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0:00 - Segment 00A: Interview Identifier

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Partial Transcript: "OK, so we are recording. And I’m Tacey Ann Rosolowski. Today is the 20th of February, 2015, and I am interviewing Dr. Alma Rodriguez for the Making Cancer History Voice Oral History Project run by the Historical Resources Center at MD Anderson Cancer Center in Houston, Texas. Dr. Rodriguez came to MD Anderson in 1986 as an instructor, laboratory research and clinician in the Department of Internal Medicine. I have that correct?"

Segment Synopsis:

Keywords:

Subjects:

1:49 - Segment 01: Growing Up in a Migrant-Worker Family

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Partial Transcript: "Well, I wanted to start kind of with regular background information and I wanted to ask you where you were born, and when."

Segment Synopsis: In this segment, Dr. Rodriguez recalls her early life when her parents worked as migrant workers in the fields of Texas and in California. She talks about the effect of experiences in her neighborhood on her later life and recalls the huge range of illnesses she saw in her community where there was little medical care. Dr. Rodriguez also characterizes her parents as “survivors” who were committed to family. She recalls that her family was very frugal, but she never felts as though she lacked for anything.

Keywords:

Subjects: 1. Segment Code - A: Personal Background 2. Story Codes - A: Character, Values, Beliefs, Talents A: Influences from People and Life Experiences A: Personal Background

10:44 - Segment 02 : Support from Teachers and Family Leads to a College Education

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Partial Transcript: "Yeah. So tell me about your educational experience. When did you know that you were going to focus in the sciences, and perhaps even medicine?"

Segment Synopsis: Dr. Rodriguez talks about her educational path leading up to medical school in this segment. She says that she was encouraged to study from elementary school, when she took an IQ test and scored very high. She recalls that she was asked if she had cheated on the test. Nevertheless, her parents were advised to encourage her to study. Dr. Rodriguez explains that her mother was concerned about her plans to leave their small town to go to college, though her father supported the idea.

She says that coming from her background, going to college “was a miraculous thing.” She had little assistance applying to college, but explains that she was advised to apply for scholarships. She recalls going to San Antonio to meet with the selection panel for a scholarship. She was not awarded that scholarship, but one of the nuns on the panel arranged for a scholarship from Our Lady of the Lake College (BA conferred in 1975).

Dr. Rodriguez explains that, for practical reasons, she majored in Spanish with the intention of teaching. However she did very well in the sciences and her advisor, Dr. Rigual, advised her to consider medical school. Dr. Rodriguez recalls the educational environment at Our Lady of the Lake College, including a research program that was available and gave her experience in research methods. She began to think about going to graduate school to do research.

Keywords:

Subjects: 1. Segment Code - A: Educational Path 2. Story Codes - A: Personal Background A: Experiences Related to Gender, Race, Ethnicity A: Influences from People and Life Experiences A: Inspirations to Practice Science/Medicine A: Professional Path

23:02 - Segment 03: Going to Medical School

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Partial Transcript: "So yes, that was my exposure to research, which sort of was why I was thinking, really, that I wanted to go to graduate school to pursue that further. But in the meantime, between my junior and senior year, usually I had done either summer courses or summer research work, or something like that, the prior two years, but in between my junior and senior year, I really didn’t have anything planned, job-wise. And sometime in the spring of my junior year, two African American students from Baylor College of Medicine showed up on the campus."

Segment Synopsis:
In this segment, Dr. Rodriguez talks about her decision to go to medical school and describes her experience at the UT Medical School in Houston, Texas (degree conferred in 1979). She recalls that African-American students from Baylor College of Medicine came to Our Lady of the Lake College to talk about summer research projects at Baylor and recruit minority students to medical school. She applied to the research program, was accepted, and the experience encouraged her to consider applying to medical school.

Dr. Rodriguez talks about getting a full-tuition scholarship to the Medical School in Houston and recalls the reactions of her family to this new move. She also talks about the unique and grueling three-year program and reviews the pros and cons of the different specialties she considered.

Dr. Rodriguez speaks about a rotation at MD Anderson. She talks about the “personality” of cancer patients, who were so appreciative of care, and explains the features of oncology that appealed to her (though she did not decide to go into oncology at this point).

Keywords:

Subjects: 1. Segment Code - A: Educational Path 2. Story Codes - A: Character, Values, Beliefs, Talents A: Inspirations to Practice Science/Medicine A: Personal Background A: Professional Path C: Cancer and Disease C: Patients

38:59 - Segment 04: A Revealing Internship and Residency

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Partial Transcript: "At that point, I still wanted to do primary care. And I chose my training in internal medicine in San Antonio, one, because I had been there in college, and I liked San Antonio, but also because the population base for the medical school in San Antonio and for the training in San Antonio is largely Hispanic. And I sincerely wanted to learn more about healthcare in the Hispanic population, the Hispanic community. Diabetes is a very major issue, very major health problem. I thought I might veer in the direction of diabetes-related care and illnesses. But again, as I did my oncology rotation, I again found that very interesting. I also had a very dynamic attending. It makes a very big difference."

Segment Synopsis:
In this segment, Dr. Rodriguez talks about her residency and her decision to focus on oncology. She explains that she chose to do her internship in internal medicine at te UT Health Sciences Center in San Antonio (1/1979−1980) because she wanted to focus on health issues in the Hispanic population, particularly diabetes. She stayed in San Antonio for her Residency in Internal Medicine (1/1980−1982) and decided during her first year to focus on oncology. Next she decided to do a fellowship and approached Dr. Daniel von Hoff about working in his laboratory. (Research Fellow, Cancer Therapy and Research Center 1/1982−1983.) She explains that she wanted a year to familiarize herself with this new field and to take time for personal reflection.

Dr. Rodriguez also describes the research she conducted at the time, relating to Dr. Hoff’s theory that treatments could be personalized to the specific sensitivities of a tumor. She explains the work she did on the research projects and notes that this intellectual environment influenced her thinking about cancer.

Dr. Rodriguez then explains why she elected to do her fellowship in hematologic cancers (Fellow of Hematology/Oncology, University of Arizona Cancer Center, Arizona Health Sciences Center, Tucson, 1/1983−1986).

Keywords:

Subjects: 1. Segment Code - A: Professional Path 2. Story Codes - A: Professional Path A: Influences from People and Life Experiences A: Inspirations to Practice Science/Medicine A: The Researcher D: Understanding Cancer, the History of Science, Cancer Research

52:45 - Segment 05: The Problem of Diabetes among Hispanics

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Partial Transcript: "OK. You said you had gone to San Antonio to—with also the intention of providing some kind of medical care for the Hispanic community. And I’m wondering where that piece, how that evolved over the course of your increasing interest in oncology."

Segment Synopsis: In this segment, Dr. Rodriguez explains why she abandoned her original intentions to work with diabetes in the Hispanic population. She explains that obesity is a cultural and medical issue for all patients. She talks about the centrality of (unhealthy) foods in Hispanic culture and the challenges of changing deeply engrained habits.

Keywords:

Subjects: 1. Segment Code - A: Overview 2. Story Codes - A: Professional Path A: Character, Values, Beliefs, Talents A: Inspirations to Practice Science/Medicine A: Personal Background A: Professional Path D: Cultural/Social Influences

56:52 - Segment 06 : Fellowship Research and the Move to MD Anderson

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Partial Transcript: "So tell me about the research that you undertook when you were at Arizona."

Segment Synopsis:
To begin this segment, Dr. Rodriguez sketches her research while a Fellow at the University of Arizona Cancer Center. She recalls that is was an exciting time in cancer research, given the availability of DNA analysis and new techniques in molecular biology. Dr. Rodriguez says she knew she wanted to be in a research environment. Her mentors in Arizona eventually connected her with colleagues at MD Anderson.

Dr. Rodriguez recalls that when she came to MD Anderson in 1986, the institution was undergoing a reorganization that made times difficult in the Division of Cancer Medicine. She explains that the turbulence made it difficult for a junior faculty member to settle in, as her mentors kept changing. Over the course of her first four years, Dr. Rodriguez says she realized she would not be successful as a researcher and explains the importance of having an anchor point in the institution as a basis for becoming a truly independent researcher.

Next, Dr. Rodriguez talks about her mentor, Dr. Fernando Cabanillas, who was passionate about advancing the treatment of lymphoma. Dr. Rodriguez explains that she designed studies and tested drug combinations within Dr. Cabanillas’ laboratory.

Keywords:

Subjects: 1. Segment Code - A: The Researcher 2. Story Codes - A: The Researcher A: Joining MD Anderson B: MD Anderson History C: Mentoring C: Understanding the Institution

64:08 - Segment 07: Shifting Focus from Research to Administration

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Partial Transcript: "So most of my career, really, was about designing drug combinations, testing them in clinical trials to define or determine efficacy. So that really was the, if you will, the defining perspective of the work I did for many years. And then sort of in a surreptitious way, I started doing administrative work."

Segment Synopsis: In this segment, Dr. Rodriguez sketches how she began to shift away from research as her main focus. She began, she says, by doing administrative work “in a surreptitious way.” Dr. Cabanillas asked her to serve as Director of the Lymphoma Clinic, a role that gave her experience, demonstrated her knack for administration, and her commitment to making things better for patients. She talks about working with clinical pharmacists, a new breed of specialists at MD Anderson, and the roles this connection led to.

Dr. Rodriguez then talks about how important grantsmanship is for researchers.

Keywords:

Subjects: 1. Segment Code - A: Professional Path 2. Story Codes - A: Professional Path A: The Administrator C: Evolution of Career D: On Research and Researchers

71:48 - Segment 08: Research on Lymphoma Treatments

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Partial Transcript: "Yes. OK, so that was really the watershed moment, it’s, like, OK, I’m moving on. And then this Medical Director opportunity comes, and you excelled in that area. So what were you thinking about now? You know, you’re kind of redirecting your MD Anderson career. So how did you begin to think about that? What was the next opportunity you looked for?"

Segment Synopsis: In this segment, Dr. Rodriguez describes studies she conducted on lymphoma treatments in collaboration with Dr. Cabanillas. She first explains a study that showed the efficacy of ifosfamide among patients who did not respond to the CHOP treatment. She next talks about use of the same drug for patients awaiting stem cell transplantation. This study is still in regular use.

Dr. Rodriguez then says that the current atmosphere at MD Anderson focuses on developing new drugs rather than optimizing older drugs. As an example of the value of retaining older ideas, she mentioned work by Dr. Wilson that shows that continuous infusion of drugs is more effective than bolus administration, an idea that Dr. Cabanillas originally explored.

Keywords:

Subjects: 1. Segment Code - A: The Researcher 2. Story Codes - A: The Researcher C: Discovery and Success

0:00

ROSOLOWSKI:

OK, so we are recording. And I’m Tacey Ann Rosolowski. Today is the 20th of February, 2015, and I am interviewing Dr. Alma Rodriguez for the Making Cancer History Voice Oral History Project run by the Historical Resources Center at MD Anderson Cancer Center in Houston, Texas. Dr. Rodriguez came to MD Anderson in 1986 as an instructor, laboratory research and clinician in the Department of Internal Medicine. I have that correct?

RODRIGUEZ:

Yes, well, I actually don’t recall what it was called at the time.

ROSOLOWSKI:

Oh, OK.

RODRIGUEZ:

It was in the section of lymphoma and myeloma.

ROSOLOWSKI:

OK. OK.

RODRIGUEZ:

I believe it was called Cancer Medicine, actually.

ROSOLOWSKI:

OK. And since 2005, she has served as Vice President of Medical Affairs.

RODRIGUEZ:

That is correct.

ROSOLOWSKI:

OK. She has a primary appointment as internist and professor of medicine in the Department of Lymphoma/Myeloma, Division of Cancer Medicine. OK, great. I’ll also say that Dr. Rodriguez contributed a chapter to the book Legends and Legacies, produced by Women Faculty Programs, and I say that just for reference purposes to anyone listening to the interview.

RODRIGUEZ:

Mm-hmm.

ROSOLOWSKI:

This session is being held in Dr. Rodriguez’ office and the Office of the Executive Vice President and Physician in Chief in Pickens Tower on the main campus of MD Anderson, and this is the first of two planned interview sessions. The time is twenty-seven minutes after ten. Thank you, Dr. Rodriguez for agreeing to take the time to do this interview.

ROSOLOWSKI:

Well, I wanted to start kind of with regular background information and I wanted to ask you where you were born, and when.

RODRIGUEZ:

I was born in Robstown, Texas on September 11th, 1953.

ROSOLOWSKI:

And tell me a little bit about your years growing up.

RODRIGUEZ:

Well, I grew up in a migrant family. We used to move from place to place, following, if you will, crops. As a child, one of my first memories is of following my parents around in the cotton fields. There were no babysitters, so they would take us with them. I thought about that as I’ve grown older, and as I’m more familiar with the risks of pesticides and herbicides, which I’m sure we were exposed to as children, both my sister and I. But that was our childhood, following our parents as they were doing their jobs in the fields.

ROSOLOWSKI:

Now, did you stay within Texas? Or, did you—

RODRIGUEZ:

Yes. Early on, yes, we were in Texas. Later on, during my junior high to high school years, somehow my parents got wind of the crops in California, the agricultural business in California, and that it paid better than in the State of Texas. And it was seasonal, so we could leave. By that time, we were much more settled, and we would attend school for the full school year, but in the summer, we would drive all the way to California—

ROSOLOWSKI:

Wow.

RODRIGUEZ:

Spend the summer working there, usually in the grape fields, and come back for the start of the school year.

ROSOLOWSKI:

Wow. Wow. You know, as I read some of your story about that in the essay that you did for Legends and Legacies, I wondered, you know, as you reflect back on that time, was there anything about that experience of work, you know, the context, that influenced how you thought about healthcare later on, or that gave you some particular insights that affected the delivery of care?

RODRIGUEZ:

Not particularly, not the migrant working experience. But actually, my neighborhood, in my experience with relatives and friends of my family, when I went to medical school, I was astonished as I thought back of the huge range of illnesses that I had observed, growing up. There was someone in our neighborhood who now, I retrospectively could say, he was a paranoid schizophrenic, there was a family who lived next to us that all had a genetic disorder of degeneration of muscles. And one by one, all the male children—this was a dominant inherited condition—and one by one all the male children over the years would begin to show weakness in their gait, and eventually would become paralyzed, and all of them died as young teenagers.

ROSOLOWSKI:

My God.

RODRIGUEZ:

When another lady, who was a neighbor, I remember after her pregnancy began to develop a very large abdomen, which apparently was from fluid retention related to a valve that was dysfunctional. So I vaguely remember all of these stories, and she died also very young. And her children were very young, and were left orphaned. I just of all that. And one of my grandparents died of COPD [chronic obstructive pulmonary disease], another one died of diabetes at home. One of my cousins died in a fire from burnt skin. So one of my childhood playmates had what now I retrospectively know was tetralogy of Fallot, his face was purple all the time. And I wondered about that, why his color was so different from the rest of us. And now I know he must have had a cardiac deformity, a congenital cardiac deformity, and couldn’t oxygenate his blood. And so he looked purple all the time. And he died when I was six years old.

So, I’m just thinking I did have an experience going through childhood. Death was not an uncommon event in our lives. And people had a whole slew of different illness manifestations, not to mention infectious illnesses; as a child I suffered from some sort of infectious illness, I don’t know what it was. But I do know it probably was a form of meningitis, because I was unconscious for several days. And it was only as an adult that my parents told me that they thought I was going to die. So, you know, that was my experience growing up.

ROSOLOWSKI:

Right.

RODRIGUEZ:

My exposure to health, or poor health, I should say.

ROSOLOWSKI:

Right. Or poor health. No, I assume that in not every case where these individuals that were close to you, they were treated by Physicians or not? I mean, very little healthcare—

RODRIGUEZ:

Very little healthcare.

ROSOLOWSKI:

Yeah, I assume that. Yeah. Yeah. So interesting that you remember, recall all that. I mean, did it have—I mean, how do you think about that now? I mean, what does it—did it have an effect in your selection of specialty and any of that, do you feel? Or was it really just back context that was—

RODRIGUEZ:

I think that it’s just back context. I mean, my selection of specialty really came more from my direct experience taking care of patients, as I was doing my training.

ROSOLOWSKI:

Yeah. That’s a really astonishing experience, you know, to have that in your background. Tell me a little bit more about your family. How many kids were in the family?

RODRIGUEZ:

Just two of us.

ROSOLOWSKI:

Oh, really? Wow. So that’s a pretty small family.

RODRIGUEZ:

Yeah.

ROSOLOWSKI:

And what—were there—what were lessons learned? You know, tell me a little bit about the character of your parents and kind of how they maybe influenced you as a person.

RODRIGUEZ:

Well, they were survivors. I mean, that’s the best I can describe of them. They were very committed to family, I mean, that was one thing I learned from them. Not just to us, but they were committed to their own elderly parents, to the care of their own elders. We had a very large extended family that we were in communication with. They were very frugal, so being cautious about how, when to use the small resources that we had. Obviously, we were poor given their occupation. But retrospectively, you know, I never did lack anything. I never—I was never conscious of lacking in essentials. I mean, we always had food, we always had shelter, we always had clothing. And obviously, we had a family. So to us, you know, growing up, I never knew that there was anything else different from that.

ROSOLOWSKI:

Yeah. And your sibling, brother or—

RODRIGUEZ:

My sister? A sister.

ROSOLOWSKI:

Sister. And tell me your parents’ and your sister’s names.

RODRIGUEZ:

My father’s name was Ricardo. My mother’s name was Olivia, and my sister is also Olivia.

ROSOLOWSKI:

Oh, is she older?

RODRIGUEZ:

She’s younger.

ROSOLOWSKI:

Younger.

RODRIGUEZ:

I was the older child. And by the way, my sister was also born with a cardiac defect, with a septal defect that sealed over time, it was a transitory event, but—

ROSOLOWSKI:

Did they know that at the time?

RODRIGUEZ:

Yes.

ROSOLOWSKI:

Your parents had some real scares with their children.

RODRIGUEZ:

Mm-hmm.

ROSOLOWSKI:

Yeah. So tell me about your educational experience. When did you know that you were going to focus in the sciences, and perhaps even medicine?

RODRIGUEZ:

Well, I didn’t know that I would focus on the sciences, really, until high school, and my exposure to chemistry and physics, and biology. For whatever reason, I just was drawn to those. And I was a very good student; I had always outstanding grades. And my teachers always encouraged—I mean, I do recall this even from very young in elementary school, I was encouraged to study. I really have no idea what my IQ is, but I know that we took some form of IQ test in elementary school, and that my parents were told that I should—that they should always encourage me to stay in school. I guess I did well compared to the rest of the students, would be my guess.

ROSOLOWSKI:

Yeah. Yeah.

RODRIGUEZ:

But I do remember that. I also remember being asked had I cheated on the test. I mean, I am, I was, like, I don’t know, five or six years old. I had no concept of what cheating was. I guess now that I think about it retrospectively, I think, that was really unskillful! (laughter)

ROSOLOWSKI:

But obviously they did [inaudible].

RODRIGUEZ:

Yeah, to ask a young child, are you cheating on your IQ test? Are you serious?

ROSOLOWSKI:

How did that happen?

RODRIGUEZ:

How did that happen? (laughter)

ROSOLOWSKI:

That’s whacky! Well, obviously they believed you when you said, “No,” or looked dazed at the question.

RODRIGUEZ:

Yeah!

ROSOLOWSKI:

And your parents encouraged you, so that’s really—

RODRIGUEZ:

Yes.

ROSOLOWSKI:

—really cool.

RODRIGUEZ:

Yeah, they were supportive.

ROSOLOWSKI:

Yeah. Right, yeah. And I mean, that’s not always the case in families when they feel that their children may be having an experience that will separate them from family experience.

RODRIGUEZ:

Correct.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

Well, you know, honestly, my mother did not want me to go to college, whereas my father said he would support whatever I wanted to do.

ROSOLOWSKI:

OK.

RODRIGUEZ:

And so, I just said, “OK, good, I like father’s opinion.”

ROSOLOWSKI:

Well, what was your mother’s reservation about that?

RODRIGUEZ:

Oh, fear that, you know, going away, etc., separating from family like you said—

ROSOLOWSKI:

Right.

RODRIGUEZ:

—and so on.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

Always having lived in a small town, and life is very sheltered, or relatively sheltered. There’s no such thing as a safe place on the planet entirely, but—

ROSOLOWSKI:

Yeah, when you have a small—

RODRIGUEZ:

Right.

ROSOLOWSKI:

Yeah. Well good for dad, you know?

RODRIGUEZ:

Yes. Yes.

ROSOLOWSKI:

For supporting you.

RODRIGUEZ:

Yes.

ROSOLOWSKI:

So tell me about your—that process of applying to college, and then, you know, that’s—

RODRIGUEZ:

That was really, I mean, again, thinking about it retrospectively, it was sort of a kind of miraculous thing. So I went to a very small high school.

ROSOLOWSKI:

What’s the name of the high school?

RODRIGUEZ:

In Roma. Roma, Texas, Roma High School. And we had a counselor who did meet with each of us in the senior year, and encouraged us to apply to college. But sort of was the extent of the assistance we got. You know, we were told, here’s the registrar for UT [University of Texas], you know, we were given some information and then—but we were pretty much left on our own. And again, having had no exposure in my family ever to anyone going to college, I had no idea what that entailed.

ROSOLOWSKI:

Right.

RODRIGUEZ:

Now, so the one thing that was helpful is, they advised me to apply for some scholarships. And one of them was from a small, private—or not so small, but a foundation called a Minnie Piper Foundation. And it provided for scholarships at any one of three, of the three Catholic schools in San Antonio at the time, the Incarnate Word, St. Mary’s and Our Lady of the Lake [College]. And one would go and interview with this panel of people for the scholarship. And that was the first time that I flew in an airplane. They provided travel, so I flew from the Valley to San Antonio in a small propeller airplane. (laughs)

ROSOLOWSKI:

Did you have the turbulence?

RODRIGUEZ:

Actually, no, it was a very pleasant experience.

ROSOLOWSKI:

Good.

RODRIGUEZ:

Yes. (laughter) It was my first time being alone in a large city, San Antonio being relatively large to where I grew up. And meeting with this panel, you know, I’d never had had such an experience either, before. And needless to say I probably was shy, or perhaps not as fluent or verbally convincing as the other candidates, but I did not get that scholarship. Nonetheless, one of the nuns on the panel from Our Lady of the Lake apparently was impressed enough with me or my presentation that I got a separate offer from Our Lady of the Lake for a scholarship and financial assistance, if I attended Our Lady of the Lake. So it happened to be a small college, it happened to be Catholic, and it sort of was aligned with, more or less, the values of my family. So my parents that I could go. So that’s how I ended up—

ROSOLOWSKI:

Wow! And women supporting women, yay!

RODRIGUEZ:

That’s how I ended up at Our Lady of the Lake. Which—

ROSOLOWSKI:

Of the Lake, yeah. Huh. So that must have been a really big deal, packing up and going away to college.

RODRIGUEZ:

Yes, it was.

ROSOLOWSKI:

Yeah. Well, tell me about how your education and perspective evolved when you got there.

RODRIGUEZ:

Well, initially, you know, every study was assigned to a mentor, and every student is asked to declare—was asked to declare what their major would be, or what their primary area of interest would be. And despite my liking sciences, actually, I was just being pragmatic. I thought, oh, I’ll get a Spanish—I’ll get a major in Spanish, because I could read and write fluently in Spanish. And I’ll say that I’m going to be a teacher, because realistically, that did seem like a very good career at the time.

ROSOLOWSKI:

Right.

RODRIGUEZ:

And so that’s what I declared. So I was assigned to a mentor from the Department of Second Languages, Spanish—specifically, one of the Spanish teachers. They had French as well. But I was assigned to one of the faculty in the Spanish curriculum, Dr. Rigual. And so he started asking me some questions, just what do you like, what do you—you know. I said, well, I liked science, I liked this, I liked that. So I signed up for a full—I don’t know, the maximum number of hours I could take that first year. And I did very—in fact, I think I placed out of one of the basic sciences, and he was very impressed for that. And he said, well, you should consider being a science major, which was interesting, because he was supposed to be my Spanish mentor.

ROSOLOWSKI:

Right. Well, good for him—

RODRIGUEZ:

Yes.

ROSOLOWSKI:

You know, for really looking at the student’s gift.

RODRIGUEZ:

Yes. So in any event, I also did very well in my science curriculum at the end of the—so at the end of the year, when we went over my performance, he saw that I had done very well. He says, “You know, you really need to consider going into the sciences.” And from that—and even at the beginning, he said, “You need to consider going to medical school.”

ROSOLOWSKI:

Wow!

RODRIGUEZ:

Which I really didn’t think that was a good idea; I thought I don’t have money. That’s really hard to get into medical school, from what I’ve heard. And it will be a long time before I will have a real job, that was the other thing I was concerned about, because I needed to have a job.

ROSOLOWSKI:

Sure.

RODRIGUEZ:

So, it really was not the first choice that I had in my mind as to what I was going to do with my life. But in any event, I declared then, I changed my major to chemistry, and then, and second major in biology, I believe. It was two sciences; chemistry and biology. So that’s what I devoted the rest of my focus on that, for the rest of my college education.

ROSOLOWSKI:

Now, how were you visualizing your career future at that point? You know, did you—

RODRIGUEZ:

Oh, I thought I would be a teacher.

ROSOLOWSKI:

OK.

RODRIGUEZ:

Or, I would possibly, again, as I got towards my junior or senior year, my chemistry mentor, Sister Jane Ann [Slater], encouraged me to go to graduate school.

ROSOLOWSKI:

Mmmm [affirmative]. I mean, I was thinking, you know, I was just thinking about the time, the timeframe when you were in school. I mean, this is still the era when being a teacher was the nice profession for a woman.

RODRIGUEZ:

Yes.

ROSOLOWSKI:

You know, so it was kind of—and you really—

RODRIGUEZ:

Well, it was one of the optimum professions at the point.

ROSOLOWSKI:

Right. But it was very cool, actually, that Dr. Rigual, and then Sister Jane Ann were really thinking beyond that scope.

RODRIGUEZ:

Correct. Yes.

ROSOLOWSKI:

You know, not being limited by those more traditional or conventional ideas—

RODRIGUEZ:

Correct.

ROSOLOWSKI:

—of what women might do.

RODRIGUEZ:

Correct.

ROSOLOWSKI:

So lucky you, and that’s very cool.

RODRIGUEZ:

Yes, it was very fortunate that it was an environment where people could really pay attention to the students, look at the, if you will, the gifts of the student, the talents of the student and encourage them to follow their talent, if you will.

ROSOLOWSKI:

Absolutely. So tell me about that process. Well, and where the research interest. You know, it was obviously going to assert itself really strongly. Was that something you had experience in college at all?

RODRIGUEZ:

Well, again, this was another—because I was in the sciences, the college, and because the consortium of schools, of those Catholic schools, had a very high percentage of minority students. They received a grant at the time, and I’m not sure from which foundation. But they had received a grant from one of the national science foundations to encourage students to, first of all, go into the sciences, and then second, to learn about research, involvement in research. And so there were several small research projects that were available through the three colleges. And I applied to one of them, and I had been accepted to it, so I had an exposure of laboratory design, carrying out the project, analyzing data—or collecting data, analyzing data, and even presenting at a college level research symposium, which was very exciting, of course. (laughs)

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

So yes, that was my exposure to research, which sort of was why I was thinking, really, that I wanted to go to graduate school to pursue that further. But in the meantime, between my junior and senior year, usually I had done either summer courses or summer research work, or something like that, the prior two years, but in between my junior and senior year, I really didn’t have anything planned, job-wise. And sometime in the spring of my junior year, two African American students from Baylor College of Medicine showed up on the campus. And there was a flyer on the elevator, I remember, as I was in the science building, that said, “Learn more about summer internships,” or “Summer research projects at Baylor College of Medicine.”

So I thought, oh, well, I need a job for the summer, so maybe I should go look into this. (laughs) And it really wasn’t so much that it was just a research project, it was that this was an effort from Baylor to also recruit minority students for medical school. So it was a program that was supposed to prepare students to take their medical—or the medical school entrance exams, the MCATs [Medical College Admission Test]. And there was a curriculum that was associated with it, and they were recruiting students throughout various schools in the State of Texas to come there, now, and so I thought, well, OK, I need a job, so I applied. (laughs) And I got in. Now, I thought it was going to be only for students in the State of Texas. It turned out when I actually did come for the program, there were students from all over the country there.

ROSOLOWSKI:

Oh, wow.

RODRIGUEZ:

There were people from Stanford [University], NYU [New York University], as I recall. The only other person from San Antonio was a young lady from St. Mary’s. I was at Our Lady of the Lake, she was attending St. Mary’s. So the two of us had gotten accepted. So in any event, that was my summer experience between the junior and senior year. And we got—we used to have all of these rehearsals for how to study for the test, and I really had not, again, even up to that point, I had not consciously thought I am going to go to medical school. But then they took us around and showed us—these medical students would take us to their clinics, we would be observing alongside them. We even observed a heart surgical procedure.

ROSOLOWSKI:

Wow!

RODRIGUEZ:

At Methodist [Hospital] from the gallery. So it was very exciting. So when I went back, I talked to, again, my chemistry advisor and Dr. Rigual. And I said this was very exciting, what do you think? And Rigual just said, “Are you kidding? I told you, take the MCAT!” You know? (laughter) So, I took the MCAT that fall, my senior year. If you speak to medical students now, they would have thought that is a bizarre, insane trajectory, or way to approach getting into medical school. Nobody does it that lackadaisically, you know?

ROSOLOWSKI:

Yeah. Yeah.

RODRIGUEZ:

If you will. It’s not that I was being lackadaisical in my studies, but I never—it wasn’t—I wasn’t, I think the term probably still is a “gunner.” I wasn’t one of those gunners that are pre-med, and you know, do or die, I have to get into a medical school. That was not the trajectory of my life.

ROSOLOWSKI:

But the way you were thinking about it completely makes sense, I mean, given your background.

RODRIGUEZ:

Right.

ROSOLOWSKI:

I mean, you had real pragmatic, logistical concerns. I need to work. I mean—

RODRIGUEZ:

Right.

ROSOLOWSKI:

I mean, my parents worked, I need to work.

RODRIGUEZ:

Yes.

ROSOLOWSKI:

You know, and you were just really lucky that making your practical decisions led you and opened up your life in amazing ways.

RODRIGUEZ:

Right. Right.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

But even, so even after taking the MCATs, my worry—well, first of all, will I get accepted or not?

ROSOLOWSKI:

Right.

RODRIGUEZ:

And secondly, if I get accepted, how will I pay for it? And again, my choice was made strictly on pragmatic grounds. I got an offer from the University of Texas here in Houston for a full tuition scholarship. And of course, student loans. So that’s where I went.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

Because they offered me all of that.

ROSOLOWSKI:

All the money, yeah. You’re certainly not the only person who’s made those decisions. (laughter)

RODRIGUEZ:

Yes.

ROSOLOWSKI:

So, I mean, this is maybe a bit of a digression, but I’m curious. You know, as you were going through all of these exciting experiences, and you’re seeing kind of a new world from the world you grew up in, you know, how was that—how did you bring that information back to your family? You know, how did that affect kind of how they saw you in your relationship with your parents and with your sister, Olivia?

RODRIGUEZ:

Well, again, they were concerned principally because again, I was going to be moving in, and further, as you said, it’s further than San Antonio from Roma. So there was that concern. Secondly, of course, that medical school would take me even further in terms of incurred debt, in terms of education, but also that they realized that it is a very difficult profession. And so their concern all along was, are you sure you want to do this, because life is very difficult for doctors. So really, that was their primary objection, if you will. They didn’t really tell me don’t do that, they just wanted me to be sure that’s what I wanted to do.

ROSOLOWSKI:

So how did you answer their concerns at the time? Those dinner table conversations? (laughs)

RODRIGUEZ:

Well, honestly, I was just taking it one step at a time. The time that I made the application, I said, well, I have just applied. I don’t know if I’m even going to get in. And if I don’t get in, I’m going to come back and teach chemistry probably, or biology, at the high school, you know? That’s what’s going to happen, you know.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

And so I sort of had Plan A, Plan B strategies.

ROSOLOWSKI:

So you began medical school—I’m just checking the dates here—

RODRIGUEZ:

In 1976.

ROSOLOWSKI:

Nineteen seventy-six, yeah. So tell me about that process.

RODRIGUEZ:

Well, at the time, the University of Texas medical school here in Houston was unique in that it had a very compressed curriculum in three years. So their four-year curriculum was compressed into three years. And so we literally had absolutely no time off. It was—at the end of those three years, and reflecting back on it years later, is, like, I have no idea what was happening in the world at that time. Honestly, I lived at the library, I lived in—initially, I lived in an apartment building that was across from the medical school. It was called Favrot Hall. It’s been demolished since then. (laughs) But I lived in Favrot Hall. I went to the medical school, and I went to the library, so that was my triangle. You know, medical school, classes, library, Favrot Hall. Favrot Hall, medical school—that was my life throughout my first years. And then when I went into my clinical years, then I moved out of Favrot Hall because it was so confining; the environment was too confining. But in any event, on to clinical rotations. But it was more or less the same thing, you know, apartment, hospitals and of course MD Anderson was one of the hospitals we would rotate through. So hospital rotation, back to the apartment, hospital, back to the apartment. (laughs) That was basically life.

ROSOLOWSKI:

So how were your interests evolving at that time? Did you get a sense of your specialty? Your coming specialty at the time?

RODRIGUEZ:

Well, yes. I mean I think the rotational experiences through the various specialties gives the students a bit of a flavor of what, first of all, of what the physical demands of that particular specialty will be, a bit about the personalities, if you will, and obviously about the tasks themselves. So from the very get-go, I think my first rotation was in pediatrics. While it was really—it’s really lovely to interact with children, I love the Well Baby clinics and all of that, but it was very stressful dealing with the parents. And because it’s a triad relationship, it’s the parent, the child and the doctor, and at the time, that level of my psychological development, I really found that very stressful. So I knew although I loved the children and learning about their childhood illnesses and all of that, I could not handle the parental—the parents were either anxious, angry—or even worse, some of them were indifferent. And any and all of those emotions were a bit too much to handle on top of taking care of the child. So that was out.

When I did psychiatry, I actually excelled at psychiatry. But for some reason, it really did not grab me as something I was passionate about. It was interesting, but surgery was physically too demanding, getting up—the medical students were expected to be the first ones on the wards, at least at that time. Things have changed radically since then, in how students are treated. But we had to be there really early in the morning, 5:00 or so, so we had to see all the patients before the residents arrived. We had to report to the residents where the patients—how the patients were doing. Then the residents, of course, in turn reported to the attending. And then you went into the OR and spent the whole day in the OR, then you had to come back and do the rounds all over again. And then you had to close the day, went home, slept, up at 4:00—

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

It was a very, very physically demanding—very exciting, being in the operating room is probably one of the most exciting environments in medicine. But I knew I didn’t have the physical stamina to sustain that for my life, for a lifetime career.

ROSOLOWSKI:

Right. Right.

RODRIGUEZ:

And obstetrics and gynecology, similarly very exciting to deliver the babies, but the physical pain that the mothers endured was really too difficult for me to just be comfortable with. It was amazing how the nurses in labor and delivery would just—it was like they had earplugs or something, I mean, really, the screams didn’t bother them very much.

ROSOLOWSKI:

Wow.

RODRIGUEZ:

But it bothered me a great deal.

ROSOLOWSKI:

Yeah. (laughter) So what was grabbing your interest at the time?

RODRIGUEZ:

Well, so eventually, through my internal medicine rotation, internal medicine is a very intellectual discipline. You have to do a lot of thinking, it’s almost a bit doing detective work, if you will. You gather a lot of information, put the pieces of the puzzle together and make a diagnosis. So that was very interesting to me. So along the course of all these rotations, I knew I had the personality and mental inclination to be an internal medicine specialist, but even within internal medicine, there’s so many sub-disciplines; cardiology, gastroenterology, pulmonology, endocrinology, etc. So the sub-specialty choices come later.

But one of the rotations we had as medical students was at MD Anderson, and taking care of cancer patients was challenging, as well as intellectually stimulating, and more importantly, comparing the personalities. I know that it’s difficult to generalize, but in general, cancer patients were so much kinder and appreciative of the care that the medical team, you know, offered them. It was not as traumatic, for example, as dealing with patients in the emergency room, or even dealing—one of the specialties that I found very, very challenging, for example, was pulmonary medicine, where so many of the patients had self-induced illness from smoking. And I’m not judging here, I know it’s really, really hard. But many of them couldn’t help themselves. So how can the doctor help them if they can’t help themselves? In a self-induced situation. Whereas with cancer, although many cancers are linked to environmental factors, including cigarette smoking, but so many of them have absolutely no explanation. I mean, it’s certainly not a choice people—it’s not due to—the majority are not due to a self-determining choice, if you will. So it’s a different, how shall I say, it’s a different relationship that one establishes both with an illness as well as with the individual who’s suffering the illness.

ROSOLOWSKI:

So were you thinking at that time, even during medical school, that oncology was where you were going to focus?

RODRIGUEZ:

I thought I might, although I still wanted to do primary care.

ROSOLOWSKI:

OK.

RODRIGUEZ:

At that point, I still wanted to do primary care. And I chose my training in internal medicine in San Antonio, one, because I had been there in college, and I liked San Antonio, but also because the population base for the medical school in San Antonio and for the training in San Antonio is largely Hispanic. And I sincerely wanted to learn more about healthcare in the Hispanic population, the Hispanic community. Diabetes is a very major issue, very major health problem. I thought I might veer in the direction of diabetes-related care and illnesses. But again, as I did my oncology rotation, I again found that very interesting. I also had a very dynamic attending. It makes a very big difference.

ROSOLOWSKI:

And what was your attending’s name?

RODRIGUEZ:

Daniel von Hoff.

ROSOLOWSKI:

OK, that’s right, I do remember that name. Yeah. What was so inspiring about him?

RODRIGUEZ:

Well, he was very energetic. He was a clinical and laboratory researcher, and he had come to—he was young in his career. He had come to San Antonio from the National Cancer Institute, and he was very passionate about what he did, and he was an enthusiastic and engaging individual, and very supportive of residents who expressed interest in oncology. So he sort of took me under his wing and I did a year’s fellowship in his lab.

ROSOLOWSKI:

Oh, wow!

RODRIGUEZ:

After my residency.

ROSOLOWSKI:

OK, yeah. So just for—so, for the recorder, the dates. So you did your internship from 1979 to 1980, and the ’80 to ’82 was the residency in that system as well.

RODRIGUEZ:

Correct.

ROSOLOWSKI:

Yeah. So tell me about the research project that you did during that. Did you do research during this first residency? Or was it during your fellowship period afterwards?

RODRIGUEZ:

It was afterwards.

ROSOLOWSKI:

Afterwards. OK. So from 1982 to ’83, you had the cancer research fellowship at the Cancer Therapy and Research Center.

RODRIGUEZ:

Correct.

ROSOLOWSKI:

So but you—and was that Dr. Hoff’s lab?

RODRIGUEZ:

It was in Dr. Hoff’s lab, yes.

ROSOLOWSKI:

OK. But so the first couple of years you were kind of getting to know him, and making your selection.

RODRIGUEZ:

Correct.

ROSOLOWSKI:

So tell me about the process of selecting the focus on oncology. You know, when did you know that you were going to kind of separate and pay more attention to the area of oncology?

RODRIGUEZ:

My senior year in residency, the second year of residency I really was sure about that. And that’s what I approached Dr. von Hoff about during the year of—in his lab, simply because I wanted to really cement that in my mind. Also, quite frankly, it had been, like, six years from medical—if you include the three years of medical school, the three years of residency and internship, it had been six years of really relentless, unending, go-go-go-go without pause for reflection, if you will. And so I wanted that year to both familiarize myself more with the work that he was doing in the lab, but also to do some self-reflection about whether this was really what I wanted to do.

ROSOLOWSKI:

What were the issues you were weighing in your mind at the time?

RODRIGUEZ:

Well, certain—I mean, for one, it’s not a trivial decision to make—so select a sub-specialty, because then one has to commit to further training in a fellowship.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

So that’s additional time. It also, depending on where or what type of fellowship, that would mean yet another geographic change, interviewing all over again, going through the round of interviews, going through the rounds of selection and waiting to hear are you accepted or not. I mean, it had been sort of that process from college, medical school, the residency and now again fellowship. So it felt like I had been under the scope and for so many years now, in my life. So I had to think about that carefully. Did I really want to go again through another round of— But, you know, it turns out life is an endless round of interviews! (laughter) But anyway, and I just wanted to be certain of what it was that I wanted to do. And I also wanted more time to spend with my parents, because they had moved to San Antonio, actually. Along the way, they had decided that they did not—they wanted to closer to a place where they had access to airports, because they knew both my sister and I likely were never going back (laughs) to Roma. So they wanted to have—be closer to access to travel that would be easier for them. And they had moved to San Antonio, so I spent that year with them, as well. So anyhow, that’s how I really cemented my decision for oncology.

ROSOLOWSKI:

What was the research that you were doing?

RODRIGUEZ:

Well, at that time, he was—at that time, there was a concept that one could—it’s interesting to me how ideas sort of come around, they cycle. So the idea that Dr. von Hoff had, and still has—he’s still conducting research along these lines—was that one could personalize the treatment, depending on the sensitivity of the tumor to certain drugs.

ROSOLOWSKI:

Wow!

RODRIGUEZ:

So his concept for how one did that was that one would take the cells from the patient’s tumor, grow them in the lab in petri dishes, or some other medium, and then test pretty much similarly to one how tests bacteria. You grow them in the lab and then you apply the antibiotic to the plate where the bacteria are growing, and then you observe whether the bacteria die or not. And to what degree do they die when they’re exposed to the antibiotics. Well, he had the similar concept for cancer cells and chemotherapeutic agents. So if one grew the cancer cell successfully, and that’s a big barrier, first of all, getting the cancer cells to grow. Secondly, one would test specific drugs, Drug A, Drug B, Drug C, and whichever one of those drugs give the highest level of tumor kill, that would be the appropriate treatment for that individual patient. That was his model, or his concept.

ROSOLOWSKI:

Now, what did he believe made the difference between patients? Why did he believe that tumors were slightly different in different patients?

RODRIGUEZ:

Well, there’s just a clinical observation, that’s a fact.

ROSOLOWSKI:

OK.

RODRIGUEZ:

You know, some patients respond very well to chemotherapy, others don’t. And yet, they have the same diagnosis, right? Assuming that physiologically these individuals are not that different—and that’s a big assumption, in reality that’s a big assumption—but let’s say that both individuals supposedly will metabolize the drug in the same way, then the only explanation for why they get different responses is that the tumors are different.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

The tumors are biologically different. And at that point, was the beginning, as well, of genetic testing in tumor cells. So along with the drug testing, there were also cytogenetic analyses that were done in parallel. Now, I was not doing the cytogenetic testing, I was more doing the laboratory processes, testing various laboratory processes. So my involvement at the time was primarily just to test different media, design different environments for the growth of the tumor cells to see which ones would be best, and so on. So it was more of a cellular biology project that point, and that we were investigating the techniques by which one would grow the cells and which one was successful.

ROSOLOWSKI:

Did this view affect your own conceptualization about cancer? I mean, it’s a very, you know, interesting and kind of avant-garde way of looking at it.

RODRIGUEZ:

Right. Right.

ROSOLOWSKI:

How were you affected by that intellectual environment?

RODRIGUEZ:

Well, intellectually, I think I’ve always understood that, you know, cancer in individual A is not the same as cancer in individual B. I’ve always understood that there are unique characteristics of the biology of the cells that, despite appearing similar under the microscope, there are other inherent characteristics of the cells that will make the malignancies different from individual to individual. I think that we’re beginning now with the genome project and looking at exquisite analyses of the profile, genomic profile of each tumor, we’re now beginning to appreciate what those subtle differences are— What are the similarities and what are the differences, as well. But that was philosophically, if you will, and empirically we had observed that for many years. We’ve known that for many years.

ROSOLOWSKI:

So what turn did life and research take next? I mean, when during this fellowship period, you know, what was the next step?

RODRIGUEZ:

Well, that was only a one-year experience. I then did a formal fellowship in hematology and oncology at the University of Arizona in Tucson. And specifically, the focus of my research was in multiple myeloma. That’s how I ended up in the Department of Lymphoma/Myeloma.

ROSOLOWSKI:

Oh, OK. Yes. Why did you choose to go into blood diseases?

RODRIGUEZ:

One of the reasons is, you know, hematologic malignancies are much easier to culture in the laboratory, or at least at the time. It was simpler to obtain tumor samples of blood cell malignancies than it is for cell—it’s still true today. I mean, a patient with leukemia, one can do a blood draw, and the malignant cells will be in the blood sample. One doesn’t have to invade the body any more than that. Whereas in solid tumors, you know, usually it will involve having to do some deep cavity biopsies. And that can be traumatic for the patient, as well as difficult, and costly, etc. So hematologic malignancies have been traditionally model for cellular and biological investigation of malignancy processes. So that’s what makes it, in part, attractive. The other is that the biology of cancer, the studies of the biology of cancer, have been also more advanced in hematological malignancies. Hematological malignancies have been always, you know, a couple of jumps ahead of the biology analyses of solid malignancies, precisely simply because they’re easier to study and analyze. And thirdly, because there were two individuals; specifically Dr. Salmon and Dr. Durie in Arizona, who were world-renowned at the time for their work in multiple myeloma, so—

ROSOLOWSKI:

Could you repeat their names again? Dr.—

RODRIGUEZ:

Salmon, S-A-L-M-O-N.

ROSOLOWSKI:

S-A-L-M-O-N, OK.

RODRIGUEZ:

And Durie, D-U-R-I-E.

ROSOLOWSKI:

D-U-R-I-E. OK. So you went specifically to study with those individuals?

RODRIGUEZ:

Yes.

ROSOLOWSKI:

You know, and let me just backtrack a tiny bit, because I realize I neglected to ask about another dimension of that experience in San Antonio. Because you said you had gone there because you wanted to also provide some—do you need to take a check on that?

RODRIGUEZ:

I need to just check—

ROSOLOWSKI:

OK, let me just pause the recorder really quickly.

[The recorder is paused]

ROSOLOWSKI:

OK. You said you had gone to San Antonio to—with also the intention of providing some kind of medical care for the Hispanic community. And I’m wondering where that piece, how that evolved over the course of your increasing interest in oncology.

RODRIGUEZ:

Well, it didn’t evolve. And I can’t say exactly why. But I did not meet anyone who was particularly, if you will, engaging, or interested in bringing the residents into their projects, or their research or their initiatives. A lot of the work that we would do, or the training that we received in the management of diabetes was largely in the clinics, in the ambulatory clinics. And diabetes is a very difficult illness. It’s a chronic illness. It’s very difficult, because it is so directly linked, or at least adult onset diabetes is so directly linked to lifestyle and diet. And I’ve come to appreciate, as I’ve grown older, how much we are, if you will, defined, or married, for lack of a better word, to habit in diet. It is one of the most—I think next to cigarette abuse, dietary changes are another very challenging and difficult aspect of health. And, you know, despite all of the recommendations of the food pyramid and despite all the models being very thin on television, and despite the entire obsession of our culture with being thin, etc., etc., we are growing more obese as a nation, which is a very interesting disconnect, if you will, of what is presented on the surface of the culture, versus what is the reality of the culture. And the same is—so, in Hispanic culture it is very hard to shift dietary habits. We love to eat, and I speak for myself as well, we love to eat, first of all. Food is an important part of our daily family rituals. Certain types of foods are very engrained in our history as a culture. And most of them taste very good, and most of them are not very good, if you’re a diabetic.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

So, I felt, honestly, in my diabetes clinics week to week, I felt like I was just holding hands and telling my patients, well, your blood sugar is high again. There was very little that changed from visit to visit. You could change the medications, we could change the dose of insulin, the timing, etc. But they still work with—they work where they were.

ROSOLOWSKI:

Right. And they were going to go home to families.

RODRIGUEZ:

And they were going to go home to the same pattern of behavior.

ROSOLOWSKI:

So making a move into something you could really have an impact on, then?

RODRIGUEZ:

Correct.

ROSOLOWSKI:

Yeah, makes sense. Makes a lot of sense. OK, well, I just wanted to kind of pick up that piece, because it seemed like such an important motive. And we kind of lost track of that long the way.

ROSOLOWSKI:

So tell me about the research that you undertook when you were at Arizona.

RODRIGUEZ:

Well, at this time, was—this was an exciting time in the evolution of cancer research in that molecular biology techniques were being introduced. The whole field of analysis of DNA, to the level of unique genes that you could run on a certain—not as whole chromosomes, but rather as analyzing unique patterns of the gene distributions; whether some were over-expressed or under-expressed, and so on. That was happening at that time. So I learned how to do some of those DNA analyses technologies, PCR [polymerase chain reaction] analyses were just coming on. You know, that’s the famous technique that analyses paternity as well as in criminal cases identifies (laughs) whether the criminal’s DNA is in the victim, etc.

ROSOLOWSKI:

And what does PCR stand for?

RODRIGUEZ:

What does it stand for now? I have forgotten, I did it for so many years.

ROSOLOWSKI:

Oh, I can look it up, it’s all right.

RODRIGUEZ:

Polymerase chain reaction—

ROSOLOWSKI:

Oh, OK.

RODRIGUEZ:

—technique.

ROSOLOWSKI:

Yeah, I just—I had never heard “PCR analysis” before.

RODRIGUEZ:

So anyway, so that was very exciting. So I was doing that level of analytic work with tumor samples in myeloma, specifically, recognizing—and one of the analyses that we did at that time was also looking for viruses in the cells. So it was all very exciting work.

ROSOLOWSKI:

Yeah.

RODRIGUEZ:

And so I knew at that time I would want to stay and continue to work in an environment that was still linked to research, that delivered cancer care, but also was linked to research. And it so happened at the end of my fellowship that my mentors at the University of Arizona had been contacted by somebody from MD Anderson, I don’t know who it was exactly, saying we’re looking for people in the Department of Lymphoma/Myeloma.

ROSOLOWSKI:

Wow.

RODRIGUEZ:

They knew Dr. Durie and Salmon, because they were known as myeloma researchers, so they contacted them and said, are there any fellows in your program who are looking for jobs? We have openings. So—

ROSOLOWSKI:

Wow.

RODRIGUEZ:

That’s how I ended up here.

ROSOLOWSKI:

Wow. That’s an amazing story! I’m sure people who are looking for jobs now think of that and go, “Wow!” It ain’t like that now. (laughs)

RODRIGUEZ:

Yes.

ROSOLOWSKI:

So tell me about coming here. You know, how did the interview process go? I mean, how were you recruited? Did you make an application just cold? How did that all work?

RODRIGUEZ:

I think I came for one interview.

ROSOLOWSKI:

Uh-huh?

RODRIGUEZ:

It wasn’t traumatic, I mean, I was certain I wanted to come here. I—honestly, I don’t remember the interview very well.

ROSOLOWSKI:

I can just imagine.

RODRIGUEZ:

All I know is I had a job.

ROSOLOWSKI:

Yeah, great!

RODRIGUEZ:

And I moved here.

ROSOLOWSKI:

So you came and—you came in 1986.

RODRIGUEZ:

Mm-hmm [affirmative].

ROSOLOWSKI:

Yeah. So tell me about the department at the time. You know, who were the people who were there who were really significant for you? And what was the climate like?

RODRIGUEZ:

Well, it was a difficult time for the entire Cancer Medicine group. I’m trying to remember all the exact organization, you know. Obviously, I was a lowly faculty member. I wasn’t in the governing structure of the department, all I knew is that there were changes happening. It actually—Lymphoma/Myeloma was not a department, it was a section. It was a section of a department of hematology, if I recall. And hematology was yet another part of the larger group that was called Cancer Medicine [Division of]. And there was a transition happening at the level of leadership, and there were several transitions, really, that I went through before it all settled, which then made it very, very difficult—you know, for a junior faculty member starting out without a defined grant, you know, as a junior faculty member, you’re not bringing in big grants, right? You’re going to start to work under someone’s mentorship so that you can build your research portfolio and then get your own grants. But because of the continuous movement of leadership, actually my mentors kept changing year to year. And at some point, I think it was into my fourth year or so, I realized that I wasn’t going to be successful, that I wasn’t going to be successful in the lab, simply because I did not have a solid anchor for the work that I was doing. And I wanted to have an anchored perspective in my career. The chair of the—or, the chief of the section at that time was Dr. Fernando Cabanillas. We were later made into a department, and he became the chair of the department. He was very influential in my work. I mean, he really was truly my mentor.

ROSOLOWSKI:

What did you get from him?

RODRIGUEZ:

Well, he was very passionate about moving forward the treatment of lymphomas. He was convinced we could cure lymphomas. And at the time that he had trained as a fellow here at MD Anderson, actually most lymphomas, with the exception of maybe Hodgkin’s lymphoma, most other lymphomas were not curable. And he was a participant in the seminal early work that showed the first curative regimen for large cell lymphoma. And he was very committed to the development of new chemotherapy protocols and regimens that could lead to cure.

RODRIGUEZ:

So most of my career, really, was about designing drug combinations, testing them in clinical trials to define or determine efficacy. So that really was the, if you will, the defining perspective of the work I did for many years. And then sort of in a surreptitious way, I started doing administrative work.

ROSOLOWSKI:

Why do you say “surreptitious”?

RODRIGUEZ:

(laughter) Well, it was one of those things—see, in academic medicine, people want to avoid getting assigned responsibilities that are in no way, shape or form going to lead to some new project or protocol, or discovery, OK? But Dr. Cabanillas asked me if I would take on the responsibility for being the Director of the Lymphoma Clinic, and it meant sort of helping the nursing administrator of the clinic to create or come up with room assignment schedules, and doctor schedules, distributing dates of the clinic, and distributing personnel and that sort of thing, which most of my peers consider to be terribly boring work and not interesting. But I took it on, and I actually learned I have a knack for administration. Or, at least I liked, or enjoyed, working with people who were committed to trying to make things better for the patients. And so I got to interact with Patient Advocacy, with social work, nursing staff, and very importantly, clinical pharmacists, which were a new specialty in the organization. And these were young men and women who wanted to not just be in the pharmacy dispensary but wanted to be in the front lines of the clinic, and to interact with the Physicians and advise on drug safety, and help us to standardize protocols and standardize the chemotherapeutic order sets, and so on and so forth. And I learned tremendously from them; I hoped they learned from me.

But we standardized the structure of orders sets in our clinic, we began to develop, if you will, standard operating procedures for how we would control nausea, how we would hydrate patients, and how we would use certain kinds of catheters to facilitate patients getting chemotherapy, and so on. So this was a multi-disciplinary effort from nursing and the pharmacist and myself, and some of my peers contributed to that as well. But in any event, it was exciting to sort of think of ways in which we could make our work life and the patients’ treatments a little bit more structured and predictable, if you will.

ROSOLOWSKI:

So you held that—this was the period 2000 to 2003, when you were a Medical Director? Or is this actually prior to that?

RODRIGUEZ:

Yes. It’s that time. And then afterwards, we also were—well, even prior to that. There were several iterations of the clinic and several iterations of the title.

ROSOLOWSKI:

Oh, was it? Oh, OK. Yeah, here it may be. Clinic chief lymphoma—

RODRIGUEZ:

Yes.

ROSOLOWSKI:

—and myeloma. And that was 1994 to ’96.

RODRIGUEZ:

Yes. Yes.

ROSOLOWSKI:

OK.

RODRIGUEZ:

Yes.

ROSOLOWSKI:

Wow. I mean, you know, it’s funny, because when you said that you found psychiatry interesting, you know, but didn’t have a passion for it, I thought, huh, I wonder why that was. And it seems like that requires kind of a knowledge of people, and maybe getting people together, getting people to work together. So those skills suddenly reasserted themselves even in more complicated ways during that period of being clinic chief. So that must have been exciting to discover kind of an entirely new skillset.

RODRIGUEZ:

Yes.

ROSOLOWSKI:

Yeah. So how did your thinking about that change? I mean, when he asked you to take on that position, did you have a plan? Or was it kind of learn on the job?

RODRIGUEZ:

It was just he asked me to do that, he needs help, I was grateful that he had supported my shift in career orientation from the lab to the clinical research, and—

ROSOLOWSKI:

That was it.

RODRIGUEZ:

And that was it.

ROSOLOWSKI:

You had a kind of a new thing. Now, just so I understand that period of shift, you said about after four years here, you began to see the handwriting on the wall, that it was going to be really difficult to build a real research career. Now, during those first four years, were there some landmark studies you participated in, or feel you made a major contribution to, that we should talk about here?

RODRIGUEZ:

Well, not really.

ROSOLOWSKI:

OK.

RODRIGUEZ:

I mean, that was part of the problem, that I felt I was spinning my wheels.

ROSOLOWSKI:

OK.

RODRIGUEZ:

And, I mean there were a couple of clinical—there were a couple of projects that did ultimately get published. But they were not ground—majorly ground-breaking—

ROSOLOWSKI:

Right.

RODRIGUEZ:

—number one, and secondly, it took a great deal of effort to get them done, and it wasn’t enough to move to—it wasn’t enough, or solid enough, that it was a good foundation for grantsmanship.

ROSOLOWSKI:

Right. Right.

RODRIGUEZ:

And to really be successful in research, then as now, one has to have the skill of grantsmanship. And foundational to that, of course, is good data. But beyond good data, you also have to have excellent writing skills. You have to have perseverance. You have to keep sending, amending, revising, redoing your applications endlessly. And after a certain number of those redoings, rewriting, resending, some of us really don’t have the psychological strength to keep doing it. Some people do. I forget it was where I read where Arthur Miller sent off Death of a Salesman to I don’t know how many publishers and got rejected, like, thirty times. So I don’t know where I get that number, thirty, but he was rejected, like, an enormous number of times and he still kept sending it out.

ROSOLOWSKI:

He kept sending, yeah.

RODRIGUEZ:

So, you know, some people have that level of resilience of continuing to do—for me, it’s, like, I—if I have done something several times, and I think I’ve done my best at it, and it still doesn’t work, why keep doing it?

ROSOLOWSKI:

I think it was W. C. Fields who said, “Try, try, and then don’t be stupid.” (laughter)

RODRIGUEZ:

Yes, something like that. Yes.

ROSOLOWSKI:

Yes. OK, so that was really the watershed moment, it’s, like, OK, I’m moving on. And then this Medical Director opportunity comes, and you excelled in that area. So what were you thinking about now? You know, you’re kind of redirecting your MD Anderson career. So how did you begin to think about that? What was the next opportunity you looked for?

RODRIGUEZ:

Well, like all other junior faculties, you look at what is it that’s going to get me to my promotion. To the next promotion. And essentially, you know, you have to write papers, you have to collaborate in research protocols, get some funding for your work, and whether it’s from pharmaceutical grants, or NCI [National Cancer Institute] funded research protocols, so essentially that’s what I really focused a lot of my attention to; how am I doing, who am I collaborating with.

ROSOLOWSKI:

Because you shifted your research focus at this time. So how long did it take you to settle on a new research project, or do an arena of research projects?

RODRIGUEZ:

Well, that wasn’t difficult, because Dr. Cabanillas, like I said, really was passionate.

ROSOLOWSKI:

OK.

RODRIGUEZ:

So we were literally turning out protocols after protocol after protocol.

ROSOLOWSKI:

Wow.

RODRIGUEZ:

That was not difficult at all, I mean, we were short-handed in terms of the number of people who could do all the clinical studies.

ROSOLOWSKI:

Wow.

RODRIGUEZ:

It was a very rich time in terms of the development of new combinations of chemotherapeutic agents that were successful. So that’s what we did, write protocols, conduct the clinical trials, report out, present at the national meetings, etc.

ROSOLOWSKI:

And what were some key studies that you worked on there, on things that would be relevant to talk about here?

RODRIGUEZ:

Well, at the time, so Dr. Cabanillas had done some early work with a drug called ifosfamide, and shown that in some patients with large cell lymphoma who, unfortunately, their tumors might not respond as well as they should to the best front-line regimen, which at the time was a regimen called CHOP [Cytoxan, hydroxy doxorubicin, Oncovin, Prednisone]. It still is, actually, the golden standard today. It hasn’t shifted much, it still is one of the golden standard regimens. So if the patients didn’t do so well with CHOP, if they were treated with this drug called ifosfamide, some of them responded further and went on to achieve complete remission. So we did a number of studies using ifosfamide base combinations. At that time, we were also starting to do stem cell transplants, so we explored the use of ifosfamide in high doses as what we call an induction regimen for stem cells. And actually, ifosfamide base combinations are still—are today still the pre-stem cell transplant induction regimens of choice for large cell lymphomas. There’s been some tweaking to them. But they still are, at this point in time.

ROSOLOWSKI:

And that’s at other institutions here, and at other institutions?

RODRIGUEZ:

Mm-hmm [affirmative].

ROSOLOWSKI:

Yeah? Wow.

RODRIGUEZ:

So some of that seminal work was at that time. We also showed the benefit of a combination of a drug called Cytarabine and Cisplatin, and that’s another regimen that’s still in use today. So that was in the early—in that face of shifting focus in my career. Later on, and even to today, the attention now is more to the introduction of very new investigational agents into the trials. It’s ironic, but relatively more attention is being paid to new drugs versus exploring, perhaps, optimization of old drugs. Now, let me say that one person who has done just that is at the National Cancer Institute, Dr. Wyndham Wilson. He actually took the exact same combination of the CHOP and he altered it in ways that we had advocated before. We had said, you know, drugs by continuous infusion do better. Dr. Cabanillas had been pooh-poohed for that. Dr. Wyndham Wilson took that to heart, and he redesigned the protocols. And he has shown that really, continuous infusion of certain drugs really does yield better results.

ROSOLOWSKI:

Wow. Why was that not seen as a good idea before?

RODRIGUEZ:

I really don’t know. Perhaps we didn’t design the studies well enough to be convincing, but we had tried—in fact one of our—to this day, I consider the continuous infusion of certain medications to be much safer than the bolus administration. And that’s been shown in studies. But in the community of oncology, because the bolus—the rapid flush administration is much more efficient, less time-consuming, it can be done in the clinic, that sort of has stayed as the standard. But infusional administration of particularly some of the very toxic drugs can be safer for the patients. Very interesting—

ROSOLOWSKI:

Yeah. Yeah.

RODRIGUEZ:

Issues going on in research, but—

ROSOLOWSKI:

Huh. What makes sense to talk about now? I mean, we’ve kind of, you know, have been following the theme of your research, and I know that your research kind of shifted some direction, or maybe you added new dimensions to it as you began focusing—your career took its shift to administration. Would you like to talk about some of those studies? Or would you like to talk about some of the new administrative promotions that you had?

RODRIGUEZ:

Well, I have to go give a presentation at noon.

ROSOLOWSKI:

Oh, OK, so—

RODRIGUEZ:

And so we have only about, what, ten minutes, fifteen minutes?

ROSOLOWSKI:

Right. Right. Would you like to stop now? Do you need some time to prep? Or—

RODRIGUEZ:

I just probably am going to need some time to travel.

ROSOLOWSKI:

OK.

RODRIGUEZ:

Because these days we have to go from one place to another.

ROSOLOWSKI:

Right, I mean, because we’re kind of at a natural stopping place right now. Does that make sense?

RODRIGUEZ:

Yes, that’ll be fine.

ROSOLOWSKI:

OK, well, then I want to thank you for your time today.

RODRIGUEZ:

Oh, you’re welcome. Thank you.

ROSOLOWSKI:

That’s a very neat story. And I am turning off the recorder at about quarter of twelve.

RODRIGUEZ:

OK.

ROSOLOWSKI:

All right.