Intoxicated by Money

From the second floor of 24-Hour Fitness on McLoughlin Boulevard in Portland, you can look across the river and see Oregon Health & Science University on the hill, a reminder of what awaits even the fittest and healthiest of us.

Eventually, the human body wears out. No matter how superior your genes, how devoted you are to nutrition and exercise, you will eventually get sick and die.

Even youth is no protection against diseases like cancer.

Will a billion dollars make a difference? Phil Knight and Dr. Brian Druker think so.

The Nike billionaire is dangling $500 million in front of OHSU. The money is theirs if the university can raise another $500 million in two years. That cool $1 billion would go to OHSU’s Knight Cancer Institute – founded by an earlier $100 million grant to the university and named in honor of Phil Knight’s son, Matthew, killed in a scuba-diving accident.

While Knight’s offer is generous, it’s also a huge challenge for OHSU to raise $500 million in only two years. When Knight announced his donation-with-strings-attached six months ago, it was called unprecedented in U.S. philanthropy.

Not surprisingly, OHSU turned to the state’s taxpayers. Last month, the Oregon Legislature kicked in $200 million. Now only $300 million more to go.

Phil Knight didn’t become a billionaire by seeking grants. He was an entrepreneur. He chased an idea that turned out to have merit, and it made him a lot of money.

In cancer research, it’s the other way around. Money first, and then discoveries may follow. It’s pharmaceutical companies, though, that often clean up the profits. Some lives are saved, and some aren’t.

Druker, who heads OHSU’s Knight Cancer Institute, told state legislators that with $1 billion, OHSU could be one of the country’s top cancer research centers. He envisioned OHSU drawing the best cancer scientists to Portland with the promise of devoting at least 10 years to solid research with no worries about fundraising or grant-writing.

“The Knight Cancer Institute’s plan is audacious enough that it just might attract dream teamers because they won’t be asked to spend time writing grants,” according to The Portland Tribune.

Was it a dream team that found a vaccine for polio?  Or a dream team that sequenced the genome of the virus that caused the influenza pandemic of 1918?

In retrospect, those results appear to have been motivated by a singular obsession of two men – one to find a cure for polio, the other to discover the cause of a nearly forgotten flu that killed about 40 million people.

The rhetoric surrounding Phil Knight’s $1 billion matching grant makes it sound like the primary point is the money and status first – then research into cancer cells. OHSU officials speak of using the money to lure top researchers away from other institutions that currently outrank Oregon’s cancer institute. OHSU has never been designated a “comprehensive cancer center” by the National Cancer Institute.

There is no guarantee that $1 billion and 10 years of research will lead to significant cancer discoveries at OHSU. In fact, there is something about the exuberance of Knight’s challenge grant that is reminiscent of the expensive ad campaign touting the failed Cover Oregon Website.

Is it realistic to imagine a world without cancer? Probably not, considering what some of the causes are and the unwillingness of people to change. Cancer isn’t just one disease. It’s many diseases. Some are more serious than others.

While cancer striking a child is always tragic, there’s something unsurprising about adult-onset cancer. I say that as someone who had cancer in my 30’s and didn’t engage in any of the risky habits associated with cancer.

At the time, a coworker asked me if I ever wondered “why me?” since I appeared to lead a healthy life. My reaction was more like, “Why not me?” I was working as a newspaper reporter at the time, a job that gives you a front-row seat on how the unexpected can hit anybody, anytime.

One of my favorite cancer quotes is from writer Edward Abbey: “Growth for the sake of growth is the ideology of a cancer cell.”

Aren’t most of us contributing carcinogens of one sort to the planet? Which would be harder or cost more: To make it safer to live in a carcinogenic world – or to make the world less carcinogenic?

As diseases go, cancer can be a great equalizer. The brilliant and wealthy Steve Jobs was defeated by the same cancer that kills about 39,000 people a year.

When writer Anatole Broyard was diagnosed with metastatic prostate cancer in 1989, he discovered what a real deadline was. He flourished. In his brilliant and slender memoir, “Intoxicated By My Illness,” Broyard shares the last 14 months of his life with such vividness that he seems alive even now.

In a chapter entitled “The Patient Exams the Doctor,” he diagnoses what’s wrong with medical care – beginning with a doctor’s unwillingness to make eye contact with patients and relying on medical clichés to communicate:

“Since technology deprives me of the intimacy of my illness, makes it not mine but something that belongs to science, I wish my doctor could somehow repersonalize it for me. It would be more satisfying to me, it would allow me to feel I owned my illness, if my urologist were to say, ‘You know, you’ve worked this prostate of yours pretty hard. It looks like a worn-out baseball.’ … I’d much rather think that I brought it on myself than that it was a mere accident of nature.”

Broyard describes the ideal physician as being someone like Dr. Oliver Sacks.

“I can imagine Dr. Sacks entering my condition, looking around at it from the inside like a kind landlord, with a tenant, trying to see how he could make the premises more livable.” (Dr. Sacks returned the compliment after Broyard’s death by writing the foreword to “Intoxicated By My Illness.”)

Broyard was in no hurry to die and would have welcomed a cure. More than anything, though, he wanted to be alive when he died. I could imagine him admiring Dr. Druker’s drive for success but not wanting to be one of his guinea pigs.

In my case, I underwent chemotherapy for cancer at Loma Linda University Medical Center in Southern California about the same time it opened the nation’s first hospital-based, proton-beam accelerator to treat some cancers. The publicity regarding that event was as boastful as the news surrounding Knight’s $1 billion challenge.

Just as Oregon taxpayers are helping OHSU with its Knight challenge, American taxpayers helped build Loma Linda’s proton-beam accelerator.

How is proton-beam cancer treatment going these days? Terrific, if you can afford it. There are now 14 centers with more under construction.

Once the Knight challenge is met and Druker’s team has completed 10 years of research, what will OHSU’s cancer treatment be like?

Probably terrific, if you can afford it.

– Pamela Fitzsimmons

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