Broder's Surprise Departure From NCI Reveals Strain Of Government Service

After 22 years at the National Cancer Institute (NCI) the last six as director Samuel Broder will retire in April to become chief scientific officer at IVAX Corp., a Miami-based pharmaceutical company, at a salary reported to be about twice his current pay of $120,000. There is more than money behind Broder's December decision to leave, however. His is a portrait of a scientist frustrated with the politics of government service and increasingly estranged from scientific colleagues, cancer patient advocates, and other constituencies. Broder's legacy at NCI includes central work on the development of AZT, one of only a few drugs approved to directly treat HIV infection. He is also credited with broadly and effectively promoting the full range of basic and clinical research activities at NCI, the largest of the National Institutes of Health, with a budget of more than $2 billion. "I view him as having been more balanced than previous directors, who have been focused almost exclusively on either clinical work or on basic science," says G. Marie Swanson, a professor of medicine and director of the cancer center at Michigan State University. "Broder's tried to have a more balanced perspective, realizing we need advances in all the areas." Swanson, also a member of the board of scientific counselors for NCI's division of cancer prevention and control, praises Broder for securing increased funding for research in those areas. At the same time, recent controversies over NCI mammography recommendations and problems with an agency-supported breast cancer clinical study at the University of Pittsburgh, along with the exodus of top personnel from the institute, have clouded his tenure. "Quite frankly, I would have seriously considered earlier departures except that certain things needed to be straightened out," Broder acknowledges. "You should wash the dishes before you leave the kitchen." One persistent personnel issue for the director, from the first moment of his appointment, has been the high-profile scientific misconduct case involving NCI researcher Robert C. Gallo, accused of misappropriating the HIV virus from French researchers. According to a recent investigative report from the subcommittee on oversight and investigations of the House Committee on Energy and Commerce, prepared under former chairman Rep. John Dingell (D-Mich.) and as yet not officially released, NIH director Harold E. Varmus recently intervened in Broder's handling of Gallo. The move is seen by some observers as undermining Broder's authority. Varmus lifted media restrictions imposed by Broder on Gallo without consulting the NCI director and blocked Broder's plans to scale down Gallo's laboratory, the report contends. Broder refuses to comment on any aspect of the Gallo case, and a spokeswoman for Varmus says the director has done nothing to subvert Broder's authority. Observers knowledgeable about the Gallo investigation say that, while the situation has been a thorny political and personal problem for Broder considered a friend of Gallo's it probably was not a major factor in his decision to leave NCI. "The [Pittsburgh] breast cancer controversy is, in my view, the more direct reason that Broder is leaving," says Suzanne Hadley, an NIH employee who helped prepare the Dingell committee staff report. "He was out there all by himself. He got no support from Harold Varmus, from [Department of Health and Human Services (HHS) assistant secretary] Philip Lee, from the HHS general counsel, Harriet Rabb, nor, certainly, from the secretary, Donna Shalala. Absolutely zip. "And when he was taking the kind of shots that he was taking from the outside community, one public word from Harold Varmus that 'I support this man in what he is doing' could have made all the difference in the world. And you never heard it." Critical Attention In December 1993, Broder was widely criticized by clinicians and patient advocates for changing NCI guidelines concerning mammography, a breast cancer screening technique. Saying that the test had not been shown effective in women under the age of 50, Broder recommended the diagnostic procedure only for women over that age_a view that set him against a number of researchers as well as the American Cancer Society and other patient advocates. Then, in April 1994, Broder appeared before Dingell's subcommittee for a sharp challenge to his institute's handling of research irregularities at Pittsburgh. Patient eligibility data had been falsified at one of the approximately 500 sites in the National Surgical Adjuvant Breast and Bowel Project under Bernard Fisher, a professor of surgery at the university's medical school. The study showed the less-disfiguring lumpectomy procedure to be as effective as the more radical mastectomy surgery in many cases of breast cancer. According to reports, NCI officials first learned of the data problems in 1991, but failed to take action until 1994, after intense media coverage and congressional hearings. At that time, the 75-year-old Fisher was forced by NCI to step down as head of the project, despite the fact that statistical meta-analyses performed by both Fisher and the institute showed that the overall results were unaffected by the disputed data. Broder was criticized by some observers for failing to address the Pittsburgh problems promptly enough and by others for dealing too harshly with the well-respected Fisher when he did act. Scientists and patient advocates cite these controversies and others as contributing to Broder's opting to leave NCI. "He's had a very rough time with all the advocacy, between AIDS and breast cancer," reports Nancy Brinker, founding chairwoman of the Susan G. Komen Breast Cancer Foundation in Dallas. "No matter what you do, there's somebody there to bark at you." Brinker, for example, who counts herself among Broder's allies, is nonetheless sharply critical of him for his actions in both the mammography recommendations and the Pittsburgh case. "I openly disagreed with [Broder] about the way Bernard Fisher was handled, and we had words about it," Brinker recalls. "For Fisher to put 50 years of his life into an endeavor, and then to be brought to his knees over something that never changed the results one way or the other is a real shame. Maybe things weren't done quite as carefully [as they might have been], but there was no reason to take him out publicly and hang him. I also did not agree with the way the screening issue was handled. "But as much as I have those positions, there are those who would adamantly disagree and therein lies the problem [for Broder] of trying to govern in that atmosphere." "I can't believe that the experience with the Pittsburgh breast cancer adjuvant study wasn't a terribly traumatic and unhappy one," says Samuel C. Silverstein, chairman of the physiology and cellular biophysics department at Columbia University College of Physicians and Surgeons and president of the Federation of American Societies for Experimental Biology (FASEB). "[Broder] did just the right thing. I would defend to the very last his decision. He behaved responsibly and courageously, and the scientific community ought to speak up for that kind of administrative leadership." A continuing hemorrhaging of top scientific talent from NCI, too, has contributed to an impression of troubled times at the cancer institute, difficulties that some scientists assert are at least partly traceable to its leader. Among those who have left in the past few years are Stuart Aaronson, former chief of the laboratory of cellular and molecular biology, Richard Adamson, former director of the division of cancer etiology, Peter Howley, former chief of the laboratory of tumor virus biology, and Daniel Ihde, former deputy director. Some of the positions vacated have remained unfilled for some time. According to Broder, a number of leading scientists have chosen to leave NCI recently because they all came into government service at about the same time. They are thus all reaching the government's 20-year retirement age at about the same time. He describes the departures as something akin to a natural process of renewal. "There were a lot of really smart people, good people, dedicated people, who came to go to work for the government in the late 1960s and early 1970s, and their career time spans are now such that they're ready to leave," Broder says. "It's time for the next generation." But there are suggestions sometimes conflicting that life for NCI scientists under Broder has not always been easy. Some former NCI scientists describe Broder as a director unwilling to take counsel who became increasingly isolated in his position. "Broder was a relatively young but highly intelligent guy when he came in," recalls one former high-ranking NCI researcher, speaking on condition of anonymity. "He seemed to be quite articulate and would have been somebody that I thought would do something positive intramurally. But he really wasn't somebody that seemed to take an interest in getting advice from anybody, and he became isolated pretty quickly. The net effect was that the leadership level wasn't really what I would hope the place could have." "He's got a lot of personality," observes George R. Martin, who was scientific director of the National Institute on Aging (NIA) until November 1994, when he joined the biotechnology startup FibroGen Inc. in Sunnyvale, Calif. "If he doesn't get his way, he screams and yells. He doesn't accept responsibility, and so he passes it on to his subordinates. I can't believe he's much loved by his people." Martin notes that, as part of NIH director Varmus's effort to reinvigorate intramural research, a committee of outside scientists has been appointed to review the NCI program. The results of the review may not be flattering to the NCI, Martin suggests, although he adds that Broder inherited a difficult situation when he took over the institute. Like others, Martin praises Broder's work on AZT. "I've had a few screaming matches with him myself," Swanson says. "But he never stops listening. He'll try to convince you that he's right, he'll try to change your mind, but he won't stop listening. And that's a real plus." Broder, too, sees himself as somewhat isolated in his job, although he describes it as, perhaps, a necessary part of any leadership position. He recalls the adage that the captain dines alone at the table with his officers. If a person is properly fulfilling the duties of a job like that of the NCI director, he or she will become the target of a certain amount of criticism, Broder believes. Partly for this reason, it is important that the position be reinvented periodically, he says: "I believe very strongly that a job like the head of the NCI or the head of the NIH, these types of high-level jobs should be self-limited. I believe in voluntary term limits, if you will, and I think six years, roughly, is just about the outer limit." Martin, who was scientific director of NIA for six years, from 1988 to 1994, agrees with Broder: "These are large, administrative jobs with a large, administrative load. My own feeling is that someone like myself shouldn't stay in it more than six or seven years. By that time, you start to accumulate mistakes, and it takes the next person to come along and clean up the problems and take over." "I believe in cycles of renewal," Broder adds. "In order to do the job of director of the NCI, to make the difficult decisions that need to be made, [a person] has to be driven by what is right for the total program and what is right, not just expedient, for the long term. And that really can only be done if the job is self-limited, because otherwise you can convert it into a balancing act, an administrative tour de force as to how to survive in the prevailing political winds." One aspect of political life Broder clearly will not miss is the rite of congressional hearings, whether to defend the annual budget or answer an irate representative's charges of administrative ineptitude. "I'm looking forward to the next time I see a congressman or a congresswoman," Broder says. "They'll have to call me 'Sir.' " The position of NCI director is a difficult one and not likely to be easily filled, scientists say. "I can think of many reasons that that job is not satisfying," Swanson says. "And, frankly, I can't imagine who would want it. There's an outstanding search committee that's been set up but I don't imagine they're going to have an easy job." "There is no advice you can give a successor," Broder says. "Whatever man or woman comes in to do this job will have a new set of circumstances, new realities. To paraphrase Mark Twain, the only thing that I can advise them is, do the right thing you'll gratify some people and astonish the rest."

Broder's Surprise Departure From NCI Reveals Strain Of Government Service

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