Wesleyan University Commencement Address

Harold Varmus
President and Chief Executive Officer
Memorial Sloan-Kettering Cancer Center

Middletown, Connecticut
May 28, 2000

Proud parents; faithful friends and families; accomplished alumni; agile administrators; feisty faculty; and -- most of all -- glad graduates, grateful to all of the above:

I am here to tell a story, not to give a speech. It is a good story and true, and it has Wesleyan written all over it.

Just over a year ago, I was wrestling with an important personal decision. Should I leave the National Institutes of Health, where I had been serving happily as Director for about six years, and accept an offer to become the President of the Memorial Sloan-Kettering Cancer Center in New York City?

One day, while this question was smoldering in the back of my mind, I received a collection of essays. They were written by several Wesleyan students -- including my son Christopher, Class of 1999 -- who were enrolled in the innovative course in family biography taught by Professor Phyllis Rose. Naturally, I turned first to read Christopher's entry -- a wonderfully moving account of his older brother's musical accomplishments and emotional trials. Then, while browsing through the rest of the collection, my eye caught the word "Freeport," the name of my home town on Long Island.

Reading this essay from the beginning, I learned about a Wesleyan student's dramatic relationship with her father, a Freeport policeman with an extraordinary and sometimes self-destructive zest for life and a fierce determination to become a novelist. In 1995, just as his writing began to show genuine promise, he was afflicted with an aggressive illness that his doctors on Long Island decided was an inoperable cancer, spread to his liver.

As he faded physically and friends approached his hospital bed to say farewell, his family took a last stab at a medical miracle. They transferred him to Memorial Hospital, part of the Memorial Sloan-Kettering Cancer Center. Often, such dramatic final efforts are fruitless. Amazingly, in this case, a doctor at Memorial recognized that his liver disease was due to a bacterial infection, not to metastatic cancer; treated it with appropriate antibiotics and surgery to drain abscesses in the liver; and reversed what seemed to be an inexorable course toward death.

I wouldn't presume to compare my own response as a reader of this story to the jubilation that family and friends must have felt, living through the real events. But the effect on me was powerful. I felt a surge of pride in a cancer hospital that could recognize when cancer was not the correct diagnosis -- and could then return a dying man to the expectation of a full and dynamic life. I felt as though I had already made the decision to accept the job I'd been offered, and validation of that decision was now at hand.

That sense of validation went well beyond institutional pride in a job well done and beyond any emotional connection with these dramatic events. This story was also a reminder of what medical science had accomplished in one arena in the past and what it might achieve in other arenas in the near future.

Let me explain. The hero of today's story was saved not just because a smart doctor proved that he did not have cancer. He was saved because his disease could be diagnosed precisely and attributed to a specific foreign invader, a bacterium, for which a specific cure, an antibiotic, was available. One hundred years of science -- discoveries of microbes by Pasteur and others in the late 1800's and the development of anti-microbial drugs throughout most of this century -- were required to cure this man of his disease.

We are now beginning another fundamental transition in the practice of medicine. This transition is moving us from serendipitous discoveries of partially effective treatments for the common, chronic diseases -- cancer, auto-immune diseases, cardiovascular diseases, and others -- to systematic discoveries of more powerful therapies, based on detailed pictures of the molecular events by which such disorders arise.

One major element in this transition is the analysis of genomes -- the complete genetic blueprint of a species. We have recently learned the blueprints of many microbes and some experimental animals. This summer we will have the thrill of seeing a draft of the full repetoire of human genes. We also have begun to understand how these tens of thousands of genes work -- by learning what proteins they encode; how the proteins work together to carry out the functions of cells; and why those functions fail in the course of disease.

Those of you graduating today who enter the fields of science that are making this revolution -- fields that range from chemistry and computer science to genetics and medicine -- will participate in one of the great intellectual adventures of all time.

One way to understand this transformation of science and medicine is to re-envision the true story I have told you, but with a different ending. This ending is now only imagined, but it is surely imaginable in the foreseeable future, even within the next decade or two.

In this new version, the patient does, in fact, have cancer that has metastasized to the liver. But the outlook is far from the dire prospect of the 1990's. A sample of the tumor is taken from his liver and brought to a molecular biology laboratory. There, an automated device extracts DNA, RNA, and protein. A simple procedure with a tiny DNA chip identifies the genetic damage that is responsible for the development of his tumor. Another micro-method records a pattern of gene regulation that is emblematic of a certain tumor type. And still other methods reveal properties of some crucial proteins that cause uncontrolled growth of cancer cells.

In the same way that we now select an antibiotic to stop the growth of bacteria, we will then choose a drug that inhibits the wayward proteins and stops malignant growth. Just as 19th-century microbiology made it possible to save people from fatal bacterial infections in the 20th century, so will 20th-century molecular science make it possible to save people from fatal cancers in the 21st century. Consequently, in years to come, students in Wesleyan's family biography course will rarely have occasion to write that their parents died -- or nearly died -- prematurely of natural causes.

Of course, we haven't gotten this far yet. But signs of the future are already common. In the past few years, clinical scientists have begun to test several drugs that attack specific abnormalities in cancer cells. At least one -- a drug for treatment of an adult form of leukemia that affects nearly 5,000 Americans each year -- has shown remarkable potency in early trials in patients, with very little toxicity.

But I haven't finished yet with that cop from Freeport. Shortly after I began working at Memorial Sloan-Kettering in January of this year, I held an open meeting for the entire staff. In the course of explaining why I had decided to come to New York, I told a short version of his story. As a result, the story did not end there.

About two months later -- on the very day, believe it or not, that I heard I would be speaking at your Commencement -- I received a package from our former patient. He had learned from a cousin who happened to work on our staff that I had spoken about his case after reading his daughter's essay. "My kid is some kind of writer, huh?" he crowed. His cousin sent him a videotape of the staff meeting, and he wept while watching it. No longer a Freeport cop, he was succeeding handsomely as a writer. His latest novel was in the package to prove it. One of his movie scripts was in production with a significant star (not anyone on this stage). He has watched his twelve-year-old son make the All-Star lacrosse team. His daughter would be graduating from Wesleyan this year.

This year? That's today! So he is out there, sitting among you other parents, as were my wife, older son, and I last year, watching Christopher graduate last year. He is now watching and admiring his kid. She is seated among the other graduates in one of the rows in front of me, turning to try to see him.

Isn't this why people pray to be cured of fatal illnesses? To be on hand when their children and grandchildren graduate.

Isn't this one of the great rewards of medical science? To give people the chance to lead full lives.

Aren't our lives incredibly surprising and interesting, full of unexpected turns and connections and coincidences? Freeport, Memorial Hospital, Wesleyan. (Isn't this a reason why we continue to read those Victorian novels with endings that seem contrived? Because life does sometimes work out that way.)

Finally, haven't we learned today the point that Phyllis Rose was teaching in her biography course? That among this vast gathering of families there are so many great stories, just waiting to be told.

Thanks for listening to the one I have been privileged to tell you today.

Good luck and congratulations!