In the Elevator at the Princess Margaret Hospital

For the students in BIO 501, Biology of Cancer,
a personal view of cancer chemotherapy research after forty years

Thomas P. Fondy, Professor of Biology and Chemistry, Syracuse University
April 15, 2002

Beginning in December, 1991, and through the end of the summer of 1992, I was a Visiting Research Professor in the laboratory of Dr. Victor Ling, in the Department of Medical Biophysics at the Princess Margaret Hospital, University of Toronto, the Ontario Cancer Institute. Dr. Ling and his group of graduate students, post docs, and research technicians were then (and still are though now at the University of British Columbia, Vancouver) among the premier labs in the world in the molecular biology, genetics, and pharmacological control of natural product multi-drug resistance in cancer biology and cancer medicine.

I learned a great deal about multi-drug resistance in that active environment. I worked many long hours during the day and far into the night on the application of cytochalasin congeners to the reversal of natural product multi-drug resistance. I made the 243 mile trip between Syracuse and Toronto over the New York Thruway past Niagara Falls and by the QEW Expressway (at the prevailing Canadian speed of 125 kph Ė 80 mph) twenty times. I would often leave my lab at Syracuse University at 7 PM after a dayís work in my own lab, and arrive at my apartment on Isabella Street after mid-night, unpack and head for the Princess Margaret Hospital to check my cell cultures and begin work.

The most important thing I learned about Cancer research and Cancer medicine I learned on one of those late night ventures to the Hospital, and I learned it, not in the lab, but in the elevator.

It was just after 10 PM, when I entered the guarded building and waited for the elevator to go my sixth floor lab. There was a couple also waiting, along with one of the staff physicians, and some nurses. When the elevator door opened and we entered, it took a long time, because the couple moved very very slowly and painfully. I looked at the couple and I was transfixed by the face of the woman. She was totally expressionless. It was as if no one lived there any more. I think by the way he held her and responded to her, that they were love partners. They were both still young people, perhaps in their 30's, yet she looked very old compared to him. It was clear that they had been on what probably was their last walk together. Her eyes stared straight ahead as if she saw nothing. The light inside her had gone out, except for one tiny tear that struggled slowly down her cheek.

At the third floor, a cancer patient floor, the elevator door opened and the couple started to work their way painfully out. He had to hold her up because she was too weak to walk on her own. The doctor offered helpfully to call for a wheelchair for her, but her partner responded softly that he wanted to help her to walk with him. We held the door while they got off and we all watched quietly while they receded slowly down the dimly lit hallway and into eternity.

I learned why one does research in cancer chemotherapy far into the night and far away from home. It isnít for papers, or grants, or recognition because in fact these are all very hard to come by in research that is directed toward improving clinical management of cancer , and they are poor compensation in any event. "Success" in chemotherapy research often means active agents in pre-clinical or even ultimately in clinical settings. These usually always elude the individual, but reward the world-wide group by discovery somewhere, eventually, by someone, of agents or protocols that help patients.

We do the work because of a tear in the ladyís eye, a husband who wants to hold her to the end, or a motherís heart-break because she cannot save her child. Little by little, we will turn the light back on in those eyes. Someday, someone will be able to say to a mother with a dying child: "We know what to do. We can help."