Dr. Peter Greenwald Oral History

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Oral History: Peter Greenwald, MD, Dr.PH

National Cancer Institute

Interviewed by Kate Nagy for ONHM, November 20, 2023

This is an interview about living on the NIH campus in the Public Health Service officer housing neighborhood known as “The Station.” Dr. Peter Greenwald lived there with his family from 1981 until 2016.

Nagy: You moved to the NIH campus in 1981. Where did you come from and why?

Greenwald: We were living in Albany, New York, where I was the head of Epidemiology at the New York State Department of Health. I also was seeing patients at Albany Medical Center, and I was an adjunct professor of biomedical engineering at RPI [Rensselaer Polytechnic Institute], an engineering school in Troy. I had gone there after getting my doctorate degree – not my MD degree, but my doctoral degree from Harvard School of Public Health. I had wanted to be in a setting where I could do both individual deep investigations in epidemiology and broader population-based studies.

I studied the Love Canal. I studied [the drug] DES [diethylstilbestrol] – when mothers took it, it would cause vaginal cancer in teenage daughters of those mothers. And I was very activist. I got Congress to get the FDA to act on that even though the FDA didn’t want to, and I drafted a letter for the health commissioner to write to the 25,000 physicians in New York State and the New York Times advising them not to prescribe DES, and I did a number of other research studies.

I had been on a number of NIH study sections, mostly epidemiology, in the 1970s. Vince DeVita, who was director of NCI, who started as director just before I came, recruited me to run a division of the National Cancer Institute. After we discussed it for a while, we agreed to several things. One, I wanted to change the name – [it was a] very bureaucratic name, the Division of Resources, Centers, and Community Activities – to a simple name that had the word “prevention” in it. He agreed. And so I moved to Bethesda.

One of the things that made it easy was that Vince was allowed to have a house on campus, but since he and his wife already had a home nearby, they didn't want the house – so he arranged for me to get the house. At that time, interest rates were way up near 17%, tremendously high, so there was no way to get a mortgage with rates that way.  Harriet [note: Dr. Greenwald’s wife, Harriet, established the NIH Alumni Association in 1986 and led it until it disbanded in 2007] and I just said, “Well, that's the place to go.” We initially thought we would just stay for a short time and get a house, but it was so convenient that we just stayed for the whole 36 years. We lived on the campus and met a number of very, very interesting people who were neighbors during that period.

Nagy: Who were your family members? You mentioned your wife, and I know she did a history of the neighborhood for us.

Greenwald: All three children were born in Albany. The oldest, Rebecca, at that point was in junior high. And Laura, I think, was also in junior high.

Nagy: She was in the fifth grade.

Greenwald: The youngest [Daniel] was maybe in the third grade. They were at local schools, and it was quite easy since at that time there was no fence or anything around the campus the way there was since 9/11.

Nagy: Laura told me that her school bus stopped right in front of the Clinical Center.

Greenwald: It was very convenient, a short walk, and it was perfectly safe, so they could just go up themselves. Sometimes we walked with them, but often they would just go up and get on the bus.

Nagy: Did anyone else live with you? A nanny, for example?

Greenwald: It was just us. I mean, sometimes we’d have visitors, mainly Harriet's parents and her sister, but generally it was just us.

Nagy: That's really interesting that you took the house that Dr. DeVita was supposed to be in, because I understand there was a waitlist at that time. Or was the waitlist a little earlier? Do you remember?

Greenwald: I think there was still a waitlist. There were very few families that could live there. Maybe six or so families. There were some long-time residents, like Herb Tabor, I think, [who lived] there too. I think he recently died.

Nagy: I think he was like, 102, or something. He was very, very old. [Note: Herb Tabor, Senior Principal Investigator in the NIDDK Laboratory of Biochemistry and Genetics and longest-serving NIH employee on record, died in 2020 aged 101.]

Greenwald: But so sharp. I would talk to him often. He was very much with it.

Nagy: I've met his daughter. She's really lovely as well. Did you get to see the house before you moved in?

Greenwald: We saw it briefly, yes, and it was perfect. Duplex houses. It was about 10 rooms, three bathrooms – two full – and plenty of room for everyone. Good, fixed basement. They had closed off what had been at a garage and made it into a kind of a library. It was perfect for us.

Nagy: Do you know who lived there before you?

Greenwald: No. It was someone who was there a short time. Mort[imer] Lipsett and his wife lived in the other side of the duplex. I don't know who was there before we were there.

Nagy: What were your first impressions of the house and the neighborhood?

Greenwald: To me, it looked like a nice college campus. It was beautiful. It was one you could run around [on]. It was easy to take my dog out at a playground in the center [of the on-campus houses] with me.

We became friends with the Wilsons, Ruth Wilson and Luke Wilson, who actually owned part of the land of what is now part of the NIH campus. [Their house] was removed after they died to make the setting a part of the Clinical Center. [The main Wilson estate house still stands as Building 15K, but smaller associated houses were taken down over time.] We were very close friends. We’d go up and visit, and we let our dog run free there because the whole area was fenced in.

At that time, early on, maybe 1982 or 1983 – 1982, I believe – my group at NCI started collaborations with some Chinese scientists. We were back and forth to China a lot, maybe twelve or so times over the time I was there. We had a 35-year collaboration. Ruth had a friend, a doctor in China, who was a doctor for some of the Communist leaders of the country. Once, when we were going over, she wanted us to bring some cheese to this doctor who liked cheese and couldn't get it. We said “Oh, sure.” It turned out that she gave us this large suitcase packed full with cheese. When we went to the airport we had to talk to the airline – I think it was United, I’m not sure – to make sure they would keep the cheese cold all the way, even with a stopover. I don't remember if that time it was Japan or Hong Kong – we’d have to stop at one or the other. We did that and gave this doctor the cheese, to Ruth Wilson’s delight.

Nagy: That's a great story. Who else did you live around?

Greenwald: Well, there are a lot. I remember a number of them. One of the early ones was Surgeon General [C. Everett] Koop -- Chick. We called him Chick. If your last name is Koop, your nickname is Chick – and Betty, his wife. We had them for dinner. Actually, went on a cruise with them. My wife was head of the NIH Alumni Association and arranged a cruise. This time it was from England up the coast of Norway to the northernmost point. Chick and I and three other people were teaching continuing medical education for physicians in exchange for free cruises.

Nagy: So how – you could do that?

Greenwald: [Laughs] No problem, no ethics issues.

Nagy: I’m not sure you could get by with that today.

Greenwald: Probably not! Of course, then we knew them [the Koops] very well. The one that Chick was closest to was our son Daniel. Daniel was then in high school. He would go and help Chick get together his things he was writing. He’d go over in the evening and do that, and then he got Chick to speak at his high school graduation, which delighted his teacher because the Surgeon General of the United States was speaking at his high school graduation.

Nagy: That must have been incredible.

Greenwald: Yes, that was fun. Another one that was fun: The Assistant Secretary of Health was Ed Brandt, and his wife, Pat. Pat Brandt and Harriet would go around to most of the military bases and go shopping at their exchanges or commissaries. They were close. But the Brandts had a big fat Irish setter dog named Casey, and Daniel was charged with going up when he got home from school around three o'clock to walk Casey – or it might have been the other way around! But Daniel, would telephone just before he went up, and when he got there Casey was waiting at the door to be walked by Daniel. It was an interesting relation between them.

Another one that Harriet was very close to was Madelyn Von Eschenbach. Andy Von Eschenbach at that point was director of the National Cancer Institute, and he was friends with the Bushes, especially [George H.W.] Bush. He was just at MD Anderson before that and took care of the older Bush and was really friendly with him, so he'd go up to Kennebunkport with him and things like that. But then Harriet and Madelyn also went around to markets and shopping or whatever they were doing.

Nagy: Were you in the Public Health Service?

Greenwald: Right after medical school, I had a one-year rotating internship; [it was]one of the last rotating rather than specialized residencies. At that point, I was in Los Angeles [LA]County Hospital as an intern, and there was a doctor's draft. It was just before the Vietnam War, even though we already had Rangers or soldiers over there, but since it was a doctor's draft, I decided first that I would join the Air Force as a flight surgeon. I had all the papers to do it. The flight surgeon is basically a family doctor, but you also know how to do physical exams on pilots and take care of whatever military problems there could be in medicine. One of my professors who’d been at my medical school but also then was at LA County and the University of Southern California, called me from CDC, which was then called the Communicable Disease Center – now Centers for Disease Control and Prevention in Atlanta. He said, “Why didn't you come here instead?” It was like NIH. Some people called it the Yellow Berets.

That sounded better. I [visited] for a week and went to CDC, and at that point, I became a Commissioned Officer for two years. I did some very interesting studies. [For example], three other doctors and I did a Vanguard Study in the Tongan Islands in the South Pacific to test the feasibility of vaccinating against smallpox using a jet injector gun with a freeze-dried vaccine. The Army had developed [the mechanism using] electricity. You pulled a piston and then it would shoot a jet of water; no needle would go through the skin for vaccination. But CDC had it changed because there wouldn't be electricity where we were going, so you used a foot pedal to cock it. Since with smallpox vaccine, you have to be in the skin not through the skin, you would change the nozzle at an angle so it would make a little bubble – the way some TB tests are.  When we were testing out what dose, what immunity, we brought Polaroid cameras, which were a huge hit, because they always wanted their pictures [taken]. [We brought] a generator and showed movies – the kids had never seen movies before.

We vaccinated about 45,000 people, and that was a key step toward deciding that it was feasible to do a smallpox eradication program. One hundred years before that there was something like 300 to 500 million people who died of smallpox. The eradication program led largely by CDC (but nominally by the World Health Organization) was the first time in history a disease was eradicated from the world. I think it's history.

I was coming to NCI then in 1981 with that attitude – that prevention is really the way to go. With Vince DeVita’s, the [NCI] Director, support, I changed the [Division’s] name to the Division of Cancer Prevention and Control and went on to build a cancer prevention research program that grew to about $300 million a year, nationally, and to some extent internationally. That's what I developed and ran most of the time there. in addition to doing my own research.

Nagy: How did you know Dr. De Vita?

Greenwald: He found out about me and recruited me.

Nagy: You hadn't known each other before?

Greenwald: No.

Nagy: Which building were you working in?

Greenwald: I started in [Building] 31. Maybe for 25 years or so I was in 31, a few flights above Tony [Anthony] Fauci.

Nagy: Did you have a lot of work interaction during the day between yourself and your family? Did they pop up for lunch every now and then?

Greenwald: We were close by – less than a block or so. I would often go to work at 6 a.m. I did maybe stop home for lunch. I would always click off around six. It was good working in the morning; not so great in the afternoon, especially late afternoon. So that was good in the sense that I'd spend time with my children because they were home after dinner, and I was home after dinner. So it worked out very well.

Nagy: Did you ever – if you were working on a really hard problem, did you ever walk back up [to the office] at night or anything?

Greenwald: The weekend but never at night.

Nagy: Getting back to the house a little bit, did it ever undergo any major renovations while you were there?

Greenwald: Yes. Not major, but everything was taken care of. It was wonderful. Like, if the refrigerator broke down, we were given a new one. Same with a microwave. Same with the washing machine. Oh yeah, they built a fence around the patio so our dog could run around without getting out. There was a change when they started [building the perimeter] fencing; the first opening was toward West Cedar Lane, and then they closed it, so it was all within the campus.

Nagy: I remember reading or hearing that, for example, people who lived [on campus] weren't allowed to have cats because NIH was afraid that the cats would eat the birds. Were there other restrictions on what you could do? Was there a homeowner's association or was there a list of [forbidden] things?

Greenwald: But we had a cat and a dog! I never knew there was any restriction on cats because we had one.

Nagy: Oh, that might have been that might have been earlier.

Greenwald: They [NIH] were very, very helpful to everyone living on campus, and there was never any problem of restrictions. The only big problem was [that] after the fence went up, it was harder to have company. People would have to check in, get a guard or get someone to open the gate and go in and out.

Nagy: That must have been very difficult.

Greenwald: It wasn’t. I mean, guards would open the gate, but it was still kind of a nuisance for the kids to have friends come over.

Nagy: Your kids must have been pretty close to moved out by that time. They finished high school. I know Laura said she and her siblings went to Walter Johnson.

Greenwald: Right. That's true. They did. Yeah, they got a good education there. I don't remember how old they were when we moved, but they were about ready to go.

Nagy: Were there any specific organizations or groups or special programs or events just for the people who worked on campus?

Greenwald: There weren't that many people. I think we were closer than most of them to different people. Jane Haney; the Andersons – Pam Anderson. And the ones I've already mentioned: Ed Brandt, Madelyn von Eschenbach. But it was more one on one, or maybe two or three together, and not a lot of that. They were all busy. I think some of the spouses got together.

Nagy: Was there a lot of interaction with the people in the apartment?

Greenwald: Oh, no. We didn’t pay rent, because I was in the Commissioned Corps, and they take the allowance for housing allowance, so that was great. We didn't have to pay for anything, except telephone and TV. That was really nice.

Nagy: It was really nice. Those are nice houses! Where did you go grocery shopping?

Greenwald: Often the PX, sometimes. Sutton Place Gourmet. Someplace along Old Georgetown Road.

Nagy: What was Old Georgetown [Road] like when you were living there? I've seen pictures from earlier when it was basically a dirt road.

Greenwald: Bethesda was a village when we first got there, and now it's grown into a city. It really grew rapidly. Now it's really a large, somewhat congested city.

The Medical Center changed. First, it was National Naval Medical Center, and the Army Medical Center was down on 16th Street in DC. And then they merged and it's now the Walter Reed National Military Medical Center. We'd go there; we'd get our health care there, and it was a little odd, because I mean, I never use the title, but I was a Rear Admiral in the Public Health Service, and I had a higher rank by one star than the head of the hospital. The uniforms were identical except the design on the buttons. If they figured it out – I wouldn't often let them know, but if they figured it out, they wanted a corpsman to walk around with me. They made sure I got ahead of everybody; they gave us the best room. I didn't particularly care for that. That was the Navy doing that; the Army treated everybody the same.

Nagy: When I was working, at NCI, the Five a Day—[note: an NCI-funded program promoting consumption of five servings of fruits or vegetables each day]

Greenwald: We started it! Okay. So what happened: I had worked at the New York State Department of Health for 12 years before coming to NCI, so I knew about state health agencies and local health agencies. We wanted to have a smoking prevention program, which was run by my deputy, a fellow named Joe Cullen. We decided to work with the states because you couldn't get anywhere with Congress – a lot of them are in the pocket of the tobacco industry, so that was hopeless, so we decided to work with states. I had our staff write a Request for Applications, a [funding] set-aside, for state health agencies to do something that would improve public health.

A group from California – a woman, Barbara, I forget her last name – at the Department of Public Health in California, and Lorelei DiServo [???], who worked with Dole Pineapple, got together and started a little Five a Day program. We [already] knew about it. They applied for a grant with us, and we liked the very positive message, so we worked with them off their license and [with] our Nutrition Science Group. We built it into a national program. And the industry group, which was mainly all the produce manufacturers and the large supermarket chains, joined, and we worked with them. The rule was [that] we would have to agree to what the message was, as long as they put the whole message. Our communications group, Paul Van Nevel’s group, would check to make sure. So [for example] you could have vegetables, but not mixed with something that was high fat, or it wouldn’t count. We made the rules, and they would follow them.

They created a group called Five a Day for Better Health and said, “You’re the government, you’re too slow.” They collected about $400,000 in about a week and a half, set up this foundation. And then within six months, they went from nothing to billions actually – with a B – billions of gross impressions a week. A gross impression would be, like, one person seeing plastic bags with Five a Day or seeing an ad on TV or something that said Five a Day. The [daily] consumption [of fruits and vegetables] went up something like from three to three and a half over the country, but when you look at that over the population, it’s quite a big effect. It improved consumption of vegetables and fruits in the United States, and it’s still going on. I still see things. About 80% of the supermarkets in the country had Five a Day programs.

Nagy: Yeah, I used to have a little magnet on my refrigerator.

Greenwald: I still have shirts and t-shirts that they printed up and gave me.

Nagy: Yeah. I remember you used to, or NCI at least, used to hand out little recipe books.

Greenwald: Right. So that was our nutrition group together with the communications group. We were on the same floor a lot of the time in Building 31 on the 10^th floor. It was really good that it was that way. It also meant I was on TV a lot, especially in the 1980s and 1990s and early 2000s. Because if Communications got a call, and it wasn’t for someone specific, they could refer them to me.

Nagy: It's my understanding that over time, the number of people who lived on campus seemed to be fewer and fewer. Was that after 9/11?

Greenwald: It was, but I don't think it was only because of 9/11. I think it was better for people when the cost of mortgages went down. But yes, since 9/11, because of the [perimeter] fence. I think that that hurt. And then also, the Institutes – you could not take down those houses because they were some kind of historical [Note: the houses exemplify the Radburn concept, in which a group of buildings face inward, away from the street, toward a large common yard.] but they can make [them] into [offices] and sometimes they emptied [the houses] out, and they want to expand their office space, so they’d try to grab hold of the house.

Nagy: I always thought it'd be interesting to work in one of those.

Greenwald: It would be nice to have that community. The group I liked [who used a house for office space], they were the firefighter group. They were located there, even though the firehouses were located separately, of course. And I think NCI worked there. Maybe NIDDK. Some of them had space. It seems nice because it was a home, but they’d fix it up into offices, and they were convenient. They’d have kitchens and bathrooms.

Nagy: Are you still in touch with anybody who lived there?

Greenwald: Not really. I know them, but we're not in touch. Once in a while, I'll be in a conference call with one or two of the ones that were leaders in my division, but it's pretty rare. I saw Vince DeVita and his wife once. He was at Yale – now retired from Yale but living near New Haven.

Nagy: Are you still in touch with any of your neighbors?

Greenwald: I'm not. Harriet was, on the phone, mainly with Madelyn von Eschenbach and with Pam Anderson. With Pam, especially; it was almost every week, they'd be on the phone. I think it was every week. Madelyn less so, but maybe once a month or so. She kept in touch, but I didn't.

Nagy: And you said you were there for 36 years?

Greenwald: Yes. Right.

Nagy: Until about 2016.

Greenwald: First I retired from the US Public Health Service, and then I had a different job as a civil servant until I actually retired. After [I left] the Public Health Service, Harold Varmus wanted a change. I moved on working in OD NCI, and that was not as active. But I mean, I kept up, but I didn't feel [my career] was as productive as it [had been]. When I was about to turn, 80, Laura and my wife said, “Time to spend more time with grandchildren!” I was happy to move. We moved to, New London Connecticut.

Nagy: And you've been in New London ever since?

Greenwald: Yes, we're here now.

Nagy: What would you say was the best thing about living on campus?

Greenwald: The best was the connections; the people on the campus; the ease with going to work and back, not having to drive – [I] loved to just walk to work, go in anytime [I wanted to] – and knowing some of the people from other Institutes. I thought that was very valuable, because I mean, sometimes things were a little bit siloed. But they're pretty good at NIH for people working across Institutes, especially if they're in similar disciplines, but I thought it opened up that kind of interaction.

Nagy: Did you ever bump into one of your neighbors and start talking science and realize that you and NIDDK absolutely had to do an RFA together, for example? Or was it mostly just neighbor stuff?

Greenwald: We did some, but we bumped into [each other] more in building 31. For example, with the Eye Institute, there are two enzymes in the macula – antioxidants that help your discrete vision – and the Eye Institute wanted to do a trial. I talked with the head of the Eye Institute at that time, who was going to lead it. Their problem was, they were going to give these as vitamin pills, and they didn't have them made up. We had been doing a clinical trial in Finland, actually, that used beta carotene as one of the interventions, which is just a kind of an antioxidant, and so we helped them. We gave them our protocol, which was perfect for what they wanted to design, and gave them enough so they could have a three-month run-in of everyone on the beta carotene while they were making up the real intervention and placebo, and that allowed them to get the dropouts before they started the trial, so the trial was more efficient. So that collaboration was there.

We had a number of things with NIDDK, some around nutrition science. They were struggling to have their nutrition science program – and, of course, we had more money. Plus, we had some very good nutrition scientists. We worked with them in some of the initiatives. We had some joint Requests for Applications with set-asides, and we decided at the time how much they would put in [and] how much we would put in. We had some with the nurses that had to do with quality of life, so our nurses worked with them. There were some real collaborations.

Nagy: Was DCPC involved in a lot of quality-of-life type research at that time?

Greenwald: We had a clinical trial program called CCOP – Community Clinical Oncology Program, where we accrued patients to the clinical trials that were sponsored by the [NCI] Division of Cancer Therapy – they designed the trial. We were accruing, or contributing, over 30% -- maybe 30 to 33 or so percent of all the patients in the United States going on Division of Cancer Therapy trials. But we also added in cancer control monies, which we had budgeted separately within our division for quality-of-life studies. A lot of them had to do with things like pain management and other things. We'd always have one or two nurses that would develop Requests for Applications for quality-of-life studies, and we’d add them into the clinical trials.

Nagy: Do you miss living at NIH?

Greenwald: I’m happy now. Yeah, I liked it a lot. But right now, I'm happier here. I don't miss it. I enjoyed that part of my life, and now it's a different part.

Nagy: Is there anything else you'd like to add about living on campus, about being on campus?

Greenwald: It's wonderful atmosphere. I think NIH is a strong national and international institution. I don’t think that always gets the attention and credit it needs. Although we always had some support in Congress, it didn't show. I testified in Congress a number of times. It would be interesting. There were a few times where in the hearing, it would seem like hardball questions and things, and then when it was over, the Congressman would catch me on the side, ask about their own family, what to do. Once that happened, we knew we had their support.

Nagy: Well, they have to play to the cameras and make it look like they're tough and strong to the folks at home.

Nagy: Thank you so much for taking the time to talk to us.

Greenwald: It’s a good idea. I’m glad you’re doing this project.

Nagy: It's been really, really interesting.