Presentations

Mary Woodard Lasker: First Lady of Medical Research

Delivered by Neen Hunt, former President of the Lasker Foundation, at the National Library of Medicine on December 13, 2007.

Thank you and good afternoon. It is a great pleasure to be here among friends of the Lasker Foundation, key supporters of medical research, medical practice and the health sciences, and citizens with a deep interest in health progress. Thank you for the opportunity to talk about the life of Mary Woodard Lasker. It was a life so well lived, and as once said, as important to human health as Harvard is to American education.

Therefore, it is curious to find little mention of Mary Lasker in my review of scholarly works about great women of the 20th century. Of course, justifiably so, there is much devoted to the lives of Eleanor Roosevelt, Marie Curie, Mother Teresa, Golda Meier and even Oprah Winfrey. But Mary Lasker is arguably the one American citizen who has made the greatest contribution to the progress of human health since the dawn of modern medicine.

Therefore, the Foundation is grateful to the National Library of Medicine for featuring Mary Lasker on profiles of science, assured that this will increase recognition for this extraordinary lady.

Mary was part Joan of Arc, part Madison Avenue socialite, and part Hillary Clinton. Robert Moses, the great city planner, once said about Mary that she had it all—intelligence, vision, generosity, charm, kindness. I might add that she also had courage, passion, and indefatigable energy, and the heart and will to apply her gifts and talents to reduce suffering from disease for people all over the world.

Most of us live our lives by experiencing and sometimes promoting incremental change. However, there are people who are the Copernicus of their day—who place their hands on a key lever that results in transforming the world. Mary Lasker was one of these people.

Her personal war against disease created a "Kuhnian" paradigm shift in expectations for the role of the federal government in providing support for medical science. Through generous philanthropy, aggressive advocacy, unparallel leadership and strategic lobbying, she led a revolution in the medical research enterprise. Utilizing her wealth, charm, beauty, grace and intelligence, Mary focused the attention of the nation's most powerful leaders on medical research and its promise for improved human health.

The list of Mrs. Lasker's honors, national and international, in grateful appreciation for her efforts, fills pages. They include the Presidential Medal of Freedom and the French Legion of Honor. In 1984, Congress honored Mrs. Lasker by naming a center for her here at the NIH: the Mary Woodard Lasker Center for Health Research.

When she received the Congressional Gold Medal in 1989 from President Bush, she accepted with these words: "The strength of our nation depends on the health of our people. We must once again place the priority on research. It's good for trade, good for jobs, and vital for all Americans. Medical research is our hope for our children and for the building of a healthy America." Is it any wonder that she is immortalized as the First Lady of Medical Research?

Mary came east as a well-educated young woman from a small town in Wisconsin. She inherited her life-long interests in art, natural beauty and health from her Irish mother. We learn that "the apple doesn't fall far from the tree" when we hear the story about her mother, in the early l900s, persuading Consolidated Edison to put smoke consumers on their smokestacks to reduce the smoke and dirt in New York, an innovation at the time. Con Ed considered her mother to be a terrible menace, setting the standard for Mary when she pursued her own advocacy campaign.

Mary's mother, ever the citizen activist, also developed two parks in her hometown in Wisconsin. Mary, like her mother, remained deeply interested in urban beautification projects throughout her life, perhaps believing that nature's splendor has healing powers: the delicate beauty of a rare tulip could help the wounded mind. Like her passion for medical research, Mary's commitment to and patronage of urban beautification represented an extraordinary dedication. She persuaded Mrs. Lyndon Johnson, as First Lady, to sponsor a national program to beautify America, which remained a priority for Lady Bird throughout her life.

Mrs. Johnson refers in her book, A White House Diary, to "Mary Lasker's gift of 9,300 azalea bushes, flowering dogwoods and other plants along Pennsylvania Avenue, and 800,000 daffodil bulbs planted in natural drifts along the banks of the Potomac."

Thanks to Mrs. Lasker, through the Foundation's Salute to the Seasons program, 300 donated cherry trees blossom every spring at the United Nations, and lighted Christmas trees decorate Park Avenue every winter, while each spring the Park Avenue malls in New York City continue to be flowered by the most exquisite and rare tulips, some imported from Holland.

With her first marriage ending in divorce, however, Mary married the handsome and brilliant Albert Davis Lasker, an advertising pioneer and tycoon, president of the reputable firm of Lord & Thomas in Chicago. Believing that advertising was "salesmanship in print," Mr. Lasker succeeded at making Wrigley's chewing gum, Pepsodent toothpaste and Sunkist oranges household names. He made a considerable fortune, some of which was used to build a fantastic collection of mostly modern art. Mary made many trips to Europe to identify promising artists and to support their work; she was a lover of the impressionists and abstract art, in particular.

I remember being in Mrs. Lasker's home in Connecticut, after she had passed away, and strolling though rooms decorated almost entirely in white —furniture, walls, rugs, and her signature vase of white flowers—and viewing photo albums of the Lasker's art collection of paintings by Renoir, Matisse, Miro, Rodin, Chagall and other now legendary artists. It is hard to believe that Mary purchased a blue Picasso in the l950s for about $900. Before she died, she sold or auctioned off almost her entire collection of paintings and sculptures so that she could give away the money for worthy cause. This is one of the reasons that the Lasker Charitable Trust, which was formed from Mary's estate, has only modest resources. In this respect she was not prescient. If only we had just one Picasso!

Albert and Mary were a formidable couple who enjoyed friendships with the most powerful people in this country. Albert was appointed to head President Harding's Shipping Board in the early 1920s, and the Laskers became friends with many politicians. Their social circle gave Mary access to the Roosevelts, then the Kennedys and the Johnsons, as well as the Clintons. The Laskers also socialized with captains of industry and entertainment celebrities, like Elizabeth Taylor and Jennifer Jones, who lent their influence and resources to support her campaign for medical research.

When Albert died in the early l950s of cancer, Mary leveraged these personal connections, built on her husband's legacy as salesman extraordinaire, and with a vengeance pursued her mission, over the last forty years of her life, to conquer human disease. People who knew her in those days describe a charismatic leader who sought to fulfill her vision for research and human health with missionary zeal, unrelenting persistence, laser focus, and a commitment to the long haul.

People often ask about the source of Mrs. Lasker's deep interest in medical research. We don't know for sure. She readily admitted that she did not understand science, confessing that no one would have her in his laboratory for five minutes. We do know that Mary suffered as a child from several painful maladies: mastoids and other ear infections, the flu and pneumonia. We also know that she was deeply affected by the loss from disease of several dear friends and resented terribly that their afflictions and premature deaths were explained as the "will of God."

Mary used to say that she was opposed to cancer, stroke and heart disease the way that she was opposed to sin. This was her axis of evil and she began her front in the battle against disease by attacking cancer, the most feared killer in the l950s. At that time, if someone was diagnosed with cancer, it was referred to as a "death sentence." Cancer victims often were not told that they had the fatal disease, and families did not dare to utter the dreaded "C" word to even themselves.

Mary, with Albert's support, helped to change attitudes toward cancer from a killer that was too horrible to imagine to a threat that could be thwarted if not conquered. She helped to organize the American Cancer Society, convinced RCA president David Sarnoff that "cancer" could be said over the radio, pressured Reader's Digest to publish a series of cancer-related articles, and lobbied Congress and several presidents to create the National Cancer Institute. In 1971, after what some describe as Mary's "furious lobbying," Congress passed and Richard Nixon signed the National Cancer Act.

Here are the President's words as written in this personal letter to Mary: "I feel that with the procedures set up under this bill, we are now in a position to make a total commitment to the conquest of cancer."

Mary's impatience, optimism, and perhaps naiveté about the virulence of disease fueled the march to war. Obviously, Mary died without having the satisfaction of seeing cancer eradicated from the Earth, and this may never be possible. However, her efforts helped to lay the foundation for the unprecedented progress in biomedical science that has characterized the last 30 years—some say more progress than there has been in the entire history of medical research. Even with her great wealth and her sincere desire to make a difference, how did she do it?

Well, she learned from her rich husband that nothing gets done without money. She used to say that money "buys ideas." She called money "frozen ideas" and believed that brilliant men and women of science could vanquish cancer in ten years if they had enough money to pursue their research.

After donating a great deal of his own money to his wife's cause, Albert said that he could never provide enough resources to win the battle that she was waging. Therefore, with his guidance, Mary turned to the federal government to shame elected officials into accepting responsibility for advancing human health. Fortuitously, her interests emerged at a prosperous time in United States history. It was the l950s and the country's victory in World War II helped it to become a global power. The economy grew and so did the Federal revenues.

Mary began her march on Washington guided by the sophisticated and brilliant lobbyist Mike Gorman and then later by Terry Lierman, and accompanied by prestigious scientists Dr. Sidney Farber of Harvard and Dr. Michael DeBakey, the famous heart surgeon of Baylor Medical School, and her long-time friend Florence Mahoney, who is a legend in her right. Sharing Mary's interest in mental health and birth control, Florence became the unofficial hostess to the health lobby and brought together legislators, policymakers, philanthropists, scientists and advocates.

Mary's goal in Washington was to fundraise for research, but she would say that she was there "to friend raise."

In those days, if you wanted to testify at a Congressional hearing in Washington, you called Mary Lasker in New York.

Furthermore, she was magnificent in the Halls of Congress, able to persuade powerful politicians that the US. government had a moral obligation to reduce human suffering from devastating diseases and painful disabilities. She put in long hours, meeting with legislators and producing from her handbag a folded onionskin chart tracing the rise of the NIH appropriations over the years, and notebooks filled with statistics that revealed that paltry sums were being spent on medical research, in contrast to, for example, what the country was spending on producing chewing gum. One year, the key appropriations vote was held by the late Senator Styles Bridges of New Hampshire. Mrs. Lasker had been cultivating his friendship, and after three hours waiting to meet with him, she convinced him to increase that year's research funding.

Mary's family members, with whom I have spoken—her nephew, step grandson and step daughter in law, say that she had a shy streak and surely would not have described herself as a brilliant public speaker. However, everyone would agree that she had a genius for conveying complicated messages in plain and memorable language to the public, and most importantly to members of Congress who controlled the appropriation bills. She is famously known for her retort, for example, in response to questions from Senators about why the NIH needs more money: "If you think research is expensive, try disease!"

Likewise, she demanded of the scientists with whom she worked, to find ways to talk to legislators about science in words that a layperson can understand. The story goes that in the days when one of the NIH branches was called the Institute of Microbiology, one congressman asked, "Whoever died of microbiology?" The name was changed to the Institute of Allergy and Infectious Diseases, and Mary concluded, and rightly so, that non-scientists resonate with vocabulary that "tugs at the heart strings," and not with technical language. She also was smart to argue that the national investment in medical research was as much about national security as human life, an argument that today's health advocates continue to enhance. Testifying before Congress for more money, Mary commented on the recent death of Secretary of State John Foster Dulles, and then added that for six years the Communists tried every trick in the book to get Dulles out of their hair, and what the enemies couldn't do to him, cancer did. Today the Lasker Foundation continues to employ Mary's strategy to link arguments about the benefits of research to health with evidence of other huge payoffs—for example, the economic consequences for the nation in respect to jobs, tax revenues as the healthy return to work, and reduced costs of home care as disability rates decline.

With her charisma and ample resources, Mary was able to amass an army of health advocates, a new phenomenon in the l950s. Groucho Marx could have been talking about Mary when he said, "Only one man in a thousand is a leader, and the other 999 follow a woman." Philanthropists, kings, presidents, celebrities, Nobel Prize winners, powerful business men, savvy lobbyists, motivated citizens and the most respected professional scientists of her day joined the legions of "Mary's little lambs," and they, in turn, began to lead their own crusades to conquer disease. Today America is thriving with hundreds of influential groups, a cottage industry of spokespersons for millions of patients and their families who are looking to medical research to offer preventions, treatments and cures for autism, Alzheimer's, ALS, spinal cord injury, blindness, and diabetes, among the other cripplers and killers that spread human suffering and premature death. Mary Lasker led the way to these successes.

Most importantly, Mary Lasker helped to created this national treasure—the NIH—a billion dollar success story. Her lobbying efforts helped to increase the NIH budget l50 fold from $460 million between 1945 and l961, reaching $1 billion by the late 1960s and then $11 billion by l994; and Mary's advocate descendants took it from there to boost the budget to its current level of almost $29 billion. The NIH has funded a revolution in biology and medical care that accounts for the global leadership in medical science that the United States enjoys today, and the NIH remains the envy of the world. There is nothing like it on the planet in terms of magnitude and reach, with the power to affect health and well being for people everywhere. Mary Lasker never had children of her own, but she "gave birth" to the NIH and nursed it to maturity.

It is fair to say, though, that Mary and her "noble conspirators"—as they were referred to in a cover article of the June l967 Atlantic Monthly—had critics and skeptics among smart and powerful people who disagreed with her research priorities, blamed her for taking science in the wrong direction, resented that a lay person could influence science policy, and argued with her about her supposed wisdom that money buys ideas. She often sparred with the highly respected James Shannon, the Director of the NIH from l955 to l968. The debate about investing NIH resources to prevent cancer by developing vaccines, or to treat cancer by perfecting chemotherapies, is one area that came under acute criticism. In l955, influenced by Lasker advocates, Senator Hill—over the objections of many scientists—pushed the NIH into a massive program of cancer chemotherapy. A special committee, which studied the NIH in l965, reported that the program had begun on too large a scale, based on too little scientific data. 'The availability of money," it said, "exceeded the availability of sound ideas."

Despite the critics, Mrs. Lasker never lost her focus and never tired; and loyal and powerful friends, and citizen believers in the promise of science, often blunted the criticism with praise for her. Here is Lyndon Johnson: "There are a number of thoughtful people with a role in health policy who are apt to become highly exasperated with Mrs. Lasker. But then they remind themselves of the contribution that she and her group have made." One government official deflected criticism of Mary by saying, "People get so mad at her and they say that Mary Lasker is almost always wrong. In fact, she has been almost always right. Her instincts are very correct." And even the critics had to recognize that innovative progress had occurred because of the prodding by Lasker advocates to try novel treatment courses, to open new fields of research around aging and mental illness, and to forge collaborations within the pharmaceutical industry to speed drug development and delivery.

Mary understood, I believe, that there is no gain without risk, and so she was willing to "push the envelope" of ideas about new preventions and treatments, and to personally finance promising research directions…for example, on interferon—a natural protein— which led to an antiviral drug to combat some types of cancers. She admired and allied with scientists who were daring, and in her words, "had the guts" to innovate. Perhaps it is this spirit of reasonable but bold and creative risk-taking which is her greatest legacy.

Mary's beauty, wealth, and social and political connections made her a force to contend with; and she was not content to aim these "weapons" in the battle against disease on the rich and powerful. She recruited professional scientists as soldiers. Mary not only understood that Albert's money would amount to seed funding for the research enterprise and therefore that it could only be sustained by steady government funds; but she also realized that in order to develop public support for research that spokespeople for health had to include men and women of science who were willing and able to speak to the public and to lawmakers about research progress, and the promises and opportunities for better health, longer life and the eradication of disease.

One of Mrs. Lasker's protégés was the then young heart surgeon, Michael Ellis DeBakey. His singular achievements as an ambassador for research and medicine are a testament to Mary's talent as a tutor in the craft of public advocacy. Dr. DeBakey, now 99 years old and still active, is the best known representative of medical science around the world. His face has graced publications as popular as Time magazine and as specialized as the Journal of Cardiology. In so many of my conversations with Dr. DeBakey, he has made a point of crediting Mary with the multi-dimensional trajectory of his career— a career characterized by brilliant science but also by statesmanlike advocacy at every level of government, by successful mentoring of promising students to pursue his noble profession, and by effectively educating the public about medical research progress and its health benefits. Dr. DeBakey won the Lasker Clinical Medical Research Award in l963, and later chaired the Lasker Awards Jury for 30 years.

In spite of her shyness and despite her elite circumstances, Mary made a virtue of getting beyond the cage of privacy, making civic connections. She understood so profoundly that we are social creatures and that we can have an extraordinary impact on large problems by marshalling public support for our ideas. To increase public understanding that funding for cancer research could lead to amazing discoveries, Mary enlisted the help of a close friend, Eppie Lederer.

Eppie authored the popular syndicated newspaper advice column "Ann Landers." She reached out to her faithful readership by calling for citizens across the nation to flood members of Congress with letters of support for the war against cancer. And one of Mary's great lobbying achievements was to persuade the NIH to establish advisory councils comprised of laypeople as well as physicians and scientists to oversee the overall direction of research. She created a culture of participation in the specialized world of science and helped ordinary citizens to conclude that they, too, could have some influence over the future of their own health—a trend line that has accelerated since the arrival of the Internet and other communication technologies. In this respect, Mary was prescient!

Mary also learned how to raise awareness on a national scale from Albert, whose fortune was made, in part, by promoting the slogan—L.S.M.F.T.—Lucky Strike Means Fine Tobacco.

His success as a businessman increased the number of smokers on this planet, but the story has an ironic twist. Mary funneled his millions into cancer research, and then mental health research, and heart disease, and then stroke, and the list goes on. As importantly, she learned from Albert how to "advertise" the opportunities and successes of medical science to the American people, and how to leverage her personal influence with the "movers and shakers" for public gain. Albert taught Mary the importance of public communication, and she learned well. On his 50th birthday, in l945, she honored her husband with a gift that has become one of the most credible and respected expressions of the value of medical research to human life—the Albert Lasker Medical Research Awards Program, managed adroitly by Mary's only sister, Alice Fordyce, for more than 20 years.

The Lasker Awards are presented annually in basic and clinical research, and every other year in special achievement and public service. Award winners receive a statuette modeled after the Winged Victory of Samothrace, symbolizing victory over death and disease, as well as an honorarium. The Lasker, it is fair to say, is the most respected and coveted medical science prize in the world. Since l946, 136 individuals have received Lasker Basic Awards and 128 have received Clinical Awards. Most of these discoveries have stood the test of time for over 60 years, and have chronicled the most revolutionary advances in medical research and practice, setting the highest bar for creativity. The winners' achievements have extended life and reduced suffering from so many health problems and serious afflictions, including hypertension, cystic fibrosis, cancer, diabetes, meningitis, heart disease, arthritis, schizophrenia, Alzheimer's, depression, paralysis, memory loss, blindness, infertility, hemophilia, and kidney disease, among others. DNA finger printing, CAT scans, MRI technology, cataract surgery, heart valve replacement—each of these discoveries has revolutionized medical practice. To date, 75 Lasker winners have gone on to win the Nobel Prize.

Mary's genius was to establish a world class jury of scientists to decide the recipients of the Lasker prize, which in turn is seen by science professionals as the ultimate nod of peer recognition. She set the highest standard for the Award, and so the prize has evolved as a measure of research excellence and creativity, motivating the very best men and women of science to "reach for the brass ring" in their efforts to eliminate disease. Indeed, every Lasker Award recipient has been engaged in science that has been described by peers as breathtaking, miraculous, exquisite, and beautiful. Each has elevated science to an art—a finely tuned achievement of the seemingly impossible which, like art, offers a whole new way of interpreting reality: Avery, Sabin, Pruisner, Brenner, Benzer, Rusk, Farber, Yalow, McClintock, Varmus, Menninger, Watson and Crick are among the 300 who have won a Lasker Award.

Just as Mary Lasker's journey to further the goals of medical research was characterized by hair-pulling frustrations as well as exhilarating successes, each of the Award winners has an exciting and sometimes tortuous story to tell. Like the intrepid early explorers of the world who risked everything to reach uncharted destinations, great scientists are people of uncommon courage—and not only because they carry out bold and risky experiments that have a high probability for failure, or as Dr. Joseph Goldstein, Chairman of the Lasker Awards Jury, says, "whose works have as much a chance for success as tossing a dart into a heap of spaghetti and hoping it hits a particular strand in a certain spot." The sad fact is that many extraordinary scientists have been vilified by the press, sometimes by their own peers, or often by established institutions for breaking norms and turning convention on its head, for seeing the flaws in accepted ideas.

Robert Edwards, the father of in vitro fertilization, which has helped more than one million infertile couples to have children, had his life threatened out of fear that his science would produce two headed monsters, and anger that he was fooling with Mother Nature.

Barry Marshall, convinced that bacteria and not stress is the cause of ulcers, took a leap to prove his theory that would define his very fate. Defying the medical explanation for the cause of ulcers, Marshall swallowed the H. pylori bacteria to prove to the scoffers and the naysayers that ulcers are not caused by stress, spices or excessive stomach acid.

The Award winners are individuals with profound insight who look where others cannot see—who have a rage to know and a unique idea that defies the wildest imagination.

People like Wilhelm Kolff…[who] studied the engineering of a washing machine in his search for kidney dialysis. In the 1940s he constructed the first artificial kidney to remove the body of toxic wastes—this first dialysis machine consisted of 1,130 feet of cellophane tubing made from sausage casing, wrapped 30 times around a horizontal drum made out of aluminum strips.

The Awards which Mary established 62 years ago continue to serve her twofold purpose to educate and to engage the general public about advances in medical science, as well as to provide a benchmark of superior achievement for research practitioners. The Lasker Foundation enhances the legacy of Lasker as advocate, activist, and educator by honoring not only extraordinary science, but by recognizing individuals for outstanding public service and special achievements that have advanced the health sciences and public health.

The winners of the Mary Woodard Lasker Public Service Awards mostly have been ordinary citizens like Nancy Brinker, who began with $200 working out of her garage to build the Komen Breast Cancer Foundation into a multi-million dollar philanthropy; and elected officials like Paul Rogers, whose relentless advocacy has earned him the title of "Mr. Health" and the devotion of health advocates throughout the country; and celebrities like Christopher Reeve, who worked tirelessly over a decade of paralysis to advocate for stem cell research.

The Foundation was delighted to bestow this year's Public Service Award on one of NIH's own, Dr.Anthony Fauci, for his role as the principal architect of two major U.S. governmental programs, one aimed at AIDS and the other at biodefense.

The winners of the Albert Lasker Special Achievement Award have been successful professional scientists who have gained legendary status as leaders by expanding their interest, reach and influence beyond their laboratories.

They are outstanding and beloved mentors, like Dr. Joseph Gall, honored in 2006, who was an early champion of women and whose own students, like Elizabeth Blackburn, have gone on to make spectacular contributions as well.

They are institution builders, like Dr. Daniel Koshland, honored in 1998, who some say was overlooked by the Nobel committee for his work on how enzymes and proteins function, resulting in key conceptual advances in biochemistry. He was recognized by Lasker because he took it upon himself to remake the entire biology program at the University of California at Berkeley when he spearheaded its reorganization, combining l2 small departments into three larger ones. Koshland worked for ten years, slogging through hundreds of committee meetings, to break down the disciplinary walls in biology at this behemoth of an institution.

The scientists who have won the Special Achievement Award also have had an impact on public policy—like Dr. Matthew Messelson, honored in 2004, for working to prevent the manufacture and spread of biological and chemical weapons during the years of Richard Nixon's Presidency, and to resolve issues of military and strategic importance in the Vietnam War, convincing the powers-to-be to end U.S. herbicide operations.

Like Mary Lasker, the greatness of Lasker Award winners rests in their abilities as visionary leaders and bold experimentalists, doing the unthinkable, turning prevailing assumptions on their heads. Like Mary, they had the courage to follow through on their own peculiar hunches, or unconventional theories, or sometimes serendipitous insights into how to unravel a mystery of the human body, or to meet a challenge in research, or in public policy. Like Mary, these extraordinary achievers demanded unflagging devotion to mission, clarity of purpose, a backseat to ego, wild imagination about the possibilities arising from one's work—and good luck.

Blessed with the good fortune to be facing this new and vast horizon of exploration in medical research, all of us are obliged to find a role for ourselves that will move us closer to unraveling the mysteries of the human body and its interactions with diseases—perhaps through daring research, or as eloquent public spokespeople, as rational voices in policy debates, as effective institutional leaders, as devoted and inspiring teachers, as staunch advocates, as informed voters.

I never had the honor of meeting Mrs. Lasker. She died in l994 at the age of 93 in her home in Greenwich, Connecticut. But I know that if Mary was standing here, she would exhort you to ensure that our local, state and national leaders embrace the belief that science holds great promise for our lives—and that medical science is the certain path to improved human health. She also would assure us that each one of us is capable of making a difference in the lives of people who are suffering from devastating diseases and disabling injures. Perhaps it will be the scientists of the next generation who will fulfill Mrs. Lasker's dream of conquering not only cancer but also the other "cripplers and killers" that she devoted her to life to vanquish. So much work lies ahead to rid the world of these natural enemies. We at the Lasker Foundation hope that we can count on you to play a part.