Remembrance of Things Past
Stan Schrier wasn’t around a century ago when Marcel Proust was writing, but to listen to Schrier’s recollections, it’s as if the octogenarian might have been.
“I got to Stanford on July 9, 1959, and I went to my first Department of Medicine meeting, where I think there were about 12 other people. It was pretty clear that we had a very small department and the place was going to build,” recalls the emeritus professor of medicine.
The medical school had just relocated to Stanford’s main campus in Palo Alto from the tattered Cooper Medical College and Lane Hospital buildings in San Francisco.
“I actually never worked a day in my life at the Cooper Lane Hospital in San Francisco. I went up there to steal the equipment as the place was falling down,” Schrier confesses.
“There was some laboratory data lying around as well as large numbers of mice that had escaped from the experimental laboratories. So I went up there with my car, and I brought back equipment to help furnish my new laboratory.
“My impressions of what went on at Stanford in the city was that it was a very small service at the Cooper Lane with another Stanford service at the San Francisco General and a smaller service at the VA at Fort Miley. It was really quite small, and the one thing that I learned talking to the people who lived and worked there was they had extraordinarily good feelings about each other.”
Schrier had been recruited to Stanford from the University of Chicago where there was a very substantial Department of Medicine.
“I’d been at Hopkins, the University of Michigan, and the University of Chicago. These were well-established departments of medicine with fellowship programs, house staff training programs, and grand rounds. They had research conferences. And we got down to Stanford and we had none of that. And so we looked around and said, ‘My goodness gracious, we’re going to have to put all these things in place. We have to have a house staff program in medicine. We have to have rounds. We have to have a fellowship program. We have to have research conferences,’” Schrier remembers.
Saul Rosenberg, MD, Maureen Lyles D’Ambrogio professor of medicine (Oncology), emeritus, also came to Stanford at that time.
“I was one of the new assistant professors as was Stan, and that was a remarkable group of young faculty, mostly recruited by Hal Holman during the 60s. We had an assistant professor club, and there were 10 or 12 of us, and they were the seeds of a tremendous growth of this Department of Medicine and Stanford Medical School,” Rosenberg said in “The Mozart of Hematology,” a 2010 film by Jason Gotlib, MD (associate professor, Hematology), about the fascinating life and work of Schrier.
“It was terribly exciting because as young assistant professors with not many of the older faculty around we had enormous leverage. We proposed programs that, in fact, took place, and that have led to what we see now—an enormously powerful department with strengths in basic science and translational medicine,” Schrier says.
With the move from San Francisco came a complete revamp of the medical school curriculum that was prompted by Stanford president Wally Sterling and other university leaders including provost Fred Terman, radiation therapy pioneer Henry Kaplan, MD, and pharmacology department chair Avram Goldstein, MD.
“The curriculum that we built was heavily based on the idea that there was very strong basic science. We were now on the main campus and could interact with the basic scientists,” says the 86 year old.
During his 56 years at Stanford, Schrier has witnessed phenomenal change.
“We’re an extraordinarily different place today. Instead of 12 or 15, there are 400 in the Department of Medicine. We have people at ValleyCare Medical Center, and we have people at the Palo Alto VA, to say nothing of the enormous expansion of Stanford Hospital. The department now is in the top category of med schools in the country because it’s managed to combine very good science with translational medicine and the clinical trial program, which had been a little bit sluggish in getting started, but is now going very well,” he observes.
Comparing the clinical programs of today with those of the early 1960s is “as though we were dealing with two separate realities,” notes the former Chief of the Division of Hematology as he refers to the advances that took place under his leadership.
Among those he credits are immunologist Rose Payne, PhD, who helped develop the HLA system that allowed for transplantation to take place. He also talks fondly of Judith Pool, PhD, who discovered the cryoprecipitate that for many years was the standard treatment method for hemophilia.
With an emergent hematology division within a growing department of medicine, Schrier was able to work with Ron Levy, MD, Robert K. and Helen K. Summy professor of medicine (Oncology), to recruit people like Karl Blume, MD, who established what Schrier proclaims as “probably the best bone marrow transplant unit in the country.”
Blume hired one of Schrier’s fellows, Rob Negrin, MD, professor of medicine, who is now chief of the division of blood and marrow transplantation. Other notable Schrier recruits were Peter Greenberg, MD, (professor, Hematology), emeritus, who became an expert in myelodysplastic syndrome; Larry Leung, MD, current Maureen Lyles D’Ambrogio professor of medicine, who followed Schrier as hematology division chief and set up strong programs now with the VA; and Linda Boxer, MD (professor, Medicine), who performed research in the molecular abnormalities underlying lymphomas and rose to hematology division chief and now vice dean.
But if what’s past is prologue, then Schrier’s recollections foretell even better days to come for the Department of Medicine. In his own case “the best time of my life is now, and though I’m supposed to be retired, I’m actually an ‘active emeritus.’”
Bob Harrington, MD (professor and chair, Medicine), met recently with Schrier to discuss an upcoming search for a new chief of hematology.
“As Stan sat across the table from me, his eyes lit up and he said ‘oh, my goodness, what a great time to be at Stanford! We’re moving to the South Bay, we’re moving to the East Bay, campus is growing. What a great time to think about building hematology here at Stanford,’” Harrington relates. “For somebody who came here more than 50 years ago and who helped build this place, he is the past. But he’s the future, too, and his enthusiasm for the future says a lot about who we are at Stanford and who we want to be.”
During his 56 years at Stanford, Stan Schrier has witnessed phenomenal change
While Schrier no longer sees patients on the inpatient service, he still sees patients in consultation in the hematology clinic.
Furthermore, he still has plenty of teaching opportunities. As one of the department of medicine’s core reviewers, he reviews house staff candidates and is one of 18 in the residency program’s faculty mentorship program. He spends two sessions a week with the house staff on the hematology med 8 service (which he started almost 25 years ago), where he answers their many questions, and he also meets them at the microscope, where he shows them how morphology can aid in diagnosis and management.
“Stan sets the expectation about what it is to be an academic hematologist and a life-long learner, and I have tremendous respect for that,” says Gotlib, who views Schrier as a mentor in his role as the hematology fellowship program director. “His example is what I try to model. Showing up at conferences to teach is how you make sure that a program has the respect of its fellows and faculty.”
Schrier notes that he also has “an interesting job in the Stanford Cancer Institute,” where he serves as vice chair of the Scientific Review Committee.
As if that’s not enough for a man in his ninth decade, he proudly boasts: “I’m funded by the NIH, would you believe?”
The Program for Anemia, Clinical and Translational Trials in the Elderly (PACTTE) is funded by the National Institute on Aging. Schrier chairs a PACTTE consortium of institutions that are dealing with anemia of the elderly. The consortium is studying the impact of anemia on about 20,000 elderly patients who have congestive heart failure.
“We think we’re going to be able to make some interesting observations that will allow us to improve the care of elderly patients with heart failure,” he says.
Looking to help the elderly is a noble activity for a youngster like Stan Schrier.