Barry Cooper (Figure 1) was born on January 22, 1945, in Louisville, Kentucky, and that is where he grew up. His parents had 4 sons, and Barry was the second. One of Barry's brothers also became a physician, and the other two brothers became lawyers. After graduating first in his high school class, Barry Cooper went to Franklin and Marshall College in Lancaster, Pennsylvania, made Phi Beta Kappa as a junior, and graduated in 1967. He then entered The Johns Hopkins University School of Medicine, graduating in 1971. He interned and did his assistant residency in medicine at The Johns Hopkins Hospital and after completion of those 2 years became a clinical associate in the endocrine section of the Gerontology Research Center of the National Institute of Child Health and Human Development of the National Institutes of Health (NIH). After completing that research, he was a fellow in the hematology division of the Peter Bent Brigham Hospital of Harvard Medical School from 1975 to 1977. He then joined the Harvard faculty, where he remained for 2 years before coming to Dallas, Texas, and Baylor University Medical Center (BUMC) in 1979.
Figure 1.
Dr. Barry Cooper during the interview.
Since 1981, he has been codirector of the hematology division of the Department of Internal Medicine at BUMC and also clinical professor of medicine at the University of Texas Southwestern Medical School. During his period at NIH and the Brigham, Dr. Cooper proved himself to be a fine researcher and through the years has published 40 articles in peer-reviewed medical journals. He and his lovely wife, Lynn, are the proud parents of 3 children, one of whom is a physician, another a lawyer, and the third still in college. Barry Cooper is also a great guy, and it was a pleasure having the opportunity to ask him so many questions about himself, his family, and his work.
William Clifford Roberts, MD (hereafter, Roberts): Dr. Cooper, I appreciate your willingness to talk to me and therefore to the readers of BUMC Proceedings. We are in my home on April 5, 2006. To start, could you talk about your early life, some of your early memories, your parents, and your siblings?
Barry Cooper, MD (hereafter, Cooper): Thank you for the opportunity of sharing some of my family events with the readers of Proceedings. I was born in Louisville, Kentucky, in 1945. My parents were Rudey Cooper (1912–1988) and Rosalie Schwartz Cooper (1918–), and I was the second of 4 sons. There was a 14-year span between my older brother and the youngest son in the family. When I was 2 years old, we moved to a middle-class home in Louisville, where I lived until leaving for college (Figure 2). One of my earliest memories is learning to play the accordion when I was 5 years old (Figure 3). I practiced before going to school in the morning and took lessons until I was about 16 years old.
Figure 2.
At age 3.
Figure 3.
At age 6 after starting accordion lessons.
Education was emphasized in our family. Even though my parents did not have much formal education—each only graduated from high school—they strongly emphasized the importance of education to all 4 sons. In fact, they commented frequently that it would be our birthright for our parents to provide our education so that we could make it on our own.
We also participated in a lot of sports. I lived near a public golf course. All 4 brothers thought we were basketball players since we lived in Kentucky. I played on the tennis team at our public high school.
My father started a small smelting plant with another business colleague a few years after I was born. Metals were heated in large furnaces to prepare alloys used by printing presses to make type metal. One of the metal components was antimony. As teenagers, each of the 4 sons worked in the plant during the summers busting up bricks of antimony with a sledgehammer to prepare them for the furnaces. It was very hard work, but it taught us an important lesson. We should fully respect those people who work with their back and their hands. My father always emphasized this point, as well as noting that we would have the opportunity to make a living with our minds rather than our hands.
Roberts: How big was the plant?
Cooper: It had about 12 employees.
Roberts: Did your father's partner stay with him throughout?
Cooper: After about 6 years, my father bought him out.
Roberts: The business was a successful enterprise?
Cooper: Yes. When I was growing up, I never wanted for anything. Of course, I guess at that time we didn't really know exactly what there was to want. One thing we probably did miss was family vacations. As sole owner of the business, my father could never leave for any kind of interval, even a few weeks. So we never took much in the way of family vacations when we were growing up.
Roberts: So Louisville and Kentucky was about it for you until you went away for college?
Cooper: Yes.
Roberts: Did you have extended family in Louisville?
Cooper: Yes. My mother was born in Toledo, Ohio, and shortly thereafter moved to Louisville. Her parents were both from Eastern Europe. They were Jewish, and they both immigrated as teenagers. My maternal grandmother arrived through Ellis Island. Neither she nor my grandfather could read, write, or speak English when they came to the USA.
Roberts: Your mother was a first-generation American?
Cooper: Right. She was the oldest of 5 siblings. One sister died as a child. Most of my mother's extended family lived in the Louisville area. My grandparents moved across the street from us shortly after we moved to our new home. My father was born in Louisville. He grew up in near poverty. He was the oldest of 4 siblings; his brother was 19 years younger than he.
Roberts: He was like a father to his brother.
Cooper: Absolutely. My father was an outstanding student in high school. He graduated third in his class in a large public high school and was an all-state football player. He had the opportunity to go to college on a football scholarship. However, his father never could make a living because of a gambling addiction. My father felt that he needed to support his mom and his 3 younger siblings. He boxed professionally for a while and then drove a truck, buying and selling scrap metal for several years, until he met my mom. Thus, he really had to forego educational opportunities as he was growing up. He never forgot that, and he wanted to make sure that he could provide for his family so that his children would have maximal educational opportunities.
Roberts: Were your father's parents first-generation Americans?
Cooper: No, second generation. Their family also came from Eastern Europe.
Roberts: Do you know where your mother and father met?
Cooper: They met in Louisville through mutual friends. My mom was 18 and had just graduated from high school. My dad was 24. Their courtship lasted about 3 years. They finally gave up trying to save enough money to get married and just got married (Figure 4).
Figure 4.
Parents Rose and Rudey Cooper at their 1940 wedding in Louisville, Kentucky.
Roberts: What was your house like growing up, with 4 boys and your father working very hard? Did your mother work outside the home?
Cooper: No. Our home was our mom's domain. She was fully in charge. She had a reputation as a disciplinarian; my dad referred to her “sugar-coated iron fist.” Mom always emphasized that if we were going to do anything at all, it was very important that we do it right, and that included homework. Yet, there was not only discipline but a lot of love in our family, even with the 4 sons bickering occasionally. While my father was a very shrewd and successful businessman, my mom played the major role in the day-to-day running of the house.
Roberts: Did your father get home for dinner? Was dinner in the evening a big deal in your home?
Cooper: Yes, I think it was a big deal. My dad would go to work very early, at 5:30 or 6:00 am, and he usually closed the smelting plant and was home in the late afternoon. So we generally had dinner together. We would talk about a variety of things—current events, what we did that day, sports, our Jewish heritage. We were not strongly religious even though we belonged to an orthodox synagogue, but we did care deeply about Jewish traditions and culture. Dinner was a time for reflection about events during the day. You just didn't want to sit near the middle of the table where you had to pass all the food from one end to the other.
Roberts: Was there alcohol in your home growing up? When your father came home at night, did he have an alcoholic drink?
Cooper: There was alcohol in the house, and my father drank occasionally when playing pinochle with friends. I don't think he drank very much, and I do not recall my mom drinking.
Roberts: Did he smoke?
Cooper: He never smoked in the house, but he definitely smoked cigarettes. My mom never smoked.
Roberts: What did he die from?
Cooper: He had an aortic aneurysmal rupture, so his death was fairly sudden.
Roberts: And he was healthy before that?
Cooper: For the most part. He was having back pain and trouble with his vision from macular degeneration.
Roberts: How old was he when he died?
Cooper: 76.
Roberts: Did you go to synagogue every week?
Cooper: I did when I was studying for my bar mitzvah. There was an interval then when I was pretty religious in terms of going to the synagogue every weekend.
Roberts: Did your mother and father go as a rule?
Cooper: My dad usually played golf on weekends, but Mom attended synagogue frequently. We always attended as a family on the high holy days. But we were pretty much integrated into the Jewish community. There was also a high school club called AZA at the Jewish Community Center, which was part of the B'nai B'rith Youth Organization. All 4 of the sons participated in AZA, and we were all president of our chapter. Most of us held national office.
Roberts: That was a fun activity?
Cooper: Yes, but it also taught each of us some leadership skills.
Roberts: What was your home like? Were there books or magazines around? Did your father and mother read much?
Cooper: My parents did read a fair amount. Most books around the house were those brought home from school. My parents, however, did read novels and some nonfiction as well.
Roberts: What was your father like?
Cooper: He was a very strong-willed man who commanded a lot of respect. We always listened intently to what he had to say. He was a great motivator. There was a photograph of him in early high school wearing a football uniform; he was a fairly imposing presence. He gave a copy of that photograph to each of his 4 sons when they went away to college (Figure 5). Each of us hung it in our dormitory room above our desk, so if we ever considered slacking off on our academic responsibilities, we would look up and see Dad staring down at us. Now, that was incentive!
Figure 5.
Father Rudey in a high school football uniform; he gave this picture to his 4 sons to hang in their college dorm rooms as a motivation to focus on studies.
Dad also sent a letter every week to each son for 7 or 8 years while we were in undergraduate, law, or medical school. These letters were beautifully composed, discussing his work, current events, family matters, or other pertinent topics. Each letter included $10 and was signed with the phrase, “Love and respect.” It was always clear to us that his love was unconditional but the respect had to be earned. These personal letters in his own handwriting provided a really meaningful bond between parent and child. I have carried on this legacy with my children, writing every week to them while they were in undergraduate and graduate school and also signing each letter with “Love and respect.” With inflation, I now have to enclose $30 instead of $10.
Roberts: Did you write home weekly?
Cooper: No. It was kind of understood that it was a one-way letter. I would call every week, and I would stay in communication with my family. When there was something special happening in my life, I would write home. All 4 sons wrote Dad at the end of our education, recalling some of the special letters that had impacted our lives. Each of us saved all the letters. It's interesting to take some of them out and reread them. Dad's philosophy of life has remained pertinent through the years.
Roberts: Did your mother write when you were away at college?
Cooper: Not usually.
Roberts: At the dinner table at night, did your father dominate the conversation? Or would he just get it started? Or was your mother the more dominant figure?
Cooper: There was not a dominant figure. We discussed a variety of topics, and certainly both parents made their opinions known.
Roberts: It sounds like there was a lot of love and respect between your mother and father, as well as between your parents and the 4 of you.
Cooper: My parents had a very strong marriage.
Roberts: Can you describe the house you grew up in? With 4 boys, I gather you shared rooms.
Cooper: We had an upstairs area, with 3 bedrooms. Two of the bedrooms were shared with my brothers. We had bunk beds in each room. The biggest problem was that there was only one small bathroom for everybody. The kitchen downstairs was small, but there was a large living and dining room for family gatherings.
Roberts: What is your mother like?
Cooper: She's kind of the matriarch of the family now. She is very strong-willed and, as I mentioned, has had a big impact on her children. She is very family oriented. She conveyed a lot of love to us as we were growing up. Mom has maintained communication with the family through the years, even with children, grandchildren, and great-grandchildren at great distances apart. At 87, her mind is still very much intact. She has a great memory. She's in an assisted living community now in Louisville.
Roberts: What was Louisville like when you were growing up? How many people lived there?
Cooper: There were probably 300,000 people in the city. It was the largest city in Kentucky. I enjoyed the city very much while growing up, especially its trees and “blue grass.” It's very pretty. The Kentucky Derby is held there, although we never went to it. The city populace was very interested in sports, especially college basketball.
Roberts: When you were growing up, you could ride your bicycle around town?
Cooper: Absolutely. We didn't have alarms. I could go downtown on my own when I was 12 or 13. We could certainly walk around the neighborhood during the day and at dusk and not feel that there were any problems.
Roberts: Did you and your brothers feel pressure from your parents to do well in school or was it just taken for granted that you would do well?
Cooper: Our parents expected us to do well. All 4 sons fortunately were superb students. My older brother was an excellent student, as was I. My 2 younger brothers followed in our footsteps. There were no special rewards for doing well in school. The emphasis was the pride in doing something and doing it well.
Roberts: Were there any teachers in grammar school, junior high, or high school who had a particular impact on you?
Cooper: I have thought about this. I don't think there was any single individual who had a major impact on me. My father's youngest brother, who was 19 years younger than him, actually lived with us when we were growing up. He attended medical school for a short time and, in retrospect, probably had some impact on me. As far back as I can remember, I always wanted to be a physician. I'm not sure precisely why, other than my interest in math and science. There were no physicians in my extended family.
Roberts: Did you have any illnesses as a child that took you to a physician?
Cooper: No.
Roberts: Before you went to college, you attended public schools?
Cooper: Yes. My brothers and I went to public schools.
Roberts: You mentioned that you played basketball, but you weren't on the school's basketball team.
Cooper: Right. I played in the intramural league at the Jewish Community Center. The only formal sport I played at my public high school was tennis.
Roberts: But you also played golf recreationally?
Cooper: Yes.
Roberts: So sports were important to you and your brothers, I presume, growing up? What are your brothers' names, and when were they born?
Cooper: Alan was born in 1942, and I was born in 1945. The “second platoon” came along 6 years later. David was born in 1951, and Mark was born in 1956.
Roberts: What do your brothers do?
Cooper: Alan went to Vanderbilt for undergraduate and law school. He's now a trademark and patent attorney in Washington, DC. David also graduated from law school, and he's an attorney in Louisville. Mark graduated from The Johns Hop-kins School of Medicine, and he is an oncologist in Cleveland. Presently, he heads a corporation involved in gene therapy for various diseases. He was on the faculty of Case Western Reserve for a number of years.
Roberts: It sounds like you had a big influence on his becoming a physician and also his subspecialty.
Cooper: I would like to think so.
Roberts: Do you see your brothers much anymore?
Cooper: We see each other intermittently. Obviously, we are always together at all family events, like bar mitzvahs or weddings. We also get together during the course of the year but are spread out in Cleveland, Washington, DC, Louisville, and Dallas.
Roberts: Where does interest in the law come from? Did your parents have any influence on their choosing law?
Cooper: No. We used to joke that they selected law since they couldn't do math and science. Our family did not have any role models who were attorneys.
Roberts: Did math and science sort of come easy for you, or did you just like them from the beginning?
Cooper: I liked them from the beginning. I was very intuitive at math and science but worked hard at them as well. I clearly had a passion for that type of study. I was less adept at verbal skills.
Roberts: You went to Franklin and Marshall College in Lancaster, Pennsylvania. How did you choose that college?
Cooper: My father emphasized that we could go to any college we chose. It was assumed that we could go to a private college at that juncture if we wanted to.
Roberts: And he would pay the tab?
Cooper: Yes. My father paid the tab for all 4 of us to go to undergraduate and either medical or law school. My older brother at the time was going to Vanderbilt, and some of his fraternity brothers knew about Franklin and Marshall. I knew at that time I was interested in math and science and probably medicine, and Franklin and Marshall had an excellent reputation in premed. It was a small, all-male school. I didn't apply to many colleges. I did apply to Vanderbilt, but I felt that I didn't want to go where my brother was. My dream actually was to go to Yale, but I did not get accepted there.
Roberts: Did you apply to any other Ivy League school?
Cooper: No.
Roberts: Is Franklin and Marshall considered quite close to one of the Ivy League schools?
Cooper: Yes, it's probably just a notch below.
Roberts: How many students were enrolled when you were there?
Cooper: About 1600.
Roberts: The sciences and math were emphasized pretty strongly there. How did you feel about your competition when you went from public school to this private school near the East Coast? I imagine most of your classmates came from the East.
Cooper: I was a good student. I had graduated first in my class of 300 in high school in Louisville. At college, I really didn't know what to expect because most of the students at Franklin and Marshall had trained in the East, and a lot of them had gone to private schools. Fortunately, I felt early on, even with my public school background, that I could compete academically, even in the premed curriculum. I did well from the very beginning. I must admit, in retrospect, I worked hard. I went there not knowing how well I would be prepared, and I focused on my studies from the outset.
Roberts: Did you continue your tennis in college?
Cooper: I did not play any formal sports in college. I did intramurals. My main activity outside of my studies in college was college politics. I was elected president of the student council my junior year.
Roberts: That's pretty impressive. In high school, did you take leadership positions in student government like you did in college?
Cooper: Not so much in the public school arena as in the AZA organization. That's where I learned some of my leadership and political skills.
Roberts: How did you enjoy Franklin and Marshall? Were you pleased with your decision?
Cooper: Yes. I liked it very much. I felt I had a fairly well-rounded experience between student government and my studies. I did well academically, and I formed a lot of good relationships with the faculty members and the dean of students. When I was president of the student body, efforts were under way to make the college coed. Of course, at that time a lot of private all-male schools were considering transition to coeducation. I had no regrets attending Franklin and Marshall. I felt that I had a very positive experience there.
Roberts: In retrospect, do you think attending all-male or all-female schools is advantageous from an educational standpoint?
Cooper: Perhaps it's a little bit easier to focus on studies in an all-male environment, but I never encouraged any of my children to go to an all-male or all-female school, either in high school or college.
Roberts: Were there several all-female colleges in that area?
Cooper: There were, but obviously that's different than having women classmates and communicating with them on a day-to-day basis. Coeducation also has some impact on the strength of your various programs. Some of the social studies courses at Franklin and Marshall probably weren't as strong as the math and science courses. Part of that had to do with its having an all-male student body.
Roberts: Did you have any activities with Amish groups in the Lancaster area?
Cooper: No. We didn't really interact too much with the Amish.
Roberts: Overall, college was a wonderful experience for you. You were leader of the student body and made superb grades. Do you know where you stood in the graduating class?
Cooper: I was in a special program called the College Scholar Program. They took about 10 students after the first year based on grades. Then we were able to take special seminars together as well as regular courses, and we didn't get formal grades. Four of us were elected to Phi Beta Kappa our junior year, and that honor was awarded to the best students.
Roberts: So when you went to college, you were already desirous of going to medical school. How did it work out that you went to The Johns Hopkins School of Medicine?
Cooper: I didn't have financial constraints. Consequently, I applied to a whole host of schools, including Washington University, the University of Pennsylvania, Vanderbilt, Columbia, Johns Hopkins, and Harvard and visited all of them. I was accepted everywhere but Harvard. The reason I focused on Hopkins was I sensed that it was the most academically challenging and, in terms of its clinical reputation, perhaps the best of the schools. The location of the medical school wasn't important to me at the time. I was very impressed with the faculty I met at Hopkins.
Roberts: How did you get back and forth to college? Did you have a car in college?
Cooper: Not until medical school.
Roberts: How far is Lancaster from Louisville?
Cooper: 600 or 700 miles.
Roberts: How did Hopkins medical school hit you? Louisville is a little smaller than the Philadelphia area and Baltimore. Hopkins is in the heart of the city and not particularly in the safest part of the city. Were there any surprises for you in medical school, in the first 2 or 3 months particularly?
Cooper: No, there weren't any surprises. I really liked it from the get-go. Although there were obviously very smart students at Franklin and Marshall, the Hopkins students were uniformly bright and were all committed to similar goals and had similar interests. I really enjoyed the camaraderie and learned from other students as well as from the staff (Figure 6).
Figure 6.
With father and brothers Alan, David, and Mark on graduation from medical school in Baltimore in 1971.
Roberts: How many were in your medical school class?
Cooper: 100.
Roberts: When did you meet Lynn, your future wife?
Cooper: I came home in the summer after my freshman year in college and was asked to coach a high school sorority softball team. Lynn played second base. I was smitten from the moment that I put my arms around her to show her how to swing a baseball bat. We met on a baseball field!
She went to the same public high school that I went to, but there was a 4-year difference in age, so we didn't know each other in high school. I came home every summer and on some holidays from Franklin and Marshall, and we would see each other during those occasions and spend a lot of time together over the summers.
Roberts: When did you get married?
Cooper: We got married halfway through my second year of medical school (Figure 7). She went to Vanderbilt, but then her parents got divorced and she went back home and finished at the University of Louisville. Then she trained in medical technology. After we got married, she finished the hospital component of her medical technology training in Baltimore at Union Memorial Hospital. We courted for 4 years.
Figure 7.
With Lynn on their honeymoon in Nassau in 1968.
Roberts: Where did you live in Baltimore?
Cooper: After we got married, we lived near Union Memorial Hospital, which was on the other side of the city from the Hopkins medical facilities. That was where the Hopkins undergraduate campus was located. After about a year there, we moved across the street from The Johns Hopkins Hospital in an apartment and stayed there until I finished my training in Baltimore.
Roberts: Were there any faculty at Hopkins who had a particular impact on you?
Cooper: Yes, several did. Hopkins had some really outstanding clinicians who had a major impact on me: C. Lockard Conley, head of the hematology division; Philip Tumulty, an internist who always gave an inspirational lecture to students before their initial clinical rotations; Tom Duffy, a young hematologist who was a chief resident when I was a medical student; and Simeon Margolis, an endocrinologist who taught me many research and laboratory skills over the summers when I worked in his lab.
Roberts: How did you happen to work with Dr. Margolis?
Cooper: There were many research opportunities at Hopkins, and I was offered a research scholarship during the summers. After interviewing with him, I was impressed with his personality and interest in me. I did research in lipoprotein metabolism during medical school.
Roberts: He was at NIH for a couple of the years I was there. In college, he was a star basketball player at The Johns Hopkins University, and we played basketball together when we were both at NIH.
Cooper: We played tennis and basketball together. I beat him periodically but certainly not consistently.
Roberts: Do you know your class standing when you finished medical school? You were competing with 99 very bright people. Did Hopkins give grades or just pass-fail?
Cooper: The faculty graded students, but the students were not given their grades until they applied for internships. Hopkins wanted to deemphasize grades and focus on motivating the students to learn.
Roberts: Who were some fellow students in your class who have done quite well?
Cooper: One, Richard Axel, got the Nobel Prize in 2004. Neal Young has done outstanding work at NIH in aplastic anemia.
Roberts: But the students had an impact on you?
Cooper: Yes. I had a very good friend at Franklin and Marshall, Steve Smith, who also went to Hopkins with me. We were very close and roomed together until he got married. My medical school class obviously scattered after graduation, entering different subspecialties with diverse research and clinical opportunities. Many of my fellow students have done very well.
Roberts: As you rotated through the various subspecialties in your junior year, did you have a hard time deciding on one specialty, or was the choice of internal medicine and hematology a relatively easy one for you?
Cooper: I loved the problem-solving of internal medicine and never seriously considered surgery. Relatively early, I decided on an academically oriented career in internal medicine. Within internal medicine, most of my early research involved endocrinology and metabolism. Initially I thought I would pursue that subspecialty. During the medical residency at Hopkins, I was accepted into the Metabolism and Endocrinology Branch of NIH. Before I went to NIH, however, I was pretty certain that I wanted to go into hematology. There were several factors in this decision. First, I liked the clinical problems of hematology. The patients were usually very sick. Chemotherapy was just becoming effective, and I liked the challenge of giving very ill patients intensive treatment with curative intent. In addition, I loved the interpretive aspects of reviewing blood smears and bone marrow that was easily accessible. The field had a lot of options for research. The subject matter also came to me relatively easily, even coagulation. I was pretty much intent on going into hematology by the time I started at NIH.
The best clinicians at Hopkins in my judgment were the hematologists. I don't know whether that observation had an impact on me or not. I've subsequently learned there's nothing unique about hematologists that make them the best clinicians, but a lot of the role models who most impressed me were hematologists.
Roberts: Thomas P. Meyers told me one time that the smartest physicians at BUMC were Barry Cooper and Michael Emmett. That's a good reputation to have. How did you select your internship?
Cooper: When the time came to consider internships, I knew I was interested in internal medicine. Hopkins was obviously a known entity. I knew many of the housestaff there. Internship at the time was a very exciting experience because it was the first time you could make clinical decisions and have real responsibility for patient care. I knew that at Hopkins the housestaff had the major responsibility for patient decision-making. It was made clear to me that I could stay at Hopkins if I wanted to. I looked at Vanderbilt in Nashville; Barnes in St. Louis; Columbia in New York City; and the Massachusetts General Hospital, Brigham and Women's Hospital, and Beth Israel Hospital in Boston. I decided that the only program that I would prefer to Hopkins was Massachusetts General, but I did not get a spot there. So I stayed at Hopkins.
Roberts: How did your Hopkins internship work out? What was your day-to-day life like?
Cooper: I was in the last group of interns who worked 2 of every 3 nights. It was intensive. Most houseofficers lived across the street from the hospital, so one was able to get home for a short interval at night if there weren't new admissions. I said goodbye to Lynn on June 30 and did not see her again until the July fourth picnic. She wasn't happy. I didn't get to see my wife very much during that year. The residency year was better. That kind of training program is not very conducive to marriage; it is not designed to be. But when I was at the hospital, I loved it. I loved the responsibility. I learned a tremendous amount. There was a lot of camaraderie. Everybody was always there, and everybody had similar interests. There was a lot of positive reinforcement from the faculty. We felt, rightly or wrongly, that this was the way to acquire skills to take care of very sick patients, skills to be used for the rest of one's life. The house-officers were very interested in obtaining those skills.
Roberts: Who was the chief resident when you were an intern?
Cooper: Jerry Spivak, who later became director of hematology at Hopkins.
Roberts: During your first year of residency, you were off a little bit more than during the internship?
Cooper: Every other night. Even the night you were working, you could still get maybe a couple of hours of sleep. The intern worked up the patient initially, and then the resident would see the patient. The resident got a little more sleep.
Roberts: How many interns were there?
Cooper: There were 2 medical services: the Osler (public) one and the private service. There were 36 interns in all.
Roberts: Those 2 services combined after a while?
Cooper: Yes, they did, right around the time I was there.
Roberts: After 2 years as a houseofficer at Hopkins, you went to the NIH. What were those 2 years like?
Cooper: I was at the Gerontology Research Center, which was part of NIH, but it was located at Baltimore City Hospitals, which also was part of Hopkins. We moved to another neigh-borhood in Baltimore, and we really enjoyed Baltimore during those 2 years. Although I did mostly basic research, I still got involved in some clinical activities at Baltimore City Hospitals. Because I knew I was going into hematology, I participated in some of their consultations and reviewed bone marrow slides. I worked only during the day; I had no clinical responsibilities at night.
Roberts: So you made up with Lynn for being gone for much of the 2 houseofficer years?
Cooper: I'd like to think so. We should ask her.
Roberts: What research did you do during those 2 years?
Cooper: It was a gerontology research center. We had the only laboratory colony of old rats. I set up assays on fat cells from rats of various ages to measure adenylate cyclase activity. The lab was very well organized. Those were very productive years for me. I had several publications from that 2-year period.
Roberts: How did you enjoy the research?
Cooper: I enjoyed it very much. I loved burying myself in the library and reading research articles and designing new assays.
Roberts: When you decided on a fellowship in hematology, what went into your thinking process as to where you should go?
Cooper: I had some research interests that I felt could be applied to hematology, so I wanted some research options. I also had been away from clinical medicine for the most part for 2 years, so I was very interested in a good clinical program where the fellows had a lot of clinical responsibility. The fellowship, of course, would provide the framework for the clinical skills I would be using for the rest of my career in hematology. Lynn and I also wanted to go to a different city and experience a different environment. I looked around. We had always been interested in living in Boston. We also looked on the West Coast, which we had never seen before. It became clear to me that because I had the good fortune of having been at NIH and at Hopkins and was productive as a researcher, I could pretty much choose the program I wanted to go to. I decided on the Brigham because, first of all, the director of the program, Bill Moloney, was a well-established hematologist in Boston, who had a tremendous referral base and saw most of the leukemia and lymphoma patients in the Boston area. In addition, a lot of independent research opportunities were available. Finally, at the Brigham, the fellows participated in clinical decisions, not just the housestaff.
Roberts: How did it work out? Were you pleased with your fellowship at the Brigham?
Cooper: It was an ideal situation for me. Most of what I had hoped for actually transpired. It was a very productive time in the laboratory. I worked with Bob Handin, who was a coagulation expert. I was able to set up assays for adenylate cyclase in the platelets; we also did a lot of work on catecholamine and prostaglandin receptors on platelets. In addition, I saw a tremendous number of patients with various hematologic malignancies. The hematology division at the time was separate from the medical oncology division, and my interest was much more in hematology, both benign and malignant, than it was in solid tumors. The medical oncology program was at the Dana-Farber Cancer Institute. We interacted quite a bit with physicians there, and I did spend a few months in training with them, but they had little impact on treating hematologic malignancies when I was there. Thus, I had a lot of both clinical and research opportunities.
Somewhat surprising to me was the informality of the Brigham, at least in the hematology division, compared to what I expected. I was on a first-name basis with the staff (although not with Dr. Braunwald). I just had a very positive experience there. Living in Boston was a real pleasure for Lynn and me. We participated in a bridge group, made many new friends, and had a great time.
Roberts: And you were off most nights.
Cooper: Yes. I would take some phone calls for the staff. If patients got sick, they would go to the emergency room, the housestaff would admit them, and the staff probably wouldn't see them until the next morning.
Roberts: How many faculty were in the hematology division?
Cooper: Probably 9 full time.
Roberts: How many fellows were with you? That was a 2-year training program.
Cooper: There were 3 fellows in each of 2 years.
Roberts: So there were 6 fellows in all. Were all the fellows expected to be involved in research?
Cooper: Yes. Everybody did research. Our lab was extremely productive. One fellow, Andrew Schafer, is now chief of medicine at the University of Pennsylvania and was recently elected president of the American Society of Hematology. Two faculty members I did research with also became president of the American Society of Hematology: Bob Handin and Frank Bunn. It was a very dynamic group.
Roberts: You must have been quite pleased when they offered you a faculty position after the fellowship.
Cooper: Yes. I had always felt I would pursue an academic career doing research as well as seeing patients. We pretty much were committed to staying in Boston. I was offered a position at the Massachusetts General Hospital also, but I knew everybody at the Brigham and wanted to stay there. I spent half my time at the Brigham and the other half at the Harvard-affiliated Veterans Affairs (VA) Medical Center as director of hematology.
Roberts: How long did it take to get from the Brigham to the VA hospital?
Cooper: Fifteen minutes. I would pretty much go to each hospital every day. In some months, I did consults at the Brigham as well. My research lab and my grant were through the VA Medical Center. That's where I had my lab.
Roberts: So you were in charge of the hematology service at a major medical center just after completing your fellowship?
Cooper: Yes. We had a clinic at the VA. Different staff people would attend. Bill Castle was still seeing patients at the VA when I was there, and he had a big impact on me. Castle is famous as a clinician and as a researcher. He described the role of achlorhydria and the absence of intrinsic factors in the pathogenesis of pernicious anemia.
Roberts: He was essentially responsible for being able to allow patients with pernicious anemia to survive?
Cooper: Murphy and Minot received the Nobel Prize for “curing” pernicious anemia by feeding liver extracts to patients. Castle did seminal work in clarifying its mechanism.
Roberts: How did the departments of medicine at the Brigham and at Hopkins compare?
Cooper: They were very different. Hopkins was more clinically oriented, more interested in giving housestaff clinical responsibilities. Hopkins was much more into developing clinicians than was the Brigham. The Brigham was more focused on developing research skills. The housestaff at Hopkins had the major responsibility; the fellowship programs at the Brigham were stronger, and the fellows had a lot more clinical responsibility. Basic research overall seemed stronger at the Brigham than at Hopkins.
Roberts: Eugene Braunwald was chairman of medicine at the Brigham and Women's Hospital when you were there. Did you have much contact with him?
Cooper: I met with him when he offered me a faculty job. I met with him at various conferences, particularly at grand rounds. I gave grand rounds a few times during my 4 years there. He was obviously immensely respected by all. He had a major impact on the institution. He was a whirlwind in terms of what he could accomplish, as a chairman, researcher, teacher, and writer. We also sensed that he was definitely in charge. He made all major decisions in the Department of Medicine. But I did not have a lot of personal interaction with him.
Roberts: Braunwald, I understand, chose carefully the various division chiefs and then let them run their units.
Cooper: Absolutely.
Roberts: How did it come about that you came to BUMC in Dallas? You were at a major medical center. Your research was going well. You were happy in Boston. What was your thinking?
Cooper: It was a difficult decision and not one that I made lightly. I considered and contemplated it for several months, and Lynn and I had many discussions about it. I had always felt that I was going to be a full-time academician. I spent a lot of time seeing patients, and I spent a lot of time doing basic research. I had been doing some basic research all through medical school, NIH, and my fellowship and as a member of the staff. My concern as a career faculty individual at the Brigham was that I was drifting away from clinical medicine and with time that gap would widen further. I am the kind of an individual who tends to do what he or she needs to do to succeed. My research was going well, and I was spending more and more time in the laboratory. I felt I was getting more and more isolated from clinical care, which was rather poorly rewarded in the Harvard system. I finally decided that an academically oriented practice environment would be better for me than doing just basic research. I also felt that although my research was going well—I was very adept in organizing and designing experiments to get publishable data—I didn't have the unique imagination that would likely result in a really distinguished career in basic science. For a fulfilling and happy career, I needed to have primary patient care responsibilities in my subspecialty.
Once I reached this decision, I looked at several cities, including my hometown of Louisville and the Washington, DC, area. Most patients with acute leukemias and specialized hematologic problems of great complexity went to the university medical centers. Mike Reese was director of medical oncology at BUMC, and he invited me down to visit. He was trying to build up the program at BUMC. He is a great salesman and very enthusiastic. I was very impressed when visiting BUMC with the size and the depth of the institution and its referral patterns. It was clear to me that most of the specialized clinical problems I wanted to see had referral patterns already set up at BUMC and that I could build on this base. I was very impressed with Marvin Stone. He had been recruited to build a cancer center just a few years before I came. Everyone I met at BUMC encouraged me, especially Ralph Tompsett and John Fordtran. I was impressed with the housestaff and still am. I was given a medical appointment at the University of Texas Southwestern Medical School after meeting with Gene Frenkel.
I felt that this type of career change would be best for me, but I did not leave Boston without a lot of concerns. It was by no means completely clear to me that this was going to be the best possible option, but I did at least take comfort in the fact that I had given academic medicine a good try for a couple of years. I actually had considered leaving the Brigham after I finished my fellowship but thought academia was worth a try. I have had no regrets.
Roberts: When were your children born? Were some born in Boston?
Cooper: My oldest daughter, Stephanie, was born when I was a fellow at NIH in Baltimore (Figure 8). My son, Andrew, was born when I was at the Brigham doing my fellowship in 1976. And then my youngest, Mallory, was born in 1985 when I was in Dallas.
Figure 8.
Playing with Stephanie in Boston in 1976.
Roberts: So you already had 2 children when you moved to Dallas. That must have played some role in your decision. The Brigham doesn't pay its faculty too much.
Cooper: Financial factors were a consideration. Because I had a directorship at the VA, for an academic career I was reimbursed pretty well, especially after just finishing a fellowship. But, long-term, Boston is an extremely expensive city to live in. I wanted my children to have the same opportunities that my father gave me. Although financial factors played a role, they did not have a major impact on my decision. It was more that this was what I really wanted to do.
Roberts: Did you talk to Braunwald when you made that decision?
Cooper: Not a great deal. The person I spent the most time discussing it with was Bill Castle. He had retired but was still working at the VA hospital. I discussed with him what I really wanted to do and career options in Boston and elsewhere. He was very supportive of the career decision I made, as were some other members of the division.
Roberts: You came to BUMC in July 1979?
Cooper: Yes. Bob Mennel and I arrived the same day.
Roberts: How did it work out? The Roberts Hospital was being built or was just being finished at that time.
Cooper: Yes, the hematology unit was actually on 6 Collins at that time. All the leukemia patients were admitted in the Collins Hospital, along with other patients who were getting chemotherapy.
Roberts: Here you had two adjustments. You had been trained at very academic centers. You had always done research. Now you were in a medical center that had lots of patients, the type of patients you were interested in, but yet itself was not a medical school, although the leaders in the medical center had been extremely well trained. How did you adjust to BUMC, and how did you and your family adjust to Dallas?
Cooper: Adjusting to Dallas took a little time. The weather and environment in Dallas were so different from those of Boston. But everybody was very cordial. It's a very livable city. I was busy from the go. The original founders of the medical oncology group were Mike Reese, John Bagwell, and J. Richard Williams, none of whom are here now. I did a lot of coverage for them and got lots of consults.
When I came to BUMC, I not only did hematology but also treated patients with solid tumors. I had spent a month or two at the Dana-Farber Cancer Institute during my 2-year fellowship, so I did get training in medical oncology as well as in hematology, although obviously my interest was in hematology. Back then, all the effective chemotherapy drugs were used in the hematologic malignancies. There weren't many effective drugs for solid tumors. Initially I did about 75% hematology, but in the last 10 years, I dropped the solid tumor cases completely.
I became heavily involved in the resident teaching program at BUMC, and we started a medical oncology fellowship program. The housestaff at BUMC are excellent, and one of my proudest achievements was being twice selected the outstanding internal medicine teacher. I have admitted a lot of patients to the teaching service, especially the more complicated patients. I have not really missed the basic research after I got away from it for a while.
Roberts: So it's worked out just like you wanted it to. And Lynn has grown to like the city and the environment? Where do you folks live?
Cooper: We now live in a gated community south of I-635 off Churchill Way.
Roberts: You moved after your kids were gone?
Cooper: Yes. We lived on Mason Dells in North Dallas for about 20 years when raising our family (Figure 9).
Figure 9.
Family portrait at Stephanie's bat mitzvah in 1987. Back row: Lynn, Andrew, Barry. Front row: Mallory, Stephanie.
Roberts: You have 3 children. What do they do?
Cooper: All 3 of my children went to the Greenhill School in Dallas. Stephanie, our oldest, graduated Phi Beta Kappa from Yale, and then she went to the University of Chicago law school. She is an attorney in Farmington Hills, Michigan. Her husband, Steve Blum, is in business.
Roberts: What does your second one do?
Cooper: Andrew went to the University of Pennsylvania and then to Yale Medical School (Figure 10). He is in his third year of an orthopaedics residency at Jackson Memorial Hospital in Miami. He married Meredith, who is working on her master's degree in nutrition.
Figure 10.
Barry and Lynn at Andrew's medical school graduation in New Haven, Connecticut, in 2003.
Roberts: What about the third?
Cooper: Our third child, Mallory, is a sophomore at the University of Michigan. She is majoring in psychology.
Roberts: What kind of work schedule do you have now at BUMC versus 10 or 20 years ago?
Cooper: Up until about the last year or two, I worked 4 days a week. I would usually start rounds at 6:00 am and get home around 9:00 or 10:00 pm.
Roberts: And that went on for years? What day did you have off?
Cooper: It varied. It was usually Thursday.
Roberts: What did you do on those days off?
Cooper: Sometimes I gave a lecture or prepared for a conference. Half of the time I would stay home, and half of the time I would do something at the office. But I would not see patients on those days.
Roberts: As your kids were growing up, you didn't have dinner with them?
Cooper: Correct, except on Thursdays and weekends. I worked 1 of every 4 weekends.
Roberts: When you worked, what was the schedule like on the weekends?
Cooper: I'd start at 6:00 am and get done usually at 6:00 or 7:00 pm on Saturday and probably 3:00 or 4:00 pm on Sunday, and then I'd take call from home.
Roberts: When you were working 6:00 am to 10:00 pm, what time would you get up in the morning?
Cooper: Around 5:10 am.
Roberts: You didn't get home until 10:00 PM. What time did you go to bed?
Cooper: Shortly thereafter—around 11:00 pm.
Roberts: You do well on 6 hours of sleep a night? Did you catch up a little on the weekends?
Cooper: Yes, I would, especially since occasionally I had to come back to the hospital in the middle of the night.
Roberts: What's your schedule now?
Cooper: I still get to the hospital at 6:00 am and do rounds. I get home now by 7:30 pm. But now I see patients 3 days a week and do administrative work 1 day a week. Another day I'm off completely.
Roberts: When you're off, someone else is covering your hospitalized patients and calls?
Cooper: Yes.
Roberts: How many patients would you have in the hospital as a rule?
Cooper: 15 to 20.
Roberts: Your patients are all very sick. You don't have any minimally sick folks in your specialty.
Cooper: That's mostly true, but there are consults for patients with anemia or a coagulation problem, so they're not all acute leukemia patients. For a while I usually had 5 or 10 acute leukemia patients in the hospital at the same time.
Roberts: Do you have hobbies or interests outside of medicine?
Cooper: I read novels, play golf and exercise, and see movies.
Roberts: When do you read?
Cooper: I usually read at night a little while before I go to bed. It can take me a long time to finish a book.
Roberts: As your kids were growing up, did you take regular vacations?
Cooper: Yes. We always took vacations. We would get away.
Roberts: How often did you take off, let's say, in the 1980s as your kids were coming along?
Cooper: Probably at least 4 weeks a year, usually for spring break and a couple of weeks in the summer.
Roberts: What kind of vacations did you take? Do you have a place somewhere that you go to?
Cooper: We have a place in Keystone, Colorado. Lynn and I almost always spend at least a couple of weeks there in the summer. Sometimes she'll go a month and I'll go a week or 10 days and return home and go back again. We like to do a lot of hiking in the summer. Of course, it's a ski resort. We don't ski much anymore, but some of the kids go there during ski season.
Roberts: That was a family gathering center for years?
Cooper: We've only had it about 6 or 7 years. We used to take cruises (Figure 11). And we took trips with the family to a variety of places—Mexico, Florida, North Carolina. Lynn doesn't like to go back to the same place a lot except for Colorado. We usually go to different places. I have worked hard, but we have had some quality time away.
Figure 11.
Current family photo on a cruise in 2005. Back row: Barry, Andrew, Steven Blum. Front row: Lynn, Stephanie, grandchildren Ryan and Rebecca Blum, Mallory, Meredith Cooper.
Roberts: Your first two are married. Do they have children?
Cooper: Yes. My oldest daughter, Stephanie, has 2 children.
Roberts: All 3 of your children live a long way away.
Cooper: Mallory, who is at the University of Michigan, is only about 30 minutes away from Farmington Hills, where our older daughter lives. I think one reason she went to the University of Michigan, an excellent university, was to be near her sister. They are very close. We can visit both daughters in one trip, and we do make frequent visits to Michigan now, especially to see our grandchildren.
Roberts: How did you let your son slip into orthopaedic surgery?
Cooper: I think it's Lynn's side of the family.
Roberts: You're pretty athletic. You could have gone into surgery very easily if you'd wanted to.
Cooper: I could have gone into surgery, but Andrew's a very pragmatic bottom-line sort of guy. He likes fixing something with immediate results.
Roberts: You and Lynn, it sounds like, do a lot of things together. Does she play golf?
Cooper: She has the last couple of years.
Roberts: Are you enjoying the empty nest period?
Cooper: It's not as bad as I thought it was going to be. We had a big gap. The 2 older kids are 21/2 years apart, and then there was a gap of 9 years before Mallory was born. When she was only 6 years old, Stephanie left for college, and Andrew left a few years later. Hence, our “empty nest” period was delayed for quite some time. We're very pleased that Mallory lived with us those extra years. At present, it's great that our kids communicate so much with us. They call all the time with their cell phones. Mallory still comes home relatively frequently from Michigan. Yet, we really enjoy our newfound independence.
Roberts: That's nice that Stephanie and Mallory are so close even though there is 12 years between them. How have you enjoyed practicing 3 days a week?
Cooper: I like the schedule a lot better. I have 1 day to really do a lot of things I want to do. Then I actually have another day I can do things unrelated to medicine. I appreciate the opportunity to do a little more administrative work.
Roberts: You went so many years full throttle. Is there anything else you'd like to talk about?
Cooper: No, I guess it's pretty much been covered. Thank you, Bill.