Oncology, Etc. – Mr. Paul Goldberg: Interviewing the Interviewer (Part 2)

ASCO Education

Drs. David Johnson (University of Texas) and Patrick Loehrer (Indiana University) host the second half second half of their Oncology, Etc. interview with Mr. Paul Goldberg, the editor and publisher of the world-renowned publication The Cancer Letter. In part two, Mr. Goldberg talks about literary works he has developed outside of The Cancer Letter, his perspective on the Russian/Ukrainian conflict, and more.

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TRANSCRIPT

Dr. Pat Loehrer: Hi, I'm Pat Loehrer, Director of Global oncology and Health Equity at Indiana University. I'm here with David Johnson, a medical oncologist at the University of Texas Southwestern in Dallas, Texas.

This is the second half of our two-part Oncology, Etc. A conversation featuring Paul Goldberg, who's the editor of the prestigious oncology publication, The Cancer Letter. While, part one focuses more closely on Mr. Goldberg's early life - his introduction to writing and ecology and his work with The Cancer Letter - in part two, we're going to learn more about the literary works of Mr. Goldberg which are developed outside of The Cancer Letter. We'll also learn about his insight into the Russian Ukrainian conflict. We'll pick the conversation back up with Dave asking Paul about the most important changes he's seen in oncology throughout his career.

Dr. David Johnson: What changes in oncology have you seen that have been most impressive in your mind, apart from therapeutic advances? What other changes have taken place that you've witnessed in your role as editor of Cancer Letter that you think really made a difference?

Paul Goldberg: I think there's a lot less of this kind of, I have more friends now than I've ever had before, maybe I'm just getting old and I like a lot of people. There were a lot of people that I did not like early on. For me, culturally that's a difference. I think a lot of people are thinking along the same lines. There's a language of oncology. There's an understanding of the importance of clinical trials. People are arguing about whether to randomize. It wasn't that long ago that people were wondering about whether that's even a good thing.

You mentioned Rick Pazdur. I don't know if it rises to the level of being able to say that I coined the term but the language of oncology, to some extent, is Pazdur-esque because he has gotten everybody on the same wavelength, and people do understand what it takes to get a drug to develop most of the time.

So, that would be my first observation. There’s less to argue about the fundamentals. And also, a lot of the kids I came up with are now cancer center directors.

Dr. Pat Loehrer: In one of the friendships, I think it's been really strong has been you and Otis Brawley was crucial. You guys wrote a book together. And I think part of that book, which was very interesting was the title says, First do no harm.

There are a lot of things we do in medicine that we think we're doing well, but yet, by over-testing and overtreatment, we actually don't, in the long run, help the patients or help society.

Tell me a little bit about that. You're not working on this project without us on the history of oncology. And so, the perspective of that and what are some of the most interesting historical stories that you know about?

Paul Goldberg: I think he just at one point at one of the NCI meetings might have had something to do with NSABP, he started explaining to me, the NIH Reauthorization Act of 1993, and how women and minorities’ language was bizarre in there, and the definition of minorities and definition of race.

So, here's this guy who is explaining stuff to me, which I wouldn't have really slowed down to think about because journalists generally don't slow down to think about things unless you tell them to, at least I didn't at the time. And then I said, well, this guy has been explaining stuff to me and I've been explaining stuff to him occasionally. So, it's been going on and we've been talking probably, give or take, once a day for 30 years or so.

That produced the book and the book was really funny, the first book with him. We were both wondering, where do we begin? And then I said, well, why don't we just begin with the older mastectomy? You know, the spontaneous mastectomy of a patient and he said, yeah, let's do that. So, it was like, I knew his story with which to begin. It was that kind of weird, but it was kind of fun.

Dr. David Johnson: Whose idea was the book? Was it yours or his? Was it a joint decision?

Paul Goldberg: We had been talking about that for maybe 20 years prior. And then at one point, it was very obvious because my agent even said, I think your friend and you should write a book. I think the time is now. Then I called Otis that day. But that's not a rare occasion and asked Otis to write the book and Otis said, yeah, it's time to write the book. So, we decided that we would do it.

Dr. Pat Loehrer: After 20 years, you jumped on it?

Paul Goldberg: Yeah, it was exactly like that.

Dr. David Johnson: Paul, this is a silly question. Do you actually write or do you dictate?

Paul Goldberg: I write.

Dr. David Johnson: Do you manually write or do you type?

Paul Goldberg: Yes, I type on the computer. I absolutely do.

Dr. Pat Loehrer: What do you do, Dave?

Dr. David Johnson: I actually write. I'm not a typist. I do the two-finger thing, you know?

Dr. Pat Loehrer: Yeah, I write out and then I'll type, but I write with a pencil.

Dr. David Johnson: Yeah, that's what I do as well. That's really old-fashioned.

Paul Goldberg: The young people I work with think it's pretty hilarious that I don't type correctly. But that's just not my bottleneck. My bottleneck is thinking. It's not typing. So, I'd never really learned to type properly.

Dr. David Johnson: So, you've written a lot about a wide array of different subjects. I mean, you have pointed out at the beginning, that you've written some fiction, some very successful books, it seems I came across something that you wrote on the internet. I thought it was kind of interesting, and I knew nothing about it. But you wrote a piece entitled, why every progressive should read The Good Soldier Svejk.

Paul Goldberg: Yeah, that is me.

Dr. David Johnson: I had no idea about The Good Soldier, Svejk. Maybe you could tell us about this.

Paul Goldberg: Yeah, it's kind of the fundamentals of Eastern European humor. It's also the fundamentals of all humor. It's also the fundamentals of, I would have to say, catch 22 is really impossible without Svejk.

It's basically a loosely structured novel. It's set in Prague. Svejk is the Czech national hero, kind of the Don Quixote of Prague, especially Prague. He tells old stories of, well, what it really comes down to is that he is conscripted into World War One. And he either is a complete idiot or he pretends to be a complete idiot. And that makes him a very sane person in many ways.

So, it's kind of like only a madman could survive this. But the beauty of this is that we've never really learned that he is really an idiot. And actually, he does say this, I have the honor to report that I'm a complete idiot.

So, his adventures are absolutely hilarious, and before he is conscripted, he catches dogs and sells them and just takes a mongrel dog and turns it into a terrier, by painting it black and chopping off half of its tail, that kind of stuff.

So, my mother started reading it to me, preparing me for life in the Soviet Union before there was a chance to get out. My first reading of Svejk was totally age inappropriate. And politically somewhat inappropriate. It's not an illegal sort of book. It's allowed, which is sort of a joke in and of itself because, in a totalitarian state, a book like Svejk has bragged more dissent than Bush can, who is also...

Dr. Pat Loehrer: Let me ask you this Paul, just because you brought it up and to bring it more timely to what's going on, now give us a little insight into what you think mothers and children are talking about, not only in Ukraine but also in Russia right now with this invasion that's going on? What are some of your thoughts, whatever your concerns, and just ruminate a little bit about what is in your mind?

Paul Goldberg: I keep thinking about 1968 in Moscow, in August 68, when Soviet tanks rolled into Czechoslovakia. I was nine years old, but boy I just sat down and listened, I was glued to the radio, basically listening to the voice of America and others, but I didn't know a single person who really supported that.

It's this deep feeling of shame and there's no way to hide that from anybody, children, or whoever, which is also right. At that time, actually, my mother was reading Svejk to me, which is a very appropriate book for 68. I think she started before that but here as an independent state and our leadership has decided to send tanks.

I can tell you that in 1969, during the Hockey Championship, I routed the Czechs so much. I mean, the Czech were us, they weren't them, Americans were us too. So, I was rooting for the Americans, but the Soviets beat us. But when the Czechs won against the Russians, that was the happiest day of my life, and I was like, not quite, 9.

So, it's an incredible feeling of shame and we all grew up with that. And right now, there are children all over Russia who are growing up with it. I don't know anybody who voted for Putin. I know a lot of people in Russia. Nobody I know. Maybe I never ran into anybody like that. It's just not us. It's them.

So, I guess I might as well just sort of, I grew up among the Moscow intelligence act. So, if I grew up and we had a small provincial town, maybe, definitely the feeling would be very different in the provinces over.

So, it's also, like, I'm listening to Zelenskyy speak and Russia and to the Russian people. His Russian is so much better than Putin's because Zelenskyy has read many books and Putin may have read one that was written under his name. These are the fat-faced idiots of the new nuclear bureaucracy. It's really shameful, really shameful.

There is no difference, really, that I know of between my friends there, and my friends here. Not even in age. Actually, as part of my historical stuff, I met two of the participants in the demonstration on Red Square in 1968. And I knew them fairly well, so actually, just very recently, it's my audio archive of interviews with Soviet dissidents of that time. Say, I didn't really deliberately put together that archive, I put it together to write a book but there it was, and still is.

Yeah, it hasn't changed from 1960s. It's just that there are more people, more outrage, and it's not going to go well for anybody. But Putin is one of the people for whom it's not going to go well because in Ukraine, you might be able to take Kyiv, but you're not going to be able to hold the whole of Ukraine. No way. These people are, I mean, these people my brothers culturally.

Dr. David Johnson: You wrote a book entitled, “The Yid”.

Paul Goldberg: Yeah.

Dr. David Johnson: Tell us about that. Is that from this experience that you had had?

Paul Goldberg: Slightly different, I have just finished the book that's from that experience. That's the one I've just turned in. It's called the dissident and that's coming out next year. But Yid was an interesting project for me.

I was a kid and in Moscow hanging out with my grandfather, and his various friends and my own friends, and they all spoke Yiddish, but they were all Red Army veterans. So, they're these old Jewish guys walking around with my grandfather, talking about what happened in 1943. Telling stories like, well, I took two machine gunners and we went through the swamp for three days. Then we found ourselves in the center of Leningrad, that kind of stuff.

It was just truly amazing. So, I started thinking of a way of imagining something that Stalin actually did plan to do, which was to deport all Jews. It was a kind of a holocaust that he was planning of his own. And I thought, well, what would these guys have done?

So, I wrote the comedy about Stalin's death. It begins with KGB and NKVD trying to arrest an old Jewish actor. My grandfather was a pharmacist, he was not an actor, but he did give that guy our apartment or communal flat in the center of Moscow. So, he kind of got arrested in that place. But the problem is that the arrest doesn't take place the way they usually do take place. Ths guy kills three NKVD.

Dr. David Johnson: To protect his hero he does sort of almost Spider Man-like, given your…

Paul Goldberg: Yeah, small swords number which he develops on stage. So, and then I actually, also weirdly, I was very lucky that part of my material is that my aunt comes from a very famous Jewish Intelligentsia family. And in fact, her grandfather started the Moscow Hebrews Theater, which became now the National Theatre of Israel. He was sort of a very major ethno-musicologist.

Her maiden name is Dobrushin, and that was one of the Moscow Yiddish theater playwrights. So, I was able to kind of hear the stories of my aunt telling me the stories about having seen Solomon Mikhoels, and after his trip to America, the legendary things, and they put it all together into this novel, imagining a kind of alternative history. But really, Stalin did die when Stalin died. It's just that they changed the mechanism of his death, and it's a comedy. So, it's kind of a Yiddish comedy.

Dr. David Johnson: You also wrote a book entitled, “The Chateau”, but this was more contemporary, I think, right? What was the inspiration for that book, which takes place in Florida, right?

Paul Goldberg: Right. It was my stab at Florida realism. Actually, what I did was, the characters are all fictional, and the protagonist is a journalist at the Washington Post, a little bit of a nebbish, not a little bit but very much a nebbish, gets fired for insubordination at the Washington Post, then goes over to try to write a book about his college roommate who dies mysteriously.

So, it's kind of a murder mystery. It's a kind of Florida realism. In the end, it's kind of a kleptocracy story about condo boards, which was really in America at the time. And the timeframe is right before Trump's inauguration. So, it's like Trump supporting the Soviet Jews. There's the sort of a din of, “here it comes”. And it was an interesting book to write.

I don't think I ever want to write a current - and I will write a nonfiction book - but I don't want to really write anymore about something that happens now. My model for that was Turgenev it was Fathers and Sons, so I planted it in Florida and kind of played on my fantasy of what it would be if my father was not anything like my father actually is.

Dr. Pat Loehrer: Before we wind up. Can I ask you a quick question? This comes from one of our viewers or one of our listeners. I remember when I was first dating, I would get really sweaty and nervous just calling up who would eventually turn out to be my wife. I would get that same feeling years later when I was calling a babysitter to see if she would go to take care of our kids. But the third point of terror is being interviewed by you and The Cancer Letter, and you would get sweaty palms and get really nervous. What advice would you have for someone who's being interviewed?

Paul Goldberg: I'm not a ferocious person. I just ask questions like you just did, actually, it's very strange but I wouldn't even know how to be anything but polite. Well, there are situations where you probably wouldn't want to take my calls. But you know what those situations are.

So, it's completely sort of like, not an issue. I have more friends than I have enemies by a factor of maybe 1000. It really shows, I don't think I've ever like screwed up in that way of just going after, this was the one case where I really screwed up. But this was very early, this would have been very early in my career. And now I would have just figured it out very quickly and said, oh, what the hell was I doing?

But no, I mean, I have so much respect for the people who do this work and for both of you. I have so much respect for people who serve ODAC or NCAAB, or the President's Cancer Panel, and any of these incredible groups. I have so much respect for the cooperative group system for the methodology of clinical trials. I mean, you start messing with the methodology of clinical trials. Yeah, you're gonna get me on. It wouldn't be pleasant. But you would know you're doing it.

Dr. David Johnson: I think we all agree that you've done a wonderful job of helping our field advance in so many ways, uncovering some things that aren't so good and helping us correct those mistakes. I personally want to thank you for that. I know Pat feels the same way.

Paul Goldberg: Thank you. I think I get entirely too much credit for The Cancer Letter, but it's not really been just me for a very long time. Right now, we also have the Cancer History Project and my co-editor on that is Otis Raleigh. Then The Cancer Letter operations are run by Katie Goldberg, who also happens to be my daughter, but she is also the illustrator.

Katie is the inspiration really for all the operations and she's working with Mona Mirmortazavi who's also very, very talented. On my editorial side, Matt Ong has been here for eight years. And he knows his way around oncology. Many people have dealt with him in many stories. And then there's Alice Tracy, who is an engineer, also a writer by training, and she is just a journalist with incredible talent.

Then there's, of course, Alex Carolan, who is working with the Cancer History Project. She's the staff for it. And then, of course, the web designer, David Koh, and the graphics designer, Jackie Ong. It's a big crew. It takes a lot to produce The Cancer letter and it's also really a blast.

Dr. David Johnson: One final question for you. We've asked all of our guests. We've talked a lot about your writings and your books, but if you read something recently that you could recommend to our listeners or perhaps a documentary that you've seen that you think is worthy of our time, what would you recommend to us and to our listeners?

Paul Goldberg: Well, I'm just gonna reach for a book that’s sitting in front of me right now, The Man Who Sold America. It's a story of Albert Lasker and the creation of the advertising century.

It's very interesting because one of his creations was Mary Lasker, who created the National Cancer, and it took her a while to figure it out but he taught her. He was long gone by the time this was done, but without him and the mirrors that were erected, and he taught her how to erect those mirrors and how to make it happen.

It's kind of a story of lies, lies, and lies, but then, human genius gets in there, the methodology gets put together, and everything starts happening. I mean, when they got started in this field, and this is not the book, but everybody would have a monoclonal antibody and everybody was laughing at people that had monoclonal antibodies, you know, immunology, yeah, right. Whom has Steve Rosenberg ever cured? Human genius stepped in.

Dr. David Johnson: I just clicked on Amazon to have it sent to me. It should be here by tomorrow afternoon.

Paul Goldberg: It's an interesting book about a guy with bipolar disorder, who does a bunch of weird and brilliant things.

Dr. David Johnson: Paul, thank you so much for your time this afternoon. It's been a real blast to have this opportunity to chat with you.

Paul Goldberg: Well, thank you. I'm sorry if I was being nonlinear.

Dr. David Johnson No, we appreciate your nonlinearity. Let me take the moment now and thank our listeners for tuning in to Oncology, Etc. This is an ASCO educational podcast, where we will talk about anything and everything. If you have a suggestion for a guest, you would like us to interview, please send your suggestion to [e-mail]. Thanks again. And remember, Pat is not a Russian dissident.

Dr. Pat Loehrer: Thanks, Paul. It was terrific having you, and Dave, not so much.

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