I had the honor of presenting the SNO Lifetime Achievement Award to Charles Byron Wilson, M.D. on November 22, 2008. Unable to attend the presentation were two of our beloved past presidents, Ab Guha and Ed Shaw. Ab was hospitalized in California in preparation for a bone marrow transplant and Ed was home with his ill wife. I decided to put my presentation and some of the pictures I collected on the SNO website so they and others who either missed the presentation or wanted to learn more about Dr. Wilson could have an opportunity to do so. The words that follow as well as the pictures formed the basis for my talk, however, I got carried away by the moment and neglected part of the talk and some of the pictures. I hope you enjoy this step back in history.
Victor A. Levin, M.D.
After completing his residency at Tulane, he joined the faculty briefly before becoming assistant professor of neurosurgery at Louisiana State University Medical School from 1961 to 1963. This also marked the beginning of an illustrious teaching career by winning the Best Teacher Award in 1963. That same year he moved to Lexington and established the Division of Neurosurgery at the University of Kentucky. While there, he pursued his increasing interest in malignant gliomas and developed laboratory and clinical research programs. In his laboratory studies, he started treating tumor-bearing rats with chemotherapy agents. With CSF physiologist and neurosurgeon, Edgar Bering, organized the Kentucky Conference on Brain Tumor Chemotherapy in 1965. The goal of the meeting was to develop a strategy for the treatment of malignant brain tumors. Also, while at Kentucky he received both the Outstanding Clinical Instructor and Outstanding Clinical Professor. He then was named professor and chairman of the Division of Neurosurgery at the University of California, San Francisco in 1968. In 1970 he established what would become and internationally respected Department of Neurological Surgery that he chaired skillfully until he retired as chair in 1995. Following his chairmanship, he obtained an MPHA degree to pursue health care issues within UCSF and later with a private consulting firm. He continued to operate until 2004.
I believe that the accomplishments of Charles Wilson at UCSF over a period of more than 20 years are the basis of the SNO Lifetime Achievement Award. It is well known that chemotherapy for malignant gliomas in the United States started at a number of institutions in the late 1960s through the NIH-sponsored Brain Tumor Study Group that was composed primarily of neurosurgeons. While the Clinical Chemotherapy Service at UCSF started as part of the BTSG endeavor, it would grow and transcend most other efforts around the country. At its outset, it was a team effort of neurosurgery, radiation oncology, neuropathology, nuclear medicine, neuroradiology, neurology (EEG), and nursing. For Charlie, the clinical chemotherapy program was not a free-standing program as much as it was an integral part of the large Brain Tumor Research Center (BTRC) at UCSF. The BTRC was initiated in 1968 under the joint direction of Wilson and former Division of Neurosurgery chair Edwin Boldrey, but was guided from its onset by the vision and leadership of Charlie Wilson.
In 1970, 90 patients were registered for treatment on the Clinical Chemotherapy Service; by 1974 250 patients were enrolled on protocols. I joined the BTRC in 1972 and began to see patients about 1973. My efforts allowed Charlie greater time in the operating room, for residency training, and for department administrative activities and enabled the Clinical Service to expand. By 1976, we were seeing more than 200 new patients each year for chemotherapy and radiation therapy. In 1974 I became Assistant Director of the BTRC and in 1977, became Chief of the Chemotherapy Service and Associate Director of the BTRC for Clinical Services. With Charlie’s support and encouragement, help of BTRC investigators, and help from Darrel Bigner, Mike Walker, and Jim Swenberg, the Asilomar Conference on Brain Tumor Research and Therapy was born and the first meeting held at Asilomar Conference Center in Pacific Grove, California in fall of 1975. The Conference has continued every two years as the International Conference on Brain Tumor Research and Therapy.
In 1972 the BTRC was funded by an NIH grant that by 1979 would lead to the first brain tumor Program Project Grant that continued as PO1 and SPORE support continuously since under the current Department of Neurological Surgery chair, Mitch Berger. By 1976, the BTRC had a professional working force of 31 full-time staff and 26 actual collaborators. BTRC researchers were able to report limited success with chemotherapy of the most common malignant brain tumors, glioblastoma and medulloblastoma. They had published the initial reports showing the efficacies of BCNU and procarbazine against malignant glioma. The clinical arm of the BTRC had identified the multidrug protocol combining procarbazine, CCNU, and vincristine (PCV) as a highly effective treatment - the first drug combination effective against brain tumors.
I remember the 1970s and 1980s as very exciting times. UCSF turned out to be an ideal, if not pivotal location, for Charlie Wilson to develop his dream. UCSF was becoming a major world focus for molecular and genetic research. It was full of entrepreneurial spirit as faculty at UCSF leveraged their science to create new biotech companies in South San Francisco and communities east and south of San Francisco. The School of Pharmacy ascended to become the most granted Pharmacy School in the country. Clinical Pharmacology became a legitimate medical pursuit and UCSF created the first Clinical Fellowship program. Partially as a result of the atomic bomb and nuclear fallout research, the Departments of Radiobiology and Radiation Oncology together with the Lawrence Berkeley Laboratories and Lawrence Livermore Laboratories were at the forefront of new and exciting radiobiology, bioengineering, and biomedical research. UCSF also had superb neuroradiology with Hans Newton and David Norman. The Department of Neurological Surgery also had Bill Hoyt, a world class neuro-ophthalmologist, as part of faculty.
Everywhere you looked you found first class programs training some of the best young minds of the times. Scientific achievement and entrepreneurism spilled out everywhere. As a result, BTRC investigators had unprecedented opportunities collaborative research and intellectual exchanges that led to a feeling of optimism that we were on the road that would lead to an ultimate triumph over the devastation from brain tumors. This rich environment and the willingness of Charlie Wilson to attract to his Department of Neurological Surgery a wide range of scientists made the development of the most robust brain tumor clinical chemotherapy program, one of the most innovative radiation therapy programs, and a strong collaborative and multidisciplinary laboratory research program. And in that environment Charles Wilson through astute leadership, the example of hard work and dedication to patient care, good faculty hires, and the pursuit of excellence built a program base that would impact the field of brain tumor therapy for decades.
Charles Wilson led by example. He did not miss laboratory research meetings even if he had to break from a surgical case. As you might guess, that meant that he had to have very good neurosurgery residents, which he did. He also never missed the academic afternoon of neuroradiology and brain tumor conference. His example was steadfast. He always encouraged us to move ahead, try the new, create the new, and attempt whatever you thought you could accomplish. While failure could occur, it should not prevent trying again. He also encouraged us to always remember who we were and where you came from and to be modest and support others as we moved forward in academia. And oh yes, you had better learn how to write well.
Dr. Wilson is a charismatic, scholarly, dedicated, and energetic leader and surgeon. He has contributed significantly to medical science and trained a large number of neurosurgeons who continued his tradition of excellence in patient care and investigation of nervous system disorders. He has received numerous awards and honors and has been the Wilder Penfield Lecturer, the Herbert Olivecrona Lecturer, and the R. Eustace Semmes Lecturer among others. He held the first Tong-Po Kan Professor of Neurosurgery. He has published more than 500 articles and chapters. In giving Charles Byron Wilson the Lifetime Achievement Award, the Society for Neuro-Oncology honors him for his foresight and strong support for research into the treatment of primary brain and spine tumors and for enabling and encouraging so many young scientists and clinicians in the United States and abroad to carry this work forward.