Introduction of Donald Pinkel F. Lampert Organizers, colleagues, ladies and gentle­ then to do a proper evaluation. As to the men, and above all, dear Don, everything pathogenesis of a disease, you can read is evolution, and every new field in med­ about this everywhere in a book, but the icine has its beginnings and its pioneers. patient is unique!" The story of pediatric oncology is a short The second time I spoke to Don was on but fascinating one, now covering 40 the telephone, calling from Munich to years, a time span considered holy since Memphis. It was on a Tuesday, the 18th biblical times. In Germany, that is, in of May, 1971. The mother of a freshly West Germany or the Federal Republic diagnosed 6-year-old boy with acute of Germany, the real and effective pedi­ lymphoblastic leukemia (ALL) urged me atric oncology has an even shorter histo­ to call Dr. Pinkel. She had just read in ry, and its beginning is closely connected the German news magazine Der Spiegel with Dr. Pinkel's name. It is thus a great about an almost 20% 5-year-cure rate for pleasure and an honor to introduce Don­ ALL achieved by Dr. Pinkel's group at ald Pinkel. St. Jude's Hospital, published in the I could now present to you Don Journal of the American Medical Associ­ Pinkel's scientific career, or when and ation at the end of April. I had my where he was born - I think it must have doubts, but on the phone he told me been 1926, somewhere in the USA - or something about "total therapy," includ­ mention the many awards he received, ing radiation of the central nervous sys­ the last, if I remember correctly, being tem, about aggressive multiagent therapy the most prestigious and substantial up to the biological tolerance of the pa­ Charles Kettering prize from the General tient, and about 300 or more active pa­ Motors Foundation in 1986, but I will tients with ALL currently under treat­ confine myself to some personal memo­ ment at St. Jude's; I was curious to see ries and what I have learned from him. with my own eyes. Together with Dr. The first time I met Don Pinkel was on Gregor Heinze, our local radiotherapist, the last day of August in 1960, at a barbe­ we arrived at St. Jude's on Friday, May cue at Dr. Oleg Selawry's residence on 28, 1971, and were able to study all the Grand Island, near the Niagara falls, Buf­ treatment modalities in the utmost detail. falo, N. Y I had just completed my intern­ Back home, our patient Markus received ship in the Pacific Northwest, and, on the the first dose of cranial irradiation on way back visited the famous Roswell June 8, 1971 - the first one in Germany; Park Memorial Institute. Don Pinkel was by the way, he is now a healthy university chief of pediatrics there and had also student - and was put on Pinkel therapy, been invited by Oleg Selawry. I will never as well called this ALL management all forget what Don told me during that hot over Germany. This Pinkel therapy con­ and humid Midwest evening about sisted of induction, CNS irradiation, and teaching medical students: "With a pa­ continuation therapy lasting 2-3 years. tient, the most important thing is, to ob­ This treatment protocol was easy to un­ serve, to examine, and to state the physi­ derstand and to apply. Within several cal findings absolutely correctly, and months allmost all institutions in Ger- 25 many were treating children with evolved during a dinner with live lobsters leukemia according to Pinkel. This was he invited me to Memphis. According to our first nationwide trial in ALL: 659 my diary, it was Wednesday, April 12, patients were registered, and about 240, 1972. It was after the tenth anniversary or 36%, were cured. The lesson I learned of St. Jude's Children's Research Hospi­ from Don in pediatric oncology was that tal, which now had become a world lead­ treatment should be not only specific and er in the research and treatment of child­ effective but also simple, safe, and cheap, hood cancer. Don told me about the ini­ so that everyone, everywhere can admin­ tial difficulties this institution had had; it ister it. This so-called Pinkel therapy was started as a dream, as an idea in the the right beginning in our country, which minds of Danny Thomas and Don. Go­ is federally organized with so many small ing to Memphis at that time, he said, was kings, kingdoms and opinions. We all like going into undeveloped territory. gained experience with the side effects of But setbacks are also challenges. He told toxic chemotherapy and with complica­ me about those German Jewish profes­ tions of the disease, and, above all, we sors who had been his teachers, who, af­ were now able to cure children. We were ter persecution and emigration were glad ideally prepared to take on an even and humble to be in medicine again, even greater challenge, the prolongation and with a low income and no honors. intensification of the induction period, "Humiliation makes better men!" This developed by Hansjorg Riehm in our is what you said, Don, and what always country. helped me to overcome frustrations and Many more times thereafter I had the failures. And you, yourself, set examples, opportunity to come to Memphis. and not minding working in clinics, even as a many members of the St. Jude's fa-mily director, or making night calls. But I came to Germany in the years to follow. should not dwell on humiliation, but in­ I was happy to arrange for a most re­ stead should close in your particular case markable lecture on treating children with the beginning of the hillbilly song: with leukemia that Don gave at Chil­ "It is hard to be humble, if you are per­ dren's University Hospital in Munich, on fect in every way ..." September 8, 1971. It is a great thing that you are here, The third and most unforgettable les­ Don. Thank you for coming. son lowe to Don Pinkel, however, 26 .