| National Cancer Institute/National Institutes of Health |
National Cancer Institute, National Institutes of Health
I transfered to the National Cancer Institute as an Assistant to the Director. Prior to this, I had no experience with any other medical/research programs. I was chosen for this position because of my experience and expertise in running major government programs. My role was to assist in the planning for a major thrust by the United States and the biomedical world in a fight against that dreaded disease. I traveled extensively helping develop and fund major cancer centers in this country and abroad and developed the technical systems necessary to develop information flow between researchers and treatment specialists all over the world.
When the National Cancer Plan was completed, I left this challenging position after four years.
I decided at this point in my life to leave government work and the space business, sold all my possessions in the Washington/Virginia area and bought a ranch in Weiser, Idaho. I will detail this time in a section by itself later on this web site, a section I call "My Idaho Connection".
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| The logo for the National Cancer Institute with the crab signifying the disease having its claw into a man and across the top, the parts of the program depicted by symbols. |
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The National Cancer Program formally dates from 1971, when it was created by P.L. 92-218, the "War on Cancer" Act. I had just gotten this large data analysis contract with the NCI and in the process began a lot of contact with Dr. Carl Baker, the Director. He and I hit it off very well and spoke the same kind of language when it came to planning and spending. Dr. Baker held the rank of Rear Admiral in the Public Health Corps and wore a military uniform to work most times.
Dr. Baker, the Director of the NCI, wanted to bring into the NCI some planners from other government agencies that had been involved in developing large programs and were not connected in any way with research within the NCI circle of funding. He hounded me to get back into Civil Service and go to work on his staff as an Assistant to the Director.
Even before the legislation was signed into law in December 1971, NCI director Carl G. Baker, M.D., began an elaborate program planning effort that culminated in a strategic plan sent to Congress in October 1973 and a five-year operational plan in August 1974. The strategic plan was updated once, in 1974, and rolling five-year plans were issued annually until the mid-1980s.
Short blurb on Dr. Baker: Carl Baker, who was director of the National Cancer Institute during the US "war on cancer" in the early 1970s, died Feb. 11 at Casey House hospice in Rockville, Md. He had myelodysplastic syndrome, a bone marrow disorder. He was 88.
Dr. Baker spent most of his career at the cancer institute in Bethesda, Md., the largest branch of the National Institutes of Health. He was director of the cancer institute in 1971, when President Nixon signed the National Cancer Act, which added $100 million to the institute's budget and was seen as a declaration of "war on cancer."
During Dr. Baker's three years at the helm of the cancer institute, its annual operating budget jumped from $181 million to $378 million.
He solidified the institute's standing as the country's premier center for cancer study by increasing research efforts in leukemia and cancers of the bowel, prostate, and bladder, and by expanding chemotherapy programs. He was also part of a US delegation that reached cooperative health agreements with the former Soviet Union.
Carl Gwin Baker was born in Louisville, Ky. He graduated from the University of Louisville and entered its medical school. In 1942, he joined the Navy. After graduating from medical school in 1944. In 1949, he received a master's degree in biochemistry from the University of California at Berkeley.
During his 23 years with NIH, Dr. Baker was a commissioned officer of the US Public Health Service, reaching the rank of rear admiral. He began his career in 1949 as a biochemistry researcher studying cholesterol and amino acids. But he developed asthma as a result of an acute sensitivity to animal dander and, after two years, had to turn to administrative work.
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While I was still working at Wolf Research, I began my new assignment as a consultant to the Director of the NCI, Dr. Baker. We became friends and he took me to all the Congressional hearings on the new National Cancer Program. Dr. Baker had a temper and low tolerance for incompetence and dealing with the members of these Congressional committees was not his forte. In the middle of meetings while he was testifying, I would keep reminding him that he could not explode at the questions that were being asked him. One day he could not control himself any longer and that cost him his job. He was relieved of his Public Health Services assignment of the Director of the National Cancer Institute.
Dr. Frank Rauscher, who chose to go by the name of "Dick" rather than Frank, became the new Director. I had already worked with him so the transition for me was good. He and I also worked well together.
This photo below is one of my favorite of any I have even though it is not a good representation of either Dr. Rauscher or myself. We had been in some tough meetings and this was a break during the meetings. The questions being thrown at Dr. Rauscher had to do with the system the NCI was using to award grant monies to researchers. More people were now into the mix since it appeared that the NCI budget was going to grow considerably. Critics wanted to be able to more easily get the money into their own facilities to do the research they wanted to do rather than having the NCI direct any of their efforts, and certainly not be in a position to be critical as well.
Dr. Rauscher and I went out to the street and sat down on the curb where he could get my opinions on what he should do. It was great! We strategized right there at curbside and went back into the meeting prepared.
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| Dr. Frank (Dick) Rauscher, Director of the National Cancer Institute, and Dick Holt sitting on a curb outside the building where a very important meeting was taking place in the early stages of developing the National Cancer Plan. |
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According to Section 407 of the Act, titled "National Cancer Program":
(a) The Director of the National Cancer Institute shall coordinate all of the activities of the National Institutes of Health relating to cancer with the National Cancer Program.
(b) In carrying out the National Cancer Program, the Director of the National Cancer Institute shall: (1) with the advice of the National Cancer Advisory Board, plan and develop an expanded, intensified, and coordinated cancer research program encompassing the programs of the National Cancer Institute, related programs of the other research institutes, and other Federal and non-Federal programs.
In the first few years, there was extensive input from the scientific community into scientific program contained in the strategic plan for the National Cancer Program. The plan was organized as a multi-level hierarchy of goals, objectives, approaches, approach elements, and project areas. Baker and staff posed the fundamental goal (develop the means to reduce the incidence, morbidity, and mortality of cancer in humans) and developed seven objectives for working purposes. A series of 40 panels involving more than 250 scientists met at Airlie House between October 1971 and March 1972 to identify several approaches to each of the seven objectives, several approach elements under each approach, and multiple project areas under each approach element.(6) The result was summarized in the wheel, a circular graphic that was used to illustrate the conceptual basis for the National Cancer Program (Figure 1).
There were several more rounds of planning involving large numbers of researchers, including cancer control planning sessions held in September 1973 and a major revision of the strategic plan in January 1974 that fed into the first five-year operational plan (NCI, 1974). After that, however, the plan was revised each year by staff. The text began to be repeated from year to year, with just the numbers updated.
The plans explained that the NCI director was also director of the National Cancer Program and responsible for its development and management. That is, the NCI director had two hats. He was head of NCI, the lead federal cancer research agency. He was simultaneously charged with developing [with the advice of the National Cancer Advisory Board] a coordinated program in cancer research and control that includes activities conducted in and out of the Federal Government, to assure the Nation of a well-balanced cooperative program that recognizes the relevant contributions and achievements of the biomedical community (NCI, 1974:1-2).
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The National Cancer Program concept in the 1971 act went well beyond the traditional directed vs. undirected research issue. First, it called for a greater and sustained effort to identify areas of research in which knowledge has reached a stage where a focused effort might have a significant payoff for control of cancer in man (NCI, 1974:VI-6). This would imply an effort not only to do research but to monitor the results, have criteria to decide when research results are ready to be developed for practical use, and devote significant resources to applied research and development.
Second, the National Cancer Program concept saw NCI, although primarily a research agency, becoming involved not only in the development of research results into practical applications but working with the full range of national institutions involved in cancer in bringing those applications to bear in prevention, diagnosis, treatment, and rehabilitation efforts as part of a national attack on cancer. The National Cancer Program was not supposed to become the national cancer care system but it was supposed to interact enough with the system to improve the delivery of patient care by promoting the use of state-of-the-art treatments by front-line health care providers.
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The National Cancer Plan was finished and published for the world to see and read. The task that I was hired to do at the NCI included establishing an information system which could be used world-wide by patients and physicians alike to get information on cancer all the way from what it was, early detection through treatments for the many kinds of cancer. That task was implemented through the National Library of Medicine with whom we collaborated in this major information system endeavor.
So, as far as I was concerned, my almost four years at the NCI produced what I had agreed to do in this far-distant field from my own, working in missile and satellite systems. But in all truth, I was burned out in my work. It was time to make a major move in my life. I had found a haven of rest where I could do something completely different. It was IDAHO, a little-known part of this country.
That story is next! Read the interesting twist my life took when I resigned from the NCI, Federal employment, and headed West to Idaho. What a change!! It was a very exciting time in my life.
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