Most of these medical pioneers, nicknamed the “Cancer Cowboys” are gone now. Their ranks once included James Holland, Tom Frei and Emil “Jay” Freireich. Arguably, the best known of this group, Donald Pinkel, died March 9 at his home in San Luis Obispo, CA, at the age of 95.
A giant in the field of oncology, Pinkel served at the St. Jude Children’s Research Hospital from 1961 to 1973 and proved that childhood cancer was a curable disease. Beginning at Roswell Park in Buffalo, and more notably at St. Jude he made medical history by creating an effective therapy for acute lymphoblastic leukemia (ALL), a disease once considered almost universally fatal.
In 1956, Pinkel was named Roswell Park’s director of pediatrics. (Part of his initial $9,000 salary came from funds provided by philanthropist Mary Lasker.) Early in his time at Roswell Park, Pinkel lost three children to leukemia in a single day. As they died, he remained at their bedsides, talking to them in a hushed voice. Later on, back at home, he felt so depressed that he wondered how he could go back to work the next morning.
Dr. Mitchell Rubin, professor of pediatrics at the University of Buffalo, had warned Pinkel that he would be “throwing away his career” by staying in this field of medicine. After all, Pinkel was a highly regarded doctor, with a growing family to take care of. He didn’t have to hold to this career path—taking on cancer with little support.
Still, as he sat alone at the kitchen table, Pinkel asked himself, “If these children and their parents can face this disease every day, what’s wrong with me?” He realized that if he didn’t care for them few in the medical community would step up.
“The kids I was treating couldn’t run from this, neither could their parents and family. So I decided I wouldn’t, either,” he told me decades later. “If you saw a kid drowning in a river, you wouldn’t worry about the how swift the current may be or how deep it is. You’d try to save him, wouldn’t you?”
– Source: St. Jude Children’s Research Hospital
Members of Pinkel’s extended family had summer cottages across the Niagara River, along the Canadian shore of Lake Erie, and the doctor rented a rundown place for his family on Waverly Beach, not far from the Peace Bridge. By the end of the summer, when it was time to return to Woodward Avenue in Buffalo, Pinkel was reluctant to do so. Instead, he found a brick farmhouse at Windmill Point, a mile or so from Lake Erie. It had a run-down chicken coop and a pig barn that was now used to burn garbage. Yet with a new furnace and better insulation, the cottage at Windmill Point became the family’s year-round residence for the rest of the doctor’s time at Roswell Park.
The crunch of the gravel driveway meant Pinkel was home from the hospital, often with a notable person in medicine in tow. Dr. Robert Guthrie, who introduced the first newborn screening system in the U.S., and Nobel Prize winner Dr. Rita Levi-Montalcini were among those who visited Windmill Point. After Pinkel came home so late from the hospital that he had to throw snowballs at the bedroom windows to have somebody to let him in, the front door remained unlocked.
“My Dad’s patients nearly always died, at least early on,” said one of his daughters, Becky Pinkel. “So there were times when he would come home to Canada and sit on the porch at night and look out on those fields. Just alone with his thoughts.”
When Donald returned home to Buffalo, becoming the head of pediatrics, he expected to be at Roswell Park “for the rest of my life.” Yet when the winter arrived, he soon developed a bad case of pneumonia. In addition, his legs began to spasm and his lungs remained congested. “Don, you have to get out of this climate,” Pinkel’s doctor told him. “Your lungs just won’t clear up.”
Reluctantly, the 34-year-old Pinkel accepted an interview for a new job in Colorado. He was ready to visit when officials at the planned St. Jude Children’s Research Hospital in Memphis reached out to him.
– Source: Roswell Park Comprehensive Cancer Center
Danny Thomas was the driving force behind the new facility in Tennessee. The actor had vowed to build a shrine to St. Jude Thaddeus if his career ever took wings. Kind of a personal deal with God. Once Thomas became a household name in the popular television show “Make Room for Daddy,” he discussed his plan with Catholic priest Samuel Stritch, a close friend and the Archbishop of Chicago. Stritch told the actor that there were plenty of shrines. What was needed was more places to heal the sick.
After discussions about building such a hospital in Boston or St. Louis, Thomas decided “to put it in the South,” said his daughter, Marlo Thomas, “and then Cardinal Stritch in Chicago said, ‘I’ll help you to put it in Memphis because there’s where he’s from …”
On the way to Boulder, Pinkel stopped off at Memphis, where he didn’t mince words. He asked the hospital board and members of the University of Tennessee Medical School if they would “accept all children, including Black children, at this hospital, and that there would be complete integration in all levels—staff, nurses, everything?”
One of the university chairmen refused to consider the notion and Pinkel didn’t say a word. But inside he recalled, “I boiled, boiled, boiled. I thought, ‘Wow! That guy is giving me a challenge. To say I can’t do that.’”
Pinkel’s worst fears of the South had been borne out. After all, He had grown up in a large, liberal family in Buffalo that hung a large portrait of Abraham Lincoln on the wall. His ancestors had fought for the Union in the Civil War and one of his great-uncles had been killed in the conflict. Personally, he vowed to never work in that part of the country because “there was so much prejudice down there.”
Pinkel continued west to Colorado, where he was offered “a sweetheart job.” The university already sported a state-of-the-art hospital right on campus, with quality staff and excellent students. It seemed to be an easy choice.
Yet what nagged at Pinkel was that he had been challenged by the university chairman in Memphis. Back in high school, a coach had warned Pinkel that you “never run away from a fight. It’ll be more and difficult the further you run to fight back.”
The next morning, Pinkel awoke and decided he would take the job in Memphis, building a hospital for Danny Thomas. His friends were stunned. His mentor, Mitchell Rubin, who was from Charleston, South Carolina, wrote Pinkel a long letter telling him, “You can’t do that.” But Pinkel’s mind was made up.
He reached out to Ed Barry, the chairman of the board for the new hospital, and Mike Tamer, the executive director for the American Lebanese Syrian and Association Charities. (Thomas was Lebanese). If they weren’t in his corner, Pinkel knew he had little chance of success in western Tennessee.
where he was known to work late into the night. – Source: Pinkel family
The three met at a neutral site—a hotel room at Conrad Hilton in Chicago. There Pinkel outlined his vision for the research hospital. How they would not only take care of all children, but the primary focus would be on kids with cancer and other supposed incurable diseases like muscular dystrophy. Barry, like Pinkel, was Jesuit-educated and one of the wealthiest, most influential men in Memphis. The two of them soon hit it off.
“Our minds just met,” Pinkel said. “It clicked. We didn’t have to explain things. We were from the same background.”
In comparison, Tamer hadn’t finished high school, but he too believed strongly in civil rights. He urged Pinkel and Barry to sort out the details and he would focus on the big picture. At the end of the day, the three shook hands and Pinkel officially took the job. A few weeks later, the doctor arrived in Memphis on the Feast of St. Jude, which he took as a good omen.
“(My) mother had a devotion to St. Jude,” Pinkel said. “She used to go down to St. John Maron Church in the inner city … to see a Father Shemalie, who was a typical Eastern Church holy man. She would bring donations and pay, and she asked him to pray for us.
“I remember when I took a scholarship exam for high school and everybody was hoping for a full scholarship. We couldn’t pay for it. She called up Father Shemalie and said, ‘Pray for my boy. He’s taking a scholarship exam.’ He said, ‘I’ll pray for him’ and he did. And my mother said, ‘Father Shemalie came through. St. Jude did it.’”
Still, if Pinkel had known what awaited him in Memphis, he would have thought twice about taking the post. By the time he arrived, the new hospital was already running out of money and he first had to become a fundraiser to assure that the patient wing was built.
Decades later, looking back on the move to Memphis, Pinkel said the job “was a very iffy proposition. But it sure got my attention. The people there told they would support me, so I decided to find out.”
The new doctor in town soon became involved with the African American community. When several local civil rights leaders were jailed and went on a hunger strike, Pinkel visited them and brought along infant formula. He told them to drink it to keep up their strength.
By the end of his first year, Pinkel had 126 patients at St. Jude. They were “girls and boys, Black and White, Catholic, Protestant and Jewish,” Memphis magazine detailed. Just as importantly, Pinkel had assembled a medical staff of 100, many of whom took some cajoling to move to the South.
Despite such early success, Pinkel realized that if he didn’t fix a problem with the local blood banks little of the cancer research he was proposing would get off the ground. At the time, there was a steep mark-up from the donor level to the local hospitals in the Memphis area. Pinkel’s new hospital was sometimes being charged as $35 a unit. So, he appealed to the commanders at the Millington Naval Air Station, urging the naval personnel and Marines there to become regular blood donors. A system was worked out where men in uniform received weekend passes to Memphis for every blood donation they gave. Pinkel also recruited local college students and inmates at local prisons. In doing so, he formed the first volunteer donor system in western Tennessee and, as he said years later, “broke the back of the local blood banks.”
At St. Jude, Pinkel soon began a series clinical trials “based on all the stuff I knew, the experimental work and laboratory work and experience.” He called it Total Therapy and divided the regimen into a series of studies that combined multiple anticancer drugs with radiation treatment.
Decades later, looking back on the move to Memphis, Pinkel said the job “was a very iffy proposition. But it sure got my attention.”
Pinkel later told Smithsonian magazine that his hypothesis “was that there were some leukemia cells that were sensitive to one drug and other cells that were sensitive to another. But if we used all these drugs at once and hit them along different pathways, we could permanently inhibit the development of resistant cells.”
Under his care and direction, one out of six children with acute lymphoblastic leukemia (ALL) were moved into remission. And they stayed in remission even when maintenance measures were stopped. The Total Therapy approach is still used at St. Jude, which now has a 94 percent survival rate for ALL. It proved to be the major milestone in Pinkel’s career. One in which attitude was as important as anything for the doctor.
“As I’ve said, a sense of hopelessness pervaded the entire field—to the point that many in the medical community thought, ‘Why bother to take on leukemia?’” Pinkel told me. “Well, lots of people thought we were nuts. And when you look back at what we had to overcome, not only in Memphis, but at other hospitals, like Roswell Park, perhaps we were crazy. Maybe we had to be.”
Tim Wendel is the author of Cancer Crossings: A Brother, His Doctors and the Quest for a Cure to Childhood Leukemia.
