Apparently, sometime in the spring of 1962, I reached the apex of my academic career. I don’t recall that moment, but it did not go unnoticed by a classmate in the Maine-Endwell school district in upstate New York, a student named Clement Richard Boland, who would earn his bachelor’s degree at Notre Dame, his MD at Yale, and then embark on an award-winning career in medical science. He was most recently the recipient of the Lifetime Achievement Award by the Collaborative Group of the Americas on Hereditary Colon Cancer.
I met up with Rick Boland last fall at our 50th high school reunion. I had a few war stories to share. Boland had a book to share: “Cancer Family: The Search for the Cause of Hereditary Colorectal Cancer.” A few weeks ago, on vacation in sunny Barbados, I got some time to catch up on my reading, including my high school classmate’s book.
A memoir of Boland’s academic and professional path, it goes back to his early education, including that 1962 junior high graduation:
“There were 250 students in my junior high school class. After finishing ninth grade we would merge with students throughout the consolidated school district . . . There was a ritual graduation, and they read aloud the names of and grade averages for the top 10 students. We all knew there was one boy-genius in the class, Richard Rein, and he was a substantially better student than the rest of us. The night before the graduation, Dad asked me if my name was going to be read the next day. I had no clue, and told him I didn’t think so. . . .
“We all sat down for the event, and they read off the names. Top average, Rein, of course. There was applause, and he went forward to pick up his award. They then said: ‘other high averages were . . .’ and there it was, ‘. . .Clement Boland.’ Second place, but a long way from Rein. This totally took me by surprise. I thought I had misheard the principal. It was most important since Dad was there. I didn’t want to disappoint him. Maybe there was hope in life after all.”
So there it was: The apex of my career (though I remember none of it). I do know that sometime soon after that I pretty much took my brain off the throttle and cruised through high school, struggled in college, and turned my energies to the less rigorous, but possibly more expansive, world of journalism.
Boland, on the other hand, was just igniting the after-burners.
By any standard my classmate’s research area is important. Colon cancer still kills almost 50,000 people a year. Routine colonoscopy screenings, recommended for most people starting at the age of 50, have dropped the incidence of the disease and would drop it even more if more people underwent the test. On February 8 of this year the 52-year-old president of Cornell, Elizabeth Garrett, announced she had colon cancer and was cutting back her workload. On March 6, less than a month later, she died.
Important by any standard, but much more important by Boland’s standard. His book is called “Cancer Family” and the cover shows a Boland family portrait from about 1927. If cancer took the form of a person, it would be in the front row. Boland’s great-grandfather died after being operated on for colon cancer in 1895. His grandfather developed colon cancer at age 27 and died at age 45 of a second cancer in the lower colon. His father, a pediatrician, survived colon cancer at the age of 25, but died of a second colon cancer just before turning 50.
Numerous aunts and uncles also battled cancer, particularly colon cancer. Yet no one in the family discussed the disease until my high school classmate entered the medical profession, determined to discover the cancer’s familial connections, come up with a way to detect its threat early, and cure it.
My ninth grade science — apparently genius level in some eyes — does not enable me to keep up with the intricacies of Boland’s genetic research. But even I can marvel at the inside look at the discovery process and the pitfalls and challenges along the way.
As Boland notes, regarding another scientist’s attempts to get a paper published in one of the professional journals: “New concepts can be hard to sell. The editor of Cell rejected the paper on the grounds that he thought the paper did not have sufficient mechanistic evidence to call this a new ‘pathway to tumor development, which was not actually a reflection of the reviews.” The author was furious and sent the editor a profanity-laced E-mail. The editor responded by telling the scientist he should probably never submit another article to the journal. The researcher, in turn, suggested “that the editor stick his journal in a safe, warm, personal hiding place. He showed me this E-mail exchange, but propriety prevents me from reproducing it here word for word.”
Later Boland ran into the same researcher. In a conversation about their research efforts, the other scientist suddenly accused Boland of stealing his idea.
“His comment was totally nuts and he quickly realized it,” Boland writes. “I realized the close finishes and his fear of losing priority on microsatellite instability [a feature of a tumor that indicates loss of a critical DNA repair mechanism] had been hard on him. . . I genuinely respect his intellect and learned a lesson about keeping perspective on the issues of competition and cooperativity in science. He felt as though he had been burned a few times, and it had eaten up a piece of his soul.”
Boland and other researchers continued the quest to unravel the traits of this hereditary cancer, known as Lynch Syndrome.
“In May, 1993, we got our first glimpse into what was previously a dark mystery, and the story unfolded in an astonishingly rapid fashion. The pace of discovery was accelerated by the love of science, old-fashioned competition, overheated egos, and the desire to attract attention. Some of the discoveries were serendipitous; others were hammered out with the use of elegant thinking and scientific discovery,” Boland writes.
“Each time we thought we understood the story, something new would emerge to complicate the concepts we thought we understood, and we had to think and learn new things. As each new concept seemed to clarify itself, something new and disruptive came along as the next chapter.”
By 2001 Boland was finally able to identify the exact strain that was causing the disease in his family. A test was developed to detect the presence of the mutant gene. The test was administered to Boland and his three siblings. Two had it, two didn’t. (Boland does not disclose who has what to protect the privacy of the next generation.) “This was it,” he writes. “We had just moved from the era of assuming into the era of knowing.”
For those who have the gene the diagnosis means, among other things, colonoscopies as often as once a year, beginning at age 25, “with very careful removal of all polyps,” Boland writes. “As you might imagine, we shared a lot of colonoscopy and colon prep jokes in the family.”
Unlike the group in the family photo on the cover of his book, Boland’s extended family today is doing much better. Of the 27 cousins on the Boland side, 20 are still alive and well at a median age of just over 60. “This disease looks very different in the 21st century than it did in the 20th.”
Sitting alone on the balcony of my hotel in Barbados, I flip through the book and notice an inscription: It’s in a physician’s scrawl but I think it says “To the smartest guy in the room — every time.” At the moment there is no one to argue with Boland, a pretty smart guy himself. The trouble for me is that this vacation solitude won’t last forever, just like ninth grade.