Dr. Donald Pinkel, big damn hero, has passed away at 95.
About 23 years ago, I was watching some sort of special on PBS. I don’t remember the title, but as I recall, they were talking about developments during the 20th century. One of the things they spent a lot of time on was the story of childhood leukemia.
There were drugs that could push leukemia into temporary remission. Emphasis on the “temporary”. It always came back.
Dr. Pinkel combined multiple chemotherapy drugs to drive the disease into remission. Then, when the patients were healthy enough, he and his team bombarded their skulls with radiation and injected drugs directly into their spinal columns, attacking places where Dr. Pinkel suspected the cancer was hiding during remission.
This would go one for months, even years. Children would lose their hair, their appetites. Some died. But by 1968 Dr. Pinkel’s regimen, which he called Total Therapy, was achieving remarkable results: Out of 31 patients in one study, 20 were in complete remission after three and a half years.
A decade later, after continued refinements to the protocol, the five-year survival rate was up to 80 percent. Today, still using Dr. Pinkel’s framework, it is 94 percent.
I realize we’re talking 60 years of scientific advancement here. But to me, this is still an amazing story. Turning things around from “everybody dies” to (almost) “everybody lives”. And going from zero to 80% in sixteen years?
Beyond that, Dr. Pinkel also helped build St. Jude.
One day in 1961 Dr. Pinkel got a call asking if he would be interested in a job as the head of St. Jude. During a period of emotional and professional distress, Mr. Thomas, the hospital’s founder, had prayed to St. Jude, the patron saint of lost causes, for help. When he recovered, he decided to build a hospital to help children in similarly dire straits.
Dr. Pinkel was tired of the cold, wet Buffalo winters, but he wasn’t sure about the offer: Memphis was a segregated Southern city, and many in the medical community said Mr. Thomas’s status as a television comedian made it hard to take the idea seriously.
Still, he met with several members of the hospital board and came away impressed. They, like him, believed in focusing their efforts on childhood cancer, and they agreed that the hospital should be need-blind, and that both its staff and its patient population should be completely desegregated.
Dr. Pinkel drove to Memphis in his Volkswagen Beetle, arriving to find a hole in the ground where the hospital would one day be. He made himself an integral part of the planning process, insisting, among other things, that the hospital have integrated bathrooms.
He also insisted on as much common space as possible, including a single cafeteria for all —- doctors, scientists and administrators — to encourage creative cross-pollination. He also opened the cafeteria to patients and their families, to give staff members a visual reminder of their collective mission.
“It was a civil rights culture,” Jackie Dulle, one of his first executive assistants, said in a phone interview. “He wanted everyone to be equal.”
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Dr. Pinkel and his team found early success with his Total Therapy approach but kept the results unpublished until the late 1960s, to ensure that the data was solid. Still, when he did publicize his findings, he was met with skepticism, even derision; other doctors said he was cruel to give patients and their families hope in the face of what everyone knew was an incurable disease.
But after he invited a few of his most prominent critics to visit the hospital, they changed their tune; one of them, Alvin Mauer of Cincinnati Children’s Hospital, took over as the president of St. Jude when Dr. Pinkel left.
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