You need to document, but you need to be a doctor. Can I segue into--   LARRY NORTON: We ought to spend the whole podcast on that topic someday.   DANIEL F. HAYES: No, yeah, let's do that.   LARRY NORTON: Because the thing is-- well, because I think that the thing is, when you're taking care of a patient, and you're thinking, obviously, we're always thinking what's best for the patient, all of us. But you're also thinking of gathering information in a verbal way about the patient. So you can talk about that patient to your colleagues, or write it as case reports, a series of case reports is a different mindset than when you're thinking about how am I going to fill out my electronic health record?   And I think the mindset differences, and I frequently say to the younger people that I teach or that I'm in contact with, that they grew up in a digital world. And I grew up in an analog world. And the way you think in an analog world is very different than the way you think in a digital world. Maybe it's for the better. I mean, only history will tell, but I just miss that kind of analog thinking. Much of what we have today is because of it.   DANIEL F. HAYES: Let me take you into your role in modeling and especially with the so-called Norton-Simon hypothesis. How did you hook up with Richard Simon? And what did he teach you? Because I find him to be a fascinating person.   LARRY NORTON: Oh, a fascinating person, and obviously, one of the really important people in my professional career. The math was in there. Because along with, I mean, I studied math. I had studied math in college, and I was--   DANIEL F. HAYES: I should-- describe it. Just for a minute, describe what it is for our listeners.   LARRY NORTON: Oh, the Norton-Simon hypothesis and the--   DANIEL F. HAYES: Yes.   LARRY NORTON: All right. Oh, yeah, well--   DANIEL F. HAYES: Briefly, briefly.   LARRY NORTON: It's very simple is that way before my time, Skipper Schabel and colleagues at Southern Research Institute had described the way experimental tumors in their laboratory grew which was exponential. And they made the observation called the Log Kill hypothesis, which is the Log Kill rule which is a given dose of given drug kills a percentage of the cells that are present rather than an absolute number of cells, which is actually counterintuitive. It shouldn't be that way if you think about it in terms of biochemistry, but it is that way.   And we were all taught the Skipper Schabel model and Log Kill hypothesis. We were all taught that. And I was in the clinic taking care of a patient with Hodgkin's disease, nodular sclerosis Hodgkin's disease. And this patient had [INAUDIBLE] involvement with Hodgkin's disease.   Remember, I was working with Vincent Davita, a great influence on my life, Bruce Chabner, Bob Young, many people who-- George Canellos, who you know very well, great luminaries doing lymphoma therapy as a clinical associate at the National Cancer Institute. Hampton's patient is they had to Hodgkin's disease, got MOPP chemotherapy, roared into complete remission. Basically, two cycles of MOPP, was in complete remission. I've been involved in oncology since the early days of MOPP to show you how long I've been involved in oncology.   And I got four more cycles, because we give six cycles no matter what. We're two cycles beyond complete remission in that setting. And it was about a year. And the patient came back with mediastinal lymphadenopathy. The biopsy showed that was exactly the same lymphoma. Put him back on MOPP chemotherapy, and he responded again and went back into remission.   I don't recall whether it was complete remission or partial remission. And I said, this is really fascinating, because the math was already in my head at the time. Because I thought I want to graph it out and show how well it fit the Log Kill hypothesis. And it didn't fit at all.   I mean, it just didn't make any kind of sense. From a mathematical point of view, you couldn't make the equations fit. And about that same time, I became aware that others were describing that tumors were not really growing exponentially-- solid tumors were not growing exponentially as Skipper had shown in his laboratory models, a certain leukemia named leukemia 01210.   But rather, by a very strange curve called a Gompertz curve, which was developed in 1825 by Benjamin Gompertz to fit actuarial data, actually, not anything in terms of biology. And that's an S shaped curve. So it looks exponential at the beginning. And then it bends over and eventually seems to try to reach a plateau size.   And so I went back, and I applied the Skipper Schabel model mathematically to the Gompertz curve. And I realized that, for this individual patient, it would make a whole lot of sense if the tumor, when it was growing quickly, regressed more than when it was growing slowly at a very large size. In other words that the hypothesis is that the rate at which it would shrink is proportional to its rate of growth.   And since, in a Gompertz curve, the rate of growth is always changing, the rate of shrinkage changes as a function of time as a tumor shrinking down. And that was of germ the idea. And then the question is how to test it.   Under contract Arthur Bogden in Massachusetts did some animal modeling for us. And we published my first paper actually that showed tumors were growing in a Gompertzian fashion. And in fact, a subsequent paper showed that they regressed also in the Gompertzian fashion which is what the Norman-Simon hypothesis is.   Almost immediately thereafter, a couple of implications, in terms of cancer therapeutics, and I want to get back to that. Remind me to get back to that later on. Because this is around 1977 or so that all this was really becoming clear.   So it was actually one patient that made me think of it. I mean, frankly, it was one patient's experience that made me think of it. And that's what you were saying before, Dan, is the importance of learning from each individual patient.   DANIEL F. HAYES: And actually, it's gone on to be tested in many, many trials. But probably the most definitive was run by Marc Citron and CLGB under your guidance. And I just want to say a few words, because Marc passed away just a few weeks ago. He was really instrumental in ASCO and very, very generous to the foundation. We'll miss him greatly. But that trial of 97--   LARRY NORTON: 41.   DANIEL F. HAYES: 9741, demonstrated that dose density was superior to giving things in big doses for longer periods of time. Let me ask you about--   LARRY NORTON: I just want to second there what you're saying about Marc. I mean, just an incredible human being, an incredible person, incredible clinical scientist, and he was actually the first community clinician to chair a major national trial from a co-operative group which was just an intentional decision. I believe, you were involved in that decision, actually, Dan, Hyman Muss, certainly.   DANIEL F. HAYES: Marc and I started in a group at the same time. And we grew very close. I miss him. Let me ask you to look into your crystal ball for a minute and that is with precision medicine and targeted therapy. Does the Norton-Simon hypothesis still apply to that? Do you think chemotherapy still--   LARRY NORTON: Oh, yes. Oh, yeah, yeah. Well, first of all, I mean, I'm not-- now we're getting into sophisticated science topics here. But the thing is that I'm not, to this day, I'm not sure I have chemotherapy works.   I don't think that all of chemotherapy effect is just killing dividing cells. First of all, it's mathematically impossible. Does chemotherapy, does cytotoxic therapy affect the relation cell to its microenvironment? Does it affect its relationship to the immune system? These are all things that are under active investigation and active study at the present time.   There's more to what we do every day in terms of giving chemotherapy than just killing dividing cells. Chemotherapy can be very precise. I mean, methotrexate and dihydrofolate reductase, we talked about it before. It's very, very precise therapy, hormone therapy, tamoxifen and the estrogen receptor.   So we've been talking about precision medicine for a long time. It's just that our level of sophistication in terms of likely targets has changed. But still, it works. It's a law that fast things, things that grow faster regress more quickly than things growing more slowly how you return them. And I think that there are important lessons there that we still have to learn about cancer biology.   And that got me into some very exciting areas with [INAUDIBLE] and colleagues and to cell seeding theory with cancer, for example. And that story is evolving. And more data is becoming available there and much more sophisticated mathematics that will apply to those days that I hope I will have time to work on in the next few years to be able to actually establish those principles.   But I still think that we're doing something wrong if you're talking about a crystal ball which is that-- and it relates to what I just said before. We're so self-hypnotized into thinking that cancer is a disease of cell division. The vast bulk of our targeted therapeutics are oriented toward molecules that are related to mitosis.   You hear talk, that'll be a very specific talk about molecular pathways starting with genomics and [INAUDIBLE] signaling. At the end of the slide, it says, invasion, metastasis, and growth. It's a nice little package. And that's the answer. Well, I mean, that's a big cloudy area.   I mean, those are different things. Those are separate things. Those all have their separate biology. But they're all related. It is totally true.   And how are they related? And why are they related is one of the very important topics that we have to wrestle with, because that's what we really have to perturb. And I think that the, again, crystal ball guessing, or at least where I'm putting my energies now is we have all these incredible tools for developing medicinals that can attack molecules.   Are we attacking the right molecules by focusing in cell division? Should we be looking more toward perturbing tumor microenvironment relationships? Should we look at more sophisticated ways of using the immune system as one element in the tumor microenvironment, one of many in the tumor microenvironment, to accomplish the goals that we have to accomplish?   And are we actually looking at the right things in terms of molecular analysis in cancer by looking at pathways that are concerned with cell division primarily and secondarily with other things? Or should we be looking at molecular networks and molecular pathways in a more sophisticated fashion? Just like the early days of oncology, we have to be willing to take intellectual chances. And that's something I'm seeing much less of now than I did if you go back half a century.   DANIEL F. HAYES: We can go on with this one for a long time too. And we probably will the next time we get to sit and have a drink together when the pandemic goes away. I think it relates to dormancy. And I don't think we understand dormancy or how it is broken and how to treat it.   I have two things, and we're running out of time. One of those is you probably, in my opinion, have been the king of understanding the importance of philanthropy in our field, especially in relationship to what I see directly, which was your relationship with Evelyn Lauder and her husband, Leonard, of course, in the Breast Cancer Research Foundation. But I'd just like you to emphasize to the folks coming in the field how important that philanthropy is.   I think some of them believe it's dirty to get involved with that and ask people to give money. And you and other people I think have taught a lot of us that these folks want to help us. And it's important to address that in a dignified way.   LARRY NORTON: We're all in this together. I mean, I think that's the important thing to recognize as a physician or as a scientist. I said in a paper once that just as all of us are either actual or potential healers, all of us are actual or potential patients.   Cancer is a very important problem that needs to be solved. And people have to solve in every way they can, with our intellectual ability, our hard work in the clinic, our hard work in the laboratory. And people who are working hard in other fields who accumulate some element of wealth, or even people that just in normal life contribute small amounts, a lot of people doing small amounts adds up to a lot of money also. I mean, they're all part of the same process.   I mean, the importance of philanthropy is that-- and it goes back to what Evelyn said which I quote all the time. She was very instrumental in the building of our first breast center at Memorial Sloan Kettering and then our second breast center, which is freestanding building at Memorial Sloan Kettering. She and Leonard involved in every way and not just in terms of philanthropy, but actually thinking through the problems and helping solve them and design in every way.   When we built the first building that we had, we actually raised a little bit more money than we needed for the actual physical structure. So the question is, what to do with it? And obviously, a research fund at Memorial was established.   But then in terms of where else to go with it, she invited me over to her place in New York overlooking Central Park. And we sat in the kitchen, and we drank tea. And I said, what I perceive, and with my colleagues, I'm not the only one, obviously, who's perceiving this, is an explosion of science, basic science in understanding cancer, and an incredible collection of clinical investigators that can do clinical trials, and do large clinical trials as well as pilot clinical trials in our institutions. But I didn't see the connections being very tight. Because we were in different worlds, speaking somewhat different languages.   And we had to tighten those connections somehow and do something translating scientific advances in the laboratory into clinical benefit. It also allowed the scientists to understand what the clinical problems were and how to have the approach, and how we're going to do this. And she said, I've worked around creative people all my life in my professional life. And I know, you've got to identify the right people first of all.   So that's a little bit of a talent. But that the main thing is that when you identify them, you've got to give them freedom to use their imagination and the security to know that if they do something good and it doesn't work out, that they're not going to lose their job. Freedom and security is the secret of making progress in the field.   And I said, that's what we need. We need a foundation that can give the right people the freedom to use their imagination and the security to know that as long as they do good work, they're not going to lose their funding in a more traditional grant mechanism. And that's really where it started. So the whole thing is all based on that, is to get the right people and to give them freedom and security. And another part of it I just want to mention is networking to give people--   DANIEL F. HAYES: So let me focus this.   LARRY NORTON: OK.   DANIEL F. HAYES: Breast Cancer Research Foundation, how many people are you supporting? And how much money did you give this year? Just to give--   LARRY NORTON: Oh, about, oh, I mean, it's about 200 or so or more than that. Investigators, it's international at the present time. This year has been a tough year, and the next few years probably, because of COVID, because of the pandemic.   It's been a tough year. But in general, we've probably given away about a billion dollars. But it's not given away. It's actually an investment, investment in the future.   DANIEL F. HAYES: Yes. I agree.   LARRY NORTON: And it's all about bringing people together. New investigators come in, and they're used to gladiatorial combat when it comes to grant acquisition is that they have to fight against the people to beat them out. And what we reward is people working together and sharing ideas. And phenomenal things have occurred in that direction, phenomenal, huge programs in metastasis and molecular biology, Translational Breast Cancer Research Consortium which has been a fantastic thing that we've helped support. So it's really been a joy.   DANIEL F. HAYES: It's been great. Final 1 minute, the other thing you've done as well or better than most is mentoring. And I personally want to thank you for helping me in my career.   But probably, your greatest success is mentoring Cliff Hudis who's now the CEO of ASCO and is responsible for ASCO continuing to be probably the world's greatest oncology professional society. Actually not probably, in my opinion, for sure. So for that, I thank you.   We've run out of time, unfortunately. I think you and I could go on for another hour or so with this stuff which is what's fun about my getting to do this. But I want to thank you for all you've done for the field, for all you've done for so many of us in the field, and most importantly, for the patients who have benefited from what you've done.   It's pretty remarkable. This has been so much fun for me to get to interview so many of the pioneers. But you certainly rank up there at the top. So thank you very much for your time and look forward to talking to you later.   LARRY NORTON: Thank you so much for the kind words and for inviting me to do this with you, Dan. Thank you.   [MUSIC PLAYING]   DANIEL F. HAYES: Until next time, thank you for listening to this JCO's Cancer Stories, the Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, the Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org.   [MUSIC PLAYING]

Antike Schlachten mit Mopp, da Vincis Abendmahl mit Plüschtieren und dazu ganz viel Klopapier: Bei der Social Media Challenge „Tussen Kunst en Quarantaine“ stellen Leute zu Hause berühmte Gemälde nach. Mit allen Hilfsmitteln, die eben so bei der Hand sind. Eine Idee, die im ersten Corona-Lockdown entstanden ist und zu tausenden kreativen Höhenflügen gesorgt hat.

Dr. Hayes interviews Dr. Canellos on his involvement with CHOP, MOPP and CMF as well as his role as Chief of Division of Med Onc at SFCI/DFCI for 25 years. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Welcome to JCO's Cancer Stories, The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. Hello. Today my guest on the podcast is Dr. George Canellos. Dr. Canellos was instrumental in early treatments for breast cancer, lymphomas, -- and chronic leukemias, and he's generally considered one of the so-called Gang of Five with the National Cancer Institute in the 1970s, along with Drs. Vince DeVita, Robert Young, Bruce Chabner, and Philip Schein, who ultimately demonstrated that chemotherapy could be used to cure a fraction of patients with Hodgkin's and non-Hodgkin's lymphomas. Dr. Canellos was raised in Boston, and he attended Boston Latin School. He then received his undergraduate degree at Harvard and his medical degree at Columbia in New York City. But he remained a Red Sox fan, so he returned to Boston for his residency in internal medicine at Massachusetts General Hospital. But he then trained in oncology at the National Cancer Institute where he stayed until 1974 when he once again returned to Boston to join the faculty of the then Sidney Farber Cancer Institute where he served as the Chief of Medical Oncology until 1995. He is currently the William Rosenberg Chair at Medicine at the now Dana Farber Cancer Institute and a Professor of Medicine at Harvard Medical School. Dr. Canellos has authored over 300 peer-reviewed papers and too many reviews and chapters to name. Most importantly, he served as the Second Editor in Chief of the Journal of Clinical Oncology, a role he filled from 1987 until 2001. And during that time, he directed the Journal to become the leading journal in our field. Perhaps even more importantly, he served as ASCO President in 1993 and 1994, and he's been recognized as an ASCO Oncology Luminary, and he's been recognized with the Statesman Award and the Distinguished Service Award for Scientific Achievement from our society. Dr. Canellos, welcome to our program. Good to talk to you. Great to talk to you. You know, I spent a lot of time with you at the Sidney Farber and then Dana Farber Cancer Institute, and I've heard you say, and I've also read, that you originally seriously considered becoming a surgeon because of the work you did with Dr. Oliver Cope, one of the leaders in surgery of our last century and especially related to thyroid and other cancers. So what led you to get away from surgery and become a medical oncologist? Well, I served as a surgical intern at Mass General at that time, which was a lot of exposure to serious illness and surgery. But it dawned on me. Two things dawned on me. One is that if one was interested at all in malignancy that surgery really wasn't the answer, certainly, in any way. And in those days, of course, even radiotherapy was not the answer. And so the other thing I realized, that I had the manual dexterity of a California fur seal. I didn't really feel, being left-handed, I didn't feel that I really had the dexterity required to do some of the complicated surgery that was going on in those days because I held retractors as an intern for some very long operations that really didn't achieve more than taking out a gallbladder. It took three hours. Now, we can do it with a laparoscope in a half an hour, probably. So I switched into medicine at Mass General and stayed in medicine at Mass General. And being inspired to really think about other treatments for malignancy in those days, there were very few really textbooks available that talked about chemo. There was some. I would nip up to the library of the hospital rarely and try to read about them. There were new drugs coming out at that time, but there was very little really known about the action of the drugs and the potential of the drugs that might have existed at that time. Then I went to NCI, as one had to because there was a doctor draft. And two years of residency in medicine, I actually went to the medicine branch of the NCI. And there, under Emil Frei III, another investigator named Freireich, Jay Freireich, who were around at that time and running the program, such as it was, we first were experience-- I was thinking that I would do research there, and I did. But at the same time, the Clinical Associate Program entailed a year of clinical exposure, of clinical care, and I had several colleagues. The first major colleague was Vincent DeVita who really, at that time, decided to approach a treatable more solid malignancy, as acute leukemia of childhood was being approached, with combination chemotherapy. However, there weren't many drugs that were very active at that time. There were some. An alkylating agent, nitrogen mustard, steroids, a vinca alkaloid that had just been relatively new introduced for adult disease. And there was no procarbazine. Of course, it hadn't been invented yet, but methotrexate. And so the first combination regimen that came out of that program was MOMP, M-O-M-P, and that had some activity, but it was only given for a relatively short period of time. Eventually, the tolerance of patients to these drugs was considerable, a considerable issue, because we didn't really have granulocyte support. There were a lot of things that we'd take for granted now that were not available then. So the toxicity of some of these programs, such as the M-O-P-P Program when procarbazine came along, the MOPP program was considerable. But the interesting thing is the patients that we had were generally on the younger side, younger than 45, let's say, and they could tolerate the therapy. And I found that, honestly and subsequently, with testes cancer, that younger people who get a lot of toxicity from these drugs, despite that, if they think there may be a cure around the corner, will tolerate it. And you don't hear a great deal of complaints about it, about the toxicity, interestingly. But the older patients, of course, are far more vulnerable. Their bone marrow reserve not being great, these regimens were quite toxic. But, fortunately, the first targeted disease was Hodgkin's disease, and it's generally a disease confined to younger people, in general. About 20% of them are in the older group. But we first tested the aggressive chemotherapy, known as MOPP, in the younger patients, actually. But what was surprising to us, and surprising to everybody, was the fact that they failed to relapse as they were all expected to do at that time. In the single drug agent era, of course, Hodgkin's disease would relapse eventually. As house officers, we just expected that to happen. Now, the training in the major academic hospitals in those days, oncology was not an important part, or even a desired part, of the program, if you will. And so most who arrived at a place like NIH really didn't have much background at all in the treatment of cancer because they probably didn't see it all that much. I know I didn't. As a surgeon, yes, but not as internal medicine. I was going to ask you that. When you were at Mass General and you said you noticed that surgery wasn't curing people, there couldn't have been anybody around that was mentoring you or said, why don't you-- how did you even hear about-- No, no, there wasn't. There were some docs there who really cut their teeth on giving hormones to breast cancer patients, and that was about it. But very few people were giving-- I couldn't think of anybody who was giving-- one person who was giving chemotherapy, a lady, a fine lady, fine physician actually, but on the private side, but nobody on the academic side that amounted-- So what made you-- What made you say, I'm going to go to the NCI and learn how to do this? I mean, that seems like that was completely out of the blue. Well, you weren't given much choice. Of the two institutes, I applied at the Heart Institute and the Cancer Institute. The Cancer Institute accepted me, and the same with Vince DeVita. He applied to the Heart Institute but got into the Cancer Institute. And we were both there, probably you could say, as our second choice at the time. Because-- Yeah, that's interesting. Yeah. Very little was known about oncology as a field, and there we were. On the other hand, seeing these patients at least respond to these drugs in the way they did, and seemingly not relapsing, made you wonder whether or not, in time-- when I went back to the NIH, I came back to the MGH to be a senior medical resident. I can tell you what was interesting, because there was no oncology Fellow, per se. They would ask me to see a patient if the patient had a malignancy. And I remember going in and seeing a patient with ovarian cancer. She had a huge belly full of ascites, malignant ascites, and I said that the drug for this disease is thiotepa, an alkylating agent. I wrote out the recipe, if you will, how many milligrams, et cetera. And I wrote in the note, and I will give the first dose, which I did. The intern covering the service, a surgical intern covering the GYN service, obviously read part of my note but not all of it, or decided he was going to give another dose as well, but somehow the woman was double-dosed. And there was a certain panic by the nursing staff, et cetera. She tolerated the drug surprisingly well. But more surprising, everything went away. She had this dramatic response to therapy. The ascites went away. The abdominal masses went away. And she was discharged. And I said to myself, at that time, this is a precedent for something, and that era will arrive once-- if it's not the right drug, we'll find the right drug for the disease. But I can tell you, it was very uplifting to me. I had already been to NIH. That's a great story. When you guys were at the NCI, a similar question is, when did the light bulb come on that it looked like you were actually curing Hodgkin's disease? Well, you're talking about a two-year appointment. At the end of the two years there, the remissions were already clear. That is to say, the disease had not come back, and the people were being followed. But two years is just two years. I mean, it's not a long time. And when I went back on the faculty-- see, I went for a year in England to become a hematologist because everybody had to be a hematologist in those days if you were interested in cancer. Anyway, that's what I did. And when I got back, they recruited me to the faculty, and the patients were still in remission, and that was great. And then we put our attention to the non-Hodgkin's lymphomas and modified the MOP regimen by putting cyclophosphamide instead of nitrogen mustard, which was a horrific drug by the way, nitrogen mustard in the doses that we gave. But like it or not, we put Cytoxan into it and we called it CMOP. It was like MOP but it was with C instead of the M. So we called it CMOP. And early in the 1970s, we did a randomized trial with the radiotherapists who were throwing radiation at everything that walked in with a non-Hodgkin's lymphomas, and we did a prospective randomized trial stage by stage, histology by histology. And I remember looking at the data for the large cell lymphomas with the CMOP and I said, Vince, you know, if we judged everything by median, the median survival of our patients was what you'd expect historically. But just below the median, the line straightened up, flattened out, and was going out now several years, at least four or five years, flat in a disease that usually recurred very quickly and killed everybody who was affected by it. And I remember when the Board of Internal Medicine decided to create a specialty called Medical Oncology and have an exam, et cetera, Vince thought it was because of Hodgkin's. And I'm sure it contributed, but I said it must be also the non-Hodgkin's because it's far more common. It's far more common. We helped far more people. And indeed, it probably is. Can I interrupt you for a moment? I interviewed Saul Rosenberg for this series, and he told me just [INAUDIBLE] the radiation psychologist. So Dr. Kaplan had referred to him from Memorial to come to Stanford and do radiation, and Dr. Rosenberg told Dr. Kaplan, I think we need to give these people chemotherapy, and Kaplan agree. But the Chair of Medicine did not and would not let Rosenberg see patients in his own clinic and give chemotherapy. So he wrangled a room from a hematologist, and he told me he would see patients in the room. He had a chair in the hallway. If the patient needed chemotherapy, he'd have the patient go sit in the chair in the hallway. Get an IV pole. He'd start the IV himself and then mix up the chemotherapy himself, hang it up. While the patient was getting chemotherapy in the hallway, he'd see the next patient in the room. Those are the kinds of obstacles he had to do. And the other thing I have to say, I didn't get to interview Dr. Holland before he passed away, but relative to your looking at the Kaplan-Meier curves, I'll never forget his yelling at me one time that, if you need a statistician to see what you've done, you probably haven't done much. I said that, 'cause I remember saying that as well, but anyway. Let me ask you another question. Yeah. You're know for lymphoma and chronic leukemias but also for breast cancer, and generally you're credited for coming up with the so-called CMF regimen. Vince and I were called into the director's office. At that time, the director of NCI was [INAUDIBLE]. And they said, all this lymphoma stuff is wonderful, but we want you to do solids. Now, we didn't have a referral pattern for solids at all. The only breast patients we saw were relatives of employees of the NCI. So Vince wanted to do ovarian, and I said ovarian is a good disease because they have malignant cells floating around, and we can do stuff on those. And Vince really wanted to do ovarian. I chose breast. And, again, we had no mastectomy surgical group or anything. And so what we did was make deals with medical oncologists in the community, two of them who actually trained-- one of them trained at the Brigham Hospital, actually, and they lived in the area. And they liked to come to our conferences and things. They would refer patients. And what we specified, initially, was that we have patients without isolated bone lesions only, that they had to have measurable lumpy, bumpy disease. And so to design a therapeutic treatment for them, we had to use the principles that we learned from the lymphoma experience. And that's where CMF came. CMFP, we used to have prednisone in some circumstance. And so that was the regimen that-- if you notice, the design of it would be like the MOP program. Anyway, so we started treating people like that. Suddenly, they did respond and some responded quite well. They had some toxicity, of course. And the very first paper we wrote was on the toxicity of CMFP. It was hard to get things published in medical oncology areas, and the Lancet was wonderful for us. The Lancet was very helpful, and we published a lot of stuff in the Lancet. But the first one was in the British Medical Journal, the toxicity of CMF program in patients, and we especially cautioned patients who had compromised liver function because they seemed to get worse toxicity at that time in our imagination. But it worked. It did work. We published it in the Annals of Internal Medicine eventually. But the important thing was, our friend Johnny Bonadonna would come over periodically to find out what we were doing. And he came over with an offer. He said he had all these patients who would get mastectomies and then nothing. Let me interrupt you for a moment 'cause I was going to ask you about Dr. Bonadonna. Yeah. Would you, just for the audience, a lot of them may not know who he is. Oh. Well, Johnny Bona-- Do you want me to describe him? Well, at that time, he was a young investigator working in Milan at the major hospital there in oncology, and he trained at Memorial before and then went but back to Italy. So he came and he wanted to know what we were doing. We showed him the protocol that we were doing for breast, and he was interested. And what he offered was the opportunity of doing a randomized trial on patients with a higher risk, if you will, breast cancer, node-positive patients. And he said that in Italy that nothing was done for them and that he could randomize them nothing to chemotherapy, and we offered him a contract. He required money. We gave him a contract. We gave him our protocol, at least the chemotherapy protocol. He went back to Italy and did that trial. And he left the prednisone out. He made sure it was of just CMF. And the patients, apparently, I guess, knew what they were getting, but I don't know whether they had strict requirements or informed consent and things like that. We didn't ask. We didn't ask. All we wanted was randomized data, and he certainly had it. And I remember being at the ASCO meeting in 1976, I think it was, '75 or '76, in Toronto when the first data was presented by Bonadonna. And the media people were there. People were barely hanging from the rafters to hear. The room wasn't big enough, really. None of the rooms were big enough because they never expected the attendance, that there were that many young oncologists around or people interested in oncology. And so he gave that first data, and that was a shot in the arm for adjuvant therapy, certainly for breast cancer, but for other things as well. I think, in general, he and Dr. Fisher, who sadly passed away before I had a chance to interview him, are responsible for thousands and thousands of people. Yeah. Absolutely. Absolutely. Absolutely. But I'm giving you the NCI side, my personal side of it, and you're right. Bernie was a real pioneer because he had so much opposition from the surgical establishment at the time. I can tell you that. From a surgeon's point of view, they really thought he was the Antichrist. I mean, it was terrible. I saw him and Jerry Urban get into a verbal argument at a meeting. I thought it was going to be a fistfight, actually, over-- Really? Yes, yes. Yes, they're severe. But anyway, let me go-- let me go to my next question, which has tended to change gears for a moment. You may or may not remember this, but when you were ASCO President, in your presidential address, I was in the audience and you said something to the effect that the greatest clinical experiment you have conducted are the Fellows you have trained, or something like that. Yes. Yeah. And I was in tears, of course. But you certainly can claim success on that. The division chiefs, department chairs, cancer center directors, most recently a Nobel Laureate, [INAUDIBLE], all of them came out of the program. But when you returned to Boston, you could not have envisioned all of this. What was the atmosphere, and what was Dr. Farber's vision? Well, Dr. Farber had died by the time I got there. Oh, he was already gone? OK. He was already gone. And when I was leaving, when Tom Frei recruited me, Vince thought I was mad because they made me Clinical Director. At least have a go at acting job as clinical director of the NCI. But really, down the line, it was a bureaucratic evolution. And I said, I don't really want to be an oncocrat at this age, anyway. What I said was, Vince, I said, the doctor draft is over. The best and the brightest and the youngest and the cheapest are all going to be in these hospitals, and there are a lot of them in Boston because I happen to know Boston, including house staff at the Brigham, house staff at the BI and Mass General. And I said, that's the future, or at least the future challenge. And I think he accepted it, but he didn't like it. I mean, he thought-- well, we were great buddies and we worked well together, and that goes for Bob Young and Bruce Chabner too. They thought I was very-- Where else-- at that time, there must have only been two or three places to train in oncology in the whole country, I would imagine. Yes, yes, yes. And people were just starting to set up cancer centers, sometimes without funding. And then there were all these, not many, but job requests for me to go and look at the job at Wisconsin or you name it, but I didn't want to do that. I really wanted to do medical oncology and not be a bureaucrat in any way. And many of the places, Dan, would say come and be a head of our cancer program, and it was also translated in parentheses, come and write a CORE grant. A lot of places who didn't deserve a CORE grant were asking me for people to come and write a CORE grant. You knew forever they would never get one because they really didn't have the makeup for it, yet. So what were the hurdles in Boston when you got there? Well, the hurdles in Boston were twofold. One is the fact that oncology had a very slow start in Boston, and that goes at the Brigham and at the MGH. The MGH was even disinterested in oncology at that time, actively disinterested. They didn't think it had any academic merit and therefore didn't put any effort into it. I have to say that Gene Braunwald, who was Chief of Medicine at the Brigham at the time, was interested because he had been at NIH at the Heart Institute, he knew Tom Frei, and he wasn't sure about it yet because he couldn't swallow it, I guess. And the fact was that it was growing a bit, and one of his very close associates developed large cell lymphoma and he got chemotherapy, he got to see MOP. And he was long-term remission. And I remember telling Braunwald, he was shocked that it was so successful. And I kept telling him, I said, this is not a rare event. This is happening. But the big challenge, Dan, at Dana Farber was that there was no oncology known, and we had to build the program from the bottom up. We hospitalized our patients at the Brigham before we opened the beds at the Dana Farber, but we needed the volume of patients. And we had all these beds, I think 59 beds, licensed beds, open. And I kept saying, we don't have the patients. But Tom Frei opened the beds. The next thing you know, I was talking to trustees because Tom said, we'll bring George up and we'll grow. The clinical program will grow. So the trustees thought the program would probably grow the next day. It didn't. It took a lot of effort without the [? scare ?] and myself going around giving talks in every little hospital that existed. And one of the big things I had my mind, because the house staff looked after our patients as well, was to show them what we could do. Now, in those days, other than the large cell lymphomas, of which we did not have many because they were in the hands of hematologists, was testes cancer. And the head of urology at the Brigham Hospital used to have these Saturday morning urology rounds inviting all of the practicing urologists around to come and they'd present their problem cases, et cetera. But he asked me to come along and give a talk about this new drug called cisplatin, which was having a big effect in testes cancer in other places. And I did. And I would come and talk about the early results in other places in testes cancer and that we were interested in actually starting a program. Then, they would-- of course, urologists are anything but chemotherapists, and so they would refer the patients in because, A, they couldn't give any chemotherapy. There was nothing oral that would work. What we would do is, if they sent patients in, we would do an early trial and we would publish the series in a, let's say, not spectacular journal and get reprints. We would send them reprints. And in some instances, I put the name of the referring doctor, if he'd sent us more than one patient, on the paper for, let's say, testing some antineoplastic thing. And we would put their names on the papers and send them reprints. And there's nothing a urologist loves more than to see his name on a scientific paper, a medical paper. And we started getting a ton of testes cases eventually and did trials and wrote papers about them. And I remember, when we recruited Phil Kantoff, a Fellow of mine, and I thought he was going to go back to the NIH and do gene therapy. And he walked in one day and he said, I'd like to apply for the GU job, and I said, it's yours. And he wrote quite a few papers based on the accumulated testicular data and the [INAUDIBLE]. Oh yeah. Yeah. And he was wonderful. He's Chief of Medicine now at Memorial. He's Chief of Medicine at Memorial, yes. I want to bring up one more thing that this segues into, though, and I believe now almost every medical oncologist who has trained in the last 10 years thinks that multispecialty tumor boards have always existed. But I believe that another of your trainees, Dr. Craig Henderson, who was my mentor, frankly, and you really started the first multispecialty clinic perhaps in all of oncology in this country. Do you agree with that? We called it the BEC, the Breast Evaluation Center. Yes, and we got cooperation but from surgeons. There were surgeons around, more nihilistic surgeons, if you will, not wanting to do radical surgery and radiotherapists, like Sam Hillman. And they were all around and doing those things. And we brought them into this BEC, the Breast Evaluation Center, and your mentor, Craig, was a little rough on the Fellows, I can tell you, in those days. Just his demands. Anyway, whatever it was. And so I would go to that clinic as well and see breast patients just to calm things down a bit at times. Anyway, it worked. And I know that the breast people elsewhere were recognizing that Craig had a nice thing going there with the multidisciplinary aspects. You know, it was so awful that breast cancer was treated so badly. I mean, they'd have a radical operation. And God knows, if there was some disease, that they would then get radical radiotherapy to their chest. And they were walking around sort of mutilated. And we had a part-time psychiatrist when I first arrived to see these patients because many of them had body image problems. So the idea of not doing radical mastectomy was revolutionary at that time. And I remember being called by the local Blue Cross to serve on a committee to decide whether or not Blue Cross should pay for breast reconstruction on these poor patients, and we voted. There was a committee of medical oncologists from MGH, me, and a plastic surgeon, and we voted 3 to 3 to they should pay, and they didn't. Then they said, thank you for serving on this advisory committee, but we're not paying. We've decided not to pay. Then, I can tell you, a women's agitation group got a hold of the facts. And one of them called me up and she said, I heard you were on this committee that voted not to pay. And I said, absolutely we voted to pay. They told us, thanks very much but we're not going to pay. So within two weeks then the insurance company changed its opinion because they went bananas at the insurance company. Yeah. The strength of advocacy, that's been something. Anyway, we're running out of time. I'd like to thank you for taking your time with us. Not at all, Dan. Not at all. It's a pleasure. And as I have done for every other interview in this series, I want to thank you not just for taking time with us but for all you've done for the field, for those of us who trained with you or are in the field, and most importantly for all the patients who have benefited. You look back over the-- Yeah, I know. I still follow them. My clinic has follow-ups of cured patients. You become the primary care doc for cured patients. Well, you think of the 60 years of your career and other fine folks that you were with at the NCI and then beyond, and the thousands or millions of people who have benefited, it's pretty remarkable. Yeah, well. Thanks again. I appreciate you being on. Not at all. And enjoy the rest of the day. Thank you very much, Dan. Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org.

Heute in einer sehr hygienischen Sonderedition haben wir unsere Freundin mit dem Wischmopp zu Gast! Wir mischen mal wieder seltsame Getränke mit Wodka und unsere "Gästin" berichtet von aufdringlichen Arbeitskollegen, dem Online Dating Business und warum Ghosting das aller Letzte ist. Schnappt euch euren Mopp und auf geht das feucht fröhliche Swipen.

Vom kleinangezeigten Sammlerstück und Pferdeköpfen mit Diesel im Blut, vom TV to go und frustrierten Spinnen sowie vom Mopp der Muff heißt und stilsicherem Beinkleid.

Dr. Hayes interviews Dr. Lippman discuss on being one of the first translational scientists in solid tumors.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Welcome to JCO's Cancer Stories, The Art of Oncology brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the role of cancer care. You can find all of these shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist and a translational researcher at the University of Michigan Rogel Cancer Center. I'm also the past president of ASCO. I'm really privileged to be your host for a series of podcast interviews with the founders of our field. In this series of podcasts, I'm hoping I'll bring appreciation of the courage, the vision, and the scientific background among the leaders who founded our field of cancer clinical care over the last 70 years. I think that by understanding the background of how we got to what we now consider normal in oncology, we can work together towards a better future for our patients and their families during and after cancer treatment. Today, I am privileged to have as my guest on this podcast Dr. Marc Lippman. Dr. Lippman was really instrumental in the early studies of the role of the S receptor in breast cancer. And personally, I consider him with his former colleague Dr. William McGuire the first investigators to perform what we now call, quote, "translational," end of quote, science in solid tumors. Dr. Lippman was raised in Brooklyn. He received his undergraduate degree at Cornell where, by the way, he played on the varsity tennis team. And then he got his medical degree at Yale. He did his residency at Johns Hopkins and returned to Yale for a fellowship in endocrinology. Somewhat surprisingly, to me at least, he served a year from 1970 to '71 as a clinical associate in the leukemia service at the National Cancer Institute while simultaneously working in the laboratory of biochemistry with Brad Thompson, with whom he published extensively. Dr. Lippman has authored nearly 500 peer-reviewed papers. He co-edits Diseases of the Breast, which is considered the Bible of breast cancer with Dr. Jay Harris and Monica Morrow and Kent Osborne. And fundamentally, he has mentored the leaders of breast cancer in the world, in my opinion. Welcome to our program. Hello. I have a number of questions I'd like to ask you. First of all, clearly, you took a really unusual path to being a cancer doctor. To my knowledge, you actually never formally trained in oncology. Can you tell our audience how you went from being an endocrinology Fellow to being an oncologist? I think it's worth it, from my vantage point, to give a little background about me. I came from very, very intellectually rich family. And there was never any question that I was going to do some kind of science. I was certain that that's where I was headed. And when I was in medical school, I think it's important that while everybody was doing research at the school like Yale, a lot of medicine as we now think of it as evidence-based was completely mysterious. In those days, when I was starting medical school, really, I think the only fully scientific field was infectious disease because we had Cox postulates. And we knew what drugs killed what bugs. And we knew what bugs caused what diseases, for the most part. And that was wonderful. But endocrinology, at that time, was completely functional assays. It was completely not scientific. You looked to see if the rabbit ovulated or something like that for a bio assays. And Nobel Prize winning research was done, which developed the radio immuno and the radio receptor assay. And that completely transformed endocrinology over night. And within about one year, virtually every endocrine disease, the pathophysiology of Addison's, thyroid disease, you name it was worked out based on being able to measure minuscule amounts of hormones. And to me, this was fabulous. I was going to be an endocrinologist. I had no doubt about it. This was real science. And I could get into it. When I was in medical school, you had to do a thesis. And for reasons that I'm not even sure of now, I can recall, I got involved with a guy who was a hematologist. But he did work on leukemia. And I enjoyed that work greatly. It was very interesting. And right about then, you may recall, there was a minor episode going on called Vietnam. And many physicians or people who were about to become physicians, myself included, weren't very anxious to go to Vietnam. And one of the main alternative routes was to become an officer in the public health service at the NIH and to do your military service at the NIH. And that seemed like exactly what I wanted to do. It was a very unusual process. People at the NIH picked you for their own personal lab. And because I had been working in this hematology lab, a scientist, an administrator actually at the NCI invited me to join his lab, Saul Perry. And I took him up on that because that seemed like my only alternative. But after I finished my internship and residency and showed up at the NIH, because I was part of Saul Perry's group which was the leukemia service, I had to spend a year on the wards taking care of extremely sick people, most of whom died during that year. But because of my love of endocrinology, I kept studying all kinds of stuff around endocrinology, took the molecular endocrinology courses. And then I met this wonderful mentor, Brad Thompson. And my first project with him actually was an attempt to combine leukemia and endocrinology. And I started measuring glucocorticoid receptors in leukemia. And that's, frankly, some of the best work I ever did. We showed that they existed, that they were receptors, and that they predicted response. I mean, we did in leukemia what people were doing in breast cancer, and I thought that was pretty interesting. And there was always this tension in my mind between the science of endocrinology and the almost complete lack thereof, at that time, in oncology. And I thought that I might try to think about putting them together. But I needed to do formal endocrine training. So after I finished my clinical year at the NIH and my two years in the laboratory with Brad Thompson, I went back to Yale to do endocrinology. And I thought that's where I would complete my career. After I'd been there about a year, Paul Carbone called me up and said, would I like to come back to the NCI and join the breast cancer service? And I have to tell you candidly, I had never treated a case in breast cancer in my life when I went to join the breast cancer program at the NCI. And I completely learned everything I learned about breast cancer absolutely on the fly. So what made Dr. Carbone call you to do breast cancer? Well, I'm not absolutely certain. I had done well at the NCI. I'd been very interested in a lot of things. And I'm not certain I can remember anymore. I don't remember why Paul called me, but he did. And at that time, I had been looking at several endocrine jobs at a variety of institutions, including University of Chicago. And I was thinking I'd just spend my life as an endocrinologist. But I thought this was such a great opportunity to pursue my research that I decided to take my chances. I was extremely full of myself in those days. And I didn't see the problem that I had never treated breast cancer. I know it sounds dumb to say it. But I actually said, well, OK, I'll figure this out. How hard can it be? And I guess I didn't find it all that hard. And at that time, because I had already gotten into what I would refer to as molecular endocrinology, half of which was steroid-hormone action, I was highly familiar with the work of Elwood Jensen, who was the real pioneer at that time, one of two actually. So naturally, it made sense to me to take the work I'd already done in glucocorticoid receptors and try to make models in tissue culture for how breast cancer responded to hormones, the kind of thing you would never suggest that a newly minted faculty member try a completely insane project, which I was extremely fortunate that it succeeded. You refer to Elwood Jensen. Tell us more about Dr. Jensen and what he did that got you where you were. Well, Elwood was a tremendous scientist and basically a chemist. And people don't understand how technology sometimes makes a field possible. And just as I mentioned before, radio immuno and radio receptor assay made the entire field of endocrinology and now so many other subspecialties of medicine possible as you measure pulmonary and GI and cardiac hormones, in the same exact sense, what Elwood succeeded in making was radiolabeled steroids. And you can't do receptor assays unless you have high specific activity compounds. We don't use radio isotopes touch so much anymore, and people don't appreciate that. But there was absolutely no way to measure the binding in picomolar and centimolar ranges without high specific activity steroids. And Elwood was able to manufacture created hexestrol, which is a similar compound to estradiol. And with that, he was able to basically separate bounds from free hormone and prove the existence of receptors. It was extremely important studies that he did at the time. And it opened up the entire field of hormone dependency in breast cancer, which, up until that time, had been based entirely on clinical criteria for response. And furthermore, what occurred almost simultaneously with that was finally the invention of some serious drugs that could interfere with hormone action, most notably tamoxifen but several others that were synthesized at the time. And so rather than just having to oblate organs or use very toxic super pharmacological doses of steroids to treat patients with breast cancer, there was now a readily obtainable and usable oral therapy. And so there was a tremendous need to figure out how and why it worked. And a lot of people got into that field relatively rapidly. Bill McGuire being among them. James [? Whitless ?] being among them, myself for sure. And all of us felt that this was an extremely important aspect. There was the clinical aspect, which became clear in the early '70s that there was, as you would expect, a very, very nice correlation between the presence of receptors and response. And that led up to the entire opening of this field of now that you could measure these receptors of how they worked, where they bound, what they did, what genes they induced. And so that became a lifetime exercise for many. My impression is that before about 1970, endocrine therapy, which dated back the 1890s, was mostly done by the surgeons. Did you have to muscle your way into that field? Or were they openly agreeable that some guy who had never even did oncology would start treating breast cancer patients? Well, I think that what was going on then, in England, there was a much greater delay in medical oncology as a field. And these patients were still treated by surgeons and radiation oncologists. I don't think there was any parallel issue in the United States. There were some very wonderful pioneering surgeons, but they didn't, I think, pretend to fundamentally want to get into molecular endocrinology. I don't recall that as being an area of conflict in terms of doing these kinds of studies. And of course, in this country, we were unbelievably blessed by the extraordinary, absolutely extraordinary pioneering and organizational skills of Bernie Fisher, tremendous scientist, in his own right, a tremendous surgeon, but, even more importantly, the ability to really form the most effective, ragtag, co-operative group the NSABP, which was able, from its very inception, to do some of the most groundbreaking studies not just around hormone therapy, which they certainly did, but obviously as we all know about, differences in surgical care. And so-- You eluded to Dr. Carbone. My impression is the NCI, mostly, in those days, was all about leukemia and lymphoma, the so-called gang of five, MOPP and CHOP and Doctors Frei and [INAUDIBLE]. Who was behind you to move out and start taking care of patients with cancer in a more scientific basis? Was it just Carbone or were there other people at the NCI who [INTERPOSING VOICES] Well, shortly after I got, there Paul left. He went to Wisconsin. And Doug Tormey, who had been nominally head of the breast group, departed. And so I was suddenly given an empty stage and said, well, why don't you do it? So within two years, I was running a program in which, the previous year, I hadn't even treated a patient. It was extraordinary. But right about that-- I was-- that's a very good question and a slightly personal one. About 30. About 30, 31. Yeah. Most 30-year-olds now are just starting their residency or their fellowship. Right. And it is unfortunate that people with the most energy and most intelligence get increasingly pushed downstream. I mean, the age of first RO1s in this country is horrible, as we all know. And that's a major other problem that people need to address. But at that time, as you may recall, several groups were developing the first multi drug combinations for breast cancers. CMF, or as Johnny [INAUDIBLE] used to refer to it as CMF, and of course other variations with the MD Anderson regimens of so-called FAC chemotherapy, F-A-C, and other regimens that included vinca and prednisone. And so for the first time, reasonably active regimens were available for metastatic disease. Where in the past, it had only been a handful of single agents, vinca, methotrexate, 5-FU. And at the same time, I think there were the extraordinary, a little bit later, the extraordinary first data that adjuvant therapy was successful. I mean, the studies done by the NSABP initially was single agents and then the CMF studies from Milan were extraordinary. I mean, breast cancer was and remains the most tractable of the solid tumors with the possible exception of testicular that we've treated in this country or anywhere. Tell us about your lab work and how you established what you did, and then really interested in how you looked at what you were doing in the lab and said, jeez, this relates to my clinical work. Well, thank you. As I said, when I had been working at Yale before I came back to the NCI. And at that point, at Yale, I was trying to develop models of gluconeogenesis in liver cells. It had nothing to do with cancer. And so I arrived at the NCI, recruited by Paul, offered some laboratory space, and said, go to it. And I literally, literally scratched my head and said, well, what am I going to do now? And because I hadn't had a previous thing I was just going to expand on. And because another great miracle that had been growing from very late '50s to the mid '60s was cell culture. I don't think people can now imagine how pioneering the results were to grow cancer cells and to get them to reflect, in any sense, the phenotype of human malignancy. I mean, now we take it for granted. But these were pioneers trying to figure out how to grow cells, Harry Eagle and Hamm and Dulbecco, and all of these other wonderful people. So anyway, it seemed to me, wouldn't it be great, since someone had described a cell line that had estrogen receptor, I said to myself, what would be more straightforward than to figure out how you could manipulate these breast cancer cells with hormone therapies and figure out the mechanisms by using cell culture as a model for steroid hormone action? So I set about doing that. And after about six months, I succeeded. And that was the good news. And ironically, the better news was that nobody else could reproduce it, including Dale McGuire. And lots of people said this was, frankly, garbage, that I was making it up. And so when eventually-- no. It was very upsetting. I don't think many people when they first start off and they have their first big set of papers, and I published this stuff in Nature and serious journals. And all of a sudden, everybody says, it's not true. I remember giving a lecture at Harvard. And somebody at the end at the questions said, we just can't reproduce this data. We don't think you're telling the truth. I mean, how often you want to have that happen in your career? And as I said, what turned out to be very fortuitous was that we were right. And so eventually, that made things even easier for me in terms of my career. There's no question about that. And a lot of people wanted to go to the NIH. I think it's now with so many wonderful-- what are there more than three dozen comprehensive cancer centers? But the United States in those days, there were just a handful. And most of them were doing leukemia and lymphoma, like Stanford, which certainly had almost no breast cancer program at the time. And so people who wanted to work in breast cancer came to work with me. And lots of people wanted to get a BTA degree, Been to America. So I was fortunate to have some very outstanding people from Europe and Asia come to participate in my work. And there was still the tail end of Vietnam. So some of the very best and brightest, if I could misuse that expression, people like Neil Rosen and Ed Gellman and Doug Yee and George Wilding, people who all became cancer center directors were people that I was very fortunate to have work with me. And I was pleasured to deal with them. When did you say you were doing the lab models of cell lines and discovering how ER mediated the effects of estrogen? When did you start saying, let's take this over to the clinic? I mean, what was the first thing you did that you translated into the clinic? Well, the first translational study I did when I was a fellow when I tried to do correlations of response to glucocorticoids in leukemic patients and ALL and AML. So I mean, I was used to going back and forth that kind of way. And we did a series of drug trials in breast cancer patients. I was seeing patients. I haven't spoken much about it. But I don't know how to say that any other way whether it sounds modest or not. I simply love being a physician. I found that the main appeal of oncology was dealing with people at times of enormous obvious stress and disturbance in their lives. And I found that that brought out some of my best skill sets. And so I was anxious. I was always involved with patients like that. One of the main trials that we got involved with involved Allen Lichter because Allen and I were endlessly discussing what was the right therapy for localized breast cancer. You may recall that Sam Hellman, the joint center, refused to be part of clinical trials looking at lumpectomy and radiation, as he was convinced, turns out correctly, that that was equivalent to doing mastectomy. And we felt, Allen and I, I think somewhat maybe arrogantly again, that we could do a single institution trial for lumpectomy versus radiation. And we did. We ran a randomized trial of about 350 women at the NCI, a prospective randomized trial of lumpectomy and radiation versus chemotherapy. And of course, all of these patients became fodder for advanced disease trials and everything else we were doing. And those are some of the happiest days of my life working with Alan side by side in what may have been the first multidisciplinary clinic in breast cancer. If I may, I'm going to interject. Allen Lichter, who started the department of radiation oncology at the University of Michigan, where I'm sitting right now, was my dean when I arrived here, became ASCO president at one point, and then was the ASCO CEO for years. Since this is an ASCO publication, if you will, I'd give him credit for all of that. And well he deserves it. Well he deserves it. Yeah. I can't agree more with that. That's for sure. The other thing I've heard you-- by the way, I've always wondered. How did you get 350 patients onto that trial at the NCI, since you've tended not to see walk in the door kind of breast cancer patients, right? So how did you? Well, the NCI remember, everybody was treated free. So fortunately or unfortunately, given American medical economics, people who had a diagnosis would come to see us because they had no other option. We would pay all their travel and everything else. So we treated patients. And I have to tell you, up until last year when she died, I still had patients from that study who had followed me around the country to be treated. That's a great story. It's true. It's absolutely true. So the other thing I've heard you talk about, and I think people should-- given the proliferation of medical journals now, there's one on every corner, I've heard you talk about the fact that you really have a hard time finding places to present your endocrine results, that the Endocrine Society didn't care about cancer. And AACR didn't care about endocrinology. ASCO didn't really exist almost in those days. Give us some stories about that. Well, that's completely true. It's completely true. There was always a session in the Endocrine Society called cancer and hormones, which was late on Friday afternoon. And everybody had gone home. And AACR had the same thing. Because at that time, there just wasn't an obvious niche for cancer. What began to make it more popular to both societies were when things like, quote, "growth factors," close quote, became more in evidence. And they clearly played a role in cancer. But clinical trials and clinical experience had no role in the Endocrine Society. And basically studies in molecular oncology just didn't seem all that attractive to AACR. It wasn't like you couldn't talk about it. It just wasn't front and center what people were interested in. Everything goes through vogues periods. We're now going through an immunooncology voguish period. And I'm not trying to suggest that that's not extremely important and going to have endless value for people. But now, if you're doing almost anything else, you can't even write a protocol. It's true. It's true in some ways. I was trained. [INAUDIBLE], who's an endocrinologist, was at the Dana Farber and told me that cancer is just endocrinology gone wild. In fact, I believe, in many respects, that's what precision medicine is all about is that we begun to take what you guys did 50 years ago and said, let's do it for all the diseases other than immunology, which is a different issue. I agree with you. I think that that's a good point. I think that one of the fundamental differences between normal and cancer, however, is genomic elasticity. If you had psoriasis, and I put you on methotrexate. Then 10 years later, I doubled the dose, it would kill you. Because you never amplify the target gene, dihydrofolate reductase. And you remain sensitive throughout your entire life. Whereas doing that with a leukemic cell, in a couple of months, you'd be completely resistant. And that is, in my mind, one of the shortcomings of so-called precision medicine in which you're trying to match a pathway, an oncogene, to a specific therapy. In that, oftentimes, these studies are in end stage patients with multiple resistant clones now has become endlessly clear from single cell sequencing studies. And I think that there is, I think, personally, slightly less to most efforts in precision medicine than most people think. And I believe that it's amusing that precision medicine has come to include immunooncology, which has little, in my mind, to do with the initial way in which precision medicine was touted, which is find the oncogene. And we will give you the drug. And I think, by and large, that, except for some incredible successes like Gleevec for CML, hasn't really panned out. Personally, I think what we're going to do is head back to what doctors Hall and Frei and [INAUDIBLE] taught us, which is that resistance is a heterogeneous issue, and we need to combine drugs. We just need to do it more thoughtfully than perhaps we've been doing in the past. Couldn't agree more. I want to change the paths for just a moment. To my knowledge, you are one of the few and maybe you were the first oncologist who's been both a cancer center director at Georgetown's Lombardi Cancer Center but also a chair of medicine. You've been at two major academic centers, here at the University of Michigan and University of Miami. Why do you think there have been so few oncologists who have been chiefs of medicine, chairs of medicine? Well, your personal favorite institution, UT Southwestern, would be an example as well of a chair of medicine who's an oncologist. Right. But no particular reason comes to mind. I think that the skill sets and interests of a chair of medicine, at least as it used to be, up until maybe about 10 years ago, were someone who actually wanted to, A, have somewhat less of a research footprint, which would discourage some people, and something less of the same focus on curing a specific disease, which would certainly describe a cancer center director. And I think that exactly explains some of my clinical interest in becoming a chair of medicine at Michigan. I went there, there are always push and pull reasons. The push reasons were that Georgetown was economically a disaster. And they had sold both the hospital and the clinical practice to a large non-profit community-based hospital. And I thought that would be, more or less, the end of the cancer center as I knew it in. And unfortunately, that prediction turned out to be, in many ways, correct. So there was push issues. I just didn't want to officiate over the deconstruction of the cancer center that I had helped to build. And in addition, I felt clinically, I was raised in the era of great chairs of medicine. I was raised in the era of Don Seldon and Dan Foster and A. Magee Harvey, and people who knew everything and would teach at the bedside and knew everything about disease. And frankly, I felt that breast cancer clinically, not emotionally and not from a research point of view, but clinically is relatively straightforward and not that complicated. And I wouldn't say I was bored. But I was looking for a new challenge. And I thought the notion of really trying to bring other areas to bear in terms of my research would be fun. And so I was thrilled to be chair of medicine. But I don't think that's necessarily the career path that many oncologists or any other subspecialist would want. Which did you enjoy most, being cancer center director or being chair of medicine? Unquestionably, being cancer center director here at Georgetown. It was the thrill of a lifetime. When I came here, there were three people in the division of hematology, oncology. Two of them immediately left. And by the time I moved to Michigan, the Department of Oncology that I had created had more faculty than all of the basic science departments at Georgetown combined and more research money than all of the basic science departments at Georgetown combined. It was tremendously happy, very successful. And I felt we were doing really wonderful things. It was just a fantastic time, just like that, which is one of the reasons why I've come back. And I was going to say, although Georgetown did fall on hard times. My opinion is grown back into a major institution. And I'm sure they're happy to have you back. So we're running out of time. I really just touched the surface of many of your contributions. In addition to your scientific contributions, you really touched on it. You've been one of the most prolific mentors in our field in my opinion. I looked over your CV. I count at least six cancer center directors. I think five, four PIs and probably hundreds of others who are proud to have been under your watchful training eye, by the way, including myself, in our careers. So of all the things you've done, your science, your administration, your mentoring, we've touched on all three of those. How do you want people to remember Mark Lippman when it's all said and done? So there's a wonderful joke about that. These three guys are standing around saying what would they like to hear said around their coffin when they're dead. And one guy was a teacher, and he says, you know, I'd like them to remember what a wonderful teacher I was, how I helped people. And another guy's a physician, and I'd like to hear if I'm lying in my coffin, them say, what a wonderful physician. He did everything for his patients. The third guy says, what I'd like to hear is, look, he's moving. So it's hard to-- right. I am certain that the place that I feel most happy, it's not even a close call, is the ability to have played an important role in helping people's careers succeed. I mean, I'm something of a tough guy. But I have been, I feel, very willing to see people grow up and leave the nest and keep them nurtured and look after them for many additional years in their career and enjoy those relationships. It's incredibly enriching. Well, I also have to say there are hundreds of thousands, if not millions of women who have benefited from the contributions you and your colleagues made 50 years ago at the NCI and since then. I've tried to make it clear through all these podcasts how much we owe all of you for what you've done and where we are now. And the reason we're doing this is so people don't forget about those things as we move into medical economics and some of the other things that I think are less fun. So it's time to conclude here. I want to thank you for taking your time. And again, thank you for all you've done for the field, for those of us who've trained with you, and again, mostly for our patients. And I hope you've enjoyed this conversation as much as I have. Very much, Dan. Thanks for including me in this podcast. Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or a review on Apple Podcasts or wherever you listen. While you're there, be sure to subscribe, so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org.

Men Of Purpose Podcast - Episode 003 Welcome to the Men Of Purpose Podcast! We are your Co-hosts, Dezi and Matt! Proud Husbands, Fathers, and Sports Dietitian Entrepreneurs! This podcast is for all those Fathers and Future Fathers out there that are looking to build better relationships with themselves first so that they can build better relationships with their families through nutrition and lifestyle coaching. In this episode, we review the @EBTofficial post on "How to Succeed With Your Goals" and discuss how successful dieters are able to impact their lives positively, and what characteristics you need to include in order to be successful, long term. Please subscribe, share, and comment! Show Notes: - 0:00 - Welcome to MOPP - 0:40 - Topic - setting goals and review (@EBTofficial) - Characteristics to adhere to a dietary lifestyle long-term review - 1:40 - The Definition of “Diet” and Understanding Dieting - 5:55 - Trait #1 - They TAKE ACTION and enjoy the process - 6:40 - What happens when you are initially doing well and avoid regression - 9:10 - Trait #2 - Confidence in their ability - 10:45 - How we have implemented confidence toward our goals and staying resilient - 12:05 - Trait #3 - They are good at keeping track of themselves - 13:20 - Examples of senseless tracking - 18:05 - Knowing when and how to realize bogus information - 20:00 - Trait # 4 - They have a positive body image - 21:00 - Discussing Tech in body comp - 22:45 - discussing health mentally - 25:50 - Trait #5 - They are flexible (being ok with being imperfect) - 26:40 - Addressing schedule changes and finding time to prioritize yourself and your health - 31:10 - Establishing a support system - 32:55 Trait #6 - They have successful coping strategies - 38:10 - 6 Traits Review Instagram: @ebtofficial YouTube: https://m.youtube.com/watch?v=RgTPOh3cNFI

Duane has been called a digital nomad by friends after living in 6 cities across 3 continents and visiting 40 countries around the world. After leaving Toronto, Canada in 2011 to gain an international view of the world, he has worked for Telstra in Australia and brands including ASOS, Mopp (bought Sept. 2014), Jack Wills and Grant Thornton while in London, UK.After London, Duane went traveling in Asia for 10 weeks and then came back to Canada and got a job with Unbounce. That job allowed him to work on more PPC landing pages than any marketer in the world. He now lives in Montreal, Canada helping ecom & SaaS brands grow through data, CRO and marketing.

Duane has been called a digital nomad by friends after living in 6 cities across 3 continents and visiting 40 countries around the world. After leaving Toronto, Canada in 2011 to gain an international view of the world, he has worked for Telstra in Australia and brands including ASOS, Mopp (bought Sept. 2014), Jack Wills and Grant Thornton while in London, UK.After London, Duane went traveling in Asia for 10 weeks and then came back to Canada and got a job with Unbounce. That job allowed him to work on more PPC landing pages than any marketer in the world. He now lives in Montreal, Canada helping ecom & SaaS brands grow through data, CRO and marketing.

Dr. Hayes interviews Dr. DeVita about his role as Director of NCI and his time with CHOP and MOPP.   TRANSCRIPT [MUSIC PLAYING] The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] Welcome to JCO's Cancer Stories, The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the role of cancer care. You can find all of the shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist and a translational researcher at the University of Michigan Rogel Cancer Center. And I'm the past president of ASCO. I'm really privileged to be your host for a series of podcast interviews with the founders of our field. In this series of podcasts, I hope to bring appreciation of the courage and the vision and most importantly the scientific background among the leaders who founded our field of clinical cancer care over the last 70 years. I hope by understanding the background of how we got to what we now considered normal in oncology, we can all work together towards a better future for our patients and their families during and after cancer treatment. Today, my guest on this podcast is Dr. Vincent T. DeVita, best known as Vince. Dr. DeVita is generally considered one of the so-called Gang of Five, including Doctors Canellos, Young, Chabner, and Schein, who I've been trying to get on for this podcast in the future, all at the NCI, and who brought many of the concepts we now accept as standard into the clinic in the 1960s and '70s. Dr. DeVita is currently a Professor of Medicine and Epidemiology and Public Health at the Yale School of Medicine. I think it's also fair to say, Dr. DeVita was instrumental in the passage of the 1971 National Cancer Act. And I want to hear more about that as we get into this. He was director of the NCI and the National Cancer Program from 1980 to 1988 and then moved to Memorial Sloan Kettering Cancer Center as Physician in Chief and subsequently became the Director of the Yale Cancer Center in 1993. Among his many honors-- and I don't have time to go through them all-- but he has served as President of the American Cancer Society. And I think most dear to me, he was President of ASCO in 1977 and 1978. Dr. DeVita, welcome to our program. Nice to be here, Dan. I've done a little background. I know you grew up in the Bronx. And I know you went to William and Mary for undergrad and George Washington Medical School. And I also read what I didn't know, which is that you did your internship and residency at the University of Michigan. We're recording this just before the NCAA basketball tourney. And I have to say, go blue. We're all excited here in Ann Arbor about our basketball team. [LAUGHTER] What I'm really interested in is, were your parents physicians? Or what made you choose medicine out of the Bronx? Well, no, my father was a banker. And my mother was an interior decorator. So it was kind of a funny mix. But I think it's kind of peculiar. I was growing up, and my mother-- I tell this story in my book. My mother was kind of frightened by the fact that I really, as a seven- or eight-year-old kid, really thought the guy who delivered the ice-- in those days, we had ice boxes-- was terrific. And I wanted to be like Nunzi the iceman. And she panicked and said, no, no. You're going to be a doctor. And every time someone asked me what I was going to be, I just said I was going to be a doctor. And when I went to school, I decided I'd be a doctor. It was sort of Mama driving me in that direction. So you had a choice of being an iceman or a doctor [LAUGHS]. Right. I like-- I mean, biology was always a favorite subject of mine. So it was a good fit. And tell me about how you ended up going to the NIH and choosing oncology. Was that serendipitous? I talked to Bob Young the other day. And he said, fundamentally, he hadn't planned to be an oncologist and got to the NIH and liked it. Was that your role, or did you know you wanted to do cancer from the start? No, I was going to be a cardiologist. In fact, when I was a first-year resident, I did cardiac catheterizations and was a co-author on a paper that for a long time was well-cited in the field. So I applied to both the Heart and Lung Institute and the Cancer Institute. And those are very competitive positions. And I had an interview with Robert Berliner, which didn't go well [LAUGHS]. So I didn't get invited to the Heart Institute. And I went to the Cancer Institute. And when I walked in, Dr. David Rall was the chief of the pharmacology branch. And I asked him if I could work on the pharmacology of digoxin. And he, wise person that he was, said, sure. Go ahead if that's what you want to do. And I was surrounded by people who were working on anti-cancer drugs. And I actually became fascinated with them. And it was only a few months, because I was also on the wards at the time, that I said, oncology is the way to go. It was an exciting new field. It was kind of a funny field in those days. But I found it exciting, so I switched. So just to give you a plug here, I think many of us know that you wrote a book, The Death of Cancer, published a couple of years ago, co-written with your daughter Elizabeth by the way. But in it, you described a number of things. And one of those that I loved were your stories about Gordon Zubrod. And I trained with Dr. Frei at the Dana-Farber. He always had great things to say about Dr. Zubrod. And I wonder if you could tell the folks listening in who he was-- I think most people don't even know that-- and the impact he had on our field. Yeah, I used to call him the great umbrella. The field was very controversial at the time. And so the people who were doing things like saying, I'm going to try to cure this cancer-- leukemia in Frei's case and Hodgkin's in our case-- were considered just a little bit this side of insane. He was somebody who was distinguished. Now, Frei had-- Zubrod had been at St. Louis as a professor and also at Johns Hopkins. And he was a very distinguished-looking man and a very polite, careful man. And so he used to provide sort of the umbrella for all of us, so that [INAUDIBLE] he'd take the heat. And we could go on and do our work. So he was-- he did enormous number of things. I mean, the whole clinical trial structure was established by Gordon Zubrod. The phase I, II, III trials was all done in a paper by Gordon Zubrod in the late 1950s. So I think he was just a guy who had foresight and was a great leader. I ultimately took his job. He got tired of bucking the bureaucracy and retired and went to Florida as the director of their cancer center there. So I got to know him pretty well. And like Frei, I have great admiration with him. I mean, it's interesting how we take phase I, II, and III for granted. And when he came in, and not too long before you came in, those things weren't-- nobody really knew how to do this stuff. Doctors Frei and Freireich were already at the NCI when you got there, correct? Yes, indeed. Yeah, they were. Yeah. And so they must have been inspirational. They were, and especially Freireich. Freireich was always on the wards. And Tom didn't come over to the wards very much. He was sort of the direct-- he was chief of medicine. And Freireich was the chief of the leukemia service. So we saw Freireich all the time. Tom came over once in a while. And Jay was a super doctor. And it was very hard to stay ahead of him. You'd get an x-ray on a patient. And he'd call you up 20 minutes later and tell you what it was. He was already down looking at it. So you had to stay on your toes with Jay. And of course he was, as everybody knows-- Jay-- he was a bold guy, who-- I mean, he looked like he could walk through a wall. So he frightened a lot of people. But he was an inspiration. So I'm always grateful for what Jay Freireich taught me. There's a great story in your book, that Dr. Frei has told me as well, about the first platelet transfusion at the NCI. Can you elaborate on that? I think most folks don't know about that story. Platelet transfusion was, again, one of those radical departures. But Freireich reasoned that we were losing more people from bleeding than we were from leukemia. So he worked out a way of plasma pheresing people and collecting platelets. And we didn't have a lot of the expertise we have now. And they came in quart bags. I mean, they were plasma bags that were huge. And we were treating little kids. So they were-- throwing them into heart failure was a problem. So it was pretty radical. And he was told to stop doing it by the clinical director at that time. And in fact, he was told that if he didn't stop doing it, he was going to be fired. And he told me-- he said, I went back to my office, sat down, and thought about it. And I decided I didn't want to work at a place where I couldn't do that. So I just kept on doing it. And the person who said he was going to fire him never did. But that was Jay Freireich. [LAUGHS] He believed so strongly in it. And when I went to Yale right after I left the Cancer Institute-- I finished my residency up there. And I told them-- when I saw leukemia patients who were bleeding-- and I said, what you should do is platelet transfusions. And they said, they don't work. And I said, I used them. And I saw them work. So I think we're losing patients unnecessarily. It was just very controversial. So eventually I left the program. I was going to take a residency and then a fellowship in hematology there. And I decided to go back to the Cancer Institute where these adventurous things were going on. Times are different now, of course. Dr. Frei once told me a story that he-- you may have been with him-- that he was making rounds in the clinical center. And in those days, apparently, the adults and the kids were in the same ward. And there was a child with essentially no white cells, who'd been induced for leukemia, and a man next to him with CML. And so-- and actually, when Dr. Frei told me this, I kind of said, I don't think I want to hear this story, because he said, well, you know, the kid didn't have any white cells. And the guy next to him had way too many white cells. So [LAUGHS] I said, tell me you didn't do this. He said, yeah, we took platelets out from the guy and gave them to the kid. And the kid got better for a while. It was really exciting. I thought, boy, you don't see that anymore. Yeah, I mean, it was a very reasonable thing to do, because the white cells in a chronic myelogenous leukemia patient work very well in terms of fighting infection. Yeah. So there was no reason. And the kids, otherwise, wouldn't survive. And so, yeah, I was there when we got these-- we gave these. I mean, they weren't easy to give, because they stuck in the lungs. And we didn't have HLA matching at the time. So they were-- a lot of them were mismatched. But for a while, they were effective. And then we went to collecting white cells from normal people. But the white cells had not worked as well as platelets had worked. Platelets have been a lifesaver. Now it's a couple of hundred million dollar business each year now. So it's routinely done, as many things that Jay started are routinely done now. Of the many things for which you are credited, I think it's the use of combination chemotherapy for Hodgkin's and then subsequently non-Hodgkin's that is one of your lasting legacies. There must have been a lot of drama around doing that. I mean, I think we all just assume you're going to start protocol. You write the protocol. You get funding for it. And you go forward. But can you give us some stories about sitting around at night and thinking about how to do this? Or how did you choose those drugs and why and how to give them and the obstacles that were involved? Yeah, actually, it was a very complicated process. And we didn't have the information we have now. What we had was-- I was doing this with Jack Moxley, who left active medicine and became a dean after he left the Cancer Institute. But we're still in touch. And Jack was working with [? Sy ?] [? Perry ?] using the new isotope, tritiated thymidine, looking at the bone marrow of CML patients and also of mice. And I was doing the same thing with the leukemia 1210, which was a model that we used for chemotherapy all the time. And what we were trying to do was figure out the kinetics of human versus mouse marrow, so we could develop schedules that humans would survive. We quickly found out that you can't use the mouse as a model, because their blood cells went through a kinetic phase about half the length of humans. So you had to schedule in a different way. So we worked that out. And then we looked at very simple-- something that people really ignored is that when you give a chemotherapy agent that is toxic to the marrow, you don't get abnormal blood counts right away. For a week, you'll have a normal white cell. And then on day seven or eight, it begins to fall, because the storage compartment in the marrow works well for about a week. And then there's no replenishment. And the white count falls. So between the two, looking at the marrow and looking at the white cells in the periphery, we came up with a schedule for MOPP. And then the other things were simple. We just decided that you'd have to have three or four drugs that worked by themselves. There had been people doing combination chemotherapy before-- Tom Hall in Boston and [? Alan ?] [INAUDIBLE] at Yale. And their rationale was they're looking at a sequential biochemical blockade. But they ignored whether the drugs actually worked against the tumor, assuming that if you gave them together, that the biochemical blockade would dominate. And it didn't work. In fact, it was very discouraging. But we decided the way to do it was take drugs that had some activity in the disease and use them together and use them in full doses in the schedules that we worked out because of the prior work I was telling you about. So it took a while to put that together. And then Jack Moxley and I used to do this at a bar in Georgetown called the Lehigh Grill, where we used to-- my cardiology desire-- I used to go to Georgetown where there was a wonderful cardiologist Proctor Harvey, who used to hold Thursday night sessions. You had an auditorium that was wired. So you could hear heart sounds. And after that, we'd go to the Lehigh Grill. And we sort of put together the protocol. When we presented it to Tom, he thought it was a good idea. But the other people around him thought it was insane and really tried to stop it. Tom Frei? Yeah. Tom Frei, yeah, yeah. Well, Tom was supportive. Yeah, Emil Frei was his real name. But everybody called him Tom. Yeah, he was supportive. But the people around him and my immediate boss was very much against it, because he thought it would interfere with the protocol that they were doing and so forth. So Tom worked out a solution worthy of Solomon. He said, OK, we could do-- the magic number for phase I trials in those days was 14. If you got nothing in 14 patients, then you didn't go any further. So we could do 14 patients with the first protocol, which was called MOMP-- M-O-M-P. And we had to do the workups ourselves. We couldn't use other colleagues to work up the patients. And we had to go get the patients ourselves. So Jack Moxley and I did all those things. And the results were very encouraging. And then Jack left. And I sat down and decided that we'd put procarbazine. I was working on procarbazine. It was then called [INAUDIBLE]. And I was working on it and doing the pharmacology in the phase I study with it in Hodgkin's disease. It was a promising candidate. So we put it in. And that became MOPP. Also in those days, six weeks of therapy was it. They didn't get more than six weeks. We reasoned that the marrow problems would be acute. But you'd have to give it probably for a long period of time to affect the tumor. So we gave it for at least six months or to a complete remission plus two months. And we assumed that there were cells left after we couldn't see them. So it was a lot of good thinking that went into it that turned out to be correct, because most of the-- since then, a lot of protocols follow the same sort of routine. And it really works for a lot of cancers. But it was controversial. I went to the AACR meeting. This was before ASCO. And I presented it as an abstract. And David Karnofsky, who was sort of a god at that time at Memorial Sloan Kettering, just tore me apart. And what was I doing using the term complete remission for a solid tumor. He said, that was a term that was used in leukemia. Now, I didn't say it. But I'm thinking, the reason you use them is you can get complete remission. So we had complete remissions. And I was kind of shaking with the microphone in my hand at the time. So it was a scary but it was a good experience. I have to say-- So it just gives you an idea that people were not receptive [INAUDIBLE]. Those of us who are junior to you can't imagine that you were intimidated by somebody else [LAUGHS]. Well, I was a youngster, then. I was-- Jack Moxley and I, I would say, thinking back, we were cocky. But the big guys in the field could scare me. And Zubrod was a-- I mean, Karnofsky was a big guy in the field. Yeah. He just had a hard time getting out of the leukemia mind frame. And so of course, we've used complete remission since then in any kind of solid tumor where you can get one. In your book, you have a great quote that you presented somewhere. And Dr. Frei was there. And Wayne Rundles was there. Wayne, of course, has been at Duke for 100 years. And he said, do your patients speak with you after you're done? Well, Wayne Rundles-- when he first saw the MOPP protocol, Wayne Rundles said, that's nonsense. He said, I get the same thing with nitrogen mustard by myself. Well, nobody had ever got that with nitrogen mustard. So we actually had to set up a controlled trial and do it and prove that MOPP was better. So when I presented it when we were first starting it-- at a meeting. Tom had arranged this meeting with all the bigwigs in the field. And when I presented it at that, everybody was sort of quiet. And then Wayne Rundles raised his hand. He looked pale. He raised his hand and said to me, Dr. DeVita, do your patients speak to you after you do this? [LAUGHS] So he-- a few years later when we were obviously getting good results, he invited me to grand rounds. And by then, we were good friends. And I was up on the podium. And after I gave the talk, he was sitting down below smiling at me. And I said, Dr. Rundles, if you remember, you asked me if your patients speak to you when you do this. And I can tell you that they do for a lot longer. So it was fun. But it was fun. He was a good friend by then. And I had great respect for him. Actually, he was a very nice man. He was. When did you start thinking that you had a success? Was it during those first 13 patients or 14 patients that you treated? I mean, was it obvious right away, or did you start [INAUDIBLE]-- Well, it was obvious-- --you were in the wrong place? We put-- no. We thought it pretty early, because we were worried. We put patients in reverse isolation. Nobody knew whether you were going to kill them if you gave them all these drugs together. And it turned out the first surprise was, yeah, they had the usual toxicity. But it really wasn't that bad. So it was doable. And the second was-- we had a small number. But we had-- something like 80% of the patients went into a complete remission. And I think nobody had seen that. Now, the question was, how long were they going to last? So we were optimistic. And when we put patients on it, there was no cure for them at that time. And we said, we're optimistic that this is going to be something that will last. But we don't know. And then by three years, it looked pretty good. And I think I presented the first abstract four years after we started. And by that time, we had relapse-free survival curves. And again, nobody before that time had presented relapse-free survival curves in any of the lymphomas. So by then, by four years, I think we felt we had probably cured some patients with the disease. I asked Bob Young this same question. Did you feel a sense of history at the time, that this was really historical? Or did that come later when you looked backwards? I think what people don't realize about those days is neither Freireich nor ourselves were treating leukemia and Hodgkin's disease. In other words, we weren't out to develop a treatment for those diseases. We were out to prove you could cure cancer with drugs, because nobody believed it. If you said that, they really thought you had gone balmy. So we were out to look-- so we knew if we could do it, it would be historic. So we were excited when we looked like maybe it was going to happen. By that time, when we had first reported it, the VAMP program that Freireich did, which was an historic program-- he only had 17 patients. And they actually never published a paper on VAMP. And I asked Jay why they never did that. And he said because he didn't think they would accept it anywhere. So but by that time, they were getting about a 50% complete remission rate going four or five years. And they were thinking they're curing leukemia. And we were getting 80% complete remission rates. So I think everybody felt that we were going to prove that you could cure cancer with the drugs. And we did. So yes, in a sense, we set out to do something that would be historic. And so when it happened, I think, it is. It was a sort of a door opener for medical oncology in Hodgkin's disease. I'd like to turn now for just a minute to your role in politics. You were pretty instrumental, I think, when the National Cancer Act was signed in 1971. And that also sounds like a TV drama to me. It sounds like-- and I know this anyway, but in reading your book, it was not clear that was going to get through. Can you give us some of the playground behind that and Mary Lasker's role and how that happened? Well, Mary Lasker played a big role. The MOPP program actually played a big role, because Mary Lasker was sort of working in the background. Cancer was always a cause for her. But when we did the MOPP program, there was a guy named Luke Quinn, who she had hired to be a lobbyist, who was sort of hidden in the American Cancer Society so they wouldn't realize it was Mary Laskers' lobbyist. And he was referred to me by Sidney Farber. And I didn't want to take him at first, because he was diagnosed as having gall bladder cancer. And I said to them, you know-- I said to Sidney Farber, I don't really treat patients with gall bladder cancer. And there was silence on the phone. And he said, (SOMBER, COMMANDING VOICE) you will take this patient. [LAUGHS] So I took the patient. And when I examined him, when he came down and I examined him, he had adenopathy in both axillae. And gall bladder cancer just doesn't do that. So I had to do another biopsy. He was not a pleasant guy. So it was not easy to do these things. I had to get another biopsy. And it turned out that my pathologist at the time, Costan Berard, when he compared the biopsy, he said, it's a lymphoma, clearly. It was a diffuse, large cell lymphoma. What they had done is, because Claude Welch did the surgery-- a very famous abdominal surgeon-- and he said it was gall bladder cancer, that the pathologist sort of assumed it was. And it was a compression artifact. Long story short, he went into remission. And Mary Lasker went gaga. Wait a minute. We got something here. And that was what pushed her to get her friend, Senator Ralph Yarborough, to put up a committee on cancer to come up with the Cancer Act. And-- So it must have been quite a day when President Nixon signed that. Yeah, well, it was-- I wasn't at the signing. I wasn't high enough up in the chain to be invited to the signing. But yeah, I have all the photos of him signing it. And later when I met him-- I have a picture in the book of he and I shaking hands and him looking like he's having a roaring laugh. People ask me what I said that was funny. And I have no idea. But when I asked him, I said what is your greatest achievement as a president? He said two-- opening up China and signing the Cancer Act. So he was-- Really? Yeah, so I think he was proud that he did that. That's a great story. Actually, the other story I had not heard, but read in your book-- I'd like you to tell me about your lunch with Mr. Featherstone. [LAUGHS] Featherstone Reid, his name was. Well, this was a very-- this was a regular occurrence. Mary Lasker, when she came to town, would stay with Deeda Blair, Mrs. William McCormick Blair, who was a Washington socialite and had a lovely house on Foxhall Road. And they would have lunches and dinners. And they always arranged it so that people-- the scientists sat next to somebody with influence. And this is how they influenced the Congress to put more money into the cancer program. So one time, I got a call in the morning from Deeda Blair, saying, I'm having a lunch. We'd like to have you there. And I said, gee, I-- it's too short notice. I can't do it. And she said, well, Mary really wants you to be there. Mary was hard to say no to. So I rearranged my schedule, drove down to Deeda's house. And there was a big black limo sitting in the front of the house. I went in, and they introduced me to Featherstone Reid. I had no idea who he was. And every time Mary would say, we want more money for research with leukemias and lymphomas. Vince, tell him about what's going on. And I would tell him about. At the end of the lunch, he left. And Mary and I sat down on the couch to have a cup of coffee. And I said, Mary, who is Featherstone Reid? And she said, he's Warren Magnuson's driver. And when she saw the shock on my face-- Senator Warren Magnuson was the chairman of the appropriations committee of the Senate. When she saw the shock on my face, she said, wait a minute. When Mrs. Maggie-- he takes Mrs. Maggie shopping during the day. And Mrs. Maggie-- he fills her with all this information we're giving him. And then Mrs. Maggie is the last person to put her head down on the pillow next to Warren Magnuson. This is the way she worked. She would take someone like Magnuson, who was a good friend, but she would surround him with extraneous people who would say the same thing. So it was sort of like subliminal stimulation for him. He was always hearing these positive things. And then he supported the program. She was a piece of work. I never got to meet her. But it sounds like she was a force of nature. She was. And of course, the Lasker Award is now named for her and her husband and sort of the American Nobel Prize. She's had such [INAUDIBLE]. Yeah, and our crew won it in 1972-- Frei, Freireich, myself, and other people for other things. So I'm very fond of Mary Lasker, obviously. It's just a wonderful story. And I got to know her pretty well, so. I have one other question. And I'm not sure you'll want-- if you don't want to go off on it, we can edit it out. But in your book, you talked about Howard Skipper and Frank Schabel. And Dr. Frei used to talk about them all the time. And I think it's worthwhile to bring them into the history of what we do. Did you actually work with them or collaborate with them, or just base some of your ideas on what they had in mind? When I was starting at the Cancer Institute, I thought Schabel worked at the Cancer Institute-- I mean, Skipper worked at the Cancer Institute, because I would be working in the lab. I was doing the tritiated thymidine studies on L1210 mice. And he would be looking over my shoulder. He was doing the similar studies, but he was just doing it with cell counts in the abdomen of the mice. And he thought that was good enough. And he was there at a weekly meeting we had, which George Canellos named the Society of Jabbering Idiots. It was a great, great meeting, actually. [LAUGHS] And he was there all the time. And my view and Tom's view differ a little bit on Skipper. I think he was a real driving force, that he did the studies in mice that we were doing in the clinic with people. And he actually-- in 1964, he wrote a paper showing that you could cure L1210 leukemia. It was the first example of curing a mouse with leukemia. And I think-- so it was sort of a feedback mechanism between the Cancer Institute and the Southern Research Institute. So and he did-- he used to do these booklets. And I think he published hundreds of these booklets. Some of them, we convinced him to actually publish as papers. But I have the collection. There may be 100 booklets he wrote. And he would take a concept that we were working on and then work through it in mice. It was very, very important. And he was a wonderful person. His only problem was he smoked like a chimney. But he was-- I liked Frank and Howard. Yeah, Dr. Frei had the entire set of monographs on his bookshelf in his office and would encourage us to come in and borrow them and read them and come back. And frankly, he basically predicted what you've done with combination therapy. He predicted adjuvant therapy working. There were just a number of things he saw in these mice that we've gone on to apply in the clinic. It's pretty remarkable, I think, so. Yeah, I mean, it's not only he predicted it. But he actually showed the concept worked in mice. So as we know, mice and human are very different [INAUDIBLE]. There was a guy in Boston, Stuart Schlossman, a very fine scientist. And he didn't like mouse models. And when asked what he would do when he saw a tumor-bearing mouse, he would say, I would step on it, because he didn't believe mouse models. And but Frank and Howard did experiments and made allowances for the difference between humans and mice. So it was always good to know. I mean, I have the summary he wrote on Hodgkin's disease after he saw the MOPP program. So I think they're very instructive booklets. So I kept them. Like Tom, I think that we sort of live by them. Well, thanks for discussing them. I think our listeners need to remember these two guys. They were great. We're running out of time. I've really just touched the surface of what you've done and contributed to the field. And the people you've trained is sort of a who's who of oncology, frankly. But at the end of the day, what's your-- I'll ask you the same question you asked President Nixon. And that is, what is your legacy? What do you want people to remember that Vince DeVita did? I get asked that question a lot. And I don't have one thing that I can say. I mean, I've been lucky in my career that I've had a chance to do many things. Being the Director of the Cancer Institute was wonderful. You could sit on top of the whole field and just sort of scan it and see what's going on. And it was very important, because you've become the spokesman of practicing physicians at the same time. MOPP, of course, was important. Putting out the first comprehensive textbook in the field and watching it-- we just came out with the 11th edition-- is also very exciting. So there-- we were the first to successfully treat Pneumocystis carinii pneumonia. And we reported it in a paper in the New England Journal. I mean, there were a lot of things. I'm best known, I think, for MOPP, probably, and the principles of MOP, which I'm very proud of. But there's so many that I have a hard time. I like opera. And people ask me, what's my favorite opera? And I usually say, it's the one I just saw. It's very hard for me to pick one opera. There's so many that I like. So I'm not dodging it. But I just never can say, well, it's this. That's very fair. Frankly, I think, without your contributions, I probably wouldn't be sitting here doing what I do. And I think there are thousands of us who would say that. So we're-- Well, that's very flattering. Well, not only are we appreciative, more importantly, there are a lot of people who are alive who wouldn't have been without what you and your colleagues did at the NCI that so many years ago, so-- [INTERPOSING VOICES] I was involved in the training of 93 medical oncologist. At one time, something like 40% of all the [INAUDIBLE] directors were our graduates. So they have gotten around. And that was good for the field. They went out with the same principles we were developing at the Cancer Institute, so that's very gratifying. Have you kept in touch with any of the patients that you're treated back at the NCI? I talked to Saul Rosenberg. And he told me he still sees people that he treated 30 or 40 years ago when he first moved to Stanford. We're writing a paper on the 45-year follow-up of the first 188 patients. Again, nobody has 45-year follow-ups. And we called every one of the survivors. And there's something like 60% or so of the complete remissions are alive. So I talked to some of them. But we had a nurse talk to a lot of them. And I got messages from them after the call. And some of them still contact me, after sort of an anniversary of their treatment. So yeah, I've kept up with them. The gratifying thing is most of them are suffering from the same illness as most people who are getting into their 70s or some of them 80s. They have hip problems and so on and prostate cancer. But there doesn't seem to be any really major increase in anything in these long survivors. Now, mind you, these were patients who got MOPP as their only treatment. And so when you see second tumors in these kinds of patients, it's usually patients who got radiation therapy plus MOPP. So these patients who are 45 years had just got MOPP. And they seem to be perfectly fine. That's remarkable. I love your comment that they are getting the same illness as the rest of us get as they get older. That's great. Yeah, we don't cure bad hips and bad knees and-- Yeah, we can't cure old age. When I was at the Dana-Farber, I had a patient who had been one of Sydney Farbor's original patients from the early '50s. And by this time he was obviously an adult. He was older than I was. And he was fine, as you've said. Although he said Dr. Farber kept treating him and treating him and treating him. And then finally, when Dr. Farber passed away, someone else picked up his chair. And they said, why are you still getting this? And they stopped it. Yeah. So he got a lot of treatment. I had one of Freireich's VAMP patients. She was a girl in her early teens. And she was a wildcat. But she had had something else, and it failed. And she was one of the first patients on VAMP. And she went into remission. And she stayed in remission. And I followed her for many years. She went to college. She got married. She had children. She brought her children in to see me. And last time I had any follow-up with her, she was in her 60s. And she was one of the really first long survivors of that particular program. So it's really neat to see these patients. And it's not rare for me to go to a meeting and have people walk up to me and say they got MOPP 25 years ago. Someone else gave it to them. And they're alive and well. So that's one of the great gifts of having a chance to do this kind of work. What a privilege. Well, I think we need to end. Again, I want to thank you for being on with us today and filling us in with some of these stories. Had really good feedback for my podcast series. And it's because of the people I've had on it. So thank you very much for all you've done. It's really good talking to you. And I look forward to listening to all your podcasts. [MUSIC PLAYING] Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcast or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org. [MUSIC PLAYING]

Angela joined the National Guard as a cook and then headed off to basic training the summer between her junior and senior year of high school. She realized after basic training that being a cook wasn’t what she wanted to do. She couldn’t get out of that career field because she had received a bonus on her enlistment. She looked into going active duty, joining the Marines, but nothing panned out. She did get to switch from being a cook to water purification. The National Guard was in charge of primarily all the water purification for the Army so they were required to head to Camp Pendleton in California each year for training. She had been working in that job in the National Guard for about two years when Sadam Husain invaded Kuwait. They were immediately set on high alert with the expectation they would be deploying soon. The North Dakota National Guard had not been called up for a deployment for over 30 years so everyone was surprised, but also ready to meet the needs of the Army. They were mobilized and sent to Fort McCoy in Wisconsin for training and soon after arriving they were sent to Kuwait. One of the first to be deployed to Kuwait for Operation Desert Storm. It was pretty shocking to deploy and to be one of the first to leave was even more unexpected. She said there was a lot of learning as you went and making due with what you had. Luckily, they deployed with their vehicles and were very fortunate to have their trucks. So many other people did not deploy with vehicles. Her unit was small and made up of people who grew up together so she described it like the Brady Bunch going to war. She said there were sibling rivalry and other squabbles, but they were also a tight-knit group. But the six girls were often given the hard jobs that no one wanted to do and none of the guys were willing to help them put up their tent so it caused animosity between the group. While they were acclimating to their new environment their Sargent found them a job to do. They were training people on how to use a Reverse Osmosis Water Purification Unit (ROWPU) which turns salt water or dirty water to drinking water. They left the nasty camp they were at and headed to the Persian Gulf for training. She said it was beautiful. Her job overseas was to distribute out the water. They had to use so much chlorine to treat the water that they found their water sources somewhere else. They were lucky because they were at a base and had another supply point. They were pretty far North and the Iraqis that were near them had been cut off from supplies so they surrendered and they didn’t have to worry about that threat. But they did have to worry about chemical attacks and were constantly in their chemical gear. And one time a chemical plant was attached and after 3 days they told them they could take off their chemical protection gear because it wasn’t too bad. But it doesn’t mean there were no health issues caused by deploying for Operation Desert Storm. Coming home was a difficult transition. Honking horns had meant to get into MOPP gear and that was a daily part of life at home. And it was also so quiet. After being deployed and having constant noise ranging from generators, and other random noises to complete quiet was difficult. She also talked about the lack of reintegration and not having anyone to talk to about her experience. She was one of the first to come home from her deployment. The unit had been picked to be part of a parade to celebrate the end of the war, but their plane got a fuel leak and they had to stop in Maine for repairs and missed the parade. Mentioned in this Episode: Nice Girls Don’t Join the Military Thank you to my Patreon Supporters: Kevin Barba (Colonel)

Ein 2-tägiger Silvesterpartykater und tiefenentspanntes Spießertum - all das und noch viel mehr gibts in dieser Folge von Passiv Aggressiv zum Jahresbeginn. Alissa hat ein Problem mit großen Mündern und Autos, Jessi erzählt - warum auch immer - direkt zwei verschiedene Storys über gefährliche Orte zum Pinkeln. Freut euch außerdem auf ein Update zu der Sache mit dem Mopp, Haarausfall und den ultimativen New-Age-Hippie Tipp um gut ins neue Jahr zu starten.

Duane Brown has been called a digital nomad by friends after living in 6 cities across three continents and visiting 40 countries around the world. After leaving Toronto, Canada in 2011 to gain an international view of the world, he has worked for Telstra in Australia and brands including ASOS, Mopp (bought Sept. 2014), Jack Wills and Grant Thornton while in London, UK. After London, Duane went traveling in Asia for 10 weeks and then came back to Canada and got a job with Unbounce. That job allowed him to work on more PPC landing pages than any marketer in the world. He now lives in Montreal, Canada helping ecom & SaaS brands grow through data, CRO and marketing. Duane runs a digital marketing agency called Take Some Risk. He has helped brands including ASOS, Jack Wills, and Mopp grow through PPC (pay per click) marketing and CRO. I invited him to join me on Tech Talks Daily to share his fascinating story. We talk about how to grow any business through PPC campaigns and the digital marketing landscape. But, beyond the tech talk, we discuss Duane's traveling experience, and he visited 40-countries and working as a digital nomad.

Bæsj, flammespyttende jævler og porepuling

Our newest Business Spotlight Series Episode was with MOPP Gear LLC®. They offer all things coffee and all things American made. They're dedicated to providing you the very best of Small Batch premium roasted coffee with an emphasis on quality and freshness. Unlike many other coffee companies they don’t have warehouses loaded to the brim with old coffee bags collecting dust. They get our coffee small batch roasted for maximum freshness and ship it straight to you. Founded in 2018 by Stanley Kulak, MOPP Gear LLC® has come a long way from its beginnings as just a concept of making an American made clothing brand. When Stan first started out, his passion for wanting to start a Patriotic Life Style Brand™, drove him to start his own business. He wanted to create a brand of military and patriotic themed coffee and clothing. Made by veterans and using USA made materials. Stan served in the United States Marine Corps from 2002 until 2006. He served in 3rd Battalion 4th Marines and deployed 3 times to Iraq. Upon completing his enlistment with the USMC, he went on to work over seas from 2006 to 2010 for a private security contractor. Do you love to support small businesses with a great product?? Look no further than those in our Business Spotlight Series page! https://www.hwhpodcast.com/business-spotlight You can find MOPP Gear at the following links below! Website - https://moppgearllc.com/ Facebook - https://www.facebook.com/MOPPGEAR/ Instagram - https://www.instagram.com/moppgear/

Dr. Hayes interviews Dr. Freireich on his involvement with combination chemotherapy.   TRANSCRIPT: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Welcome to JCO's Cancer Stories, the Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist and a translational researcher at the University of Michigan Rogel Cancer Center. And I've also had the privilege of being the past president of the American Society of Clinical Oncology. I'm privileged to be your host for a series of podcast interviews with the people who founded our field. Over the last 40 years, I've been fortunate to have been trained, mentored, and also, frankly, inspired by these pioneers. In fact, it's my hope that, through these conversations, we can all be equally inspired by gaining an appreciation of the courage, the vision, and the scientific understanding that led these men and women to establish the field of clinical cancer care over the last 70 years. In fact, by understanding how we got to the present and what we now consider normal in oncology, we can also imagine, and we can work together towards a better future for our patients and their families during and after cancer treatment. Today, my guest on this podcast is Dr. Emil J. Freireich, who is generally considered one of the pioneers of combination chemotherapy. Dr. Freireich is currently the Ruth Harriet Haynesworth chair and distinguished teaching professor in the Department of Leukemia at the Division of Cancer Medicine at MD Anderson Cancer Center in Houston. He was raised in Chicago during the Great Depression, the son of Hungarian immigrants. Dr. Freireich attended the University of Illinois College of Medicine in Chicago starting, unbelievably, at age 16. And from there, he also received a medical degree in 1949. He completed his internship at Cook County Hospital and his residency at Presbyterian Hospital in Chicago. He then moved to Boston, where he studied hematology with Dr. Joseph Ross at Mass. General. And then he went to the NIH in 1955, where he stayed until he moved to MD Anderson a decade later. And there he still remains. He and his colleagues at the National Cancer Institute, Drs. Jim Holland and Emil "Tom" Frei, were the first to demonstrate that administering concurrent combination chemotherapy, rather than giving it sequentially with each episode of disease progression, resulted in complete responses in childhood acute lymphocytic leukemia. And that paper was first published in the now classic paper in Blood in 1958. In the mid-1960s, they ultimately developed the VAMP regimen. And that was reported in 1965, with really, in my opinion, the first cures that we'd seen with chemotherapy in an advanced cancer of any sort. This work was the groundbreaking basis for the subsequent cures of advanced Hodgkin's disease, non-Hodgkin's lymphomas, adult leukemias, testicular cancer, and, in my opinion, the striking results of adjuvant combination chemotherapy in breast and many other cancers. Dr. Freireich has authored over 500 peer-reviewed papers, numerous reviews and editorials. He's edited 16 different textbooks. And he's won too many awards and honors for me to even begin to list. But in particular in 1972, he received the Lasker Award, America's most highly regarded medical honor. And most importantly to me, frankly, is that he proceeded me as president of ASCO in 1980 to 1981. Dr. Freireich, I'm sorry for the long introduction. But your career is pretty substantial. Welcome to our program. Thank you. I have a number of questions. And to start with, I know, as I said, you grew up in Chicago during the depression and that you entered college at the age of 16. And I think our listeners would love to hear more about those circumstances. That's pretty unusual. And I've actually read about some of your childhood. You want to tell us more about that and how was it you chose medicine in the first place? I was born 1927 of to immigrant Hungarians. I had an older sister three years older. And they had a Hungarian restaurant in Chicago. And 1929, when I was two years old, there was a big event in the United States. They lost their restaurant. My father died suddenly, I believe of suicide, but not proven. And my mother, tough mother, went to work in a sweatshop. She worked 20 hours a day. She had two children. She found an Irish lady who worked for room and board only, no salary. Her name was Mary. So Mary was my ex officio mother. And I grew up, as you pointed out, in a ghetto community. I spent my life stealing things, hubcaps and windshield wipers, and avoiding getting crushed by the roving gangs. When I finished elementary school and when I went to a ghetto high school called Tuley, T-U-L-E-Y. In Tuley High School, I majored in typing and shorthand. My mother thought I could make a living as a secretary. I was prepubescent, short and fat. And I was a frequent victim of my colleagues in school. When I was very young, I can't tell you when, about eight or so, I developed tonsillitis. And we had in our little ghetto community one of these Tree Grows in Brooklyn physicians. His name was Dr. Rosenblum. And he took care of people in the ghetto for favors. My mother made him goulash. Dr. Rosenblum came to your house. He didn't have an office, because we didn't have any transportation. So my mother called him. And I had tonsillitis. He came and looked to me. He was wearing a suit and tie. I'd never seen that. During the depression, all the men wore coveralls and dirty pants. And he looks very elegant. He had a suit and a tie. He looked in my throat, and he said to my mother, the treatment for tonsillitis is ice cream. I always remember Dr. Rosenblum, because my mother had to go out and buy ice scream. And it's not bad treatment. It actually cools off the hot throat. So when I went to high school, taking shorthand and typing and getting beaten up by the bigger guys, a professor appeared like Dr. Rosenblum, suit and tie, young guy, PhD. Came to a ghetto high school to teach physics. Physics fascinated me. So I worked very hard in physics. He had a contest. I did a project on the Bernoulli theorem. And the classic project is a jet of water. You put a ping pong ball in it. And the ping pong ball stays in the jet, amazingly. That was because of Bernoulli. What happens when the ping pong ball goes off to one side, the fluid goes faster on the other side. It reduces the pressure, and that pushes it back in the stream. And that's the principle of airplanes and so on and so forth. So I won first prize. And he called me to his office. He said, Mr. Freireich, you should go to college. I said, what's college? He said, well, there's-- [LAUGHTER] He said there's a place down south of here called the University of Illinois where you can get advanced studies. What do you want to be when you grow up? So I thought a minute, and I said, I want to be like Dr. Rosenblum. I want to be a family doctor. He said, well, you have to go to college first. So I said, what do I need to go to college? He said you need about $25, which in that day was a lot of money. So I went home, and I told if it was my mother, my professor wants me to go to college. And I need $25. My mother, she's hardened in the depression, working in sweatshops. And she said, OK, I'm going to get $25. She asked around in the little Hungarian ghetto community. And we found a lady who had lost her husband and had an insurance policy. And so she had money. And she distributed it to her colleagues in the ghetto community for good causes, wonderful lady. So my mother dressed me up in a borrowed suit. And we went to see Mrs. so-and-so. And she patted my head and gave my mother $25. It's an incredible story. In fact, I'm struck by the fact that one of the founders of our field was a juvenile delinquent stealing hubcaps. Oh, yeah. I did that to hubcaps and windshield wipers and everything you could take off a car. I got a ticket on the Illinois Central Railroad, $6. I got off the Champaign-Urbana. And I said to the guy, where's the university? He said, over there. I went over there. I said, where do you register. They said, over there. So I went over there. And I said, I'm Freireich, and I'm registering for college. The guy said, where's your transcript. I said, well, they told me at the high school that they would send everything they needed. He said, we've never had a student from Tuley High School. I was the first to go. I was the first Tuley student to go to college. And he said, OK, I'll register you. And I'll write the university, and I'll get your transcript. I presume you're qualified. So how much is registration? $6! So I'm down to $13. I'm getting pretty poor. So I registered. And then I said, where do I live? He said, there's a list over there. And I went over there. I found the lady who lost her husband. She rented his bedroom for $6. And then I had to figure out how to eat. And I asked my friend the registrar, where do I eat? He said, go to work in one of these rich sorority houses. You get free meals. So I waited tables in a sorority house. I got good grades. When I had to elect a language, I took German, because at that time, all the science was in the Festschrift. The Germans had invented the chemical industry. And my advisor said, that's good for you if you want to be a doctor. So I took German. My professor in German, he taught stage German. And he read the role the first day. And he came to my name and he said Freireich, [EXAGGERATING "CH" SOUND] because, he said, Americans can't say. [EXAGGERATED "CH" SOUND] Everybody called me "Freireish." But he called me Freireich [EXAGGERATING "CH" SOUND]. And our book was called, Ich lerne Deutsch, I'm learning German. So "ich" was important. Freireich was important. I got an A in German because of my great name. And I did well in physics. And everything was accelerated during the war. So the university had three semesters a year instead of two. There was no summer. And the requirements for medical school were dropped from three years to two years. So two years is four semesters. So at the end of the first year, I was eligible for medical school. And my physics professor said, you better apply, because all the guys coming out of the military want to be doctors. So I said, aw, damn, I'm having such a good time scrubbing floors and smoking and getting along with good looking girls. He said, you better do it. So I applied. And I was accepted. So I had to leave the beautiful campus of Champaign-Urbana and go back to the ghetto of Chicago where my mother and my sister were living. And I couldn't figure out where I was going to get the money to pay for medical school. I had a friend who had had polio. Polio was rampant in those days. And I said to him, how do you get money to go to college? He said he gets money from the state, rehabilitation. And he said my rehab guy is coming to see me tomorrow. Why don't you come and see if you're eligible? So the rehab guy came. He said, what's wrong with you, Freireich? I said, I had a broken leg in college. He said, OK, fill in the forms. And I became a ward of the state of Illinois Department of Rehabilitation. From that point on, they paid all my tuition, all my supplies, all my microscope rentals, and so on. So I went to medical school free thanks to the State of Illinois Department of rehabilitation. So I went to Chicago. And a bunch of us sat in the room for the opening introduction. And the dean of the medical school came in. His name was Andrew C Ivey. I don't know if you know the name, famous GI physiologist. And Dr. Ivey said, you guys are lucky to be in medical school. There were 20 applicants for everyone accepted, 20. Isn't that's amazing? Because all the guys who were medics in the military realized that being a doctor is a soft job. So they all wanted to be doctors. But they didn't have as good an academic career as I did. So anyhow, I went to medical school. I did pretty well. It was complicated, medical school. I had to ride the L in Chicago. It cost a nickel. And I lived at home. And I rode the L in the morning. And I walked to the university campus. I attended classes. I walked to the L. And I went back home. And I did that for four years. And then, as I said, I graduated number six in the class. And I graduated. And I had to decide where to do an intern. I wanted to be a family doctor like Dr. Rosenblum. So I interned at Cook County Hospital. Cook County Hospital was an abattoir, terrible place. In that year, 1949, the two most prominent diseases were tuberculosis and polio. So my first rotation was the TB ward. That was horrible what you had to do to those men. 90% of them died. Then my next rotation was infectious diseases. And that was all children in iron lungs who were doomed to die. So I started off pretty badly. And then I got to the good things like surgery. I delivered a hundred babies. I did the ear, nose and throat. So I did everything. And I felt ready to go into practice. And then I got to internal medicine. Internal medicine was not like OB and all that stuff, not mechanical. It was intellectual. You had the worry about the blood flow to the kidney. And you had to get diuretics and blood and stuff. So internal medicine fascinated me. When I was on-call, I would admit 20 new patients a night, 20. And one guy I admitted was very interesting. He was a learned guy. And he was dying of heart failure. And I had to figure out how to treat him. And I admitted him. And when I got done, exhausted in the morning, I went to make rounds. And I didn't see him. And I said to the nurse, where's Mr. so-and-so. She said, don't worry about him. He's gone. I said, where did he go. She said he goes into the death room. Cook County Hospital, the problem was they had too many patients for the beds. And the head nurse made rounds every day. And the sickest patients went to the death room. And I went in there. And I found my patient. And I said to the nurse, I want my patient on the ward. I'm a young squirt. How old was I? I was 19, I think. So the next day, I get a call from the hospital director. He says, Freireich, I think you better leave County. I said, what do you mean? I'm having a good time. I'm learning everything. He said, you don't know how we operate. The nurses run the ward. And you make trouble. And that means you've got to leave. Uh-oh. So I said, well, the only thing I can do is get a residency in medicine and learn all this complicated stuff. So next door was Presbyterian Hospital, which had the Rush Clinic. Have you heard the rush clinic? They were a bunch of famous guys. I made rounds with Roland Woodyatt, the first physician in the United States to use insulin. I made rounds with-- I forgot the name of the cardiologist who described coronary artery disease. He was the first to recognize the association between chest pain and myocardial infarction. So these guys were great. And Olie Poll, who taught me EKG-- And I was going along fine. But again, the chair of medicine was a Harvard import, S Howard Armstrong. And he had a teaching service. And all the house staff wanted to be on the teaching service where they learned stuff. Private doctors, of course, were offended. So they descended on administration. And they fired the chair of medicine. Armstrong was fired. The house staff teaching service was disbanded. And Armstrong tried to tend to his house. He called me in. He said, Freireich, what do you know about medicine? I said, Dr. Armstrong, you got a wonderful department. I learned EKG. I learned diabetes. I learned heart. I learned everything. The only thing I don't know anything about is hematology, because the guy who teaches hematology is a jerk. Armstrong said, don't worry, Freireich. Go to Boston, that's where the new medicine is coming from Europe. And he gave me letters to the three great hematologists in Boston, Bill Dameshek, Joe Ross, and Dr. Israel, who was a clotter. So I took everything I owned. I put it in my 1946 fastback, broken down Oldsmobile. And I drove to Boston. When I got to Boston, I met Dr. Ross. The guy in the lab who was the chief was so Stuart Finch. I think he just retired. And I collaborated with a young man named Aaron Miller who worked at the VA hospital. And my project funded. Dameshek gave me a job but no money. Israel gave me a job, no money. Ross gave me a job and paid me $5,000 a year, wonderful. So I became a hematologist. I worked on the mechanism of the anemia of inflammation. I studied patients with rheumatoid arthritis. And we had radioisotopes. So I was able to study the iron metabolism and the binding to transferrant. And we did experiments in dogs. And we worked out the mechanism of the anemia. The biggest hematology group in the country, the Wintrobe group, who wrote the textbook, had proven that the anemia of inflammation was due to a failure to incorporate iron into heme. And we found that that was false. When we put the ion on transferrant, it went right into heme. The difficulty was the reutilization of iron from hemoglobin to new heme. And we proved that in dogs. We did experiments with turpentine abcesses in dogs. So I was on a roll. I was doing Nobel laureate stuff. I mean, I gave a paper to the AAP. I gave a paper to the ASCI. I was doing well. And one day I got a letter. You are drafted into the army as a private. If you don't want to be a private, you can become a second lieutenant if you accept the assignment we give you. So I told Ross, I'm leaving. I got to go. I tried to finish up all my experiments. I told my wife we're in trouble. We didn't know what we'd do. We had one baby, one-year-old. She was pregnant with our second child. I didn't tell you the story about my wife. What happened is the head nurse in the clinic, like me, she came for a visit to Boston. They broke into my car and stole her luggage. And so we became attached. And we got married. And we've been married 65 years. But anyhow, she got a job at Mass. General. I had a job at Mass. Memorial. We had enough money to live. And as I say, she got pregnant, and we had babies. And I got this letter that I'm drafted. So I said to my wife, we have to go to the Army. The next morning, I get a call from Chester Scott. Keefer, who you already mentioned-- Dr. Keefer was the physician in charge of the penicillin distribution during the war. He was a very famous infectious disease doctor. He was a brilliant teacher and respected and loved by everybody. When Eisenhower was elected president, as you probably know, like all Republicans, he wanted to decrease the size of the government. So he decided to combine three cabinet departments, Health, Education, and Welfare, into one. That was obviously going to save positions and money. And he appointed Oveta Culp Hobby, who was the publisher of the Houston Post newspaper. She didn't know anything about health. She didn't know anything about education or anything about welfare. So what she did was she hired three people as department heads. And she picked Dr. Keefer to be head of health. Dr. Keefer would not give up the dean of the medical school. So she agreed to have him do both jobs. He was dean of the medical school and Secretary of Health. And he called me to his office. And we all respected Dr. Keefer. You dressed up in a new coat and clicked your heels and said, yes, sir. He said, Freireich, Dr. Ross says you're doing good. Thank you, sir. Have you ever heard of the National Institutes of Health? No, sir. There's a place in Washington where they have a hospital out in the country. And they can't staff it. So we have to send young people who are drafted there. If you go to the public health service, you don't have to go in the army and get shot during the war. Yes, sir. He picked up the phone. Fred, I have a doctor Freireich in my office. He'll be there tomorrow morning. Bye. Thank you. I went home. I told my wife, I have to go to Washington. I got in my car, drove to Washington, 200 miles in a broken down car. I got there. I found the guy at the HEW. He said, Freireich, you have to go to NIH. So go out here and take the bus. It takes you to the clinical center. Before the war, they decided to put a clinical center in the campus of the National Institutes of Health, which were all basic science institutes. There was no medicine. So here was this hospital, and they couldn't staff it. So they took all the draft dodgers. They called us yellow berets. And they staff the NIH with guys right out of their training. So anyhow, I got in my car and drove out there. Where's NIH? There. Who do I talk to? There, you go there. I talked to all the clinical directors. No one needed me. I got to Gordon Zubrod, who had just come from St. Louis University. He was an infectious disease guy. Do you know Gordon Zubrod? Yeah, I actually met him a couple of times with Dr. Frei. Good, yes. Actually, I'd love to hear this story. Dr. Frei has told me the story, your first day at the NCI when you, quote, "found your office." Can you tell us about that one? Yeah. So anyhow, Dr. Zubrod said, what do you do, Freireich? I said, I'm a hematologist. He scratched his head. And he said, I'll tell you what, you have to cure leukemia. I said, yes, sir. You know I'm in the military, so you have to do what you're told. He said, your office is on the 12th floor. I went up to the the 12th floor. I walked along, looked for a name. I came to room that said Emil Frei. I said, isn't that like the damn government? They can't even spell my name. So I walked in. And there was a tall, skinny guy with no hair. I said, sir, you're in my office. He said, your office is next door. I'm Frei. You're Freireich. And we've been friends for a lifetime. He told that story to us many, many times, I'm going to tell you. He thought that was hilarious that this guy walked into his office and said, you're in my office. And he said, no, you're in my office. The other thing I want to talk about then, as you moved on, what made you and Dr. Frei and Dr. Holland decide to go at combination therapy? I think it was based on the infectious disease stuff. Correct, totally. At the time, we had three drugs, 6-MP, methotrexate, prednisone, 48, 53, and about 54, something. Each individually gave some responses. They lasted six to eight weeks. And the children all died. So the world's authority on hematology, Max Wintrobe, wrote a review. And he said, these drugs are simply torturing these children. And they don't do anything. Dameshek wrote editorials in Blood saying they're just killing children. So we were not very popular. But Zubrod came from infectious disease. And Tom Frei was infectious disease. And they had just discovered that in tuberculosis, if you use sequential streptomycin PAS, they became resistant to both drugs. If you gave them simultaneously, their effectiveness was prolonged. So combinations of agents were more effective than the sequences. So Zubrod said, why don't we do the same thing for cancer? We'll do 6-MP and methotrexate in sequence. And we'll do them in combination. To do the combination, we had to work out the doses. Dave Rolle did that in mice. 60% of two immunosuppressive drugs make one. And we gave 6-MP and methotrexate concurrently and in full dose sequentially, that is until they failed, we gave the other one. And the study was called Protocol 1. Jim Holland had gone to Roswell Park. And he agreed to join us. So we became the first acute leukemia cooperative group, Holland at Roswell Park, Frei and Freireich at MD Anderson. Freireich treated the children. And Frei protected Freireich from the rest at NCI and from Zubrod. Zubrod trusted Frei. So if I needed to do anything radical, I'd talk to Frei, and he'd talk to Zubrod. So we were a great team. That was really the start of the cooperative group set, right? That would be CALG, the cancer and leukemia group, is that right? That was the first cooperative group in the country. That's incredible. The cooperative group had to two institutions, Roswell Park and MD Anderson. Who tried to block you on these things? I know it must have taken a lot of courage to put all these drugs together. You mentioned Wintrobe. But were there others who were fundamentally opposed to using combinations? Oh, I'm getting to that. So with the first study, Protocol 1, Russell Park and MD Anderson, children received 6-MP and methotrexate simultaneously and in sequence. And it turned out that Protocol 1 was published. The combination had more frequent remissions and longer duration. So we were onto something. Next we did the prednisone. Prednisone's not myelosuppressive. We could do full-dose prednisone with 6-MP, full dose prednisone with methotrexate, same result. In every instance, the combination was superior to the sequence. So one day I'm sitting in my office. About once a week he'd come around and look. He came in one day. He said, Dr. Freireich, this ward is a mess. Everything is full of blood, the nurse's uniforms, the curtains, the ceiling. Well, anyhow, I was taking care of my bleeding children one day when a guy from Eli Lilly showed up. I think his name was Armstrong. And he said, we've got a new drug that was founded by-- you know who that was. Let me see his name. Mike Black. He discovered it in mice, periwinkle extract. Periwinkle had 80 alkaloids. And they screened them all against mice. And this one was active in one kind of mouse leukemia. But it wasn't active in L1210. So he said, we have this drug. And we offered it to Dr. Farber at Dana Farber. And we're going to offer it to you if you want to do it. I said, wonderful. So I wrote a protocol. And Zubrod said, but this drug is not active in L1210. And we know that the drugs active in L12101 leukemia are active in human leukemia. So this drug cannot be studied. Aha, time for Emil Frei III. I went to Tom. I said, look, Tom, vincristine is not myelosuppressive. As a single agent, it causes 80% complete remissions. I want to vincristine to 6-MP and methotrexate. Zubrod says no. Frei said, leave it to me. He talked to Zubrod. I told Zubrod, these children are dying. I've got to do something. So they approved it. And we did decide the VAMP. We knew prednisone was not myelosuppressive. We could add it to 6-MP and methotrexate, full dose. We knew this dose of 6-MP and methotrexate. Vincristine turned out to be not myelosuppressive, CNS toxicity. So we designed the VAMP drug. Then we said, let's let Holland and the other members of the cooperative group join so we can get this done quick. The cooperative group refused. Jim Holland refused. He wanted to do them one at a time, prednisone, 6-MP, methotrexate, vincristine, prednisone, vincristine, and so on. It would have taken us five years. We went through the same thing with MOPP. They wanted to do it one at a time. So we had to do it alone in the cancer institute. So Frei went to Zubrod and said, why can't we do it? Zubrod said, if you say it's OK, you can do it. Frei was chair of the group. And I'm not going to put my patients on the group. So Frei had to resign. Holland became the chair. And Frei was an advisor. So we started out with VAMP. We had 98% remissions. The remissions lasted about six weeks. We realized that they weren't cured. So we said to the parents, this treatment was toxic. It was full-dose 6-MP and methotrexate. And the parents said they're going to risk their children's life, but we're going to do what we called early intensification. That is, the children in complete remission would get full-dose induction therapy, never done before. And I met with the parents every morning and went over each child to be sure that they were with us. The parents were wonderful. We had solved the bleeding problem with platelet transfusions. We'd had white cell transfusions and so on. And they went along with us. So we did early intensification. We did it in about 12 patients. Two of them almost died, very severe infection on the brain. But we saved them. So we knew this was dangerous. But they all relapsed. Median duration remission was about eight weeks, even though we did early intensification. So MC Li had cured choriocarcinoma. I don't know if you know that story. MC Li and I were residents at Presbyterian at the same time. We were good friends. I was his advisor on this strategy. He measured chorionic gonadotropin in the urine. And he knew that as long as there was gonadotropin in the urine, they weren't cured. So he kept treating them. So we decided to follow the Li model. And what we did was we did early intensification, which they all survived, fortunately. And then we did intermittent reinduction. Every four to six weeks, we'd bring them in and give them another course of treatment. And we did that for a year. And then we stopped. And then we watched them. And that's when we found 20% of the patients were in remission at, I think, 18 months. Never been reported before. And I did report that to AACR. I've seen the AACR abstract. And I would love to know what was the energy in the room when that was presented. Did people stand up and throw rotten tomatoes at you, or did they stand up and applaud, or everything in between? No one applauded. Everybody was incredulous. The people in the group didn't believe it. Most people thought we were lying. If it wasn't for Frei, I'd have never gotten away with it. Let me ask you another question. Dr. Frei told me that the first patient you gave platelets to, you had to sneak out at night and do it. Is that true? He said there were people who did not want you to give platelet transfusions. The platelet transfusions were a bigger fight than the chemotherapy, because everybody knew that platelets were not the cause of it. Dr. Brecher had studied patients in the war from radiation injury. He had dogs that he completely phoresed, zero platelets. And they didn't bleed. So obviously, platelets were not the problem. The problem was a circulating anticoagulant. And I did experiments in the lab and proved that that was false. But anyway, the platelet transfusions are what made all of this possible, because the children all died of hemorrhage. And once we had platelets, we could treat them with the chemotherapy. Is there a story behind the first patients who got platelet transfusions? Again, Dr. Frei told me that-- Oh, boy, that's a wonderful story. I actually published it. This was a young man who was bleeding to death whose father was a minister. And since it was proven that platelets were not important and there was a circulating anticoagulant, I decided that the only way to arrest the hemorrhage was to do an exchange transfusion like you do in eritroblastosis fetalis. So I said to the minister, if you bring me 10 healthy volunteers, I want to do this experiment on your son. And he was desperate. His son was a beautiful 8-year-old boy. His name was Scotty Dinsmore. How do you like that? [LAUGHTER] Scotty Dinsmore was bleeding to death. And he arrived the next morning with 10 volunteers. And I sat down in the treatment room. And I did an exchange transfusion with 50 cc syringes, 50 ccs from Scotty in the trash can, 50 ccs from the donor in Scotty. And we calculated I had exchanged three blood volumes to get to where the concentration was detectable. And when I finished this four-hour procedure, bending over my back with syringes and volunteers, his platelet count was 100,000. And is bleeding completely stopped. So we thought we'd made a breakthrough, but we were smarter than that. We watched him every day and did a platelet count. And we found that the platelet lifespan was four to six days. And when the platelets got below 10,000-- we had done a retrospective study, and we knew what the threshold for bleeding was. And he started bleeding again. So it was obvious that it was not an anticoagulant. I did experiments in my lab. I took the serum and mixed it with the plasma and so forth. So we proved that it was platelets and not an anticoagulant. And then we had to figure out how to get platelets. And Allen Kleiman in the blood bank and I worked together to do platelet phoresis. We took the unit separate platelets, put the blood back, volunteer donors. And we proved that platelets stopped the bleeding. And we published that, a great paper, citation classic. I was going to say for the young folks. And I asked Dr. Frei this too when I was at the Dana Farber. Did you ever doubt yourself? Did you think, we need to quit doing this? This is more than we can handle. I know Dr. Farber was widely criticized in Boston for-- Oh, boy. He studied vincristine at the same time we did. Yeah. So did you ever say, maybe we should set this whole system down and give up? No, I was never intimidated, because Dr. Zubrod gave me orders, cure leukemia. So I was going to do it. Yeah, my impression from talking with Dr. Frei is Gordon Zubrod was the sort of unsung hero in all of this. He is. He is. He had the courage to back a 25-year-old guy and his resident to do things that were potentially insane. We could have gone to jail for what we did. We could have killed all those kids. That's what Dr. Frei-- Dr. Holland has told me the same story. So we owe you a great debt. So let me ask you. When you were the president of ASCO, in those days, what made you decide to run for ASCO? It was still pretty early in the early 1980s. Well, that's a very good story. I'm a pioneer in that regard too. When you became a cancer doctor, you had to join the AACR. AACR was dominant. I joined the AACR. I sent my papers on platelets and chemotherapy to AACR. They accepted all of them. But they put the clinical papers on Saturday morning. When I gave my first paper at AACR, the chairman of the session, my wife and my son were the only ones in the audience. Nobody stayed till Saturday morning. So I got mad. I said, I'm discovering things, and I can't present them at AACR. No one's listening. So we said, let's form a society that is clinical oncology and meets the day before AACR the clinical scientists who want to go AACR don't have to go to two meetings. So we organized a plenary meeting the day before AACR began. In the first session, we had a lecture on CML from-- I forgot who the talker was who is treating CML, Berechenal or someone. Karanovsky? I don't know. So we had lectures, not papers. And we did that for a couple of years. And then AACR knew what we were doing. We were totally cooperating. But we hired a manager. And we started a scientific exhibit. So we had lots of money. And AACR needed money. And we were rich. So I got a call from the president of AACR. And he said, we don't want to continue to meet at the same time, because all of our doctors want to get these free samples. And they go to your meetings, and they don't go to our meetings. So we're separating from ASCO. I said, that's terrible, because the ASCO doctors all want to go AACR. He said, sorry, we can't take you anymore. I forgot who was president at the time. So ASCO had to separate from AACR. They separated from us. Most people think we separated from them. They separated from us. You were there at the very start. So I really appreciate your contributions to the field. And I appreciate your taking time today. And I appreciate all the things you did to help all the patients who've now survived that wouldn't have if you hadn't. Thank you very much. Until next time, thank you for listening to this JCO's Cancer Stories, the Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or a review on Apple podcast or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, the Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org.

Brent, Joseph, and Brandon welcome Ron Cooks, a great friend of the show, to Breaking Business Barriers. Ron Cooks is a proud military veteran of 25 years, turned real estate professional. Ron shares a story from Operation Desert Storm and explains the positives and negatives of wearing a MOPP suit in desert temperatures exceeding 120 degrees. These suits were designed to help keep our soldiers safe against chemical weapons. While Ron was preparing for his retirement from the military, he was selling his home as a for sale by owner. That process of selling his home opened the doors to his career in real estate. Ron classifies himself as an entrepreneur in transition. He explains how being constantly in transition better helps his clients and team members. His innovative approach as a leader has led to newfound success. Ron's advice to aspiring professionals - persistence and consistence. As we close out our episode with Ron, he shares a comical story about a very special home for sale. It's a knee slapper for sure.

Very Old Fish träumt davon, dass Wizadora auf einem fliegenden Teppich durch die Welt saust. Aber sie hat keinen Teppich. Da soll der Mopp herhalten. Er kann zwar sprechen, aber es dauert eine ganze Weile, bis er das Fliegen lernt. Und am Ende ist Wizadora zu schwer für den fliegenden Mopp. Damit sich dieser nichts auf seine neuen Fähigkeiten einbilden kann, wird er von Hangle, dem Kleiderbügel, seiner ursprünglichen Bestimmung wieder zugeführt: „I can’t fly, Wizadora, but now I can clean my floor“. (Online-Signatur Medienzentren: 4981720)

Katie ist verschwunden. Tom sucht Hilfe bei Wizadora. Doch nur Phoebe Telephone ist zu Hause, die penibel eine höchst detaillierte Personenbeschreibung aufnimmt. Als Wizadora zurückkommt, sucht sie mit ihrer Zauberbrille (magic glasses) die Umgebung ab: Katie ist nicht zu sehen. Da erscheint Tatty Bogle in der Zauberküche: Entsetzt erzählt sie von Katie, die auf dem Mopp durch die Luft fliegt und nun umständlich in der Mitte der Freunde landet. (Online-Signatur Medienzentren: 4981721)

Today's story: Airmen and Soldiers participate in a joint training exercise on chemical, biological, nuclear and high yield explosives techniques and procedures.

Guest: Duane BrownFounder of Take Some Risk Bio: Duane has been called an international man of mystery and digital nomad by friends. He has lived in 5 cities across 3 continents and visited 40 countries around the world. He uses his curiosity for people and love for people watching to run better marketing campaigns for clients. After leaving Toronto, Canada in 2011 to gain an international view of the world. He has worked for Telstra in Australia and brands including ASOS, Mopp (bought Sept. 2014), NSPCC, Jack Wills and Grant Thornton while in London, UK. He now lives in Vancouver, Canada helping brands grow through data, CRO and marketing. Links: https://www.takesomerisk.com/ https://www.instagram.com/TakeSomeRisk https://www.Twitter.com/DuaneBrown Sponsored by: Spark Shipping – Dropshipping Automation

Angela Beltz of Reynoldsburg is a 49-year-old Ohio National Guard veteran who served in Operation Desert Shield and Operation Desert Storm in 1990 and 1991. Beltz’ military career started after her junior year in high school, having joined the North Dakota Army National Guard in 1986. She grew up primarily on the Spirit Lake Nation reservation and wanted to experience life away from it, she said. She also was looking for a way to pay for college. Military service might be in Beltz’ blood, as her ancestry is rich in it. “My great-grandfather was a scout for the U.S. Cavalry, (and) my relatives on this side have served in every conflict,” she said. “My grandpa served in World War I before he was officially a U.S. citizen and allowed to vote.” On her father’s side, military service can be traced back to the Civil War, she said. Beltz also recently submitted an application to become a member of the Daughters of the American Revolution. Beltz’ basic training began at Fort Dix in New Jersey in 1986, during the summer between her junior and senior year, when she was only 17. She recalled a drill sergeant who was particularly challenging – frequently barking at her to do pushups. “He picked on me. Every time he saw me, he made me do pushups,” she said. “I hated going to eat because -- if he was marching us -- because I was guaranteed at least 100 pushups (during) that three-block (trek).” She said she had asked him at the end of basic training why he was so tough on her. He told her it was because she was so young and that he wanted to make sure she would make it. After basic training, Beltz returned to high school for her senior year. She recalled the students all thinking about homecoming and prom and how their hair would look. “Those things were no longer important to me,” she said. During a nine-month break, she said, she took part in an 11-day stint with the Marines but re-enlisted with the National Guard in North Dakota and attended refueling school at Fort Lee, Virginia. Beltz said the equipment for fuel was mostly the same as that used for water distribution. Beltz was deployed to Saudi Arabia in September 1990 and eventually was moved to Log Base Charlie near Rafha, a town in northern Saudi Arabia near the Iraq border, as part of the 134th Quartermaster detachment. The unit comprised 24 people ages 18-23, with the exception of three staff sergeants. Many of the soldiers had attended high school together, including her cousin. “We all basically grew up together, so it was really kinda weird,” she said. “It was like the Brady Bunch going to war.” While in Saudi Arabia, Beltz had to endure the threat of not only scud missiles but also chemical alerts. In one incident, a chemical plant had been bombed and the wind was blowing chemicals in the direction of her unit, prompting MOPP 4 – a mission-oriented protective posture that required all protection to be worn, including suit, boots, mask and gloves. She also described the stigma of being an American woman in Saudi Arabia, where women weren’t even permitted to drive. “You would see the strange looks of people … and you were a female and you were driving, they’re just like, ‘Oh, my gosh, you know, what is this woman doing driving?’” she said. “Some of the police and border people weren’t real happy to have us there.” After six months in Saudi Arabia, her unit came home and was invited to participate in a ticker-tape parade in New York City that “didn’t work out.” Her plane had developed a fuel leak and had to land at an Air Force base and wait for several hours to have the plane dug out of a snow bank. They had missed the parade. Upon returning home, her Dakota tribal elders honored her with two Indian names because she was an “Akicita” – meaning “warrior,” she said. One was Kowakapi-Sni-Winyan, which is translated to “I Am Not Afraid Woman.” The other is Tasunka-Na-Kan, which is translated to “She Rides Her Horse.” Beltz had met her husband, Daryl Beltz of Ohio, overseas during Operation Desert Storm and transferred to the Ohio National Guard upon her return. Beltz’ next deployment was to Stennis International Airport near Kiln, Mississippi, after Hurricane Katrina in 2005. She said numerous units from all branches of military and most of the states had arrived there, even a North Dakota unit she had recognized – a water-purification unit. The flooding was devastating, she said, but the looting was widespread. Military personnel and police were under fire on occasion while trying to secure areas from being looted, she said. “It just gives you a glimpse of the breakdown of society when there is no law and order,” she said. In some areas, however, local residents were more welcoming, she said, even inviting military personnel to cookouts. Following her retirement from service, Beltz was hired by DFAS-Columbus and continues to take care of soldiers and their families. She’s also an advocate for women serving in the military and for female veterans. She is the chairperson of the Ohio Women Veterans Advisory Committee, under the director of the Ohio Department of Veterans Services. Her decorations include the Army Achievement Medal, the Army Commendation Medal, the National Defense Service Medal with Star, the Global War on Terrorism Service Medal, the Armed Forces Reserve Medal, the Humanitarian Service Medal, the NCO Professional Development Ribbon, the Army Service Ribbon, two Kuwait Liberation Medals, a Driver Mechanic Badge, the Ohio Commendation Medal and the Ohio Defense Service Medal. Her husband, Daryl, also a Desert Storm and Afghanistan veteran, is a lieutenant colonel in the Ohio Army National guard. They have two sons, Wyatt and Garett. Wyatt is now an airman in the U.S. Air Force. “So the legacy continues,” she said. This podcast was produced and hosted by Scott Hummel, ThisWeek assistant managing editor, digital.

Follow @lilmopptop live in studio interview from H D E Luxury Studio Phila PABack at it live updates and more follow us on ig @wmihradio email whosmakingithappenradio@gmail.com for spins interviews and more

Follow @lilmopptop live in studio interview from H D E Luxury Studio Phila PABack at it live updates and more follow us on ig @wmihradio email whosmakingithappenradio@gmail.com for spins interviews and more

Duane Brown has been called an international man of mystery and digital nomad by friends. He has lived in 5 cities across 3 continents and visited 40 countries around the world. He uses his curiosity for people and love for people watching to run better marketing campaigns for clients. After leaving Toronto, Canada in 2011 to gain an international view of the world. He has worked for Telsta in Australia and brands including ASOS, Mopp (bought Sept. 2014), NSPCC, Jack Wills and Grant Thornton while in London, UK. He now lives in Vancouver, Canada. Favourite Place: Laos Favourite Food: Cheese Duane Brown Vroom Veer Stories Believe In Yourself I have lived in 5 cities across 3 continents and visited 40 countries around the world. Moving to Australia and UK with just a visa and money in my pocket was scary but also the best thing I did for my life and career. Sometimes you just have to jump off that cliff and hope you make the landing... when taking a calculated risks. Do What Scares You AND don't get to comfortable in life Quit my job 14 months ago to startup my own agency and those it was super scary with tons of unknown. I did it because it scared me and I need to get outside of my comfort zone if I was going to do something amazing. Stand Your Ground When I lived in London and worked for a startup. The dev team made a major change and our perform and conversions drops. They swore for weeks that there is no way the design of a website could drop performance. Despite everyone disagreeing with me I had numbers to back me up and stuck to my ground until we changed the site back and saw numbers return. I was lucky that the CS team agreed with me. Always Research and Plan My life advice when people ask me how to move abroad. Value Your Time I was taking a trip to Poland and landed at the airport. I did my research and found out that there are two buses downtown: regular and express. The former stops at every stop to the city and takes just over an hour. The latter makes 4 stops and gets you downtown in 30 minutes and only costs you a few dollar more. You can always make more money but you can not create more time. Always find out all your options when leaving an airport. Don't just follow the crowd who 98% went to the regular bus. Me and 3 other people shared the express bus. I'm lucky Luck is really just preparation meet opportunity and saying yes to everything that comes your way. Usually I'll say "yes and" to qualify people and only take on amazing work, clients and opportunities. More people should say yes to life and enjoy the opportunities that come their way when they live a positive and happy life. Duane Brown Connections www.takesomerisk.com LinkedIn Instagram

Der „wilde Mopp“ bezeichnet in der Regel ein sehr gefährliches Putzgerät. Bekannt für seine Gründlichkeit, aber auch seine Unberechenbarkeit gegenüber verdreckten, politischen Ressentiments. Am Besten im Schrank zu halten, bis der Frühjahrsputz naht. Episode auf iTunes gratis anhören.

In this Pacific Newsbreak, U.S. Forces in Japan updates the liberty policy for all service members and Sailors and Marines in Iwakuni conduct realistic training on land and in the water.

The Landmarks series continues with DeVita's original MOPP (Hodgkin's Disease) publication from 1970. Discussion points include WBC monitoring, why cyclophosphamide isn't included, and wigs.

On this episode Duane Brown, Founder at Take Some Risk, joins The PPC Show. A global citizen with 11+ years experience working across digital marketing and branding for clients including ASOS, Mopp, Telstra, Jack Wills, Cineplex, Grant Thornton and BBDO. This opportunity has given him the chance to work with large data sets and help advise global brands on the best approach to using paid search, paid social and display + programmatic to increase conversions while maintaining budgets. --- Send in a voice message: https://anchor.fm/the-ppc-show-podcast/message

Kommen ein Minbari und ein Centauri in eine Stripbar... Londo erhält nämlich den Auftrag, etwas mehr mit anderen Rassen auf der Station anzubandeln und da sucht er sich den erstbesten aus, der nicht schnell genug weglaufen konnte: Lennier. Wir erleben die beiden also, wie sie sich durch die Station schlagen und das ist tatsächlich wörtlich zu sehen. Dabei begann der Abend doch ganz harmlos in der Stripbar, in der Lennier den guten Londo mit seiner Lebensgeschichte zu Tode langweilt: Wir erfahren, er hat ein ähnlich spannendes Leben im Kloster wie Herr Lano auf Puerto Patida. Unser Minbari-Klosterschüler hat sich allerdings weniger mit geistigen Getränken, als mit geistreichen Rechnereien beschäftigt. Und treibt kurz darauf als wahnsinnger Wahrscheinlichkeits Wahrsager seine Mitspieler am Pokertisch in den Wahnsinn - und in den Bankrott Deutlich weniger lustig und noch nicht mal schlüpfrig geht es in den anderen beiden NebenHandlungen zu, von denen wir trotz der titelgebenden Heilerin keine ernsthaft als Haupthandlung bezeichnen würden. Zumal sie am Ende ohnehin irgendwie zusammenmäändern. JMS hat tiiiiiiieeeef in die Klischeekiste gegriffen und wir präsentieren: HERRN MÜLLER! Der hat es irgendwie geschafft, einen Sicherheitsmann umzubringen, obwohl Garibaldi diesen doch persönlich ausgebildet hatte... Deshalb will unser Sicherheitschef den bösen Deutschen am liebsten in die Luftschleuse stecken, wo er gesiebtes Vakuum atmen kann. Schließlich ist ja kein Platz im Knast. Und erst recht nicht für Verbrecher, so! Schließlich kommt man überein, dem fiesen Möpp einmal mit dem Mopp feucht durch den Kopf zu feudeln, sein Hirn einmal neu zu formatieren und das Betriebssystem "Angepasster Trottel 2.0" frisch aufzusetzen. Dazu muss die gute Talia aber erstmal dramaturgisch wirksam feststellen, wie fies der Typ wirklich ist. Für die Zuschauer, die das vor lauter Augendrehen bisher verpasst haben Zum Glück kommt der Bösewicht nicht weit und landet in der C-Handlung der Folge um eine illegale Praxis und eine mysteriöse Alienmaschine, die eine vetrocknete alte Schachtel irgendwo ausgegraben hat und jetzt dazu nutzt, um Andere zu heilen. Dabei hat die Maschine doch früher eigentlich dazu gedient, Leute hinzurichten, indem man ihnen die Lebensenergie entzieht...hm...ob sich das irgendwie mit der 2. Handlung verbinden läßt? Und so kann sich JMS ziemlich billig aus der Affäre ziehen, was die moralische Bewertung von Strafe und Sühne befrifft. Und auch die Krankheit der angesprochenen alten Schachtel betrifft. Ausserdem kann Franklin auch gleich noch die nicht ganz so vertrocknete Tocher der Schachtel zum Essen einladen. Und was macht Susan? Wir sind weniger als unterwältigt, was zwei der 3 Handlungstränge betrifft und würden - wie Londo in dieser Folge übrigens auch - maximal einen Penis aus unseren Klamotten ziehen, wenn da nicht dieser tolle Handlungsstrang um unser verrücktes Paar gewesen wäre. Londo und Lennier reissen die Wertung damit nach oben, so dass wir am Ende 2,5 von 6 Penissen vergeben können.

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