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Oncology Times:
doi: 10.1097/01.COT.0000324874.42477.6f
Simone's Oncopinion

Another Adventure

Simone, Joseph V. MD

Free Access

Why would an old duffer like me take on a difficult full-time job at 72? I have had a full and satisfying career, my wife and I are financially secure, our three daughters are grown and have wonderfully happy families, our five grandchildren are a continuous feast for the soul, and I enjoy consulting for cancer centers part time. I love writing this column and working for ASCO's Quality Oncology Practice Initiative. So why rock the boat?

That is not easy to explain, and there are many reasons not to do this. The job requires a move of our household away from family and friends and selling a house in a difficult housing market. The job is full time and will require a lot of stamina. I have no need to build a career or seek academic promotions and recognition. So why rock the boat?

First, let me provide a brief background. In 2006 I was asked to do an extended consultation at the University of Florida concerning the construction of a new cancer hospital and other matters. This required frequent trips to Gainesville over six months or so. That job ended in December 2006 and early in 2007 I received a call from the Moffitt Cancer Center asking me to re-examine their regional network and make recommendations for greater efficiency and impact. I made frequent trips to Tampa for months. While winding down that job, the University of Florida and Moffitt began discussions about a joint cancer effort.

The institutions are about 100 miles apart. Because I knew both institutions well, I was asked to help with the discussions and with drafting a memorandum of understanding, which I finished. An agreement subsequently was reached and signed early in 2008.

A few months ago, I received a call from Bill Dalton, CEO of Moffitt, asking if I would be interested in heading the cancer center in Gainesville to help implement the agreement and after a year or 18 months, to help recruit a permanent director (I had made it clear that two years' full time was my limit). Then perhaps I would stay on in a part-time advisory capacity. I wavered back and forth and finally accepted the job. After lengthy discussions with my wife, God bless her, she said something like, “let's go and have another adventure.”

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Why Rock the Boat?

I still haven't answered the question, why rock the boat? So now I will try in a few seemingly unrelated paragraphs.

I didn't understand this until later in life, but I came to realize that I have a bit of the pioneer in me and I am bored easily (Pat, my wife, understood this long before I did); I think these two traits often exist together. I get some of this from my dad, who at the age of 17 and an orphan, took a boat to the US, stayed with his brother a while, and then struck out on his own, speaking little English and having little money.

A key factor in this decision was our youngest daughter. She and her husband have two boys—two and a half years old and seven weeks old. They live an easy drive from Gainesville. We moved to Atlanta almost seven years ago to be near two other growing grandchildren, both now nearly grown up. For us, the opportunity to be near two pre-school grandsons, to watch the miraculous transformation of growth and development, and to help their family a bit is a special gift not to be missed.

Figure. Joseph V. Si...
Figure. Joseph V. Si...
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Fortunately, we have good health and are in a position to make such a move.

After retiring from academia in 2001, I have worked as a consultant. It became a joke among colleagues that I was “retired” but still working. I pointed out to them that retirement did not necessarily mean stopping all work. To me retirement meant working when I chose, for only as long as I wanted, and only on projects that were interesting and stimulating. My goal was to stay intellectually engaged.

Also, I have learned that it is often best to go with your gut feeling. Prior to this job I had four institutional jobs. Before accepting three of them I was told by many people I respect that I was making a big mistake: all three jobs turned out great. The one job that everyone thought was a good idea turned out to be a failure for me and the institution.

But the reasons go deeper than that—a sense that we only go around once in this life and, especially for those of us on Medicare, there is a faint sense of urgency, of not wanting to postpone or miss opportunities, health and circumstances permitting. Perhaps Jack London, the American author of Call of the Wild, said it better:

“I would rather be ashes than dust! I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry rot. I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet. The proper function of man is to live, not to exist. I shall not waste my days in trying to prolong them. I shall use my time.”

And for those of us who are physicians and still retain a glimmer of the young idealism that steered us into medicine, it is a rare opportunity to use one's experience to try to improve medical care, but more importantly, to fulfill one's potential. Howard Thurman, philosopher, Baptist minister, and educator, said it better:

“Don't ask yourself what the world needs; ask yourself what makes you come alive. And then go and do that. Because what the world needs is people who have come alive.”

And finally, an even broader view of living life is well said in this Cherokee expression:

“When you were born, you cried and the world rejoiced. Live your life so that when you die, the world cries and you rejoice.”

So beginning in July, I will be working at the University of Florida and with the Moffitt Cancer Center to develop stronger cancer programs and to help guide the next generation.

If my past experience of listening to my gut when selecting jobs is any indication, this should turn out great. I will be very busy, but I intend to continue writing this column and working for QOPI, two things I love to do, and to have new adventures to savor and to write about.

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IOM Retooling for an Aging America Report: 10 Sponsors

The new Institute of Medicine report, Retooling for an Aging America, warning that significant changes are needed for the country to be prepared to care for the increasing numbers of aging baby boomers had 10 cosponsors. Five of them were listed in OT's article in the May 10 issue (the John A. Hartford Foundation, AARP, the Commonwealth Fund, the Retirement Research Foundation, and the Robert Wood Johnson Foundation), and the other five full sponsors are the Atlantic Philanthropies, the California Endowment, the Archstone Foundation, the Josiah Macy, Jr. Foundation, and the Samuels Foundation.

The report notes that there is an overall shortage of health care workers in all fields, especially geriatric medicine.

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Coming in Future Issues!

▪ News, Analysis, & Controversy from ASCO Annual Meeting; International Conference on Malignant Lymphoma; American Society of Breast Surgeons Annual Meeting

▪ More from AACR Annual Meeting: (1) Novel Targeted Drug Shows Promise in Advanced Basal Cell Carcinoma; (2) HER-2/neu Peptide Vaccine for Breast Cancer Induces Clinical Responses Regardless of HER-2 Expression Level; (3) Research Lends Biologic Plausibility to Link with Alcohol; Even Minimal Exercise May Lower Risk

▪ From Digestive Disease Week: (1) Confocal Laser Endomicroscopy: Real-Time Technique Appears to Offer Detection Advantages in GI Cancers; (2) New Screening Method Using CA19-9 Plus Endoscopic Ultrasound Found More Likely to Detect Pancreatic Cancer in Early Stages; (3) And Even with the Latter Alone, Patients Who Undergo that at Diagnosis Found to Have Longer Average Survival than Those Who Do Not

▪ Glioblastoma: Preoperative Depression May Worsen Outcomes of Patients Undergoing Surgery

▪ ‘Home Health Parties’ Are New Prevention Strategy for Hispanic Farm Workers in Washington State

▪ How They Do It: MSKCC Provides Successful CME Program with No Commercial Funding

▪ From “Cancer Progress Conference”: (1) Investing in Biomarkers Takes a Hit; and (2) Companion Diagnostics: How Far Should They Be Developed?

▪ Adding Taxane to Anthracycline-Based Therapy Does Not Improve Outcomes

▪ Vitamins May Play Role in Treatment of GI Cancers

▪ Urban Women Have Increased Breast Density, May Explain Increased Risk of Breast Cancer

▪ XELOX, FOLFOX, FOLFIRI in Metastatic Colorectal Cancer: Physician Choice Based on Toxicity Profiles

▪ Gastric Cancer: Oral Fluoropyrimidine S-1, Good Standard Therapy in Japan, But Not At Least As Yet in US

▪ Activating Mutations in JAK2 and Trisomy 21 Collaborate in Down Syndrome ALL

▪ The Evolution of the Pioneering Palliative Care Center at Medical College of Wisconsin

▪ Esophageal Cancer: Preop Chemo Boosts Survival

▪ Controversial Breast Cancer Imaging System Aims to Coordinate MRI & Ultrasound, MRI Found Better than Mammography for Diagnosing Pure DCIS

▪ Elderly Patients with Metastatic Colorectal Cancer Can Safely Be Treated with Standard Chemotherapy Regimens

▪ MDR Gene Confers Poor Clinical Response in Breast Cancer

▪ Study: Oncologists Typically Recommend Same Treatment to Patients They Would Choose for Themselves

▪ CNS Screening Advised for Patients with Metastatic RCC

▪ Warning about Calcium and Magnesium's Effect on Response to Oxaliplatin Called Premature

▪ Pain Disparities Found Between Non-Caucasians & Caucasians with Metastatic Breast Cancer

▪ Genomic Medicine in Clinical Practice Lagging for Chronic Diseases

© 2008 Lippincott Williams & Wilkins, Inc.

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