Friday, May 31, 2013

Medical Money: How Private Philanthropy Contributes to Medical Research by Arjun R.




Ping. A woman’s calm, soft voice came over the speakers, “Fourth floor. Radiation Oncology.” I stepped out of a sleek, mirrorless elevator onto a small balcony overlooking the main lobby of OHSU’s Kohler Pavilion, home of the Department of Radiation Medicine in the Knight Cancer Institute. My shoes squeaked on the crisp, freshly scrubbed white marble tile floor as I walked towards the sliding glass doors to the department’s waiting room. Adjusting my backpack, I strode into the waiting room and immediately noticed the smell: classic doctor’s office. The unmistakable, all-pervading aroma of medicines and sickness hung in the air, clinging to my hair, clothes, and skin. The room was spacious, clean, and carpeted, and dominated by stained brown wood panels and generic office plants. In contrast to the impersonal, sterile feel of the waiting room, the desk attendant was warm and friendly. “Hi!” she said cheerily. “What can I help you with?” I stood there surprised by her upbeat tone, which seemed out of place for such a serious institution. Looking like a suffocating fish as I tried to formulate a coherent sentence, I stammered, “I’m here to see Dr. Tanyi. I’m working on some research with him.” I looked around the room awkwardly as the receptionist called Dr. Tanyi. I saw several patients sitting in chairs with coarse upholstery. Most were elderly, but a few of them were middle-aged and a couple really young. All of them were threatened by cancer, a mutation in their own bodies that was hurting them, killing them. I made eye contact with two of them, an older woman and a middle-aged man. They both smiled sadly at me, knowing their condition. My throat tightened a little as the full impact of their situation hit me. Fortunately, at that moment, the receptionist opened the doors, allowing me to walk through to the offices and treatment labs.  “Thanks,” I said to the receptionist, my voice a little husky. “No problem,” she replied. “Good luck with your research.” I nodded, shifted my backpack once again, and entered the main hallway of the department.
I walked down the hall past several offices, each one housing a scientist pondering a medical mystery. Fundamentally, all offices look similar: the same harsh blue-white fluorescent lighting, the dull whir of computers running their screen savers, standard-issue black-upholstered office chairs. The one difference between Radiation Medicine’s offices and offices in any other building around the world is that right around the corner are the treatment rooms. These rooms are dominated by a sleek metal linear accelerator, a device that’s used to administer the radiation to the patient. The large doors to these rooms are solid, lead-lined behemoths with bright yellow signs across reading: CAUTION. HIGH RADIATION LEVELS. Throughout the halls, I saw doctors dressed in blue scrubs ushering patients into the treatment rooms, occasionally reassuring them. The closeness of such treatment was striking, especially compared with the mundane nature of the offices. Just looking at the offices, you’d never guess such critical work was being done just a few steps down the hall, locked behind massive metal doors.
About a minute later, I reached my destination: a basic, dimly lit office with four computers, desk covered in loose papers. Dr. Tanyi, my supervisor, was peering closely at one of the monitors. “Hey, Dr. Tanyi?” I asked politely. “Ah, Arjun!” he exclaimed. “Come in!” A tall Cameroonian man, Dr. Tanyi is a medical physicist who fills up the room with his enthusiasm. “Let’s get to work,” he said, gesturing to one of the computers. “Yeah,” I said, thinking of those patients sitting in the waiting room, “Let’s.”
Oregon Health and Science University (OHSU) is home to many of the top clinical research programs in the nation. The facilities are state-of-the-art, and OHSU manages to continually place itself at the forefront of medical research and development. You could trawl for hours through the list of centers of specialization: the Brain Institute (home to the Parkinson’s Center and the Multiple Sclerosis Center of Oregon), the Casey Eye Institute, the Vollum Institute of Neuroscience, etc. However, there is one research facility that draws attention from around the globe, with world-renowned physicians and researchers: the OHSU Knight Cancer Institute. When you hear the name “Knight,” in Oregon the first thing that’ll probably come to mind is Nike. Though Nike has revolutionized the sports attire industry and become a corporate giant in the field, the company is not Phil Knight’s only legacy. The Knight Cancer Institute is the product of Phil and Penny Knight’s $100 million donation to the former OHSU Cancer Institute, catapulting the center into the lead in the fight against cancer (Peck).
In 2008, Knight contacted the director of the Cancer Institute, Dr. Brian Druker, and asked him to explain his plan for combating cancer. Druker’s reply must have been convincing, because the resulting donation, spaced out over seven years, became the largest in OHSU history at the time (“Oregon Health and Science University”). As a result, the now-renamed Knight Cancer Institute became one of the United States’ top cancer centers (“OHSU Knight Cancer Institute”). The Institute is known worldwide for turning lab discoveries into directly applicable treatments. The center prides itself on care that has been custom-fit for each patient, personalized treatments for cancer, and the discovery of new forms of preventative care (Editorial Board). Even before Knight’s donation, the Cancer Institute was a leader in the fight against cancer, and in 1997, it became Oregon’s only National Cancer Institute (NCI)-designated cancer center (“OHSU Knight Cancer Institute). The research done at the Institute attempts to combat cancer at the molecular level, and the Institute’s cutting-edge resources and facilities help not only to produce high-quality lab work and research, but also to control costs. All these factors attract top-level scientists from all over the United States, and even around the world.
One of these scientists is Dr. Brian Druker, and he has an astonishing list of accomplishments in his field. Druker received his medical degree from the University of California School of Medicine at San Diego, completed an internal medical residency at Washington University in St. Louis, and finished an oncology fellowship at Dana-Farber Cancer Institute at Harvard Medical School. In 1993, Druker moved from Harvard to OHSU, hoping to devote more time to research. Among the medical community, Druker is known as the creator of the drug Gleevec, used to combat chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GIST). Gleevec was designed to attack the proteins causing the overproduction of white blood cells in the patient’s body, and the drug specifically targets the cancer cells while avoiding healthy tissue. Druker’s medical wizardry improved the CML patient survival rate from 50% to 90%, and as a result, Druker was named a Howard Hughes Medical Investigator in 2002 and received international acclaim. In 2007, Druker succeeded Dr. Grover Bagby as the director of the Cancer Institute, where he has pushed the Institute to the head of the fight against cancer with his powerful vision and passion. However, the Institute can’t survive on just exceptional scientists alone; the money has to come from somewhere.
OHSU receives much of its funding from private philanthropic donations. These donations, some from prominent figures well-known throughout the state or even country, provide the large sums of money that are critical in expanding and improving the universities services and capabilities. But how do you get these wealthy individuals to donate to OHSU, specifically the Cancer Institute? How do you find these donors, and how do you inspire them to invest in your vision, your belief in the importance of combating cancer?
Looking for answers to these essential questions, I decided to talk to someone related to the OHSU Foundation. Established more than a century ago, the Foundation is a philanthropic institution that organizes and supports the donations that pass through to OHSU (“OHSU Foundation”). Like all educational institutions, there’s a Board of Trustees. The Foundation holds more than $650 million in assets, an impressive amount, all to support its mission “to improve the health and wellbeing of the state and its citizens.” In addition, the OHSU Foundation runs a program that administers research grants, the Medical Research Foundation. These grants are awarded to biomedical researchers all across Oregon, 10 grants up to $40,000 each per quarter and one $75,000 grant per year. I approached a contact on the board, an honorary trustee, whom I happened to know.
The air was crisp, the skies clear. Although I appreciated the break in the monotonous, dreary fall weather Portland is famous for, I wasn’t too pleased with the bite of the chilly wind. Stepping gratefully inside a Starbucks, I sat down at a small table, taking out my notepad and interview materials.
The moment Dick Rubinstein walked through the door I knew I was in the right place. “Can I get you anything to drink?” he asked as soon as we’d finished our standard introductions. I had been all set to buy him a drink as a show of gratitude for taking his time. I was happily surprised by his generous and thoughtful gesture. In hindsight, it seems obvious, considering Rubinstein’s work with the OHSU Foundation. His philanthropic work at OHSU has been absolutely critical to the development of new departments and the recruitment of top researchers. I was eager to understand where the inspiration came from, the motivation to devote so much time and money to this cause.
Rubinstein works as an investment manager, in essence taking other people’s money and investing it for them according to a plan he has devised. “A number of years ago,” Rubinstein said, “I was chairman of the investment committee at Oregon Health and Science University, you know, the Foundation. It was kind of a natural connection.” A man of medium height with medium length white hair, Rubinstein walks with a slight stoop. He was casually dressed in a blue plaid shirt and khakis, and you’d never guess he’s had such an impact on so many lives. “Back in 1984, Betty Gray, who was then chairman of the Foundation board, asked both my wife and me to involve ourselves, in my case to go on the Foundation board. That’s how I got involved, and Betty Gray was a major influence in my life, even to this day.” Rubinstein has an animated, energetic way of talking, drawing you in like a Gatorade-drenched spider web, energizing and capturing you at the same time. His hands moved wildly, infused with energy, while his voice changed tone constantly, sometimes higher, and then dropping down to a rumble, keeping me engaged in the conversation. “She was just a person who had this great ability to get people to really want to involve themselves. The president at the time, Dr. Leonard Laster, literally volunteered me, drafted me and another fellow by the name of Charles Allis to co-chair a cancer chair when there wasn’t even a cancer department at OHSU at that time. So we went out, being very naïve, knocking on doors, thinking we could find the funding to raise the money.” The cancer chair was crucial in the long term development of the Cancer Institute, later renamed after the Knight gift. But where was the money going to come from? The amount of funds required to start something on this scale is massive. “We were looking for $2.5 million to fund that chair,” Rubinstein explained. “A successful lawyer on the Foundation board, Otto Frohnmayer, was very important in the completion of that chair. Diarman was a very successful lumber family in southern Oregon who were clients of Frohnmayer, and he was instrumental in getting the family to basically support the funding. We used to joke that if it weren’t for Otto and the Diarman family, we’d still be knocking on doors, asking for money. All this led to having these outstanding relationships built around the connection at OHSU, and Betty Gray always said we don’t fundraise, we “friendraise.” In other words, you cannot ask people for funding unless they become your friends, unless they really want to become a party to what you’re doing.” That’s now Rubinstein’s job. He spearheads many of the fundraising operations through the Foundation, getting private donors to become interested in what we have here at OHSU. “Not only is it challenging,” Rubinstein said with a grin on his face, “but it’s also fun to build something and you kind of feel like you’re a party to seeing this built.” I walked away from Starbucks that day marveling at Rubinstein’s dedication to this cause that goes way above and beyond what could be expected from a volunteer. The deep satisfaction he gets from his work is unmistakable.
A couple weeks later, on a dark, rainy afternoon I walked into Baird Hall on OHSU’s Marquam Hill campus in search of Room 1011, the office of Dr. Joe Robertson, the president of OHSU. I had a meeting with Dr. Robertson in order to find out how the university gets donors to be interested in OHSU. There many opportunities to donate back to the community, so how do these guys make sure the money comes to OHSU?  “It’s not as much about making a sales pitch as you might think,” Dr. Robertson said. A tall man, Dr. Robertson has a very clean-cut look to him: dark suit, crisp white shirt, and a plaid tie, a classic look for the president of a large institution. However, he exudes a warmth and enthusiasm that really gets you engaged in conversation with him. “You find out if somebody’s interested and what their specific interest is. This is a journey that you embark upon; it’s not like selling a car. I think it’s a different level of engagement. You may never ask a specific question. For instance, you know someone has given you signals that they want to give. You’ve found an area of interest. You’ve tried to explore that area of interest with them. You have tried to get some general idea of the magnitude of the gift that they’re considering, and if it’s a particularly large gift, you often ask the potential donor if you can put a proposal or proposals in front of them. You generally put proposals in front of them that span the gamut of areas where you think their potential giving interest lie, and they react to that. It’s not going into the room and asking, ‘Will you please give us 10 million dollars for this project?’ Now, there are times where you do that, but it’s a much more continuous process, than just an episodic experience. Development is different than sales.”
In order to get a look at philanthropy in OHSU from a more administrative perspective, I also spoke to Dr. Tim Stout, one of the eight vice presidents at OHSU. Each vice president is in charge of a different piece of OHSU: human resources, research, legal issues, etc. Dr. Stout is in charge of commercialization, or the ability to market and sell the drugs and products developed at OHSU. “As a whole,” Dr. Stout said, “OHSU essentially is funded by a couple of different things. We get some money because we see patients and treat patients and bill for that. So there’s clinical income. We get some money from people writing grants. So they’ll write a grant to the government or the NIH and say, ‘I want to study this and give me a million dollars to do it,’ and there’s successful data from the experiment. Then there’s some income that comes from commercializing what we’ve discovered. We might discover a drug that’s good for the treatment of cancer, license that to Merck, Merck says okay, and Merck sells like a zillion units of that, and we get a small fraction of that. We’re also a school. So we charge tuition. The teaching part of what we do is funded partially by tuition. Some of our money comes from the state, even though we’re not a state school. So money comes from a lot of different places. As it turns out, the money we get from the state is miniscule. The money we get from tuition, despite the fact that tuition is high, is miniscule compared to the entire budget. Tuition just doesn’t cover the cost of education. So for us to continue to run that enterprise, we benefit from folks who say, ‘You know, this is a great place, they’re solving great issues, they’re asking good questions, so we’re going to contribute X amount of dollars to help them do that.’” Dr. Stout, similarly cleanly dressed like Dr. Robertson, is extremely passionate about his work at OHSU. His open, easygoing but energetic manner really gets you passionate about his work too. “Most of that money ultimately winds up going to the research part of our mission. We do a lot of things, but we’re often referred to as a three-legged stool, where there are three things that we do. We see patients, we take care of them, do surgery and we bill for that. We have a school, so we teach, and we charge tuition for that. We do research and we write grants for that. So research, teaching, and patient care, those are the three legs of the stool. For our research efforts, a lot of the money we get comes from grants. But, as a generalization, a lot of grants will only allow you to ask questions and get so far. If you actually want to commercialize and make a product that can get into treating patients, there’s a lot of development that has to be done. And there’s quite a gap, called the valley of death, where the grant money from the NIH is no longer appropriate for development, but you’re not getting any money from venture capitalists because you don’t really have a product, so there’s this huge gap in there. And philanthropy can help a lot with that. Philanthropy can help the development of research and development. It also helps with basic research. Sometimes people will come up with a great idea. Unfortunately, for most grants, the cycle is many months or years. And if somebody comes up with a great, hot idea, you don’t really want to wait a year and a half to get funding from the government to do that. So sometimes philanthropic dollars will go and support that.”
Rubinstein talks about the people at OHSU with great enthusiasm, especially regarding his work with them. Dr. Charles Thomas, the head of the Department of Radiation Medicine, is someone Rubinstein holds in high regard. “When Charles came here, the head of development, Rachel Huntsinger, wanted me to meet him because she thought that we would really get along well. When you’re around him, you’ve got to run to keep up, and when I met him they were just building the 4th floor of the Kohler Pavilion.” The Peter O. Kohler Pavilion, named after a former president of OHSU, is part of the Knight Cancer Institute and hosts the Department of Radiation Medicine, where I now find myself spending several hours each week working under Dr. Tanyi’s enthusiastic guidance. “So when I saw it,” Rubinstein said, “it was just walls that hadn’t really filled out, and he was so proud; he felt so responsible that it was like he was building his home. That’s how much of a personal interest he took in it. He is kind of a contagious, infectious person; as soon as you meet him you want to support him. What happened then in the Cancer Institute was a lot of education, recruitment, and reaching out to the community that was not very typical for what is a radiation medicine department. Most grateful patients do not have relationships with their radiation oncologists. And when you have grateful patients that do support their docs, it’s basically a referral. So we felt that, within the cancer council, we should have a group that would support the mission that Charles wants to do, and that would bring in high schoolers and college students and get them involved so that their future can go on into education in medicine, sciences and so forth.” At this time, support for the new Department of Radiation Medicine was limited, and the Institute needed new, highly qualified personnel to support Charles’ vision. “To our knowledge, there was no radiation biologist on the staff, and I think I’m pretty safe in saying, other than going up to Seattle, there was certainly no one in the Portland Metro area or in the state. So we first recruited a few interested people to be a sort of advocacy group, and one of our first functions was to raise funding, to show support and good faith. Then, mainly through Charles’ efforts, they were able to recruit this biologist for the department.” Not only does this funding go to the recruitment of these highly qualified researchers, but it’s also put into creating new departments, improving facilities, more advanced technology, and the enhancement of the education at the University. Evidently, money really does make the world go around.
One of Rubinstein’s tasks, as a key philanthropic partner, is to assist in the recruitment of new, highly skilled researchers and doctors for the Institute. “What we’re trying to do,” said Rubinstein, “is help them not only in their recruitment, but also their retention. That’s one of the big concerns, that while you’re trying to bring people in from outside, you’re also losing them. If you have top people, they’re on everybody’s wish list for recruitment.” Dr. Robertson emphasized that same point, “Academia is like a sports team. You want the stars. You want the people that have the novel ideas and the people that can generate funding, both through describing their proposals in exciting ways to potential philanthropic supporters or writing NIH grants.” However, everybody else is looking at these stars, these big players. In order to keep these top people, you have to stay competitive. “Strangely enough, that’s actually one of the ways you can monitor competitiveness, whether or not your faculty are leaving,” Dr. Robertson said. “Because you want to be competitive not only in the sense of what your faculty are producing, but I worry more about not being competitive in being able to keep the faculty. And that’s where philanthropy is very important in helping you recruit and retain faculty because it gives them the resources to work with to be successful. It also provides the seed money, for instance, for the pilot data for the next grant that they submit. You really have to have a lot of the experiment run before you submit the grant, because they want to fund success. So, philanthropy is very important in giving you this seed money so you can go out and get that pilot data.” After the pilot data is acquired, thanks to the private support, researchers can write a grant to the NIH, which is where the majority of project funding comes from. But, as Dr. Robertson said, the government only wants to fund projects that look successful. In order to get the project up and running, you need the private support before you have enough data to apply for a grant from the NIH.
Rubinstein has had numerous experiences recruiting these top researchers and doctors. “Before the Knight gift, we were losing our good people. There was one I was close to in particular who went to the University of Pittsburgh. He wanted to stay here, and the department made certain promises that did not come through. Meanwhile someone from Pittsburgh offered him such a deal that he couldn’t refuse. So we lost him.” The competition between different organizations and universities for these high level researchers is driven in large part by what you can offer them, and whether you can deliver. “A few years ago,” Rubinstein said, “I visited one of my friends in New York and he basically greeted me with ‘What do you want?’ because everybody wants something.” Rubinstein chuckled, remembering the moment. “I said, ‘I’m not looking for anything, I just want to talk to you about one of our problems.’ So I explained to him that we were losing good people and part of the reason is that we weren’t able to support a lot of those programs. He said to me, ‘Good.’” Rubinstein’s first reaction was “Why is it good?” And I had the same reaction when I heard Rubinstein tell this story. Why would it be good that OHSU was losing its top people? Rubinstein’s friend had the answer, “If you’re losing your good people, then they’re on these recruiters’ lists, and that means you’ve got some big names.” Rubinstein summed it up neatly, “Nobody wants the losers, they all want the winners.” He called the experience an eye opener. “That meant to me,” Rubinstein said, “if we’re losing our good people we must have something pretty darn good here.” Rubinstein’s motivation to continue his work comes in part from seeing the figures, the numbers of people still dying from cancer. Over the past few years, the number of cancer deaths overall has decreased, yet there has been no decline in the deaths of the 15-39 age group. This younger demographic has been slightly sidelined, partially due to lack of insurance, or overconfidence in their health, both of which lead to lack of examinations. “OHSU is one of the pioneers in a lot of these cancer treatment areas. As to why I keep doing this,” Rubinstein explained, “you see these voids and you try to help out where you can, you try to support these departments.”
Despite all the motivation and idealism that drives these researchers forward, the money has to come from somewhere, and over the last several years, the money going into cancer research through the National Institutes of Health (NIH) hasn’t changed at all. In fact, looking at the economy and inflation, the value of the funding has declined. “NIH funding across all disciplines has been essentially flat,” said Dr. Robertson. “The purchasing power has not been preserved. If you look, what we’re proud of at OHSU is that each year we have gained an ever-increasing market share of the total NIH dollar. As our funding has gone up, we’ve gained something like a 0.1% market share each year, which is a small number, but when it’s from a huge denominator of total dollars, it’s significant. The private support has allowed us to do these things, to recruit the faculty, to buy the equipment, to get the pilot data to submit the grants. You spend these philanthropic gifts, and there are two options. You can put it in an endowment or you can spend it. There’re plenty of justifications for doing both. But for instance we are investing the vast majority of the Knight gift because we have enough confidence we can invest it in a way that can develop programs that are self-sustaining. Otherwise, if you put it all in an endowment, you just get to spend 4.5% a year and you never get that big boost.” Between the development of a particular research project and the point where you receive the grant money, there’s this void where the initial development isn’t funded by grants from the NIH or from venture capitalists seeking to make a profit. “Private philanthropy is necessary to pick up a lot of that void,” said Rubinstein. “I don’t think it’s changed from this “friendraising,” so what we do is invite people to campus and they get to hear these top recruits speak about their work. That’s why I think every day, ‘Thank you Phil and Penny Knight,’ because if it weren’t for them, we wouldn’t have these recruits. A lot of these recruits bring grants with them, research projects and so forth. Each recruit that comes to Oregon brings a family with them, and that means housing, grocery shopping, and so on. It really becomes an economic stimulus for this metropolitan area. In the end, it’s really missionary work, making calls, bringing people to campus, tours, all of the above. There’s no one right way.”
Rubinstein recalled one of the most defining moments of this portion of his life as when he was invited to see Dr. Druker receive the Lasker-Debakey award, the American equivalent of the Nobel Prize. “Dr. Richard Goodman, chairman of the Vollum Institute said to me, ‘You will never be anywhere else where you’ll ever see more scientists that are Nobel Prize winners than you will see today.’ Just to be there in that presence motivates you to keep doing more. And whatever you do, it’s never enough. All you’ve got to do is sit in that waiting room of Radiation Medicine and see those people waiting for their treatment, and you know we are not doing enough.” From my work in the department, I knew he was right. I’d been there and seen those people with my own eyes. “We are never finished,” Rubinstein declared, “Not until these docs tell you they don’t have a job anymore.”
Rubinstein’s belief in the perseverance of the fight against cancer comes through most clearly in the Rubinstein Radiation Scholars program, designed to support and develop the next generation of radiation oncologists and scholars. The program recruits from talented high school and college students and allows them to participate in research around the department. These students aren’t just shadowing the scientists; they’re actually being mentored and getting hands-on experience in research in this field. The students take part in active research projects that are currently on deck within the department, and in some cases, end up being co-authors on research papers. Through the Radiation Scholars Program, I’ve had the chance to work in the department on projects that the researchers are currently dealing with. “When I look at these scholars,” Rubinstein said, “and see them as future MDs, PhDs, see what they’re working on, I feel that we are the real lucky ones, we are the real winners. There’s hope that they will continue here at OHSU and hopefully come up with better ways of treating patients.” These scholars, through Rubinstein’s program, will go on to have greater careers in the fields of science and medicine. “It just makes you feel good,” Rubinstein said with a wide grin.
The money that Rubinstein, along with other members of the Foundation, is able to collect ends up being distributed into advancements in technology and improving the facilities. However, at what point do they decide that there’s enough? “It’s like a bottomless pit,” Rubinstein explained. “We used to say that if Bill Gates were to leave his fortune to the Cancer Institute, we’d still be out the next day looking for money. There is not enough money. There are always projects to take on.” Not only does money have to go the maintenance of the equipment, commitments to recruits have to be supported. “I believe,” Rubinstein said, “that if I made a deal with you, we’ve got to honor that commitment or we’re going to lose you. Why would you stay? And we’ve lost people because we didn’t honor those commitments.” Taken all together, I began to understand that there truly isn’t enough money. There’s always something else to do, another challenge to overcome, another expert to hire. “We want to recruit the top in the field,” said Rubinstein, “and it just goes on and on. And that’s just the Cancer Institute.” So how is the Institute able to keep those commitments? Large sums of money are required to fund many of these projects. For example, a professorship in a department costs $1 million. A chair costs $2.5 million. How do you get the money to fund these additions? “What you want,” explained Rubinstein, “is the private donor. If you don’t get the money from private philanthropy, you’re not going to be able to honor those commitments, because the Foundation or the department is unable to fund department chairs or professorships.” This isn’t due to any rules or regulations. Rather, there simply isn’t enough money at the department level to fund those additions. You need private philanthropy to close the gap, to support those additions.
The Knight Cancer Institute is nationally recognized and respected, but this acclaim was received only recently. “The Institute,” said Rubinstein, “is nationally recognized more for our recruitment, because of the people working there.” Before Phil and Penny Knight’s transformative donation, the Cancer Institute wasn’t well known, partially because of its location in Oregon. “You know, people just think ‘Oh, somewhere up there,’ pointing vaguely to the Pacific Northwest, thinking we all still drive stagecoaches,” Rubinstein said with a laugh. The development of targeted drugs and personalized medicine, such as Gleevec, began in Oregon, with OHSU leading the charge. However, there was no national press for these cutting-edge advances. “The Knight gift gave the Institute instant credibility, and that gift spilled over to other departments,” Rubinstein said. “When the tide rises, all the boats go up. It’s the connections, the connections, the connections.”
Still, to forge these links with wealthy donors, there has to be some motivation behind the actions. There’s always a reason why you do anything. In Rubinstein’s case, this isn’t hard to answer. “You want to make a difference,” he said. “When people ask ‘why do you do it,’ I answer ‘Why wouldn’t I?’” Dr. Stout said, “There are so many compelling stories ‘on the hill’ of people who’ve come up with an idea, people who’ve tried it out, it seems to work, and it cures a disease or alleviates a problem that has stumped medicine for forever. And you tell that story to somebody, and they get it. It’s not rocket science. You don’t have to go into all the little details. People get these stories. People understand that it’s really helping somebody. The stories are pretty compelling. It’s not difficult to get in front of people because I think most philanthropists want to know. I think most philanthropists want to make the right decision, I think most approach this with a desire to do good. That’s how we get them to be interested. From a philanthropic standpoint, it’s not hard to make a pretty compelling case.” The developments in technology, the advancements in personalized medicine, the outstanding personnel all contribute to wonder and greatness that is the OHSU Knight Cancer Institute. “You go to these presentations,” Rubinstein said, “you hear these scientists talking, and some of the things just amaze you. That’s how it all begins, being impressed by research.” Private philanthropy is indispensable to the Institute’s support system. It is absolutely critical to keeping the Institute on the map, at the forefront of the fight against cancer. The importance of private philanthropy is being seen all over the country in many different research centers (Blendon 946-950). In order to fill up the void that the decrease in NIH funding is leaving, private philanthropy starts becoming more targeted, more focused, as the Knight gift clearly shows. The advanced research, the level of care patients receive so that, as Dr. Druker said, “No Oregonian has to leave for their cancer treatment,” both make you realize that there is something truly special in the Knight Cancer Institute, and OHSU as a whole. “It’s basically like our description,” Dr. Stout said, “the knowledge of all for the care of one. And that’s kind of what the deal is. We get a bunch of really energized, smart people working together on a project to help eventually one person. And that’s the deal about medicine. Where the rubber meets the road, it’s one person. When you’re in that room doing surgery on one person, that’s the one person. When I’m talking to parents of a kid who I’m going to do surgery on, they’re the ones who you’re focusing on. It’s the ultimate translation. It’s science, it’s social, its medicine, it’s research, all focused on helping one person at a time.” And this amazing institution isn’t all the way across the country like Dana-Farber, Harvard’s cancer center. It’s right here in our own backyard. OHSU’s Knight Cancer Institute truly is a local wonder, something Oregonians can be proud of.
Late one Friday evening in the Department of Radiation Medicine, I was just finishing up my research for the week in Dr. Tanyi’s office. Rain was coming down in buckets, drenching those walking to their cars and transforming the turnaround outside the Pavilion into a massive lake. The clinic had quieted down; most of the researchers had gone home for the night, including Dr. Tanyi himself. The dim fluorescent lighting and the dull whir of the computers contributed to the mellow atmosphere, causing my eyelids to droop a little. Eventually, the computer I was working on finished saving the treatment plans I’d made, and I shut it down. Stiffly, I rose out of the chair, shaking out the cramps I’d gotten in my left leg and stretching out my back. I packed up my things and glanced one last time around the office, taking in the empty card board boxes lying on top of a file cabinet and the loose sheaves of paper pinned haphazardly to the wall. I shifted by backpack on my shoulder, turned off the lights, and stepped into the hallway, closing the door behind me.
Walking down the hall, I ran into a couple of doctors heading back to their offices. Both were wearing the stereotypical white doctor’s coat over a collared shirt and slacks. I nodded politely to them as I passed and received smiles in return. Rounding a corner, I spotted Dr. Charles Thomas, head of the department, walking towards me. A big grin split his features as he noticed me. “Hey, Arjun! How’s it going man?” he called as he strode over to me. “I’m good, how are you?” I responded. A tall, African-American man with a short black beard and a permanent twinkle in his eyes, Dr. Thomas was also dressed in his white coat, sleeves rolled up casually. “Doing well, doing well,” he replied. “How’s that research of yours going?” “Going well,” I said, “I’ve burned through a number of patients on the list and I’ve gotten a head start on several of the others.” “All right, sweet!” he exclaimed. “This is good work you’re doing here, get stoked!” “Don’t worry,” I said, grinning widely as Dr. Thomas’s infectious enthusiasm took root. “I’m super pumped.” “Good stuff! I’ve got to run now, but I’ll see you later!” he called as he started walking briskly down the hall past me. I chuckled to myself as I resumed my exit.
Opening the doors to the waiting room, I once again saw several of the cancer patients. CNN blared in the background from the flat screen TV in front of a small brown leather couch. Some of the patients were confined to wheelchairs, others had tubes running through their noses, and still others were hooked up to IV drips. Many had blank, vacant expressions, some staring through the windows at the tram set against the dark veil of clouds. The receptionist smiled at me as I walked by her and said, “Have a nice evening, see you later!” “You too,” I said as I walked through the sliding glass doors to the elevators and balcony. Pushing the button, I gazed through the massive windows of the Pavilion’s main lobby at the turnaround, now practically submerged. Down below, I saw a nurse in blue scrubs helping an older patient into a van driven by a concerned family member, heedless of the unrelenting downpour.
Ping. The woman’s calm, soft voice sounded over the elevator speakers, “Fourth floor. Radiation Oncology.” I stepped into the empty elevator, turning around to look out over the balcony once more. As the elevator’s polished doors slowly slid shut, I thought about not only what both Dr. Thomas and the receptionist had said to me, but also about the patients sitting in the waiting room, hopeful for some sort of relief and care. The elevator began its descent, and I said to myself, “Yeah, I’ll be back.”


Works Cited:

“OHSU Knight Cancer Institute: Personalized Medicine & Cancer Treatment.” OHSU Knight
Cancer Institute. Oregon Health and Science University, n.d. Web. 22 Oct 2012. <http://www.ohsu.edu/xd/health/services/cancer/>.

“OHSU Knight Cancer Institute: Mission & History.” OHSU Knight Cancer Institute. Oregon
Health and Science University, n.d. Web. 22 Oct 2012.

Druker, Brian. “OHSU Knight Cancer Institute: Director.” OHSU Knight Cancer Institute.
Oregon Health and Science University, n.d. Web. 22 Oct 2012.

"OHSU Knight Cancer Institute: Dr. Druker's Profile." OHSU Knight Cancer Institute. Oregon
Health and Science University, n.d. Web. 22 Oct 2012.

“OHSU Foundation – donor stories: Dick and Deanne Rubinstein.” OHSU Foundation. Oregon

Peck, Dennis. “OHSU Cancer Institute gets $100 million donation.” Oregonian. (2008): n. page.
Web. 24 Oct 2012.

Editorial Board. “Cancer institute’s expansion signals innovation and profit.” Oregonian. (2010):
n. page. Web. 24 Oct 2012.

Rubinstein, Richard. Personal Interview. 31 October 2012.

Blendon, Robert. “The Changing Role of Private Philanthropy in Health Affairs.” New England
Journal of Medicine. (1975): 946-950. Web. 27 Nov. 2012

Kaufman, Michael. “NIH Research Funding Faces ‘Unprecedented Threat’.” Oncology. 05 Apr.

“OHSU Foundation – About.” OHSU Foundation. Oregon Health and Science University. Web.


“OHSU Foundation.” OHSU Foundation. Oregon Health and Science University. Web. 28 Nov

Robertson, Joe. Personal Interview. 29 November 2012.

Stout, Tim. Personal Interview. 30 November 2012.

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