Who is Dr. Ralph Moss?

In his own words on the 28th anniversary of his career as a science writer:

Ralph W. Moss, Ph.D. Weekly CancerDecisions.com Newsletter #40 06/18/02

An Anniversary

On June 3, I marked the 28th anniversary of my career as a science writer. Back in 1974, Richard Nixon was still president and I was an energetic idealist with a freshly minted Stanford PhD. Although I had a lovely family, I hadn't yet found my life's calling. Teaching at the college level left me dissatisfied. Since my early years I had wanted to write for a living. But I lacked a focus.

One day I heard about an opening for a job as science writer at Memorial Sloan-Kettering Cancer Center. The "war on cancer" was under new leadership, and Sloan-Kettering was looking for "bright young minds" to help in the fight.

I decided I had the enthusiasm for the job, and so I applied. The head of the public affairs department gave me a chance to prove my worth: he asked me to write an article for the employee newsletter. I spent the weekend with scientific reprints and Stedman's Medical Dictionary open on the dining room table. The result was my first foray into medical writing.

This fledgling effort earned me a much-needed two hundred dollars and an employment interview with Lewis Thomas, MD, the president of MSKCC. This was like a young acolyte being summoned to meet the Pope. Dr. Thomas was not only a distinguished immunologist but the author of breathtaking essays on biology in the New England Journal of Medicine. It was from him that I had discovered how good science writing could be. (A collection of his elegantly crafted essays, titled "Lives of a Cell," later won the National Book Award.)

What a disappointment that meeting was! Instead of matching my enthusiasm, he stared vacantly through a haze of pipe smoke, resigned to the chores that kept him away from his writing. Sad to say, after I was hired, he was no friendlier. He would not even return my "good morning" in the elevator. I took this personally until I heard two secretaries discussing his condescending rudeness. I was learning that heroes often have feet of clay.

By contrast, Robert A. Good, MD, PhD, president of Sloan-Kettering Institute, was compulsively outgoing and gregarious, the Hubert Humphrey of science. His face had been on the cover of Time and he was widely rumored to be in the running for a Nobel Prize. He had a penchant for unusual ideas and served as mentor to physicians who would later become some of the most prominent alternative practitioners, such as Nicholas Gonzalez, MD, and Charles Simone, MD.

What pride I felt as I first rolled my Memorial Sloan-Kettering stationery into my IBM Selectric and signed my name at the bottom. The world suddenly treated me with a heightened respect, a reflection of the institution whose glory I borrowed. I had discovered what happens when you align yourself with a powerful institution. I was euphoric. I didn't yet see the downside.

Officially, my job was to write one article per month for the center's newsletter, as well as various press releases and the research section of the annual report. But I soon discovered that the position held responsibilities that were not included in my job description. My first assignment was to investigate the background of one of Sloan-Kettering's doctors, William Summerlin, MD, who had recently been fired for perpetrating a research fraud. He had claimed that he could transplant tissues between unrelated individuals and, to support his claim, had Magic Marker-ed blotches of black "skin" onto the backs of white mice. A technician uncovered the fraud by rubbing the rodents' backs with a swab of alcohol.

It was feared that Dr. Summerlin was going to implicate top officials in this canard. My role was to phone Summerlin's previous employers and (to put it in plain English) "dig up dirt" on him. I obediently took up this detective work, little realizing that I might someday be the object of similar scrutiny.

I was also handed a hefty folder of unanswered letters from the general public about unconventional cancer treatments. On the front, in big black letters, someone had block-lettered "PSHAW." Initially, I thought that this was Sloan-Kettering's collective judgment on alternative treatments, until I learned that it was the first initial and last name of my predecessor, Phyllis Shaw.

The folder grew even thicker with questions, suggestions and diatribes concerning cancer. The public wanted an outlet for its opinions on the war on cancer, but the prevailing view at Sloan-Kettering was that the answers would come only from professional scientists. We were obliged to humor the public because it paid the bills, but we weren't expected to take their opinions seriously.

Although this was how I was indoctrinated, I had inherited from my father an interest in human nature and I enjoyed listening to various speculative theories of cancer. Luckily for me, so did my boss, and he encouraged me in this direction. One woman tried to convince me that cancer could be cured by drinking water that ran beneath a pine forest. She offered to send me some. There were various weird theories about gamma rays and the like. About half the letters concerned a substance derived from apricot kernels called laetrile, then much in the news. People demanded to know why we weren't testing or using what they called "vitamin B17." Our scientists scoffed at the notion.

On my lunch hour, however, I browsed through the local health food stores, devouring literature about alternative cancer treatments. It was through reading these enthusiastic tracts that I first learned about the world of alternative cancer treatments. My office bookshelf filled up with works on laetrile, the Hoxsey herbs and the Gerson diet.

In the land of the blind the one-eyed man is king. I knew very little about these treatments but those around me knew even less. The average scientist knew nothing at all. So I became Sloan-Kettering's majordomo of alternative treatments.

Until 1976, Americans had no federally funded Cancer Information Service to provide answers to their questions about cancer, and public inquiries to cancer centers got catch-as-catch-can answers. Many calls to MSKCC were forwarded to the public affairs department, and I became their de facto "answer man." Soon, MSKCC's telephone operators had notes taped to their switchboards stating that "calls about alternative medicine go to Dr. Moss." Over the next three years I answered hundreds of such calls, listening sympathetically to patients' experiences and problems and offering ad hoc advice when it seemed appropriate. Mainly I listened.

A Trip To Tijuana

In the spring of 1976, I slipped away from a scientific meeting in Anaheim, California, and drove on my own to Tijuana, Mexico, to visit the Cydel Clinic. This was the Mecca of the laetrile movement. Incognito, I met with Dr. Ernesto Contreras, Sr., and was struck by his kindliness. My favorable impression of him was diametrically opposed to his portrayal in the US media as a predatory quack. The clinic was like the man, a serene oasis in a world of toxic conventional treatments.

I also talked to some patients who seemed to have been helped by the treatment. One "terminal" patient told me that this natural therapy had relieved his intense pain, which he likened to "someone twisting a knife back and forth in my throat," within a matter of days. "I'd like to take an ax and smash up the FDA," he said, expressing such intense hatred for the federal government that his words seared my brain. Violent emotions! But I found it hard to argue with the rights of a terminally ill patient to receive any reasonably nontoxic treatment of his choice.

In New York, I had a standard form letter saying that laetrile had been proven worthless. Imagine my astonishment when I found out that our most experienced researcher, Dr. Kanematsu Sugiura, had found that laetrile decreased the spread of cancer in test mice! Suddenly, my cozy work world, with its collegial lunches and Christmas parties, started to collapse around me. I was not only surrounded by fundamental dishonesty but was rapidly being dragged into it as an active participant. My son, who was 10, said to me, "You cannot go on working for them and against them forever." Indeed, I could not. In November 1977, I was fired after holding a press conference to discuss the topic of laetrile at Sloan-Kettering. Well, that is a story for another day.

Times have changed. Today, the US government puts $100 million per year into the evaluation of treatments that were scorned as quackery 25 years ago. It has been my pleasure, for the last ten years, to play a role in that process as an advisor to the National Institutes of Health. Most surprising to me personally, in May 1999, I was invited to give the Grand Rounds lecture to the Department of Surgery at Memorial Sloan-Kettering. How strange to walk those corridors once again and, surrealistically, to be applauded by the very institution that had padlocked my files and had me escorted out by armed guards decades before.

What lessons have I drawn from my 28 years as a science writer? Once we start to shape our writing about science to accommodate the wishes of doctors, patients or institutions, rather than the facts, we are sure to end badly. We must always speak to cancer patients with a finely balanced mixture of compassion and honesty. Finally, we must always demand a fair evaluation of all treatments, conventional and alternative. Only on a level playing field can the true value of any cancer therapy be determined.

Cancer Decisions

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