Reunions are fun, but they can make you feel old. I remember strolling around Penn’s campus for my 25th reunion, and seeing several buildings named for people I knew in college. Wow, I thought, that’s when you know you’re ancient.
Another way is when the chancellor of your university – the senior official at UCSF – was your chief resident. Despite the exaggerated creakiness that I’m feeling in my bones, I’m thrilled that a few hours ago, University of California President Mark Yudof named Sue Desmond-Hellmann to be UCSF’s next chancellor, succeeding Nobel Prize winner Mike Bishop, who is retiring.
Sue was a resident, chief resident, heme-onc fellow, and junior faculty member at UCSF in the 1980s and early 90s. After a brief stint at Bristol-Myers Squibb, in 1995 she joined Genentech, the South San Francisco biotech giant founded in the 70s by UCSF’s Herb Boyer and venture capitalist Robert Swanson. Although today we think of Genentech as big pharma with a Silicon Valley sensibility, it is worth remembering that it was a much smaller enterprise in 1995, with virtually no footprint in oncology (its early focus was on human growth hormone and on cardiovascular therapeutics, especially the clot-buster t-PA).
Sue rose through the ranks meteorically, becoming chief medical officer within a year and later president of product development, the company’s number two executive. Under her leadership, Genentech launched several hugely successful drugs, most importantly the chemotherapeutic agents Avastin, Herceptin, and Rituxan, whose combined sales are about $4 billion. Many credit Genentech’s remarkable run in oncology (now its biggest product line by far) to Sue’s ability to sniff out blockbuster therapeutics.
When the Swiss drugmaker Roche assumed control of Genentech last month, I remember wondering what was next for Sue. My friends at Genentech are really worried that Roche’s relatively conventional (and Swiss) corporate culture will screw up Genentech’s more freewheeling, Segway-laden style (it’s not quite Googly, but it is awfully mellow for pharma – and in 2006, Fortune magazine named Genentech the best place to work in the U.S.). So I guessed that Sue would leave, but I certainly didn’t predict that she’d land at UCSF as chancellor.
That’s because Sue is an unconventional choice for the job. Typical chancellors at places like UCSF have long academic pedigrees; Sue’s contributions have mostly been in industry. Sue will also be our first woman chancellor (another candidate was another of my chief residents, Julie Gerberding, who stepped down from directing the CDC just in time to miss the Swine Flu funhouse).
But when you consider the roles of the chancellor – inspiring the faculty, students, and staff; setting a scientific and clinical agenda; being the public face of the university; fundraising; and building relationships with key partners (a biggie being biotech and industry more generally), you can see why Sue is such a logical choice for today’s times. Although she hasn’t run a major academic enterprise (UCSF has a staff of 21,000 and a budget of $2.5 billion), it is hard to argue with her managerial background – her role at Genentech involved leading 3,000 people and managing a budget of $2 billion.
(Speaking of fundraising, Sue is reported to own more than a million Genentech shares and options – hmmm, Roche’s takeover offer was $95 per share… you can do the math. So fundraising might begin at home. By the way, Mike Bishop’s 2008 salary was $402,000; that year, Sue’s Genentech compensation was 20 times higher – is it any wonder that we lose some of our best faculty to industry?)
I’ve only seen Sue a few times in recent years, but my memories of her are all splendid. She was chief resident at Moffitt-Long Hospitals – the academic medical center of our three-site training program (the other sites are a VA and San Francisco General Hospital). Back then, Moffitt had a reputation of being a bit stuck-up (I’m hoping that its reputation among our trainees is different today, but as chief of its medical service I’d be the last to know), and Sue was a breath of fresh air. She was obviously whip-smart and had natural leadership chops. But the most common term people used to describe her was “really nice” – in the best way.
So nice, in fact, that I was a bit surprised by her steady ascendancy up the corporate ladder, since such jobs require a steely disposition and a willingness to break some eggs. Yet I’ve never heard anybody say anything negative about Sue during all her years at Genentech – when I’ve inquired about her over the years, the most common reply from Genentech insiders was “she’s really impressive.”
And she has been in the line of fire – including the time when she faced off against an angry mob of ophthalmologists after Genentech’s decision to deny them access to an ocular (and cheaper) version of Avastin. “I know that people don’t believe us and our motives,” she said at the time. “We don’t expect to make friends with this decision.” She may find herself recycling this line when she has to tell prominent faculty why they can’t have the lab space or parking spot they covet.
Her background partly explains her extraordinary trajectory and her values. She grew up in Reno, the child of a drugstore owner and an English teacher. She and her 6 siblings attended college at the University of Nevada, Reno, where they all commuted to school, partly to save money. She went on to complete medical school in Reno, and arrived at UCSF in 1982 (someone correct me if I’m wrong, but she may be the only Nevada-Reno grad to go on to become a UCSF medicine resident – I guess we should be keeping our eyes open for another).
Like so many of us who were residents at the time, she found herself swept up by the infections and tumors that we were seeing in those scary and heady early days of the AIDS epidemic. She completed a fellowship in heme-onc at UCSF and an MPH at Berkeley, concentrating on Kaposi’s sarcoma. Married to a fellow UCSF resident, the laid-back, very funny, and incredibly good-hearted (but mediocre golfer) Nick Hellmann, the two went to Uganda in 1991 to conduct AIDS research and teach at Makerere University.
“Taking care of patients in the beginning of the epidemic, I felt so overwhelmed with the sense that young people were dying and there was so little to do,” Desmond-Hellmann said in a 2006 interview. “That challenges us working in other fields to ask, ‘How could it work for us? How can we have the kind of molecular breakthroughs that were seen in HIV?'”
In 1993, Nick and Sue returned to Nick’s hometown of Lexington, Kentucky, where Nick practiced HIV medicine and Sue joined a two-person oncology practice. But they soon became restless, and Sue and Nick both left private practice (a decision she later called “heartbreaking”) for positions at Bristol-Myers Squibb, where she found herself leading the team that brought Taxol to market. Soon Genentech, spying a rising star, called, and the rest, as they say, is history.
There is no way that a single person can come with the skills and experience needed to truly understand all the diverse agendas and programs at a major academic health center and university, and Sue will have to traverse some learning curves: in running a hospital (we own our academic medical center, and the med center CEO reports to the chancellor), managing a vast educational enterprise, and practicing today’s clinical medicine (particularly with its new emphasis on quality and safety). But she has all the Right Stuff, and I know from first hand experience that she is passionate about delivering high quality, safe care and teaching the next generation of leaders in medicine. And I have no doubt that she will be a great listener and a quick study.
Most importantly, she knows the importance of establishing a set of values and a positive corporate culture. Listen to a recent interview with Genentech’s present chief medical officer (and my former resident), Dr. Hal Barron:
No one person at Genentech really does as much as Sue has done to ensure the culture is focused on doing what’s best for patients. When someone has a singular focus like that, it’s a call to action for the entire company. Once everybody in the culture adopts that focus, it becomes part of Genentech… Go down ten levels below her and ask somebody why they are at Genentech, there’s a good chance they will say, ‘I’m here because I think I can make the biggest difference to patients.’ They might not ascribe that to her, they might not necessarily even have ever met her, but I think that the entire workforce comes here and stays here because of that belief.
So welcome back, Sue (and, as they say on this year’s 24, “First Gentleman” Nick Hellmann). I look forward to a long and successful run and to getting the chance to rekindle our friendship.
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