Simoneʼs OncOpinion

JOSEPH V. SIMONE, MD, has had leadership roles at St. Jude Children's Research Hospital, Huntsman Cancer Institute, Memorial Sloan-Kettering Cancer Center, the University of Florida Shands Cancer Center, the National Comprehensive Cancer Network, and the National Cancer Policy Board, and has served on the NCI's Board of Scientific Advisors.His OT column has been recognized with awards from the American Society of Healthcare Publication Editors, as well as with APEX Awards of Publication Excellence. He welcomes comments and suggestions. Email him at [email protected]It is not unusual during one of my walks in the park for some aspects of my life to pop into my head for no discernable reason. I find myself reminded of a success or failure, a bit of wisdom or foolishness, a productive or embarrassing act. In fact, my embarrassments and poor judgments pop into my head unbidden more often than any other aspect of my musings. It seems the negatives left deeper impressions on my psyche than the positives. My favorite in this category occurred when I entered the first grade at Ryerson School. Miss Peterson asked some of us students when our next birthday was. When she asked me, I said, “I don't know what it is this year, but last year it was September 19th.” My classmates roared in laughter immediately. That is the only thing I remember from that class. Fortunately, it is also not uncommon for me to think of how lucky I have been in life. And that thought always reminds me of those who helped make that “luck” happen, including family members, teachers, mentors, colleagues, and authors. We all receive lots of advice and learn important lessons during our lives; most of it is evanescent, like a fleeting fog that leaves no permanent impression. The advice and lessons I remember are those I acted on and benefited from, a selection of which follow: Dr. Ted Schwartz The first professional advice that stuck with me was offered during my residency in internal medicine at what was then Presbyterian-St. Luke's Hospital in Chicago. It was my first in-depth exposure to careers in academic medicine. It began to appeal to me, so I told Dr. Ted Schwartz, an endocrinologist the house staff held in great regard, of my interest and asked what advice he might offer me. He said, “you need to learn to do two things: write well and speak well.” He said these were essential basic tools and that the science and medical direction would come later. I asked how one develops these skills. He said you must write and speak. That was pretty thin gruel for me, so I began reading about how these skills are developed and found written advice. To write well you must read excellent literature so that a good style and vocabulary become embedded in your thinking. I also bought The Elements of Style by William Strunk and E.B. White. The fourth edition, a slim paperback of fewer than 100 pages, sits on my desk. It is the most concise and accessible primer on writing well. I also read that good writing comes from reading poetry. A poem's concision, clarity, and economy of words often leave a strong impression; this was something to emulate in prose or scientific writing. Very good advice. I then started keeping a journal to write observations and thoughts about my professional work, family, public events, books I read, movies I had seen—anything that interested me, just to get in the habit of writing. I started the journal in August 1962, almost 50 years ago, and have continued to make entries ever since. Dr. James Campbell What about speaking? The first opportunities I had to speak publicly were at the elaborate grand rounds run by Dr. James Campbell, the chair of medicine at that time. He was old school. Grand rounds started precisely at noon and ended precisely at 1 pm. If you arrived late, Campbell would stop the proceedings and verbally tear a long strip of hide off the offender. You also could not eat or drink anything in the auditorium. If he saw someone with a lunch bag, he would say, “Did you bring enough for everybody?” And the offender was asked to leave. He did this because in those days we often brought the patient under discussion to the grand rounds to hear directly from him or her about symptoms and signs of the disease under consideration. Campbell said it was discourteous and disrespectful to eat or drink when the patient was there. The ban was enforced even when we didn't have a patient in the room because one could not predict whether or not a patient would be present. We residents had to present the history, physical findings, imaging studies, and all laboratory results in a coherent, concise manner, followed by our own diagnosis. Then came questions from Dr. Campbell and others—often quite tough ones to see if the speaker covered all possibilities. The lessons imbued in us were: know your material cold; be prepared for questions; make the presentation clear so anyone in the audience can grasp it. Dr. Campbell, by his example, also taught us that respect and courtesy were essential parts of approaching a patient, no matter the setting. This imprint went deep and stayed with me. Dr. Donald Pinkel Dr. Donald Pinkel offered the next bit of advice that stuck. He was the first director of St. Jude Children's Research Hospital and the man who gave me my first job after I completed my training in 1967. When I was appointed director of St. Jude in 1983, he called to congratulate me. I thanked him and asked if he had any advice for me. What he said surprised me, “Take time to think; make it part of your schedule.” He knew well the pressures on one's time when heading an entire institution. So I took his advice and scheduled two hours every Tuesday and Friday afternoon to think. My secretary blocked out the time and could not schedule anything without asking me first. Very soon I saw the wisdom of his advice. Sometimes I pondered professional problems, or read an article that I hadn't gotten to, or walked the halls of the building to get a sense of cleanliness, orderliness, and the like. The time could not always be protected because of an urgent meeting or a visitor, so I would have to skip a day, but the “meeting with myself” stayed on my calendar for a long time. It was invaluable. Many times the extra thought and investigation helped me choose a better direction. Mary Kledzik, my secretary at the time, understood the principle involved in such an approach. When I would write a blistering note in anger for her to type (no e-mail then, thank God), she would bring it into my office and say, “Dr. Simone, you should put this in your desk drawer for a day or so.” More excellent advice. My Dad The final example of good advice I received occurred when I was about nine years old (1944). My dad loved movies, and a big treat for me was when he took me downtown to see a movie at the Chicago Theater. One Saturday we went to see an early movie (each movie ran continuously in those days), we then had lunch and went to see another movie. Heaven! After the second movie we walked up Michigan Avenue to the Tribune Tower where an American fighter airplane was on display in the courtyard. It was a P-47 Thunderbolt (I knew all the planes). It was a thrill to be that close. I can see the scene even today: as we walked away, I commented to my dad that I hated the Japanese, a common and vocal sentiment in those days. He stopped walking and looked me in the eye and said, “You should never hate anyone; you should hate what they do.” He said it kindly, without anger, and it reflected how he lived his life. I will never forget that advice, the best of all. Hear Joe Simone on BBC Radio!ImageJoe Simone was recently interviewed by the BBC radio program “Soul Music,” following up about his 5/10/12OTcolumn about Peggy Lee's song “Is That All There Is?,” written by Jerry Leiber and Mike Stoller. Listen to hear him talk about why this devastating song about disillusionment inspires him nonetheless: http://www.bbc.co.uk/programmes/b01qgr4h

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