A Pioneering Life
The man who pioneered bone-marrow transplantation grew up the son of a Texas frontier doctor. He has focused his life on his research, a dedication that can be intimidating. He learned early that hard work is just the way life is, and he simply expects the best from himself.
The wife of a bone-marrow transplantation patient got some good news about her husband's progress. Rushing up to Dr. E. Donnall Thomas, who headed the experimental program at Fred Hutchinson Cancer Research Center, she gave him a big hug.
``He was very uncomfortable,'' recalls a colleague. ``He was looking for a place to dive.''
But last Monday, after he was awakened before 4 a.m. to hear he'd won the Nobel Prize for medicine, Thomas was on the ward within hours to thank all the early-shift nurses for their role in making the prize possible. And, surprising the nurses who knew he was no hugger, he embraced them all.
The moral of the anecdote: This is a man who values control - in others, but especially himself - but a man who also values people. And more simply: Like most brilliant people, Thomas is complex.
Consider this mix of descriptions by his colleagues:
Intimidating. Unfailingly polite. Wastes no words. Moral. Thoughtful to a fault. Focused his life on his research like a heat-seeking missile.
A man who's proud of coming a long way in intellectual development and sophistication from his days in rural Texas, son of a
frontier doctor - but whose values and sense of purpose go At Harvard, Dottie and Donnall Thomas felt like hayseeds, but worked to shed their naivete and most of their accents.
back to that frontier doctor.
After he won the Nobel, says his half-sister Opal Thomas, who at 84 is 14 years older than Thomas, ``He said, `The only thing I hate is Daddy's not here to see me get it. I sure miss my Daddy. I owe so much to him.' ''
From the time he was a boy, everyone in the little town of Prairie Hill, Texas, where he was raised called him ``Doc.'' He always wanted to be one. Like his father.
``Our Daddy was hot stuff,'' insatiably curious and bent on all his children becoming accomplished scholars, recalls Opal. Edward Thomas had a general practice, delivering babies, setting bones, and performing surgery only in emergencies, traveling the muddy roads on horseback.
He was 50 when Thomas was born - Thomas' mother was a Latin and English high-school teacher - and was still practicing at 71, when he was killed in an auto accident returning from a wee-hours delivery.
By high school, Thomas was driving his dad on night calls in their Model T so his dad could sleep between treating patients.
Thomas marvels today that his father had only 11 months of schooling before he entered medical school at 18, and in his 30s - in about 1902 - realizing the inadequacy of his earlier training, went to medical school all over again.
Only once when he knew him did his father take a vacation: They took five days to go fishing at the Texas coast. They had to return because a pregnant patient was due to deliver.
Thomas grew up thinking working that hard was just the way life was.
Ironically, the future winner of every major prize in the field of medicine was not a spectacular student in Prairie Hill. ``There were the usual two or three girls who were smarter, got better grades. I got the highest grades of the boys. I thought I was nothing out of the ordinary.''
In the beginning he wasn't spectacular, either, at the University of Texas. The first semester, he got all B's. ``I worked pretty hard. I thought, `I'm a B student, I better work harder and live with it.' ''
But by the third semester it was all A's. ``The tougher things got, the easier it got for me,'' he says.
At UT, he met his future wife, Dottie, who was a whiz kid - and who would become her husband's right arm in work as well as private life.
Valedictorian of her large San Antonio high school, she entered college at 16 and earned straight A's. Three years later, she married Thomas, and dropped out to follow him to Harvard Medical School. Between an Army scholarship and a ``Mrs. scholarship,'' as he puts it, from Dottie Thomas, who trained as a medical technician, the couple made it through the lean war years.
``We had no financial support, she had to work,'' Thomas says. ``In retrospect, it's too bad, because she could have gone on to get her doctorate.''
Dottie Thomas, who has been listening to the interview from a nearby desk in their office at the Hutchinson center, pipes up: ``I'm happy, I have you.'' Earlier, she has explained that, yes, she would have loved to become a doctor herself. ``It wasn't feasible,'' she says. ``You have to deal with the time you live in.''
At Harvard the two felt like hayseeds, but worked to shed their naivete and most of their accents. After Harvard came post-doctoral work and research in Boston and New York, and Thomas began his pioneering work in bone-marrow transplantation.
Now the leading therapy for leukemia and certain other blood-related and genetic disorders, the technique involves replacing the cancerous bone marrow with healthy, donated marrow.
In 1963, Thomas moved his family - which by then included two boys, and a few years later would include a daughter - to Seattle to become professor of medicine and the first head of the Division of Oncology of the University of Washington School of Medicine.
By 1968, he assembled the core of what would become the bone-marrow transplantation team, then housed at the old U.S. Public Health Hospital (now Pacific Medical Center), and in 1974 moved it to the new Hutchinson center.
A more disparate crew could scarcely be imagined, says Dr. Alexander Fefer, an early member of the team, which also included Drs. Rainer Storb, Reginald Clift, Paul Neiman, Dean Buckner and John Hansen.
Considerably older than his hot, young recruits, Thomas became a kind of father figure to them. He commanded their respect and trust, but a certain distance always remained.
Talking with some of these colleagues, this picture emerges:
Thomas was not known for positive strokes, because he didn't have time to give them. He simply expected the best. He gave his people freedom to explore new ideas, welcomed their opinions - but his opinion always counted most.
He was on first-name basis with everyone down to the technicians, but he discouraged intimacy. He didn't show emotion, though after years colleagues could tell by little changes in facial expression; if angry, he would simply stop speaking, but never yell or become hostile.
With the nurses, he was unusual in treating them as fellow professionals and including them in decision-making about how the ward was run; as a result, despite the depressing nature of the work, few ever left.
Other than medicine, the only thing he talked about with colleagues was hunting or fishing.
He intimidated some, who feared appearing foolish before him. Thomas himself, hearing that others were intimidated, smiles slightly and recalls what a former medical student, now a Harvard pediatrics professor, told him:
``He said I never scolded him, just asked him one question after another, until I had him pinned to the wall''; this student, too, began to always worry how stupid he'd appear. ``Actually, he's brilliant,'' Thomas says evenly. Of his relentless technique, he says, ``I was trying to lead their thought processes.''
He believed in himself so much, he didn't need outside support. And in the early years of the research, there was little from the medical community. Other national teams abandoned the research because of the emotional toll.
Recalls Fefer: ``Of the first 100 patients we wrote up in the first paper, only 12 survived. We put these people through hell, horrible pain and agony. . . It took a tremendous amount of chutzpah, arrogance, hubris - whatever you want to call it, to say we should continue and persist.''
But, he says, Thomas considered that without the treatment, all 100 would have died, and that 12 survived showed it could be done. ``He thought, `We know so little; when we know more we'll do better.' That's precisely what happened.''
Thomas and Dottie Thomas always kept track of what happened to the success stories, and kept the other team members going by reminding them of the ``half-full glass.''
Thomas agrees that total dedication to his research - which saw him and Dottie Thomas working seven days a week - required sacrifice, not just of himself, but of his children and wife.
``You only have one life to live. You make a choice.''
He adds that he's surprised that two of his children became doctors even after seeing how their father worked. ``They got their share of neglect. On the other hand, we all loved each other.''
Don Jr. is a private-practice internist and free-lance outdoors writer in Montana. Elaine - who spent her childhood Saturdays reading comics at the hospital - is a fellow in infectious diseases. Middle son Jeff is an accountant.
The children express nothing but respect for their father. While he may not have been home a lot, says Elaine, he was not emotionally remote.
The children - described by others as brilliant - say he was quiet but led by example. ``He knows what he ought to do and does it,'' Elaine says. For example, ``If you pass an accident, you pull over to see if anyone is injured and needs your help, no matter how late it is or how bad the weather. If you injure an animal, you track it down until you kill it, no matter how long it takes.''
(Incidentally, though hunting may seem incongruous with a career to preserve life, Thomas says he only kills what he can eat, and sees this as no worse than buying a steak from a grocery store. He never kills more than his allotment, he says, and quit the National Rifle Association over its continuing support of automatic rifles.)
What made the kids accept their father's schedule, they say, was that what little time was available was always spent with family - usually outdoors.
Then there was Dottie. Of his parents, Don Jr. says that, in both work and private lives, ``inseparable would be too bland a word.''
``In light of contemporary values you could question the degree she'd made his life her life,'' he says, ``but she's made great contributions.''
And Fefer says no one would question that. ``He couldn't have achieved what he achieved without her,'' Fefer says.
Dottie Thomas has worked for years as her husband's assistant (though for a long time, because of nepotism rules, she didn't get paid). Not only is she an efficient secretary, she is also extremely knowledgeable about the work. She did everything from drawing blood in the early days, to seeking out and helping write grants, getting together scientific materials she thought he should see, and attending most scientific meetings with him, taking notes and circulating them to the transplant team.
Which explains why, in sincere acknowledgement and not just pro-forma politeness, an invitation to the research center's party last week was worded this way:
``Come celebrate the Thomases' Nobel Prize!''
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