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CONFERENCE CALL INTERVIEW
CHARLES BOYD, M.D.
March 15, 2005
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MR. METZGER: This is Charles Metzger interviewing Dr. Charles Boyd for the Southwestern Chapter Society of Nuclear Medicine history-gathering effort. Dr. Boyd, how did you first become involved with Chapter leadership?
DR. BOYD: I first became involved with the Chapter through the efforts of the chairman of my department at the University of Arkansas, who was also a Chapter member. He prompted me to join the Chapter and to run for a place on the Board in the mid-1970s.
MR. METZGER: What are the highlights of your time with the Chapter? What makes you most proud?
DR. BOYD: I think it was the length of it makes me most proud. I was involved early with the Board of Trustees and eventually as the President of the Chapter. I continued with National leadership and was active and attending meetings throughout. I think the continuity and the length of time of involvement was the most important thing to me.
MR. METZGER: All right. Are there any disappointments, failures, disasters that come to mind during your leadership years?
DR. BOYD: Well, I do remember a meeting that we had to change the venue suddenly, and that was a little bit of a problem for everyone concerned. At various times I've been concerned with the program committees, particularly trying to get people from Arkansas, so I was involved in the programming of a number of meetings. I remember that one was almost a disaster, but we were able to move the meeting to another venue. So, no, not really. No major disasters.
MR. METZGER: Okay. Well, who are some of the most memorable people you've come in contact with?
DR. BOYD: I think the vivid memories I have are in the early years when at least I was new to the Chapter, and probably the person that singly comes to mind most prominently, is Tom Haynie. There were many others who were very important, too, that prompted me to be encouraged and continue with the organization. Fred Bonte became a friend as I invited him to Arkansas as a consultant. Let's see. John Burdine, and I think probably Tom Haynie stands out in the early days in my memory as most prominently in the Chapter.
MR. METZGER: Many people have responded the same. There's a lot of appreciation and affection for Dr. Haynie. What do you think is special or unique about the Southwestern Chapter?
DR. BOYD: Probably -- probably the size and intimacy of the associations. I think it is not so small that it can't generate a good deal of scientific interest, maybe even a little competitiveness; but it's also small enough that I think most people have become acquaintances, if not friends, and that includes all levels of the administration, the physicians, technologists, scientists, and even the business end. I think some of the people that supply pharmaceuticals, and the companies, the commercial people, have also become not just in it for business but also to help and promote the field and have become friends, and I think that size of it has been an outstanding characteristic of the Chapter for me.
MR. METZGER: It's very interesting. Paul Murphy said the same thing, you know - not too big and not too small. What made me think of that is this year could be almost too large, you know. The interest in the meeting and the number of people that have preregistered is amazing.
DR. BOYD: It is amazing as we think nuclear medicine is on the decline, but the meeting gets larger and larger. I think we're wrong in those assessments.
MR. METZGER: Right, and I do want to ask you about the future direction, but first, irrespective of Chapter involvement, what are some highlights of your own practice of nuclear medicine, and you know, feel free to go as far back as any sort of residency recent history.
DR. BOYD: I was actually trained in internal medicine, and during my residency when nuclear medicine was in its infancy, my mentor did thyroid disease. …and so, we used radioiodine, and then I had an army career that lasted about eight years and got out and decided I wanted to do nuclear medicine prompted pretty much by that previous experience. So I went to the University of Michigan for fellowship, and there I met several people who subsequently became prominent in the field, Gerry DeNardo, Mile(ph) Lieberman, John Keyes, just quite a few people who went through there and also encouraged me. …and then I decided to become an academician and went into medical school as a professor and became a full-time nuclear medicine practitioner. The growth from the early times when I was at Michigan subsequently were just phenomenal, and I just never even thought of leaving the field. It was an amazing growth. Dr. Beierwaltes was the chairman at Michigan.
MR. METZGER: I know Tom Haynie came from there. Were you there concurrently?
DR. BOYD: I just missed Tom but we were friends and through that association became friends. There were so many people who came through there. It's an amazing number.
MR. METZGER: Yeah. I think it was Dr. Bonte who was talking about how -- from that institution in Michigan and then the University of California, I guess in Berkeley - that those were sort of the original trees or whatever as far as educational institutions that planted a lot of seeds, sent a lot of people out.
DR. BOYD: In our Chapter -- Marty Nusynowitz is another one, Bill Allen. I can't remember if Ralph Gorten went through there or not, but let's see, Tom Haynie. That's all the chapter members I can think of who went through there.
MR. METZGER: So who was your mentor at that point in internal medicine?
DR. BOYD: Beierwaltes at Michigan, and then I went to the University of Arkansas. That's where Glen Dowerapple was the chairman, and I became the chief of nuclear medicine.
MR. METZGER: Okay, and so what year were you there in Michigan?
DR. BOYD: '68 to '70.
MR. METZGER: Okay so in '70 that's when you were full-time nuclear medicine in Arkansas?
DR. BOYD: That's right. And I continued that academic career for 18 years and then went into private practice, and I've been in practice for about 16 years.
MR. METZGER: So you've seen things go from, you know, I-131, thyroid scans, and, uptake, therapy --
DR. BOYD: That was it. There was nothing else.
MR. METZGER: You mentioned excitement that sold you to get involved fully in nuclear medicine. Was it just the ability of nuclear medicine to so effectively treat thyroid cancer or was there a sort of vision of future uses?
DR. BOYD: I think all of that. I think that some of it fit with my personality being interested particularly in mechanical and electromechanical things. I was excited by that.
I was also interested in that we dealt directly with patients, particularly the thyroid patients. That's subsequently become less evident, but I enjoyed the patient care aspects since I had been in internal medicine and liked that. That has continued, and I always promoted that among our residents, that they needed to talk to the patients and find out why we're doing studies, and to help them not just for the sake of the study but for the purpose of its medical implication; and I thought the excitement, its growth, its potential were just amazing, and it was certainly borne out.
MR. METZGER: Yes, it has. So I wanted to understand the beginning years there. You've seen it all basically.
DR. BOYD: Yeah. I've seen it since the very beginning.
MR. METZGER: Were there some studies, directions, paths that you took that dealt with new technologies that were highlights for you?
DR. BOYD: Yes. Starting from the work I had done in research at Michigan, I continued that and then the radiopharmaceutical area, particularly for gallium, became a very important part of our practice at one time. I was a representative at Oak Ridge for development of gallium as a clinical tool, and that was a very exciting time for me to go to a place like Oak Ridge and participate in something that was both basic and the beginnings of a whole new field and see it develop. You could just see these things on the horizon developing and there was just no end in sight, so a very exciting time for me was the radiopharmaceutical development. That was my primary research interest, in fact. I subsequently did monoclonal antibody research with a sabbatical in England and knew that that was going to become a great thing. I kind of ran out of resources and wasn't able to continue it financially at our institution, but that was also a very innovative and wonderful time that's also proven to be a fantastic direction for nuclear medicine.
MR. METZGER: All right. Oh, I had a question earlier. Oh, Howard Glenn is a past president, Ph.D., who was with Abbott Laboratories back at Oak Ridge you know, doing some of the earliest work with the radiopharmaceuticals, and he said there might have been two pharmacies. I guess we're talking late '50s or something like that. But, you know, when he started there may be two pharmacies that were, you know, actually involved with dispensing radiopharmaceuticals that he would go around the nation trying to promote that sort of thing but it seemed that radiopharmaceuticals were sort of overlooked. There was a lot of talk about the physics side of things, and, of course, the medical side of things, but no one was getting too involved in the radiopharmaceutical development side of things.
DR. BOYD: Right. I think we were kind of stuck on the chemistry of the isotopes themselves and what each of those could do, and I think the pharmaceutical end of that equation got neglected. But obviously, had the greatest potential of all, and certainly Howard Glenn was a superb person in promoting that, and he was another person that was very inspirational to me as part of our Chapter. I think he was President several years before I was, and I got to know him through the program committee and things like that. He was a tremendous -- had a tremendous effect on nuclear medicine.
MR. METZGER: All right, and, you know, tell me -- a number of our past presidents have been to Oak Ridge. You know, John Hidalgo was, like, a consultant, and would go for a few days every couple months or something like that, and others would go for a short period of time. Tell me about the duration of your time there and what was the objective. You're the first one I've asked this of. I know that others have been there, but was it just for some initial exposure. Now, you said there was more going on.
DR. BOYD: Well, Oak Ridge had a primary goal of research and radioisotopes certainly since they had the nuclear people -- a corps of people who were extremely knowledgeable and physicists and chemists, and they developed some things that were innovative. In doing some basic research, the one that I was involved in at least found that gallium was localized in tumors, and it just suddenly became a flare that here's an isotope that maybe we can do something besides thyroid tumors with radioiodine, and here's maybe one of the first radiopharmaceuticals or radioactive materials that we can use for tumor development. So they developed a committee of people from nearby and around the country who would be interested in developing this as a research clinical tool in their institutions in order to effect a more rapid development and get clinical material into people's hands. They just perhaps innocently but obviously very intelligently developed a great group of people who could handle research protocols that were scientifically valid. And we all got together occasionally to go over the results, and they would present the accumulated results of this, and over a several-year period of time it came up with a very valid scientific exploration of one of the first radiopharmaceuticals for tumor localization and even therapy, although that didn't pan out to work, but it was a wonderful innovation on their part to have this committee work on a project that got people from around the country to cooperate, and it was -- it was very enticing and exciting, and we could hardly wait to get there to see the results of what we were doing. We were all doing scans, and they'd send out the isotope, and it was fairly free. We didn't have to spend much money on it, and they got a wonderful project that I think advanced nuclear medicine tremendously, and they quietly go about their business, I'm sure, even today.
MR. METZGER: Thanks for that perspective, just understanding how that worked a little bit better. So you would conduct the studies as well as others all around the nation and then get together periodically at Oak Ridge?
DR. BOYD: Yeah, periodically. I think about twice a year. Two or three times a year.
MR. METZGER: All right. Well, any other highlights you'd like to mention?
DR. BOYD: Regarding the development of nuclear medicine?
MR. METZGER: Yeah, that or your own practice.
DR. BOYD: Of my own practice, I've tried to incorporate nuclear medicine into an imaging section. That's probably one of the first ones in the country to have an imaging section that included nuclear medicine, ultrasound, and CT, and subsequently MRI; and we developed fellows who actually did all of those, I think, fairly successfully, and we have several fellows who came through our program who have become fairly prominent in the radiological practice and research. That was kind of a highlight for me in my career of developing that integration of an imaging section. I think the practice of nuclear medicine outside of an academic institution was another highlight for me that I thoroughly enjoyed going back to patients, back to being a consultant for physicians and not teaching so much, but both those aspects were extremely important for satisfaction in my career. I enjoyed both of those equally well.
MR. METZGER: All right, and you retired how long ago?
DR. BOYD: I actually still work some. I retired about six years ago formally, but I continue to work part time, and even now I work a few days a month to fill in when people are on vacation.
MR. METZGER: All right. Well, I'd love to hear your perspective about the future of nuclear medicine, but also address, if you would, the declines, when, I guess, brain scans were lost to CT and maybe what we hear about the DMGs, diagnostic medical groups, and then Medicare, and these sorts of threats to nuclear medicine, and yet it persists. I think probably six years ago things were looking kind of glum and then PET comes out and it's a brand new world, but if you could kind of look at your experience of the past declines, and then a look forward would be great.
DR. BOYD: Well, I agree. I think there have been some times when things have declined and probably in many instances appropriately so. Some tests can be more easily done, more accurately done, cheaper, and they should substitute for the older ones that are not quite as effective. I think the basics of nuclear medicine, the integration of the chemical form into cellular processes both on a gross and microscopic level give it a unique characteristic that it has the ability to adapt to changing needs, and as we see new tests develop, we need to move on to ones that would be more effective. I don't feel bad at all about losing brain scans to CT. I think CT is obviously better, but nuclear medicine can do some things that CT can't, and we just need to keep that in mind and keep moving forward with the innovations, and that's why, to me, research in nuclear medicine is so important. It's just not a clinical practice where you do an X-ray and you go to read an X-ray. It has to be thought of in a continuity of chemical processes, and I think it has probably a virtually unending prospect for development if we'll support the research. That's where we'll fail, I think, if we don't support research in nuclear medicine. We just can't read scans and be satisfied with looking at a bone scan and how many lesions are there. We've got to look at the radiopharmaceuticals and promote the research end of it. The practice is important and fun, but I think that the research is the savior of nuclear medicine, if it needs to be saved at all, and I think that's where we should put our emphasis and our teaching and money. I think the government should recognize that research is that important and not just for the field to survive but for medicine to progress.
MR. METZGER: Right. All right, and the future of nuclear medicine, are there any specific technologies or pharmaceuticals or even hopes?
DR. BOYD: I think it's the self-innovations and the people who work in the field are going to see directions that need to be taken and that the uniqueness of the nuclear reactions and detectability and its therapeutic implications will take care of itself. We just need to not give on it because somebody says, “Well, we're going to replace that with this.” There are lots of things that we can do, and it may change our lives, but as long as we adapt to them, nuclear medicine has a great future.
MR. METZGER: All right. Well, I did think of the another question. That was when we interviewed Russ Norman. He was back there in the early days, and he mentioned how much the equipment manufacturers were sort of driving the development of nuclear medicine in the early days.
DR. BOYD: Absolutely.
MR. METZGER: You recall it like that too?
DR. BOYD: Absolutely.
MR. METZGER: And now it seems like it's almost more the pharmaceutical.
DR. BOYD: It is the pharmaceutical. After the Anger camera and all of its variations have come around, there have just been sort of details added to that, but the development has really been, I think, massively in radiopharmaceuticals. It's interesting, but it hasn't done that much since Anger did his development. That was remarkable, but in pharmaceuticals it's been even greater, I think.
MR. METZGER: All right. Well, anything else to add?
DR. BOYD: No. I appreciate the opportunity to give you some of my of my thoughts about the Chapter. I think that the Chapter has been a very important part of my life in developing professional and personal friendships through the Chapter. It's been exciting. It's been a grand time. Places we've been, people we've met and interacted with have just been remarkable. The work that has been done. I've been on program committees for the National and been on the -- been on the Board of Trustees, National organization, and I think that integration of the chapters with the National is an exciting organizational benefit for the National, but I think that the Southwestern Chapter is -- is well thought of, something to be proud of that we -- we've done a good job. We haven't been the largest or not the smallest, but we had excellent programs and an attitude in the Chapter that promoted nuclear medicine and its integration into medicine very well, and I think it's been a very effective chapter, and I'm very proud of it.