She was only 42 and she was married to a snowplow operator.
The years fall away and the details come into sharp focus as Dr. Gary Gilliland recalls meeting the patient who would shape the trajectory of his career.
She'd been diagnosed with acute myeloid leukemia, then given chemotherapy, went into remission – and relapsed six months later. The follow-up treatment wiped out her leukemia but her bone marrow never came back and the severe fungal infections she developed were killing her.
Gilliland, a young intern at the time, was at her side when her family arrived to say goodbye. He watched her children climb into bed with her for the last time. About 20 minutes later, she died.
"We had all the best intentions, but she died of complications from the chemotherapy we gave her," he said. "I just thought there has to be a better way. We have got to develop better treatments for people like her."
Now, all these years later, after decades of research, cures for cancer are in sight -- particularly at Fred Hutchinson Cancer Research Center, he said.
On Jan. 2, Gilliland will become the new president and director of Fred Hutch where he'll play a key role in helping those cures he once dreamed of become reality. The research center announced his new position today, following a national search.
"This is the perfect time and perfect place to develop curative approaches for cancer," said Gilliland, a physician-scientist. "Everything I've done in my career has pointed here."
Paula Reynolds, chair of Fred Hutch's board of trustees, said the search committee knew Gilliland was an ideal fit from the very first meeting, noting his exceptional scientific discoveries, his diverse leadership experience in academia and in the pharmaceutical industry, and the patient-centered approach he is known for.
"Scientific breakthroughs are born at Fred Hutch. Under Gary's leadership, we have a unique opportunity; our research will translate to more cures for patients not just in the region, but across the globe," she said.
Dr. Fred Appelbaum, deputy director of Fred Hutch, who has known Gilliland for more than 25 years, said he couldn't be happier.
"Gary is a really wonderful scientist who thinks deeply about problems, comes up with ideas and a hypothesis before anyone else does, and has tech know-how."
Gilliland, who holds a Ph.D. in microbiology as well as a medical doctorate, spent 20 years on the faculty at Harvard where he was professor of medicine at Harvard Medical School and professor of stem cell and regenerative biology at Harvard University. He was also an investigator at the Howard Hughes Medical Institute, the director of the leukemia program at the Dana-Farber/Harvard Cancer Center and has earned numerous honors for his work.
The bulk of his initial work at Harvard focused on the genetic basis of blood cancers.
"I spent 20 years in the lab at Harvard, working with talented graduate students and postdoctoral fellows, to identify mutations in genes that cause cancer," he said. "In 1985, when I was an intern, there was one mutated gene known in blood cancers. Now there are dozens, leading to the development of novel targeted drugs to benefit patients."
Appelbaum remembers "from early on, he was the brightest guy in the room. He had ideas that weren't reiterative of what people were already doing. He was leading the pack. … Some of Gary's greatest accomplishments include helping us to understand the molecular basis of acute myeloid leukemia."
In 2009, Gilliland left Harvard to go to Merck Research Laboratories to learn how to "take a good idea and turn it into a cancer treatment."
As the senior vice president and global oncology franchise head, he oversaw preclinical and clinical oncology development, as well as clinical oncology licensing. During his four years there, he and the Merck team were able to bring an immunotherapy cancer drug called lambrolizumab (Keytruda) to market in what he called "record time," from first human trials in 2011 to approval this year by the Food and Drug Administration.
"It was shocking," said Appelbaum, of the speed with which the drug was approved.
In 2013, he returned to academia when he became the vice dean and vice president of precision medicine at Perelman School of Medicine at the University of Pennsylvania.
There, he worked to bring together research and clinical care initiatives across disciplines to create a model for delivering personalized medicine to patients with a range of diseases.
All of that experience uniquely prepared him to be the next president and director of Fred Hutch, said Dr. Mark Groudine, the acting president and director.
"He's an excellent scientist who early on made seminal discoveries for leukemias," he said. "He has remarkable breadth – he is a highly respected scientist and, before leaving for his leadership position at Merck, was a Howard Hughes Medical Institute investigator at Harvard. He has strong interests and expertise in immunotherapy and its application to a broad spectrum of cancers, as well as precision medicine – two areas that are of extreme importance to Fred Hutch. He's the ideal candidate to lead Fred Hutch. We feel very fortunate that Gary will be joining us."
Gilliland is deeply familiar with innovative work at Fred Hutch in the areas of immunotherapy, personalized medicine, transplants and more, so when Appelbaum called him earlier this year about coming to Fred Hutch, he said he couldn't resist. "It feels like coming home," he said. "It feels like I've been preparing my entire life for this job."
A passion for patients
Growing up, Gilliland, now 60, always wanted to be a doctor.
His uncle, Ken Gilliland, was a general practitioner in Grass Valley, California, and he remembers going with him to see patients and make house calls. "I could see the difference that his care made in patient's lives," he remembers.
Gilliland, who was born in Tennessee, but grew up in California, studied bacteriology at the University of California, Davis, and went on to earn a Ph.D. in microbiology from University of California, Los Angeles. Four years later, he received an M.D. from the University of California, San Francisco. He completed his internal medicine residency at Brigham and Women's Hospital, where he was also chief medical resident, and his hematology and medical oncology training at the Brigham and Women's Hospital and the Dana-Farber Cancer Institute at Harvard Medical School.
In ways both personal and professional, his life has intersected with the work at Fred Hutch for much of his career. During the 1990s, he was an attending physician on the adult bone marrow transplant service at Dana-Farber, as well as at the pediatric BMT unit at Boston Children's Hospital, overseeing the procedure pioneered by Dr. E. Donnall Thomas at Fred Hutch.
"I am still moved by the amazing courage and resilience of adults and children undergoing bone marrow transplantation, and their families," he said. "It is a particularly humbling experience to see how the children, some of whom have never known a life without chemotherapy, are sweet, strong and amazing kids."
Later, he got to know Thomas when the two were on the advisory board of the Jose Carreras Foundation and remembers how this giant of medical research and his wife, Dottie, were so sweet together.
"He was a legendary figure in our field, but he was a kind and gentle person," he recalls. "And although it was rough going in the early days of bone marrow transplants, his vision and persistence in the face of adversity put the Hutch at the forefront of bone marrow transplantation and immunologic approaches to curing cancer."
In 2001, Gilliland witnessed bone marrow transplantation from another viewpoint when a loved one had the successful procedure at Fred Hutch.
"I know what a great transplant center is from a physician's perspective," Gilliland said. "But seeing what a wonderful place the Hutch is from a patient's perspective was truly inspiring. It's a privilege to return to this patient-centered cancer center in a leadership role."
'He can see where we'll be in a decade'
Gilliland is someone who could be arrogant about his accomplishments but is not, say those who know him well. Instead he keeps his focus on finding ways to give patients better options, or pointing to the promise of the next generation of scientists and physicians.
"What I'm most proud of in my career are the people I've trained or whose careers I've supported," he said. "They are in academic medical centers all over the country – and I take great vicarious pleasure in their successes and accomplishments."
And, as always, everything comes back to the patients.
"Gary is a man of unquestionable integrity, who has an exceptional record of scientific discoveries, impactful publications, and ground-breaking research investigations," said Dr. Brian J. Druker, director of Knight Cancer Institute at Oregon Health & Science University. "Gary was among the first investigators to understand the power of engaging patient advocacy groups in furthering research investigations."
When he's not focusing on science and patients, Gilliland and his wife of 35 years, Karen, also enjoy the ballet and the symphony. Whenever he can, he turns to his place of refuge – his piano. He mother made him start taking lessons when he was 5, he remembers. Now he jokes it's one of the things keeping him sane. In the evenings, or when he has free time, he sits down at the keyboard and gets lost playing classical music from composers including Debussy, who had the vision to weave individual notes into beautiful, transcendent works.
Like them, Gilliland has always had the ability to see the larger dream, Appelbaum said.
He likens him to hockey great Wayne Gretzky. "He didn't skate to the puck – he skated to where it was going to be. That's Gary. He can see where we'll be in a decade, where the field is going."
His new role at Fred Hutch will draw from the best parts of his career to help facilitate the boldest of all goals – cures for cancer. To help get there, he wants to make sure researchers have the resources and support they need. He's passionate about career development and diversity. He's eager to find innovative ways to use intellectual property as a continuous source of revenue. He wants explore opportunities to expand the footprint of Fred Hutch because, he knows, that will allow more patients to be helped.
During a conversation, he becomes animated whenever he talks about the possibilities: the importance of personalized medicine and sequencing of tumors, the great work being done in immunotherapy and other cancer research at the Hutch by "some of the best and brightest investigators in the world."
"We've made enormous progress in treating cancer patients and improving their quality of life, but our goal is to cure cancer," he said. "For the first time, for me at least, I can see it coming across a broad spectrum of human cancers. The place where will that happen – the leading edge for that – is Fred Hutch."
Linda Dahlstrom is the senior writer/editor at Fred Hutchinson Cancer Research Center. Previously, she was the health editor for NBC News Digital and msnbc.com. She's also worked at several newspapers during her 25-year career as a journalist covering AIDS, cancer, end-of-life issues and global health. Reach her at [email protected].
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