Introduction of Donald Pinkel
F. Lampert    Haematol. Bluttransf. Vol 32
Organizers, colleagues, ladies and gentlemen, and above all, dear Don, everything is evolution, and every new field in medicine has its beginnings and its pioneers. The story of pediatric oncology is a short but fascinating one, now covering 40 years, a time span considered holy since biblical times. In Germany, that is, in West Germany or the Federal Republic of Germany, the real and effective pediatric oncology has an even shorter history, and its beginning is closely connected with Dr. Pinkel's name. It is thus a great pleasure and an honor to introduce Donald Pinkel.
I could now present to you Don Pinkel's scientific career, or when and where he was born I think it must have been 1926, somewhere in the USA or mention the many awards he received, the last, if I remember correctly, being the most prestigious and substantial Charles Kettering prize from the General Motors Foundation in 1986, but I will confine myself to some personal memories and what I have learned from him.
The first time I met Don Pinkel was on the last day of August in 1960, at a barbecue at Dr. Oleg Selawry's residence on Grand Island, near the Niagara falls, Buffalo, N .Y. I had just completed my internship in the Pacific Northwest, and, on the way back visited the famous Roswell Park Memorial Institute. Don Pinkel was chief of pediatrics there and had also been invited by Oleg Selawry. I will never forget what Don told me during that hot and humid Midwest evening about teaching medical students: "With a patient, the most important thing is, to observe, to examine, and to state the physical findings absolutely correctly, and then to do a proper evaluation. As to the pathogenesis of a disease, you can read about this everywhere in a book, but the patient is unique!"
The second time I spoke to Don was on the telephone, calling from Munich to Memphis. It was on a Tuesday, the 18th of May, 1971. The mother of a freshly diagnosed 6-year-old boy with acute lymphoblastic leukemia (ALL) urged me to call Dr. Pinkel. She had just read in the German news magazine Der Spiegel about an almost 20% 5-year-cure rate for ALL achieved by Dr. Pinkel's group at St. Jude's Hospital, published in the Journal of the American Medical Association at the end of April. I had my doubts, but on the phone he told me something about "total therapy," including radiation of the central nervous system, about aggressive multiagent therapy up to the biological tolerance of the patient, and about 300 or more active patients with ALL currently under treatment at St. Jude's; I was curious to see with my own eyes. Together with Dr. Gregor Heinze, our local radiotherapist, we arrived at St. Jude's on Friday, May 28, 1971, and were able to study all the treatment modalities in the utmost detail. Back home, our patient Markus received the first dose of cranial irradiation on June 8, 1971 the first one in Germany; by the way, he is now a healthy university student and was put on Pinkel therapy, as well called this ALL management all over Germany. This Pinkel therapy consisted of induction, CNS irradiation, and continuation therapy lasting 2-3 years. This treatment protocol was easy to understand and to apply. Within several months allmost all institutions in Ger many were treating children with leukemia according to Pinkel. This was our first nationwide trial in ALL: 659 patients were registered, and about 240, or 36%, were cured. The lesson I learned from Don in pediatric oncology was that treatment should be not only specific and effective but also simple, safe, and cheap, so that everyone, everywhere can administer it. This so-called Pinkel therapy was the right beginning in our country, which is federally organized with so many small kings, kingdoms and opinions. We all gained experience with the side effects of toxic chemotherapy and with complications of the disease, and, above all, we were now able to cure children. We were ideally prepared to take on an even greater challenge, the prolongation and intensification of the induction period, developed by Hansjörg Riehm in our country.
Many more times thereafter I had the opportunity to come to Memphis, and many members of the St. Jude's family came to Germany in the years to follow. I was happy to arrange for a most remarkable lecture on treating children with leukemia that Don gave at Children's University Hospital in Munich, on September 8, 1971.
The third and most unforgettable lesson I owe to Don Pinkel, however , evolved during a dinner with live lobsters he invited me to Memphis. According to my diary, it was Wednesday, April 12, 1972. It was after the tenth anniversary of St. Jude's Children's Research Hospital, which now had become a world leader in the research and treatment of childhood cancer. Don told me about the initial difficulties this institution had had; it started as a dream, as an idea in the minds of Danny Thomas and Don. Going to Memphis at that time, he said, was like going into undeveloped territory. But setbacks are also challenges. He told me about those German Jewish professors who had been his teachers, who, after persecution and emigration were glad and humble to be in medicine again, even with a low income and no honors.
"Humiliation makes better men!" This is what you said, Don, and what always helped me to overcome frustrations and failures. And you, yourself, set examples, not minding working in clinics, even as a director, or making night calls. But I should not dwell on humiliation, but instead should close in your particular case with the beginning of the hillbilly song: "It is hard to be humble, if you are perfect in every way. .."
It is a great thing that you are here, Don.
Thank you for coming.