Freireich's Fight: Making Progress Against All Odds

Andrew D. Smith
Published: Thursday, May 04, 2017
Emil J. Freireich, MD, DSc

Emil J. Freireich, MD, DSc

Emil J. Freireich, MD, DSc, was the originator of combination chemotherapy, the primary architect of the first cure for a systemic cancer, a major contributor to the cures for half a dozen other systemic cancers and, quite possibly, the man who did the most to transform MD Anderson from a minor facility to one of the world’s leading cancer centers.

He is also a man who has been fired 8 times during his career—a fact that astonishes both total strangers and his closest friends. Strangers are naturally amazed that a man who ranks among the greatest medical researchers of the past century has ever been fired. Friends, on the other hand, tend to be amazed that the 90-year-old has not been fired more frequently.

Many scientists fancy themselves daring truth seekers who follow the evidence wherever it leads, damn the consequences, damn the bureaucracy, and damn the feelings of those who are too timid or too dense to embrace the truth. Freireich actually is such a man, and his unrelenting commitment to all-out war against cancer has led to a life of both incredible achievement and unending conflict, not only with the disease that he swore to defeat, but also with many of his ostensible allies in the war against it.

He is credited with establishing the efficacy of combination chemotherapy and neoadjuvant therapy in acute lymphoblastic leukemia (ALL). He also advanced the science of allogeneic bone marrow grafts and has helped pioneer and molecular genetics in patient care.

Freireich still lives with his wife, Haroldine Lee Cunningham Freireich, in the home they bought after a single day of house hunting 50 years ago for the simple reason that he’s been busy with more important things for the past half-century. “I will keep working, assuming they will not actually have security throw me out,” said Freireich, who is the Ruth Harriet Ainsworth Chair, Developmental Therapeutics, at MD Anderson. “I will not stop until I die. I do not want to relax. There is nothing else. I want to cure cancer, and I’m willing to suffer whatever abuse I need suffer to test as many ideas as possible. I could even endure all those 20-somethings in Washington telling me I know nothing about cancer, but for the fact that they control all the grant money.”

Actually, Freireich would welcome the insults of 20-somethings, if they were mocking an old man’s conservatism. Science, he believes, progresses when the daring ideas of each new generation unseat the ossified convictions of its elders. What terrifies him is that an overly conservative system has so neutered younger scientists that they are more timid than researchers who supplement their salaries with Social Security.

Blood Transfusion Breakthroughs

Things were very different in 1955, when a 27-year-old Freireich took a job with the National Cancer Institute (NCI) to escape the draft and, on the strength of a hematology residency, ended up in charge of the pediatric leukemia ward, free to give children nearly any treatment he found promising. The resources at the brand-new facility were unbelievably plentiful. Staff outnumbered patients. Labs stocked every conceivable new technology. Researchers received whatever funding they needed.

The most important advantages, however, may have been several intangibles. Freireich took his job less than a decade after the invention of the modern medical trial, and he was among the first people to apply the technique to cancer. He also had the good fortune to serve a generation of people forged by World War II, people who thought it normal to take great risks in pursuit of great ends. When he received the job assignment, his new boss said, “I’ve got a good idea for you. Cure leukemia.” He meant it.

Still, it would have been hard for a visitor in the pediatric leukemia ward circa 1955 to imagine that such advantages would have enabled Freireich to save any of his young patients. Only a few years had passed since Sidney Farber had devised the first treatments that had any effect on systemic cancers, and the newest treatments available to Freireich only managed to let the children suffer a few extra months before they died.

The ward looked like a butcher shop. Children bled from their eyes, ears, mouths, noses, and the skin around their nails. Nurses repeatedly changed each patient’s bloodied sheets, and they spent their idle minutes scrubbing blood off the walls. Idle minutes were scarce, however, even in a half-empty ward, because the staff spent so much time racing from emergency to emergency, trying to keep internal bleeds from killing patients.

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