1. Simone, Joseph V. MD

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I began writing this column when I was approaching my 80th birthday, a time of recollection, assessment, and reverie. Getting to be 80 means one has lived through a lot of history. And I can no longer say only that I am aging, though that is true, but more honestly that I am actually old. "You don't look a day over 76," the guy at the gym cracked. Others try to be kinder and say, "You don't look that old." But I am, which is underscored when I recall the notable events-societal, medical, and personal-that I have lived through in over three-quarters of a century. Describing some of these events and changes may make my lifespan more tangible, since we all are influenced by the environment, events and culture we have lived in:




* I was born in the middle of the Great Depression, which had an indelible effect on my family and me; our values concerning the unreliability of financial security and material things never left us.


* My father was an uneducated immigrant who drove a taxi and earned $15 to $20 a week. I never realized we were on the poor side of the social spectrum (along with many, many others); but we had enough to eat and a loving home.




* I was married in May and graduated from medical school in June; I was 24.


* I started a rotating internship at Presbyterian-St. Lukes Hospital (PSLH) in Chicago (now Rush) a few years before that training category disappeared, to the detriment of subsequent post-graduate clinical experience.


* We did simple lab tests in the inpatient unit (urinalysis, stool guaiac, stomach acid, hematocrit) at night and during the day when a quick answer was needed.


* The first contraceptive pill went on the market.


* John F. Kennedy was elected president.




* I was in the midst of a residency in internal medicine at PSLH and was on call every other night, the same as during internship.


* I started writing a journal, which I have continued to this day, because a faculty member said that would help me learn how to write; it turned out to be an excellent way to think about problems, patients, work, life, and family-and occasionally a way to vent my spleen. (It is now well over a million words.)


* James Meredith, the first black student at the University of Mississippi, registered there, escorted by federal marshals.


* St. Jude Children's Research Hospital opened its doors and accepted its first patient, a boy with acute lymphoblastic leukemia (ALL).


* I and most of the house staff at PSLH were drafted into the military due to the Cuban missile crisis; many of the drafts were rescinded (mine included) after hospitals around the country complained that they would be forced to shut down. Many of us then joined the National Guard.




* After four years as a pediatric hematology-oncology fellow at the University of Illinois Department of Pediatrics, Dr. Donald Pinkel recruited me to St. Jude in Memphis. My wife and I had never lived outside of Chicago and we had three daughters six years old and younger.


* We bought a four-bedroom house for $27,500 with an FHA loan and a $2,200 down payment that included closing costs. We had only $200 to our name (credit cards didn't exist). We drove all night in our 1963 VW Beetle with the girls sleeping in the back. After a week at work I asked Don Pinkel when we would get paid.


* I passed the written and oral certification exams for pediatrics and internal medicine. Oral exams were later abolished.




* This was a historic and tumultuous year for the whole country and beyond. The Viet Nam war was at its peak, causing President Johnson to decline to run for a second term.


* Robert Kennedy was assassinated.


* Civil rights and student protests popped up everywhere, and not just in America. The air was filled with tension, polarization, demonstrations, rioting, civil disobedience, and a deep sense of unease and anger. In this medium, acts of violence and lawlessness were selectively condemned or justified depending on one's viewpoint.


* Dr. Martin Luther King, Jr. came to Memphis to support the striking city sanitation workers, who were all black. On March 28th, three St. Jude colleagues and I decided to march with him because of the injustice of the city's leaders. In the middle of the march, windows were shattered and riots broke out and everyone scattered. The four of us started to run back to the hospital, but I reflexively picked up two of the posters that the sanitation workers had carried and dropped when the chaos started. The posters hung in my office until recently when I passed them to my daughter.


* A week later, April 4th, Dr. King was assassinated.




* Dr. Pinkel appointed me to head hematology-oncology at St. Jude.


* Neil Armstrong landed on the moon.


* Gasoline cost 35 cents a gallon.


* Woodstock attracted more than 350,000 fans.




* The St. Jude group published the first paper projecting a possibility for the cure of ALL. I received nasty phone calls (e-mail did not exist) from colleagues criticizing me for giving patients and families false hope. I responded that if they didn't believe cure was even a remote possibility, maybe they should send their patients to us. (I did have some chutzpah.)


* Terrorists at the Munich Olympic Games murdered eleven Israeli athletes.


* G. Gordon Liddy, general counsel of the committee for re-election of President Nixon proposed burglarizing and wiretapping the headquarters of the Democratic National Committee in the Watergate complex in Washington, D.C. A few months later a security guard called the police, which started the Watergate affair.


* The Senate passed the Equal Rights Amendment to the Constitution giving equal legal rights to men and women.




* The St. Jude group published a seminal paper demonstrating long-term survival for half of patients with ALL in Total Therapy Study V, even after cessation of therapy.


* President Nixon was inaugurated in January but was forced to resign later in the year due to the Watergate scandal.


* The U.S. Supreme Court voted 7-2 in Roe v. Wade making abortion a right based on their interpretation of the Constitution concerning personal privacy and rights.


* Leisure suits became the fashion. I have photos of me wearing one and I assure you they will never see the light of day.




* I was appointed to succeed Dr. Alvin Mauer as director of St. Jude.


* President Reagan signed legislation making the third Monday in January a national holiday honoring Dr. Martin Luther King, Jr.


* Motorola introduced the first mobile phones to the public.


* ARPANET, founded in 1969 by the U.S. Department of Defense to test models for electronic communication, officially changed the structure to the Internet Protocol, thus creating the Internet.




* Leaders of Washington University asked St. Jude leaders to consider moving the institution to St. Louis; after months of discussion and deliberation, St. Jude stayed in Memphis.


* The AIDS virus was identified and within a year the disease became widespread.




* After 24 years I left St. Jude to become physician-in-chief at Memorial Sloan-Kettering Cancer Center.


* Four years later, I was recruited to Utah to help develop further the Huntsman Cancer Institute. I retired from academia five years later, in 2001.


* On September 11th, 2001, we physically moved to Atlanta to be near our two grandchildren and did not hear of the morning attack on the World Trade Center until late afternoon. Our youngest daughter was only blocks away from the attack and we could not communicate with her until late in the day; she was OK physically, but not OK emotionally.




* I started writing this column for Oncology Times in 2002 and hope to continue indefinitely-this particular one is #217.


When pulled together, my experiences (and that of many others my age or older) describe a long arc, making my age more tangible in the midst of so many events. And I know how it ends because Shakespeare has told us with the "Seven Ages of Man" speech in "As You Like It" that ends thus:


The sixth age shifts


Into the lean and slipper'd pantaloon,


With spectacles on nose, and pouch on side,


His youthful hose well sav'd, a world too wide,


For his shrunk shank, and his big manly voice,


Turning again towards childish treble, pipes


And whistles in his sound. Last scene of all,


That ends this strange eventful history,


Is second childishness and mere oblivion,


Sans teeth, sans eyes, sans taste, sans everything.


Although Shakespeare was right, in general, I am blessed with good health, a fairly good intellect (short-term memory not as sharp, but OK), financial security, and a wonderful family with all members also in good health and happily bonded to each other. What a blessing to have lived in an exciting age when good health is more common, medicine is more effective, and the opportunities to good are readily available.


I can say that 80 is just a number and mean it, and I will enjoy whatever time I have left with gusto.