[Congressional Record Volume 140, Number 15 (Tuesday, February 22, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 22, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
       DR. HAROLD JAMES WALLACE, JR., 1993 VERMONTER OF THE YEAR

  Mr. LEAHY. Mr. President, each year I look forward to the year-end 
edition of the Sunday Rutland Herald/Barre Montpelier Times-Argus--and 
the newspapers' annual Vermonter of the Year Award.
  I find myself in complete agreement with their judgment year after 
year. This year is no different. I am sure you will all agree after 
reading the attached article about Dr. Harold James Wallace, Jr., the 
1993 Vermonter of the Year.
  Herald reporter, Yvonne Daley, captures the essence of this beloved 
physician in her report. Dr. Wallace's pioneer work with cancer 
patients in Vermont is a tribute to his humanity, as well as his 
professional skills.
  In this article from the December 19, 1993 edition of the Sunday 
Rutland Herald and Times-Argus, it is the recollection and testimony of 
the good doctor's patients, not his own modest pronouncements, that 
solidify his credentials as the 1993 Vermonter of the Year.
  I ask unanimous consent that this article be reprinted in the Record 
in its entirety.
  There being no objection, the article was ordered to be printed in 
the Record, as follows:

     [From the Rutland Herald and The Barre-Montpelier Times-Argus]

                           (By Yvonne Daley)

       Marie Harris of Manchester calls herself a cancer survivor, 
     a blessing she attributes to one man: Dr. James Wallace.
       In 1986, Harris was found to have a rare form of cancer. 
     She had no tumerous mass, but many tumor seeds scattered 
     throughout her abdomen.
       She had an unusual procedure in which the lining of the 
     abdomen was removed, then received chemotherapy once, twice, 
     three times. James Wallace was with her through it all, 
     assisting in her surgery, rushing to the hospital to comfort 
     her in the middle of the night, even when the problem was not 
     related to cancer.
       Today, Harris proclaims herself ``pretty healthy. I think 
     it's because of Dr. Wallace's terrific psychological approach 
     as much as anything else. He never seemed to panic. He always 
     gave the impression that there was hope down the road.
       ``There's nothing that's too much trouble for him,'' Harris 
     continues. ``Once, I was having a hard time with another 
     problem, tachycardia. I called him in the middle of the 
     night. He had already called the hospital and made 
     arrangements for me to be admitted. He had had his typically 
     long day, making rounds in the morning, seeing patients all 
     afternoon. But he was on his way. He introduced me to the 
     cardiologists and made sure everything was okay. The fact 
     that Dr. Wallace was there when it wasn't even his problem 
     was so reassuring. That's the kind of doctor he is.''
       Dr. Harold James Wallace, Jr., a well-known figure at the 
     Rutland Regional Medical Center where he established the 
     Community Cancer Center, has been chosen the 1993 Vermonter 
     of the Year, an annual recognition of a distinguished 
     Vermonter by The Rutland Herald and The Barre-Montpelier 
     Times Argus.
       in this time when health-care reform has captured the 
     attention of both the state and the nation, when the medical 
     profession has been attacked as venal and self-serving, 
     Harold James Wallace Jr. proves to us that a physician can be 
     both at the forefront of his field and devoted to his 
     patients--a scientist with the values of a family doctor on a 
     house call.
       Very recently, Wallace has been named executive officer for 
     the Cancer and Leukemia Group B clinical research program at 
     Dartmount Medical School--a consortium of 27 member-
     institutions from coast-to-coast, themselves connected to 
     more than 200 hospitals and universities where 1,700 
     oncologists work and study.
       ``It's a whole new age of science,'' says Wallace, excited 
     with the potential that this linking of clinical research 
     projects in microbiology, molecular genetics and preventative 
     medicine could mean for the future treatment and prevention 
     of cancers.
       Wallace, 63 years old, is a soft-speaking, unassuming man 
     with a balding head, cheerful face and a direct gaze. He 
     knows illness and the medical profession from both sides. His 
     right arm was paralyzed as a result of childhood polio. In 
     1967, he lost his left leg to cancer. Until the very day of 
     his surgery, Wallace the oncologist, has never considered the 
     possibility that the tumor on his left shin bone was 
     malignant. It was--a fact he learned only upon awaking from 
     the surgery.
       Perhaps because he has known personal adversity, Wallace 
     emotes a kind of even-tempered optimism. His energy isn't 
     flashy but, judging by his accomplishments, it is constant 
     and efficient.
       In 1979, after a successful career as a researcher at some 
     of America's most prestigious research centers, Wallace 
     realized that he missed more direct contact with patients. He 
     had discovered that the higher he rose in the medical-
     research hierarchy, the fewer patients he had time to see.
       ``And that,'' says Wallace, ``wasn't what I went to medical 
     school for.''
       At the same time, he looked at National Cancer Institute 
     numbers and realized that 80 percent of the cancer patients 
     in the country were being treated at small community 
     hospitals while the nation's cancer specialists and its best 
     treatment equipment and drugs were centered at the big 
     university hospitals located in urban settings.
        For example, Rutland, Vermont's second city, had a modern 
     hospital with a well-trained staff but had no oncologist and 
     no radiation and chemotherapy treatment programs prior to 
     1979. Cancer patients from Rutland had to travel to 
     Burlington or Hanover for treatment, at considerable physical 
     and financial expense to themselves and their families.
       Wallace wanted to establish a cancer-treatment program 
     connected to a community hospital. He talked with the 
     National Cancer Institute about creating a pilot program that 
     would bring the latest drugs and treatment protocol, even 
     experimental drugs and procedures in the final stage of 
     testing, directly to patients living far from a university 
     hospital.
       With the blessings of the National Cancer Institute, he 
     started looking around for the right community. Having spent 
     his high school years in St. Albans, Wallace, a native of 
     Utica, N.Y., knew Vermont well. Much of his academic work had 
     been at the university of Vermont. And there was Rutland 
     without an oncologist.
       It took Wallace 10 more years to realize his dream of 
     creating the Community Cancer Center at the Rutland Regional 
     Medical Center. Approval hearings before the Vermont Health 
     Policy Corp. review board took two years. Working with 
     hospital staff and experts in the field, even architects, 
     Wallace was involved in all aspects of the creation of the 
     facility.
       For much of the 10 years between his arrival and the 
     opening of the cancer wing, Wallace and his right-hand-woman, 
     his wife Dottie, ran what they call a ``Mom and Pop'' 
     operation out of a tiny office on Allen Street. the two 
     staffed the office, Dottie doing paperwork in the mornings 
     and setting up appointments while Wallace made his rounds. 
     Then, working as a team, they would treat patients in the 
     afternoon, with Dottie mixing chemotherapy drugs. One or the 
     other would administer the drugs and stay with sick patients 
     through the afternoon.
       The Community Cancer Center opened in 1989--a state-of-the-
     art complex where patients can be examined, receive treatment 
     and attend seminars, where the local Tumor Board meets to 
     review current cases and a variety of studies are being 
     conducted. These currently include scientific investigations 
     into prevention of breast and prostate cancer, the 
     administration of experimental cancer-prevention drugs and 
     quality of life studies.
       And despite his heady, new responsibilities at Dartmouth, 
     Wallace remains connected to the Rutland hospital, spending 
     Friday afternoons and weekends on call, doing consultative 
     work and--his favorite part--making rounds and checking in on 
     patients.
       ``That is what being a doctor is all about, isn't it?'' 
     asked Wallace.
       Shirley Rosen of Mendon was one of Dr. Wallace's pioneers. 
     Diagnosed with breast cancer in April 1983, Rosen also has 
     signs of cancer in seven of her 27 lymph nodes.
       ``It looked pretty grim,'' said Wallace.
       Rosen's treatment included a full year of chemotherapy. 
     When her veins failed and she needed another way to receive 
     the drugs, Dr. Wallace was able to get permission for her to 
     be the first person in New England to test a Port-A-Cath, a 
     device inserted into the chest through which drugs were 
     administered. She wore the thing for four years, a kind of 
     security blanket.
       ``He sat with you or his wife and gave you your treatment. 
     I'd bring my poodle to treatment. He didn't care. You could 
     call that man up at any time. One day he saw me at 2:30 in 
     the afternoon and then again later for a second appointment 
     to talk about the game plan for my treatment.''
       After her surgeries, Rosen returned to work, taking naps 
     when she was tired. Over and over she told herself, ``I'm not 
     sick.''
       ``When I lost my hair, that was the worst. That was a day I 
     cried. I called Dr. Wallace. I bet he still remembers my 
     treatment plan,'' she says.
       He does.
       Today, Rosen keeps a busy schedule, running an accounting 
     firm with her husband, Howard, attending several aerobics 
     classes a week. She lifts weights and works our with sports 
     equipment.
       Rosen gave up red meat when she came down with cancer, 
     limits fats and dairy products, all with the support of her 
     doctor.
       Rosen recalls that Wallace cautioned not to think of her 
     disease as fatal. ``It may not even be chronic,'' she says he 
     told her. ``Heart problems are chronic. Diabetes is chronic. 
     The power of positive thinking is real. If you don't feel 
     rapport, a certain charisma with your doctor, it's impossible 
     to know you can get better. To heal you have to have 
     confidence in your healer. I had an awful good helper.
       ``Dr. Wallace has that tremendous charisma. He's a 
     tremendous listener. He's always there when you need him,'' 
     said Rosen, who currently takes tamoxifen. The chemical, 
     which blocks the effect of estrogen on cancer cells, is 
     available to Rutland area patients who qualify under one of 
     the dozens of pilot programs that Wallace was able to bring 
     to the Rutland hospital.
        One of the clinical trials that the Rutland hospital is 
     conducting aims to determine if low-fat diets reduce hormone 
     levels and cancer risks.
       Participants include women who have had breast cancer and 
     exceed recommended body weight by more than 10 percent. They 
     are asked to reduce their fat intake while the hospital keeps 
     track of their hormone levels.
       ``Low fat diets reduce the risk of cancer,'' notes Wallace. 
     ``High fat increases the risk of recurrences of cancer.''
       Wallace graduated from the University of Vermont in 1954 
     and graduated cum laude in 1958 from the UVM School of 
     Medicine. In the last months of his last year of medical 
     studies, he saw two nurses walking down a hall at Mary 
     Fletcher Hospital. One caught his eye; it was Dottie.
       There was an upcoming social event and it was generally 
     accepted that senior medical students would bring a date, but 
     Wallace was shy.
       ``That was my first venture in dating. I had pretty much 
     had my nose to the grindstone but a spark had been lit,'' he 
     says.
       ``He does things when the pressure is on,'' laughs Dottie.
       A friend helped arrange the date and the rest, as the 
     expression goes, is history.
       The couple married in 1959 and had three children: Harold 
     James Wallace III, a radiation oncologist at Cape Cod 
     Hospital in Hyannis; Elizabeth Marie Morton, the supervisor 
     of in-patient registration at Rutland Regional Medical 
     Center; and John Hill Wallace, a para-legal working in a law 
     office in Washington, D.C.
       Wallace had initially thought he needed to go straight into 
     a high-powered medical internship after he graduated from 
     medical school but he didn't get accepted where he wanted to 
     go and ended up doing his internship and residency at Mary 
     Fletcher Hospital.
       ``It was the best thing for me, taught me everything 
     happens for the best. It showed me all sides of medicine,'' 
     he said.
       But hormone and chemotherapy treatments were just coming 
     onto the scene, and the young Dr. Wallace was interested in 
     learning an overall view of the disease and its care. In 
     1962, he became a senior research fellow at the Roswell Park 
     Memorial Institute in Buffalo, part of a clinical-research 
     project funded by the National Cancer Institute. Roswell Park 
     combined clinical or technical programs in which the newest 
     drugs and treatments were tested and administered directly to 
     patients.
       Here, Wallace undertook two years of training in the new 
     expanding science of oncology, the technical name for the 
     treatment of cancer. Wallace's mentor was Dr. Jim Holland, 
     whom Wallace describes as a leader in the research into new 
     treatments and doses of drugs for battling cancer. Holland 
     went on to become chairman of the cancer-treatment department 
     at Mt. Sinai Hospital in New York City.
       In 1964, Wallace returned to the University of Vermont 
     Medical School to bring some of what he had learned at 
     Roswell to the new students. He was the first medical 
     oncologist in Burlington, and his duties included teaching 
     the new science of oncology to UVM medical students as well 
     as the direct care of patients at Mary Fletcher and 
     DeGoesbriand Hospital.
       Three years later, Wallace began to suffer from swelling 
     and pain in his left leg. When he went in for a biopsy, 
     however, cancer was the furthest thing from his mind.
       ``I was a medical oncologist and I went into the surgery 
     never thinking it could be malignant. I never realized how 
     powerful denial was. I woke up coming from the operating room 
     on my way to the radiation room with a tourniquet still on 
     the leg. After that, I was sick from infection and they had 
     to amputate above the knee. I was out, totally out of 
     commission, for about a week,'' he recalls.
       Dottie remembers that as ``a terrible time. Jim was so sick 
     and we were so busy with these little children.''
       Today, he says, a smaller biopsy, better radiation 
     treatment procedures and chemotherapy probably would have 
     saved the leg.
       Wallace was in a wheelchair for about six months while he 
     recuperated and learned how to use his prosthesis, but he 
     still worked part time.
       ``Dottie would cart me to the hospital. We would go in 
     through the emergency room and would make the rounds. I was 
     doing clinical teaching with the students. We had no cancer 
     wing then so the patients were on six floors in two units,'' 
     he says.
       ``We'd pick him up with one child helping to push the 
     wheelchair, one carrying the briefcase and one in his lap,'' 
     says Dottie. ``They were little but they were a big help. 
     Once that first bad week was over, there was never any 
     question he was going to make it. Realizing that put things 
     into perspective. We don't worry about the small things.''
       ``I learned to walk with the prosthesis fairly quickly,'' 
     adds Wallace. ``I couldn't use a cane very well, because I 
     needed my good hand to carry my briefcase. There was no 
     question I had to walk, so I had to wing it. I haven't used a 
     wheelchair since.''
       Cindy Polcaro of West Rutland was only 29 when she was 
     diagnosed with breast cancer in June 1988. Like the other 
     patients, she remembers the date of her surgery, the day her 
     right breast was removed.
       For Polcaro, being fitted with a breast implant was an 
     important part in her healing. But soon after the operation, 
     she developed problems and had trouble breathing. She had a 
     blood clot on her lung, was admitted to the hospital and 
     given blood thinners to dissolve the clot.
       Unfortunately, Polcaro developed an infection and the 
     prosthesis had to be surgically removed. ``It was like losing 
     it twice,'' says Polcaro. ``I needed more surgery. In all, I 
     had seven operations and chemotherapy for a year.''
       Chemotherapy sometimes decreases a woman's ability to have 
     children but Polcaro was lucky. Almost three years ago, she 
     had a baby boy.
       ``I was really mad when I heard Dr. Wallace was leaving,'' 
     Polcaro says. ``I remember him when I found out about the 
     cancer. I was a wreck. He said, `You look like I did 25 to 30 
     years ago.' That put things in perspective. He said, `You're 
     here, aren't you?' I think if you trust in your doctor, well, 
     I was trusting him with my life and he fulfilled my trust. He 
     was a big asset to me. Still is.''
       ``I think a positive attitude helps and the things that 
     promote that are important,'' Wallace says, defusing the 
     moment of sadness.
       ``Why don't you just say what it is you give--tender loving 
     care,'' Polcaro rejoins.
       After his own cancer operation, Wallace was concerned about 
     his stamina and his ability to keep up a hectic pace so he 
     went to Roswell Park to talk to his old mentors who invited 
     him back as acting chief of the department of medicine.
       ``We had a strong interest in treating leukemia and using 
     brand new drugs in the initial tests on humans. The treatment 
     for leukemia in children had advanced tremendously. We were 
     seeing 50 percent success rates in children and were 
     beginning to find successful treatments for acute leukemia in 
     adults.
       ``In the early 1970's, we developed the standard doses and 
     chemotherapy still in use today for some of the new drugs 
     being tried on humans for the first time. We were one of four 
     institutions in the country selected to do the trials,'' he 
     said.
       A colleague led the tests on Platinol, the standard drug 
     used now to treat for testicular, ovarian, lung, head and 
     neck cancer. ``It's one of the best and does result in cures. 
     It was astounding, a big event in our scientific life,'' 
     Wallace said.
       What Wallace and the other scientists were learning was how 
     cancer cells differ from normal cells and in what ways they 
     were more susceptible to injury. These various drugs that 
     were being developed led to better and better ways of 
     selectively killing off cancer cells by interfering with 
     their genetic makeup or their metabolism or by stimulating 
     them to self-destruct.
       In 1975, Wallace took a year's sabbatical from Roswell to 
     study and do research at the National Cancer Institute while 
     he developed his idea about bringing research and advanced 
     treatment programs directly into communities.
       After a few years more at Roswell, he was ready to come to 
     Rutland and get back into the daily care of patients.
       Dottie Wallace says the phone didn't ring for the first 
     week they were open in their new office here. But once the 
     phone began ringing, it never stopped.
       ``I was the only help he could afford initially,'' she 
     says, jokingly. Even so, the couple dipped into their savings 
     to keep the office open in the initial year.
       ``Dottie was nurse, secretary and accountant. She started 
     the lab work. She mixed the drugs. Between us, we'd give the 
     chemotherapy,'' says Wallace.
       One of the problems at the time was that oncology wasn't 
     recognized as a specialty by the insurance companies. At the 
     same time, Medicare and insurance reimbursements were often 
     made at a rate below cost especially when it came to 
     reimbursement for the expensive chemotherapy drugs that 
     Wallace was treating patients with.
       ``We didn't research this very well before we came here. We 
     hadn't even thought about it. The hospital could get the 
     drugs cheaper but they couldn't sell them to us because then 
     they might be perceived as competing with the drug stores,'' 
     recalls Dottie.
       Much of it was trial and error. The first patient took two 
     days to get started on treatment because of the paperwork and 
     protocol required by the National Cancer Institute. But that 
     woman, a breast cancer patient who took part in a clinical 
     study of adjuvant, is fine today, 14 years later. Adjuvant is 
     now a standard treatment for breast cancer.
       ``It's always nice to have your first case a success,'' he 
     jokes.
       Says Dottie: ``He had thought private practice would be 
     relatively easy in comparison to what he had been doing. We 
     were both pretty surprised with how much we were needed.''
       ``So I didn't get to play golf; I didn't go to the race 
     track. And I don't have weekends off,'' says Wallace. ``But I 
     don't mind. I once tried to be an antique dealer. But things 
     got busier and busier and the antique business got left 
     behind.''
       Before coming to Rutland, Wallace had a goal of 
     establishing a statewide clinical oncology program that would 
     organize all the oncologists in the state not affiliated with 
     the University of Vermont. Then, there were four oncologists 
     in Vermont who weren't UVM faculty. Now, there are seven and 
     three more oncologists are joining Vermont hospitals over the 
     next few months.
       Called the Green Mountain Oncology Group, the network links 
     cancer specialists working in Bennington, Montpelier, Rutland 
     and Burlington. They can compare cases, share data and the 
     results of various clinical tests and work cooperatively in 
     treating complex cases.
       Once the Rutland cancer center was up and running, Wallace 
     began looking for another oncologist to share duties with, 
     someone he might trust to take over the center eventually. It 
     took two years of reviewing resumes and interviewing 
     candidates before Wallace and other members of the hospital's 
     selection team chose Dr. Allan D. Eisemann, a graduate of 
     Stanford and Kansas University, to join the oncology staff.
       Eisemann says it was Wallace who drew him to Vermont.
       ``Because of him, there had been a strong foundation 
     established here, the integration of all the non-university 
     oncologists in Vermont in an effort to continue clinical 
     research,'' notes Eisemann who was attracted to the research 
     components of Rutland's cancer center.
       At the same time, he says, there was community here, 
     something often lacking in large medical centers in big 
     communities.
       Eisemann is interested in continuing to emphasize these two 
     aspects of the cancer center. He says that because of 
     Wallace's work, the Ruthland hospital has a proven track 
     record of showing it can conform to the government 
     regulations regarding research protocol.
       ``It makes it easier to stay in the research programs,'' he 
     says.
       According to Priscilla Constantino, director of oncology 
     services at the Rutland hospital, the center was recently 
     selected to conduct breast and prostate cancer prevention 
     control studies.
       Constantino says Wallace will be a tough act to follow.
       ``Most rural areas don't even have their own oncologists. 
     By bringing the Community Cancer Center together with the 
     hospital, radiation therapy and chemotherapy all located in 
     the same area, we have rapid referral and treatment back and 
     forth,'' she says.
       ``By bringing in the research part of it in, Dr. Wallace 
     made it possible for people in this area to have the most up-
     to-date treatments. At the same time, there's a collaborative 
     relationship with Hospice and the Rutland Area Visiting 
     Nurses. I had never seen anyone collaborate all those 
     services all together under one roof,'' says Constantino who 
     came here from a hospital in the Washington, D.C. area.
       Before Eisemann was hired the game plan had been for 
     Wallace and a second oncologist to staff the center and for a 
     third oncologist to be hired as Wallace phased out his hours 
     at the hospital.
       ``It took two years to find the right medical oncologist. 
     We wanted someone with a high quality of knowledge, an 
     interest in research, a desire to work with other oncologists 
     along with a warm, caring personality,'' says Constantino.
       ``When we found Dr. Eisemann, what we liked about him was 
     that he was a younger version of Dr. Wallace in many 
     respects,'' she says.
       Eisemann is expanding on Wallace's dreams, bringing his own 
     interest into outreach and consumer education to the 
     community. Now, for example, Rutland hospital is the only 
     hospital in Vermont to offer free breast-cancer screening 
     clinics.
       Wallace's career had also been interwoven with that of 
     Rutland Hospice, the group that offers a variety of services 
     to friends and families caring for terminally ill loved ones 
     at home. Wallace was a founding member of Hospice and remains 
     its medical director.
       A year ago last September, Wallace saw a notice in a 
     newsletter that Dr. Ross McIntyre was looking for an 
     executive officer to organize the Cancer and Leukemia Group B 
     research program at Dartmouth. Wallace knew McIntyre from 
     Roswell Park.
       ``It hit me. I was beginning to wonder what I was going to 
     do next. Dr. Eisemann was coming. He is an excellent 
     oncologist and I felt comfortable with him. I was 63 and I 
     knew I wanted to make a change by age 65. I thought, `I could 
     do Dartmouth'.''
       Wallace thinks of this new move as another full circle in 
     his career. Again, he is back in the clinical laboratory. 
     This time, however, he spends most of his day with his 
     computer communicating with scientists all across the nation.
       As he sits in his comfortable living room, the laptop 
     computer that links him to the Rutland hospital and the 
     Dartmouth laboratory at rest on a table in another room, 
     Wallace talks with emotion about the future.
       ``It's a whole new age of science,'' he says, talking of 
     the anticipation with which scientists are now competing to 
     be the first to detect the gene that causes breast cancer.
       ``With that, we'll be able to identify the five percent of 
     women with the genetic change in the gene that puts them at 
     risk. Another five percent of them will have other changes 
     placing them at risk as well. If we can change certain 
     factors, certain environmental factors, and take other 
     preventive measures while at the same time providing 
     counseling and support services for those at risk, we can 
     save lives,'' he says.
       ``We've made great strides in curing cancer, but we need to 
     do more to prevent cancer. That's the area I'm working in 
     now,'' says Wallace. ``That's the future.''

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