Charles A. LeMaistre, M. D.

Leaving a Legacy of Excellence

By MARY JANE SCHIER

But for his dog Inga, 10-year-old Mickey LeMaistre might have died from a burst appendix in the spring of1934. He remembers the experience clearly and with gratitude for his canine companion.

"I'd gone walking with Inga in the woods near our house. She was a wonderful champion German shepherd, who accompanied me everywhere. She especially enjoyed the woods. Suddenly, I felt an awful pain in my abdomen and collapsed with what I learned late r was a ruptured appendix. If Inga had not gone to get help, I probably would have died, because I could not move," Dr. Charles A. LeMaistre recalls.

Although that frightening ordeal occurred 62 springs ago, Dr. LeMaistre will never forget how Inga helped save him. In retrospect, he says, "I have believed for some years now that I was spared for a special reason."

In preparing to retire this summer after 18 years as president of M. D. Anderson Cancer Center, Dr. LeMaistre spent several hours recently reflecting on a remarkable life that began in a small Alabama town and led him to become one of the nation's most influential medical leaders. He credits "family and faith" for the firm foundation on which he developed a rare combination of abilities as a physician, educator, administrator and proponent of public education to reduce the risk of cancer.

He states emphatically, "Everything I did for so many years was a preparation to serve as president of M. D. Anderson. I truly believe I was destined for this job."

When he assumed the position on Aug. 1, 1978, Dr. LeMaistre was only the second full-time president in the institution's history. During his tenure, M. D. Anderson has doubled in physical size, but, more importantly, its international reputation for innovative patient care, research, education and prevention programs has been solidified.

Explaining why is easy for him.

"The Anderson's greatest asset is our outstanding 'family' of faculty, staff, volunteers, members of the Board of Visitors and all of the generous donors who support the important work under way. I frequently say this team represents the most formidable force ever assembled against cancer. They all share a common commitment to eliminate cancer as a major health threat for people everywhere," Dr. LeMaistre notes.

He also stresses that members of the M. D. Anderson family have an obligation "to do more than those at other centers" to assure the lofty stature is enhanced through further impressive contributions to reduce the toll cancer takes.

In his characteristically modest manner, Dr. LeMaistre says, "People are what make this institution so good. The president is just responsible for making sure these talented people have the resources and the opportunities to be as productive as possible and for communicating often and openly with them . . . I feel privileged to have worked with so many enthusiastic, dedicated faculty, staff and supporters. I also will be forever grateful to the thousands of patients who have placed their trust in M. D. Anderson. It is a combination of all these people who will assure that we eventually achieve a future free from cancer."

Throughout his career, he has mirrored basic values instilled in boyhood primarily by his mother, Edith McLeod LeMaistre, a school teacher. His father, John Wesley LeMaistre, was in the lumber production business in Lockhart, in southern Alabama, and was a member of the Alabama Legislature. The youngest of six children, Mickey was just 5 years old when his father died of a severe strep infection that damaged his kidneys.

"My mother was an exceptionally strong woman with an unshakable faith. She was beautiful in stature and even more beautiful in her approach to life. As I grew older, I tried to emulate her in the way she lived and in how she expressed her faith . . . Despite losing my father and having six of us to continue rearing and educate, I never once heard her complain," he recalls.

Although he had his father for only a few years, Dr. LeMaistre felt close to him. "My father is responsible for my nickname. I was born at home. When my father first saw me, he commented that I looked like someone named Mickey, whose picture was in a magazine he'd just read. Then he told my mother, 'We'll call him Mickey,' and they did. < p> "Over the years," he relates, "my schoolteacher aunts referred to me as Charles, as did most other teachers and my professors in college and medical school. But I always introduced myself as Mickey LeMaistre, and after awhile no one tried to talk me out of using it. Frankly, I think my nickname has made me more approachable and, well, human."

Because his father had bought one of the first home movie cameras available, Dr. LeMaistre was able to see and study the entire family at work and play. He also listened attentively to stories his mother and siblings told about his father.

"Fortunately, my father left a good estate. After he died, we moved from Lockhart to Tuscaloosa, where my mother devoted full time to encouraging all six of us to develop our individual talents," he says.

Two of his brothers and one sister were organic chemists; the other two brothers became attorneys. Their mother lived to age 91, so she was able to appreciate the numerous contributions her children made.

In high school, Mickey and Sam, who is two years older, excelled in tennis. Once when they had both boasted about winning some tough matches, their mother suggested that she play them the following morning.

"She beat me soundly; in fact, I didn't win a game. Then she played Sam and beat him, too, although I think he won one game in their match. That was her way of teaching us not to brag, and it's a lesson that has meant a lot to me," Dr. LeMaistre relates.

Another memory involves a family discussion on Dec. 7, 1941, when Pearl Harbor was bombed. The four older LeMaistre brothers were eager to enter the Armed Forces. Two went on to distinguish themselves in the U.S. Navy, one was in Gen. George Patton's Army, and Jack, the oldest, designed smokeless powder used in guns and developed propellants for rockets.

"As the youngestÑI was 17 thenÑI stayed at home to help my mother and sister, but I yearned to serve as wellÑand eventually I did," he says.

His decision to study medicine evolved during his teens. After the ruptured appendix episode when he was 10, he sustained some broken bones in high school, where in addition to tennis he played football and golf and learned to sail. He also suffered an eye injury, in which slivers of shattered glass scratched his left eye; this accident kept him from accepting an appointment to West Point. Innately curious about science, he began discussing career choices with neighbors who were faculty at the University of Alabama in Tuscaloosa.

"Soon after going to the University of Alabama, I decided to study pre-med. It didn't take long before I knew I wanted to be a physician," he recalls.

Upon receiving a bachelor's degree, he went to the Medical College of Alabama for two years, then transferred to Cornell University Medical College, where he earned his medical degree in 1947. He took an internship and residency in medicine at New York Hospital and finished a two-year postdoctoral research fellowship in infectious diseases at Cornell.

After joining the Cornell faculty, Dr. LeMaistre was recruited for the first unit of the U.S. Public Health Service's Epidemic Intelligence Service. During what he describes as a "fascinating" two-year stint, his family and friends thought he was an instructor of medicine at CornellÑand he wasÑbut he also handled several highly confidential assignments, including research dealing with defense of possible germ warfare and a secret mission to contain a strange pulmonary epidemic among almost 500 children on an Indian reservation.

All of the youngsters survived, and, from that event, a model health program evolved for the reservation in Arizona.

In two years as an instructor and another year as an assistant professor of medicine at Cornell, Dr. LeMaistre worked on developing tetracycline-type antibiotics and several experimental drugs. He treated many patients with tuberculosis and diseases of the chest.

"I was keenly interested in infectious diseases, the mechanism of aerosol transmission of infectious agents and how patients' host defenses were compromised," he notes.

About a year after he began balancing his duties at Cornell with an intelligence mission in Atlanta, Dr. LeMaistre went back to Tuscaloosa to visit his mother. He was with an old high school friend on the University of Alabama campus when he looked across a tennis court and saw "absolutely the most beautiful young woman I'd ever seen . . . Within a few minutes of watching her, I knew in my heart that this was the woman I would marry."

Fortunately, his friend knew Joyce Trapp, who was a student at the University of Alabama. Enlisting the friend's help, Dr. LeMaistre arranged a date and took Joyce to meet his mother. The two women "instantly bonded" and spent the evening getting acquai nted.

"I did convince Joyce to see me again, but I was sent off on a confidential assignment, during which I could not communicate with anyone . . . Finally, nearly eight weeks later, I was able to see her again . . . I must have been pretty persistent because she finally agreed to marry me." The wedding took place June 3, 1952.

In April 1996, Dr. and Mrs. LeMaistre received the Humanitarian Award from the National Conference of Christians and Jews.

The couple lived briefly in Atlanta, then moved to New York City for Dr. LeMaistre to continue his research, teaching and patient care responsibilities. In 1954, he accepted an academic appointment at Emory University School of Medicine in Atlanta; thre e years later, he became chairman of its new Department of Preventive Medicine and Community Health and coordinator of clinics at Grady Memorial Hospital.

"We spent five marvelous years in Atlanta before I took a faculty position at The University of Texas Southwestern Medical School in Dallas in 1959. By this time, we had three young children as we drove to Texas, arriving in Dallas in late August. The temperature was 108 degrees, and I felt certain Joyce thought we'd made a big mistake," Dr. LeMaistre chuckles, "but everything worked out well."

He especially enjoyed supervising the fellows and other teaching duties, and he treated patients at several hospitals, including Parkland Memorial. He also was medical director of Woodlawn Hospital's Chest Division. In 1965, he became associate dean of the UT Southwestern Medical School, a post that provided a springboard to becomi ng vice chancellor for health affairs at the UT System in Austin a year later. One of the highlights of his Dallas period was serving as the youngest member of the first U.S. Surgeon General's Advisory Committee on Smoking and Health, which in 1964 issued its landmark report identifying cigarettes as a major cause of lung cancer. He already had observed the ravages that tobacco took among his patients. When he saw how a physician can affect public policy, Dr. LeMaistre dedicated himself to making a difference about smoking. Today, he is considered one of the world's leading auth orities on the subject.

No one has campaigned more tirelesslyÑor eloquentlyÑfor more than three decades to educate millions of Americans about the dangers of smoking. He chaired the 1981 National Conference on Smoking OR Health and a 1985 International Summit on Smoking Contro l Leaders, both milestone meetings. While national president of the American Cancer Society in 1986, he traveled widely to promote the growing good news about cancer prevention, in particular how many malignant diseases could be avoided if people never u sed tobacco.

"But the smoking and lung cancer connection we reported in 1964 is only a part of the human tragedy caused by tobacco use," Dr. LeMaistre emphasizes.

Elaborating, he cites these effects that more than 50,000 solid scientific studies have shown are linked to smoking:

¥ One-third of all cancer deaths ¥ A major portion of all cardiovascular disease ¥ Virtually all chronic bronchitis and emphysema

"Smoking is the most significant cause of catastrophic illness and injury in our country today. Phrased another way, smoking is the single most preventable cause of all morbidity and mortality in the United States. Nothing else even comes close. As ma ny as 500,000 Americans will dieÑmany prematurelyÑduring 1996 because they or their loved ones smoked," he explains.

Dr. LeMaistre says the problem of smoking should be viewed within "its larger context of an unprecedented economic, moral and political crisis." Because he is by nature an optimist, he remains "hopeful" that Congress will approve some of President Clinton's proposed regulations to help curtail smoking among American youths.

Looking back, Dr. LeMaistre confides that he "never planned on being a full-time administrator" because he genuinely enjoyed patient care, teaching and research at Cornell, Emory and Southwestern. "I really left Cornell and then Emory to avoid becoming an administrator," he says.

However, in 1966, then-UT Chancellor Harry Hunt Ransom convinced him to move to Austin as vice chancellor for health affairs of The University of Texas System. Dr. LeMaistre advanced quickly to executive vice chancellor, then chancellor-elect and, from 1971 until1978, he served as the system's chancellorÑthe only physician in the University's history to hold that high post.

"Harry Ransom was the most persuasive person I'd ever met. He was responsible for changing my mind about administration. Fortunately, he was willing to share his secretary to help me get organizedÑand I have been blessed to have Judy Watson work with m e now for more than 25 years," Dr. LeMaistre says.

During his tenure as chancellor, Dr. LeMaistre led a huge expansion of UT components that included new medical schools in Houston and San Antonio as well as the state's only School of Public Health. Other biomedical and academic units were enlarged, an d The University of Texas at San Antonio, The University of Texas at Dallas and The University of Texas of the Permian Basin in Odessa were established.

"Dr. Mickey LeMaistre is truly a remarkable physician, administratorm and visionary medical innovator. Under his leadership, the M. D. Anderson Cancer Center has become one of the most respected institutions in the world for its cancer research and the effective medical treatment of patients." At left, Dr. DeBakey, right, and Bernard Rapoport, chairman of the UT System Board of Regents, meet with Dr LeMaistre in 1994.
Among special memories from his chancellor's period was buying a Gutenberg Bible that experts considered among only 20 original copies in perfect condition. The quest for such an historic Bible was begun by his predecessor and ended when Dr. LeMaistre a nd Art Dilly flew to New York City on June 21, 1978, with checks totaling $2.4 million to purchase a complete edition of the two-volume Bible.

Dr. LeMaistre views the Gutenberg Bible with Art Dilly of The University of Texas Board of Regents.

"The chancellor and I each carried a part of the Bible in zippered tote bags, which never left our sight until we were safely back in Austin," remembers Dilly, long-time executive secretary of the UT System Board of Regents. "It was an incredible advent ure."

Today, the Gutenberg Bible is on display in the Harry Ransom Humanities Research Center. To Dilly, the rare Bible "remains a prize possession and an important symbol of the high quality of education" at UT-Austin.

Thinking back, Dr. LeMaistre says, "I had told the Board of Regents I only wanted to be chancellor for four years, but former Governor Allan Shivers had been appointed a regent and persuaded me to remain beyond that time."

As chancellor, Dr. LeMaistre was chairing a search committee for the president of M. D. Anderson in the spring of 1978. Several faculty leaders at M. D. Anderson started a campaign to recruit Dr. LeMaistre to succeed Dr. R. Lee Clark, the institution's only full-time director and president who would be retiring after 32 years.

Upon relinquishing chairmanship of the search committee and agreeing to become a candidate, Dr. LeMaistre remembers "praying for a long time" about his future. "Once more, Joyce and I discussed at great length what would be best, not just for me but for our entire family, including the four children, and we reached the mutual decision to come to the Anderson," he says.

The more he thought about it, the more Dr. LeMaistre looked forward to the challenges that M. D. Anderson offered. He was especially elated to be returning to an exciting medical environment, albeit as an administrator.

"I had worked closely with Dr. Clark during my 12 years with the UT System, and I knew what a national standout the Anderson was. Its reputation was broadened in the early '70s when it was chosen one of the first three federally designated Comprehensive Cancer Centers. I was impressed with the caliber of the faculty and staff, the hi gh level of clinical standards, the increasingly productive research, the opportunity to enhance its academic stature and the great potential to start a formal cancer prevention program," he remembers.

At the time, Dr. LeMaistre considered M. D. Anderson "the crown jewel in the UT System." He thinks that assessment is truer than ever now because of all the achievements made during the past 18 years.

"M. D. Anderson was established specifically to make progress against cancer, and its record of progress over the past half century is outstanding. Today, research here is leading the way toward elimination of cancer as a major health hazard. We are on the verge of unlocking many secrets at the molecular level. Our scientists are gathering new knowledge about oncogenes and tumor suppressor genes. Together with their clinical colleagues, they are exploiting this information and applying it with growin g rapidity to patients already diagnosed with cancer and, in some instances, to those at increased risk for cancer. I am certain," he states, "that the Anderson will continue to out-distance other cancer centers and make even more important contributions in the future to help conquer this age-old disease."

Elaborating on his earlier comment about how people have made M. D. Anderson what it is, Dr. LeMaistre credits The University Cancer Foundation Board of Visitors and the many thousands of donors who support the institution with "giving us an extra edge i n efforts to strengthen our mission areas and move closer to the day when cancer control is a reality."

Among examples are the highly successful Fulfill The Promise campaign, which in 1995 exceeded its $151 million goal in half the time predicted and which is making possible a modernization of physical facilities to match "our talented and dedicated facult y and staff."

Dr. LeMaistre also stresses, "The Anderson has more than lived up to its commitment to the State of Texas since it was created in 1941. There is no question that this institution has returned in great measure the confidence that Texans have placed in their cancer center."

Today, state support as a percentage of M. D. Anderson's total resources is less than 16 percent, down from almost 40 percent 12 years ago. Instead of complaining about that decrease, Dr. LeMaistre says, "The Anderson has demonstrated more than any other state agency that we can pay our own way. The percentage we receive from the state i s a critically important part of our budget and helps support the institution's infrastructure."

The M. D. Anderson faculty and staff currently generate more than $5 for every $1 the state invests. These earned resources come from external research grants and contracts, fees for patient care services and private philanthropy. "This is a phenomenal achievement, particularly in light of the budget-tightening we've needed to take to handle the tremendous changes in health care, notably the growth of managed care-covered services," he says.

Dr. LeMaistre has been widely honored. The Texas Tuberculosis and Respiratory Disease Association saluted him in 1970 for contributions as chairman of the Governor's Committee on Tuberculosis Control and Eradication in Texas. He received the American L ung Association's President's Award in 1987 for his tobacco control efforts. The next year, he was chosen for the first Gibson D. (Gib) Lewis Award for Excellence in Cancer Control. In 1990, he was named "Mr. South Texas" by the Washington Birthday Cele bration Association.

Other awards include the "People of Vision" Award from the Texas Society to Prevent Blindness in 1991, the Caring Spirit Tribute from Houston's Institute of Religion in 1993, the American Medical Association's Distinguished Service Award in 1995 and, mos t recently, a Humanitarian Award from The National Conference of Christians and Jews. He also has received distinguished alumnus awards from both his alma maters, the University of Alabama and Cornell University, and five honorary degrees.

Dr. and Mrs. LeMaistre have been honored jointly as 1987 Houstonians of the Year by the Houston School for Deaf Children and with the 1991 Service to Mankind Award from the Texas Gulf Coast Chapter of the Leukemia Society of America.

In addition to serving as national president of the American Cancer Society, Dr. LeMaistre was president of the Damon Runyon-Walter Winchell Cancer Fund for four years.

He was president of the Council of Southern Universities, president of the Philosophical Society of Texas, and he chaired the National Aeronautics and Space Administration/National Institutes of Health Joint Advisory Committee on Biomedical and Behaviora l Research.

Among civic activities, he was a director of the Greater Houston Partnership and has chaired the Economic Diversification Committee of the Houston Chamber of Commerce. He is a director of the Rotary Club of Houston Foundation, the Forum Club of Houston and Texans for Quality Education.

Dr. LeMaistre is an active member and ordained elder of the First Presbyterian Church of Houston.

***** What advice does Dr. LeMaistre have for his successor?

"Retain and build on the unique culture of the Anderson and cherish all the peopleÑfaculty, staff, volunteers, supporters and especially the patientsÑwho form such an incredible common bond," he replies.

Turning to the future, he laughs when asked about retirement plans. At age 72, his definition of retirement differs from many senior citizens.

"I have always loved teaching and would hope to return to a classroom in some capacity, perhaps to teach health policy. But I am also interested in what I could do for younger children. I want to make a difference in young children's lives, because I a m certain we could prevent many of the teen problemsÑdrugs, dropping out of school, pregnancy and violence, among othersÑif we started earlier. I probably will continue some sort of church work, and perhaps I'll get involved with a foundation," he answers.

Those are only a few possibilities. He goes on to discuss his long-time interest in hunger, not just in Houston but around the world. "I truly believe much more can be done to alleviate this problem," he emphasizes.

Having had an affinity for the water since he learned to sail and crewed on a deep sea fishing boat as a teen-ager, he also "just might get serious about sailing again." Dr. LeMaistre's first priority, though, will be spending more time with his wife, their four children (two are physicians, one is an attorney and one has a master's in health care administration) and six grandchildren, who range in age from 3 to 17.

"Joyce has been my rock for almost 45 years and the real reason our children have turned out so well," he says.

How does his wife anticipate "retirement"?

"My dream is that he'll relax a little bit, but I don't see him ever retired and in the rocking chair," Joyce LeMaistre says with a broad smile. "Although he's been very busy during all periods of his professional life, Mickey cherishes his family, and I know he'll devote even more quality time to our grandchildren. I also believe he'll find some significant community service that will be good for him and benefit others."

Dr. LeMaistre admits he is "sad" at the thought of leaving M. D. Anderson on Aug. 31. "I will miss being invigorated on a daily basis by all of these wonderful people, but I believe once touched by the Anderson you are changed forever and for the better. I expect to hold these memories in my heart and to treasure them in years to come," he concludes.