Emil Freireich, MD

Emil Freireich, MD Session 1—October 5, 2011 About transcription and the transcript This interview had been transcribed according to oral history best practices to preserve the conversational quality of spoken language (rather than editing it to written standards). The interview subject has been given the opportunity to review the transcript and make changes: any substantial departures from the audio file are indicated with brackets [ ]. In addition, the Archives may have redacted portions of the transcript and audio file in compliance with HIPAA and/or interview subject requests. The views expressed in this interview are solely the perspective of the interview subject. They are not to be interpreted as the official view of any other individual or of The University of Texas MD Anderson Cancer Center. Chapter 00A Interview Identifier Tacey Ann Rosolowski, PhD 0:00:10.6 I am Tacey Ann Rosolowski, interviewing Dr. Emil J Freireich. It’s Emil, correct? Emil J Freireich, MD 0:00:17.8 Americans say “ee.” Tacey Ann Rosolowski, PhD 0:00:21.7 How would you like me to say it? Emil J Freireich, MD 0:00:23.1 J. 1 Interview Session: 01 Interview Date: October 5, 2011 Tacey Ann Rosolowski, PhD 0:00:23.4 J Freireich at the University of Texas MD Anderson Cancer Center in Houston, Texas. This interview is being conducted for the Making Cancer History Voices Oral History Project, run by the Historical Resources Center at MD Anderson. Dr. Freireich holds the Ruth Harriet Ainsworth Chair in Developmental Therapeutics. He is also a distinguished teaching professor and director of special medical education programs as well as the director of the Adult Leukemia Research Program at the University of Texas MD Anderson Cancer Center. This interview is taking place in Dr. Freireich’s office in the main building on the MD Anderson campus. This is the first of two planned sessions. Today is October 5, 2011. The time is approximately 9:20. Thank you, Dr. Freireich, for devoting your time to this interview and to this project. I’m very much looking forward to talking to you. As I mentioned before, you were interviewed in 2001 by Leslie Brunet on a variety of subjects, so I wanted to not cover all the ground. I’ll be asking you some questions in areas that I feel were not covered in depth. The first thing that wasn’t covered was something you already brought up, which is that you’re called J, and that J doesn’t have a period after it even though it looks like your middle initial. I’m wondering if you could tell the story about this strange—or mysterious—middle initial. 2 Interview Session: 01 Interview Date: October 5, 2011 Chapter 1 A: The Researcher A New Idea and A Controversy: Transfusing Platelets in Leukemia Patients Story Codes A: Personal Background A: Overview A: Definitions, Explanations, Translations D: On Research and Researchers D: Understanding Cancer, the History of Science, Cancer Research D: The History of Health Care, Patient Care C: Discovery, Creativity and Innovation A: The Researcher C: Professional Practice C: The Professional at Work C: Collaborations B: Devices, Drugs, Procedures C: Faith C: Portraits C: Patients C: Discovery and Success Emil J Freireich, MD 0:01:58.1 Well, when I grew up I was addressed by my family as “brother” because I had a sister. So there was “brother” and “sister.” In school, my name was Emil, but when I received my induction notice at the age of seventeen to go into the military, they required a birth certificate. As you know, I grew up in a very modest part of town, and we finally discovered that the city of Chicago did have a birth certificate. Lo and behold, the birth certificate said Freireich, Emil J, so I consulted my mother, and she said that when I was born she’d only been in this country about five or six years. She was young and didn’t speak much English, and the nurse said, “What do you want to name him?” So she said, “I want to name him after his grandfather whose name was Emil.” They were Hungarian, but they spoke German. They were located in that slit that was between Austria, Hungary, and Germany. She named me Freireich, Emil J. It was supposed to be junior, but the birth certificate had no “R,” just “J.” So I became Emil J Freireich, because it didn’t stand for junior, it didn’t stand for anything. It was just J. That’s how it happened. 3 Interview Session: 01 Interview Date: October 5, 2011 Tacey Ann Rosolowski, PhD 0:03:47.5 Does that have any significance for you? Emil J Freireich, MD 0:03:49.0 Yes, because Americans don’t like this name Emil. It’s kind of European. As you pointed out, many people—Americans—call it “ee-mil.” The French call it “a-mil.” But it’s very European. And when I married my wife—my ever-loving wife—she didn’t like the name at all, so she began calling me J, so everybody calls me J. Some people call me J Emil Freireich. Tacey Ann Rosolowski, PhD 0:04:24.0 It just shows the power of that initial with no period after it. Emil J Freireich, MD 0:04:26.9 When I write papers, as you know, the period always appears. Typesetters can’t avoid it. Tacey Ann Rosolowski, PhD 0:04:34.2 I did notice that, yes. They add things. Well, if you don’t mind, I’d like to talk about some of the areas in which you’ve made contributions, specifically starting with the work on the continuous- flow blood separator. I know that you developed that with George Judson when you were at NCI from 1955 to1965, but the one topic that really wasn’t covered in too much detail in the 2001 interviews was how the blood-flow separator was developed technically once you got to MD Anderson. I’m wondering if you could tell me that story, and then about the trials that you began to run. Emil J Freireich, MD 0:05:24.4 Did she give you the reprints I gave her? Tacey Ann Rosolowski, PhD 0:05:26.6 Yes. Emil J Freireich, MD 0:05:28.0 That’s a nice story. 4 Interview Session: 01 Interview Date: October 5, 2011 Tacey Ann Rosolowski, PhD 0:05:29.8 Yes, I did read it. Emil J Freireich, MD 0:05:31.6 But of course it’s very published, so it’s very slim. I can give you a little more color. When we started treating children with leukemia and patients of all kinds, we recognized that whatever you did to kill a tumor inhibited the normal bone marrow, which is a rapidly growing organ, and the gastrointestinal tract. The gastrointestinal tract you can handle by replacing fluid, but the blood was a problem. We went to work on the platelets because the leading cause of death in patients treated when they had leukemia or otherwise was hemorrhage. The hemorrhage story is also told. It’s very colorful because it had already been proven unequivocally that thrombocytopenia was not responsible for the bleeding. The science of that was volumes deep. But we decided to do a simple, clinical thing. See, I’m a great advocate of bedside to bench and back. People think that if you discover everything in the laboratory, it will immediately apply. You’ll call up some doctor, and he’ll do whatever—give him a drug or something. But in fact everything that advances our knowledge about humans and human disease begins with clinicians observing patients, and then you can go to the library, so we decided to do that. We noticed that thrombocytopenia was present whenever they were bleeding, low platelets, so we did a retrospective study where we just looked at the charts and wrote down how often the nurses and the doctors noticed that the patients were bleeding, and we wrote down the platelet counts on those days, which we did on a regular basis, and we wrote what’s a citation classic. It’s a paper that shows that there is a direct relationship between the degree of thrombocytopenia and the occurrence of hemorrhage. So then, now it’s time to go to the laboratory. I went to the lab and I said, “Well, it’s obvious we have to replace the platelets.” So I took platelets out of my blood, and I got blood out of all these children bleeding to death. I put my platelets in, and all the in vitro tests of coagulation were normalized. I said, obviously there’s something missing here. We’ve got to do an in vivo experiment. We have to give them platelets. Now there’s a challenge. This may be more detail than you care about. Tacey Ann Rosolowski, PhD 0:08:23.1 No, detail is good. Emil J Freireich, MD 0:08:24.3 It’s all in the paper. The first thing we did was recognize that the way blood was collected in the blood bank, once it’s stored three or four days, the platelets are mostly dead; they disintegrate because there’s acid and citrate. It’s refrigerated, and that lends to clumping of the platelets and 5 Interview Session: 01 Interview Date: October 5, 2011 so on, so we realized we needed fresh blood. When I had done it, I had fresh blood, but fresh blood is not something blood banks do.

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