First published April 9, 2015.
Dr. Holland has devoted her career to making sure that cancer doctors pay appropriate attention to their patients’ pain, anxiety, and depression. This was not always the case. When she began practicing medicine, she notes, “Oncologists would say, ‘We’re too busy trying to cure cancer [to focus on a patient’s suffering]. If we cure it, they’ll feel fine.’ ”
Dr. Jimmie Holland. (Photo Credit: Memorial Sloan Kettering Cancer Center)
“I grew up on a cotton farm near a little town called Nevada, Texas,” notes psychiatrist Jimmie Holland, 86. “At a young age, I used to say I wanted to be a doctor, and people thought that was a little crazy, but they put up with it.”
It’s a good thing they did: Dr. Holland would go on to establish the subspecialty of psycho-oncology, the discipline that focuses on the emotional needs of cancer patients. Her concern for patients’ mental well-being—at a time when physicians took little notice of how patients were reacting to the stresses of their illness—was to develop into a medical field that has made a difference in the lives of thousands of patients.
Back in the late forties, not many women got to be doctors (hence her family’s notion that she’d be a little crazy to try). At Baylor College of Medicine, Holland was one of three women in her class; most of the young doctors-to-be were veterans just returned from World War II.
Holland discovered the field that was to be her element at St. Louis City Hospital; she was doing a rotating internship on the assumption that she would go back to Texas and practice primary-care medicine. “But when I got into psychiatry, I found it fascinating how people respond to suffering—their emotional responses and their coping ability,” she says. “How one copes makes a difference in terms of outcome, so I got more and more interested in that side of it, and the only way to pursue that was through psychiatry.”
Holland did the last part of her psychiatry residency at Massachusetts General Hospital, at a grim time—the tail end of a major polio epidemic, the year before the release of the polio vaccine. She was dealing with the needs of patients, paralyzed from the neck down, who were destined to spend the rest of their lives in an iron lung. “We had 20 iron lungs that replaced a big ward of beds,” she says. “Studying patients in that acute situation solidified my interest in this new area of psychiatry called “consultation liaison psychiatry”—now called “psychosomatic medicine.”
When Dr. Holland moved to Buffalo, she met, and married, oncologist James Holland, Chairman of Medicine at Roswell Park Memorial Institute. Those were the days—the early 1950s—when having cancer carried such a stigma that patients were not told their diagnosis. It was a time when doctors were so busy treating the disease that they paid little attention to how patients were coping emotionally. So Dr. Holland set up programs for the medically ill who had psychological problems at the teaching hospital there, “and the rest is history.”
That history includes the establishment of the field of psycho-oncology (the journal Oncology’s website calls Dr. Holland the field’s “central founder”). In 1977, when she began the psychiatry service at Memorial Sloan Kettering Cancer Center in New York, she says, “I started what I loved and I have been doing it ever since.”
Today, Dr. Holland, who for eight years was Chair of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan Kettering Cancer Center, holds the Wayne E. Chapman Chair in Psychiatric Oncology, the first endowed chair for this area of medicine. She is the founding president of the American Society of Psychosocial Oncology (APOS) and the International Psycho-oncology Society (IPOS)
Her research began in a National Cancer Institute cooperative group, the Cancer and Leukemia Group B. James Holland was chair of the national group of medical oncologists. In 1976, the National Cancer Institute told the group that it would have to become multidisciplinary; it needed to add surgeons and radiation therapists to the group. “I said to my husband, ‘Well then, you should add psychiatry, because it’s high time we doctors are able to see what people think and feel when they are treated by clinical trials,’” she declared. “Oncologists would say, ‘We’re too busy trying to cure cancer. If we cure it, they’ll feel fine.” I said, ‘You look at their urine, their feces, their blood, but you never say, “How are you feeling?” We need to be looking at that too.’ That idea had started way back in Buffalo.”
Next page: How psycho-oncology works
I was diagnosed with breast cancer at 45 (no family history, premenopausal,young kids at home). Had my mammogram (“clear”) 8 months prior; but my extremely dense breast tissue prevented the cancer from being seen. The cancer (3.5 cm—about an inch in diameter) also didn’t show on a mammogram the day after I found the lump while doing a breast self exam, which basically saved my life. Bilateral mastectomy, early menopause, lymphedema, weight gain of 40 lbs. I would have given anything to have someone with whom my husband, my children, and I could talk about our feelings and how to deal with the unwelcome changes to our lives, but regular counselors just had no idea how to deal with a cancer patient. I wish a program like this had been available at my hospital. MSK patients: you have a fabulous resource!
Bravo to this great (and I use this word sparingily) woman! Dr. Holland is a true inspiration for all women!