Alan N. Houghton began his Memorial Sloan-Kettering Cancer Center career as a clinical fellow more than 25 years ago and is now Chief of the Clinical Immunology Service, Head of the Melanoma Disease Management Team, and Chairman of the Immunology Program, to name a few of his many positions. He shares his perspective on research and patient care, and his own experience with amyotrophic lateral sclerosis (ALS).
I didn't give biomedical research my complete focus until after I arrived at Memorial Sloan-Kettering Cancer Center in 1977 as a clinical fellow in medical oncology. Having grown up in a small New England town, I couldn't imagine living in New York City, so my intention at the time was to stay only for the required two years, then to move on. Needless to say, I never imagined that I'd still be here, more than 25 years later, nor that I would quickly grow to love living in New York City.
My real interest in research began at the conclusion of my clinical fellowship, when I had the good fortune to be accepted into Lloyd Old's Laboratory of Human Cancer Immunology at the Sloan-Kettering Institute. This was during the very early days of monoclonal antibody technology. We were able to demonstrate that monoclonal antibody therapy could shrink solid tumors in people with cancer. I found laboratory work fascinating, particularly where it intersected with clinical research, and I realized that I wanted to be both a physician and a scientist.
Having worked in the lab and the clinic, one of the inevitable trends I see starting to develop is that biomedical sciences, which historically have been driven by individual researchers, are becoming more team-based, like medicine. This will allow new discoveries to bridge the gap more quickly between lab and clinic. With the creation of Memorial Sloan-Kettering Cancer Center's Experimental Therapeutics Center and the initiation of new research fellowships for clinically trained investigators, we are well positioned to narrow this gap.
In addition to the divide that exists between the lab bench and the bedside, there is a troubling distance that can exist between doctors and patients. And, again, I happen to have experience on both sides, having been diagnosed in 1993 with ALS, a progressive neurodegenerative disease, commonly known as Lou Gehrig's disease, which attacks motor neurons in the brain and spinal cord.
I've always felt that the patient/doctor divide is extremely artificial and overused in medicine, and my experience as a patient has taught me how often people hide behind the white coat. As a doctor, it's essential that you are able to show your patients how much you care and your willingness to fight for them. This is the difference between a competent doctor and an excellent one.
As a newly diagnosed patient, I was depressed, sad, angry — all the usual emotions you go through following a serious diagnosis. But after roughly two months, I decided that I was just going to keep living as normally as possible. While I phased out some of my patient-care duties, I was fortunate to be able to continue my research, my teaching, and my administrative responsibilities, all of which, when combined with the critical support of my family, friends, and staff, has really kept me going.
One of the things that can happen when you're diagnosed with a serious disease like ALS or cancer is that you can become the disease. People can become totally absorbed in trying to uncover every possible treatment, following any lead. No matter what happened to me, I didn't want the disease to rule my life. That was very important to me.
