In two patients we
had seen tumors shrink, and in one case disappear, after our immunotherapy.
After all the deaths, after all the years in the lab, we had found
something that worked. For the first time I believed rather
than hoped immunotherapy not only could work, but would work.
The Transformed Cell
the era of President Richard M. Nixon, political turmoil engendered
by the Vietnam conflict reverberated throughout the biomedical research
world built by federal funding and NIH sponsorship in the previous
decade. The Clinical Center had its antiwar demonstrations and counterdemonstrations,
and civil rights issues led to a vigorous affirmative action program
to widen the opportunities for minorities.98
The war also brought demographic change within the hospital community.
The end of the doctor draft in 1972 resulted in a steep
falloff in Clinical Associate applications and jeopardized a critical
source of new staff physicians. Normal volunteers were less often
Mennonites and other conscientious objectors and increasingly were
drawn from a national network of small colleges.99
The greatest challenge
the Clinical Center faced came directly from the Nixon administration.
In the name of budgetary restraint and managerial efficiency, the
administration sought to curtail research spending, reduce federal
support for biomedical education, and to phase out the PHS hospital
system. Congress, however, wanted to redirect spending away from
the war effort. A collision course was set in 1971 and 1972 when
broad majorities in both houses voted massive new outlays to conquer
cancer, heart, and lung disease. The administration supported these
initiatives but insisted that off-setting cuts be made in other
health areas. As a result, the budgets of NIH categorical institutes
other than Cancer and Heart, Lung, and Blood registered absolute
declines in 1973.100
A personnel ceiling remained in place for NIH as a whole, so that
while NIH funding rose $946 million between 1968 and 1975, permanent
staff lost 350 positions, and much of this burden fell on the Clinical
Departments such as Clinical Pathology were able to contract out
as much as half their work load, but others such as Nursing were
forced to carry growing program commitments with fewer personnel.
In 1972, its bleakest year, that department reported, The
quality of nursing care is obviously deteriorating, even though
it is recognized that all personnel are doing their best.102
Demoralization was rife in scientific leadership as well. After
three vetoes of the HEW budget and putative administration efforts
to consolidate all the institutes into a single administrative structure,
there was a real fear in the scientific community that the federal
government might jettison commitments to support medical education,
hospital construction, and basic research itself.103
Dr. Andrew Morrow in surgery, inserting dye into patient's heart
with a bronchoscope, a technique developed at the Clinical Center.
Dr. W. French Anderson (l.), Dr. Michael Blaese (r.), and Dr.
Kenneth Culver (c.) attending the first patient in the ADA gene
therapy program, September 1990. The patient is undergoing apheresis.