Federal Coach

By Tom Fox, VP for Leadership and Innovation, Partnership for Public Service

Blog archive

Federal Coach: The federal employee of the year

(Fox's Federal Coach column was originally published on The Washington Post On Leadership site.)

Dr. Steven Rosenberg is the chief of surgery at the National Cancer Institute, part of the National Institutes of Health, where he developed life-saving treatments for cancer patients, pioneering the use of the body’s immune system and genetically engineered anti-tumor cells to fight the disease. Rosenberg has been the mentor to hundreds of researchers, many of whom have gone on to discover variations of immunotherapies to fight previously incurable cancers.

In an interview with Tom Fox, Rosenberg, who is the 2015 Samuel J. Heyman Service to America Medal Federal Employee of the Year, spoke about seeking to help patients face great adversity, and how he motivates his staff and stays focused on the goal of saving lives.

What motivated you to follow a career in public service?

I was interested in this desperate problem of cancer. As a surgeon, I would routinely operate on patients and they would seem well, but then the tumor would come back and destroy them. I came to the National Institutes of Health because it is the world’s greatest institution to perform research for patients who have problems that cannot be solved by today’s medicine. I stayed at the NIH because I found it to be the ideal place in which to do solid basic science and take it to the bedside.

Was there a critical event that influenced your work?

As a junior resident, I saw a patient in the emergency ward whose chart showed that 12 years earlier he had metastatic stomach cancer. This patient required gallbladder surgery and, during the operation, I discovered his cancer was completely gone. Somehow he had undergone one of the rarest events in all of medicine—a spontaneous regression of a cancer in the absence of treatment. Somehow his body had learned how to destroy the tumor. I have spent the last 40 years trying to figure out how that happened and how it can be replicated. Since then, we have gone on to develop some effective new treatments that work to stimulate the body’s own defenses to cause the cancer to regress.

Is there something that you would want to be remembered for accomplishing?

We have made substantial progress in immunotherapy over the years, which I believe will be a very important part in curing a variety of cancers. There are many people who are alive today who wouldn’t otherwise be, thanks to immunotherapy.

How have your leadership skills been tested?

In the early development of our immunotherapy approaches, we treated 66 patients in a row whose metastatic cancer progressed and they all died. Finally in 1984, we treated a young woman who had widespread melanoma and it disappeared after treatment. The greatest challenge that I had in leading this group of doctors and scientists was to keep them focused and optimistic despite all of the failures.

How do you generate that optimism?

Taking care of patients with advanced cancer is extraordinarily difficult for the patients and their families, and it can be emotionally difficult for the staff. It is important that all of our fellows and staff understand that we are doing science in the service of people who are sick. Knowing that we can’t help a patient now should serve as a motivational tool to keep going, not a discouragement to stop. When I lie awake at night, I don’t think of the patients who have done well, I think of the patients that have not done well. That serves as motivation to work harder.

Is there a mistake you made that has helped you become more effective in your job?

 There are times when it’s easy to get distracted by things that are irrelevant, and it’s very important to keep focus. I try very hard to avoid activities that keep me away from making progress in the laboratory.

How do you prioritize and stay focused?

You have to immerse yourself in the nature of the scientific and clinical problem—and avoid even interesting areas that arise that don’t lead you to your goal. When you stop at a red light or are taking a shower, your mind should be working on the problem: What am I up against? How do I solve it?

What is some of the best advice you have ever received?

My older brother instilled in me the need to anticipate—knowing how to anticipate problems so that you’re always a step ahead of the problem and that makes it easier to solve.

Is there anything that you keep on your desk for sentimental or motivational reasons?

A. When I arrived here in 1974 as the chief of surgery, my wife, Alice, gave me a little statue based on the myth of Sisyphus. It’s only about five inches high, but it has a huge rock and a relatively small person trying to push that rock. The myth of Sisyphus is that he had to struggle to push this rock up a high mountain, at which time it would roll down and he would have to do it again. I look at it every day.

Do you have a favorite book?

I keep coming back to Bang the Drum Slowly by Mark Harris. It makes a critical point and when our new fellows arrive here for training, I often tell them: “You can replace the Ten Commandments with just two words when it comes to dealing with patients, people and staff. And that is, ‘be kind.’ Those two words should be your guide.” That’s a message from Bang the Drum Slowly.

Posted by Tom Fox, VP for Leadership and Innovation, Partnership for Public Service on Oct 21, 2015 at 3:18 PM

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