[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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