Eulogy for my Father

My beloved father, Arthur H. Cash, died peacefully over the winter holidays this year after a long and well-lived life. These are the remarks I prepared for his memorial service this past Saturday. They differ slightly from what I read at the service because I skipped a bit by accident. In order to preserve this blog’s PG rating while honoring my father’s most cherished values, I will once again be making use of the french word for seal

Everyone who gets a good dad loves their dad, and I’m no exception. But I also really liked my dad. His company was always a pleasure, from my childhood, through my not-annadadapplerehabunturbulent adolescence, to my adulthood. He parented me through all these shifts, allowing our relationship to change and me to set the pace. I always knew I could call him, for advice, or a chance to vent, some cheering up, or because I had been rear-ended and was facing the wrong way on the shoulder of the freeway. He was, in short, there for me. His demands in return were few, and never more than I could bear. Nothing worse than help with his computer and occasionally removing blackheads from the part of his back he couldn’t reach. He made mistakes—bad ones—as all parents do. But unlike most parents, or most people for that matter, he apologized for them, and learned from them, thus laying the groundwork for our adult friendship.

He was a great teacher. Disciple that he was of the Enlightenment, he taught me how to evaluate evidence, how to reason empirically, and how to express my understanding. He dadbrotherratused to say, “Thinking without writing is as bad as writing without thinking.” The root cause of my somewhat impulsive decision to get a degree in biostatistics is that my dad played math games with me as a little girl, ensuring that numbers would always be fun. He planted the seeds of my interest in medicine every time I got a paper cut or a splinter, talking me through the pain by explaining the science. And of course he told me his stories of serving with the 108th General Hospital. I’ve agreed to remember the names Myron Fertig and Teddy Gomalek, because they belonged to patients that were particularly important to Dad before they died.

He was also, as you know, highly eccentric. He had strong likes and dislikes. He liked Willie Nelson, Judge Judy, and every cop movie ever filmed. He abominated chapstick, polar bears, and Mickey Rooney. He believed the most handsome man in the world was Harry Belafonte. Left to his own devices he could subsist indefinitely on a diet of peanut butter sandwiches, sardines, stoned wheat thins, hot dogs, and bananas. He would hide a banana every time a bunch came home because he didn’t trust us to leave him his breakfast, so one might open a drawer looking for needle-nose pliers and happen upon a banana instead. He owned a navy blue undershirt that he believed made him look Puerto Rican. He would corner people at parties and demand that they explain to him what the Internet was. Equally dissatisfied with explanations and with metaphors, he would listen, shake his head and triumphantly declare, “You see? No one really knows.”

He and my mom both could behave quite scandalously, leaving me no choice but to rebel by becoming a square. He felt we should be fluent in profanity, and made sure it was spoken in the home. When bantering with my brother as a teenager, I once said, “Oh Phoque3 you, David,” and Dad corrected me, “Mind your manners. It’s Phoque3 off.”  Once at a gathering I teased him for behaving sluttishly with the ladies, and Dad demurred, “No, no. I’m not a slut. I just have catholic tastes, and a universal sympathy.”

He was capable of some shocking lies, and would shamelessly play the adorable grandad card. Back in the days of Blockbuster, Mom once left town for work, forgetting to return her VHS tapes. When she realized she owed three weeks in overdue fees, Dad called Blockbuster and wove a most pathetic tale of his wife having to leave town suddenly to care for a sick and nonexistent aunt. The clerk was utterly charmed by him, and when Dad returned the tapes—for which he was not charged—the clerk said, “I hope your wife’s aunt is feeling better.” Dad looked at the young man solemnly and said, “She isn’t. She died.”

I had 36 years with him; that’s 24 more years than we were expecting to have together after he was diagnosed with metastatic prostate cancer, the first of several times he survived a grim prognosis. But, what can I say? I’m greedy. It wasn’t enough. My dad was irreplaceable, and I’ll miss him every day that I have left.

The person I’ve been thinking about most these past few days in my grandmother Dess. She gave birth to my dad at home, and family legend has it that the doctor that was supposed to deliver him was out at a poker game and couldn’t be located in time. So I believe she was alone with him when he came into the world. Maybe it’s because of the frightening times we live in, but I find myself going back to a scene Dad described of the last family dinner they had before he left for Basic Training. His oldest brother, Mitch, was already in the Navy. The middle brother, Web, was kept from serving by his disability, his health a constant worry to his mother. So they sat around the table, this family of people who are all gone now: the mother, the father who had been in love with her since they were seven years old, and the three beloved sons, all believing this might be the last time they were together, and no one sure that they world they knew would endure. I want to go back to my grandmother on that night and tell her, “It will all be ok. We win the war. They make it home. They survive with bodies and minds intact. All three of your children live past 85, and so do you. You meet eight of your nine grandchildren, and your great grandchildren run to double digits. You are all of you blessed.”

And so are we.

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The Incredible Story of Gertrude B. Elion, Mindbogglingly Awesome Lady Scientist, Inventor of a Cagillion Lifesaving Drugs, and Mensch

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Image via Brittanica.com

Sometimes when I want to think of happy things, I think of the fact that Gertrude B. Elion existed. I am talking about a legendary figure here, so you might not think the world needs a new blog post about her. She got this award you might have heard about called a Nobel Prize (one of only 12 women out of 201 laureates in the category of Physiology or Medicine). She merited her own chapter in The Greatest Generation, and her own segment in Me & Isaac Newton. She even, apparently, has her own posthumous blog? Her biography crops up in lots of places, because when someone wants to talk about the 20th Century’s great female scientists, the A-list is not that long. But when I polled a convenience sample of my friends who were available on gchat at the time, it was clear that none of them had heard of Gertrude B. Elion–neither the scientists, nor the feminists, nor the feminist scientists. So I thought, hey, folks might really like to know her story. It’s pretty amazing.

The contribution for which Elion won the Nobel, along with her mentor and collaborator George H. Hitchings and Sir James W. Black, was a revolutionary method. They pioneered the concept of drug design. In the early part of the 20th century, most drugs were more or less made by starting with a chemical and then putting it inside lab animals to find out if it did anything useful. Drug design, in contrast, starts with understanding a biochemical pathway, and then formulating a substance whose molecular properties change that pathway. As you can imagine, that was a game changer.

Sometimes a team of scientists with a game-changing method can invent a really useful drug. So the first thing you might hear about the team of Elion and Hitchings is that they invented the first treatment for leukemia, specifically leukemia in children. Let me say that again–before the drug 6-Mercaptopurine (Purinethol), all pediatric leukemias were 100% fatal. “Today, as a consequence of the combined efforts of Elion and Hitchings in developing 6-MP,” says this big-deal biochemist, “Most children with acute leukemia can anticipate a remission when the drug is used in combination with two or three other agents…and some patients can even be cured.” The drug was also quite novel at the time in its mechanism of action. It works by interfering with the production of certain types of nucleotide. You may be familiar with nucleotides as the building blocks of DNA, but at the time that Elion and Hitchings made this drug, that was unknown. The drug is still used to treat both leukemia and autoimmune diseases.

I mean, wow, right? That is an achievement that would be enough for any lifetime, letting a person feel secure that she had saved lives and done good in the world. But I’m just getting started, because Elion also helped to invent…

  • The first antiviral drug. Acyclovir is a really important drug in its own right, front line treatment for Herpes to this day. If you are not already aware of what a huge deal it is to be able to treat herpes and to lower the risk of spreading it, let me tell you about a woman I once met who was worried about losing her job because her untreated genital herpes made it too painful for her to sit down. But this is bigger than just Acyclovir. This drug proved that it was possible to kill viruses using drugs, and it paved the way for every existing antiviral medication. Remember how HIV/AIDS used to be inevitably fatal, usually within about two years? And now people with HIV in the US are not only able to live for decades, but have only about a 50% chance of ever dying of AIDS? That’s because of antiretroviral medications, and those exist because of Acyclovir.
  • The immunosuppressive drug that allowed the first organ transplants between non-relatives. So that was pretty important. Azathioprine is also still used for that, as well as to treat autoimmune disease.
  • The anti-gout drug Allopurinol. If you don’t know what a big deal gout is, let me show you the 1799 picture by James Gillray of a devil-monster eating your foot that is legally required to be included in every lecture slideshow about gout:
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    Yeah, gout really hurts. Image via Wikimedia Commons

  • The anti-malarial drug Pyrimethamine, still used. You probably know how important malaria treatment is.
  • Trimethoprim (aka TPM), a component of the front-line antibiotic treatment for urinary tract infections. And if you don’t know what a big deal urinary tract infections are, I invite you to bite me like an 18th Century gout imp.
  • Literally about 40 other drugs. These are only the incredibly famous ones. “Trudy has really revolutionized virtually every aspect of medicine that an oncologist would practice in,” said pediatric oncologist Henry Friedman in this video, “Better drugs, better ways to give other drugs more safely. She’s just changed the entire field. There’s no comparison.”

An image search for Gertrude B. Elion tends to turn up pictures like the one above of her in her later years as a celebrated biochemist, when she looked like your Bubbe. But the picture I can’t get out of my mind is this one:

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Image via Jewish Women’s Archive

That is the future Nobel laureate with her fiancé, Leonard Canter. And don’t they look hot? And so completely in love? Before they could be married, Leonard died suddenly from bacterial endocarditis. By all accounts he was the love of Trudy’s life. She never married. And in one of those ironies of history, not having a husband or family allowed her to have a scientific career that was barred to most wives and nearly all mothers of her generation (if you don’t believe me, go look up The All-Too-Familiar Story of Elizabeth Bugie Gregory, Lady Scientist who Didn’t get Credit for her Contributions to Inventing the First Antibiotic to Combat Tuberculosis). In fact, Elion only got her foot in the door because World War II left a serious shortage of qualified male chemists.

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Image via Sandwalk

The door in question was not the door to Academia, by the way–despite transcripts made of gold, she at first couldn’t get into a PhD program, then later decided it wasn’t worth it. She did all her major drug work at a pharmaceutical company, where Hitchings was working when he hired her. And while we’re talking of Hitchings, let me take a moment in praise of the male mentors of female scientists. I don’t really know much about Hitchings, but in a time when it would have been socially counterintuitive, he was able to perceive the potential in this young person, who lacked both credentials and testicles (and was Jewish–did I mention that?). If he had wanted to steal the credit for her accomplishments as young Elizabeth Bugie’s mentor did, he could have, but instead he helped Elion grow into a star.  I feel, in a way, as romantic about their collaboration as I do about that picture of Trudy and Leonard.

Thinking about Gertrude B. Elion makes me happy, even though it humbles me so profoundly, and makes me want to light my CV on fire. One of the reasons is that she seems to have been such a nice person. It’s something of a cliché that the first women to pioneer any masculine sphere are forced to act “like men”–a term that generally connotes acting “like sociopaths.” But everyone mentions what a good colleague and mentor Elion was, and how kind. Though she never had her own children, she had four nieces and nephews who adored her. And she had a true sense of the social justice aspects of science. As she said in this video for her Lifetime Achievement Award from MIT, “The same thing that inspired me over the years inspires me now. I want to get sick people well. I want to get children involved in science. I want them to have the same kind of excitement and fun that I’ve had, and do something useful with their lives.”

Gertrude B. Elion (1918-1999)

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Image via Academy of Achievement