Roger J. Packer, MD: Upbringing influences his practice

Personal dignity plays an important role in Packer’s management of children with brain tumors.

Roger J. Packer, MD, is senior vice president of the Center for Neuroscience and Behavioral Medicine, director of The Brain Tumor Institute and also director of the Gilbert Neurofibromatosis Institute at the Children’s National Medical Center in Washington, D.C.

He is professor of neurology and pediatrics at George Washington University, professor of neurology at Georgetown University and professor in neurosurgery at University of Virginia, Charlottesville.

Packer’s viewpoint on the management of children with brain tumors is heavily based upon his upbringing as a child of Holocaust survivors. Education and, even more importantly, personal dignity are essential.

Overall, his wish is that when clinicians go into this field, they view it not as a business but as a calling. He said he hopes that physicians have an understanding that they are not only taking care of children to cure their disease, but also working toward developing therapies that will cause fewer long-term side effects so that quality of life is optimal.

Roger J. Packer

What do you like to do when not practicing medicine?

I like spending time with the family, which includes my wife and two grown children, ages 30 and 27 years. My passion is sports of almost any type. I particularly like baseball, and my favorite team is the Chicago Cubs.

What would you be doing now if you hadn’t gone into medicine?

I always thought my calling in life was to be a sports writer. If not for parental intervention, I probably would have pursued that.

What do you consider your biggest success in your field?

As a child neurologist, one of the most important things is trying to define my role in the care of children with brain tumors and developing more effective interventions to not only improve survival but also to improve quality of life, particularly neurocognitive and neurologic function. I have made two major contributions in this area.

One is developing, early in my career, with collaborators in oncology and neurosurgery, one of the most effective treatment protocols for children with medulloblastoma, which raised survival rates from approximately 50% at five years to 80% to 90%.

The second is developing, again with collaborators, a different protocol for children aged younger than 5 years with low-grade gliomas, which has remained the national standard for about the last 20 years.

I’m most proud that the results we initially published were replicated by multiple centers around the world, so this was not a one-time exception. In other words, any result that cannot be replicated by many others puts your own results into question, and our results were replicated several times.

What’s the best advice you’ve ever received?

Interestingly, it was very early in my career, when I took over the brain tumor program at The Children’s Hospital of Philadelphia, which had really been the province almost exclusively of oncologists and neurosurgeons.

When I was asked to take over the position, about a year into my attending time, the two leaders of the oncology program there, Audrey Evans, MD, a renowned pediatric oncologist, and Giulio D’Angio, MD, an equally internationally known radiation oncologist, told me they wanted me to make the program we developed the best in the country.

They emphasized developing the most innovative care for children with brain tumors and stressed that that should always be the priority when developing a new program, and I followed that advice. You cannot worry about obstacles; rather, you overcome them and create the best program. Never settle for second place, even though I am a Chicago Cubs fan.

Whom do you consider a mentor?

I’ve had so many, but a couple stand out in my mind. Peter Berman, MD, who trained me in child neurology, was certainly a mentor. Others include some incredible senior physicians in Philadelphia, when I first started in the field: Drs. Evans, D’Angio, Robert Zimmerman, MD, in neuroradiology, Lucy Rorke, MD, in neuropathology and Luis Schut, MD, and Derek Bruce, MD, in neurosurgery.

Overall, I think they impressed upon me that taking care of children with tumors is a multidisciplinary effort. I had great mentors in all different disciplines, and it helped me along in my career.

Dr. Packer with his wife Bashi, both dressed in their Chicago Cubs gear. Courtesy: R Packer, MD

What do you think will have the biggest influence on oncology in the next decade?

We are going through a major transition in how we evaluate and manage children with brain tumors. The driving force will be how we translate and harness the new understanding in neuroscience and cancer for the treatment of these children. Many of the therapies that we now use will look barbaric because of the side effects they cause, and we will be evolving into molecularly based therapies in the very near future.

What was the last book you read?

There are actually two. One was a biography of Leroy Robert “Satchel” Paige, a pitcher who started out in the Negro baseball leagues of the time and later pitched in Major League Baseball. It’s about baseball and race relations in that era.

The other is a biography of Franklin Roosevelt by Doris Kearns Goodwin. I am a child of Holocaust survivors, and one thing I am very interested in and confused about is the U.S. response in the early portion of the Holocaust and the role of leadership, including that of Roosevelt.

What was the last art collection you saw?

I enjoy the Impressionists at the Art Institute of Chicago. I grew up in Chicago, and the Impressionist room is my favorite room in the museum.

What was the last CD you bought?

It was probably something by Bob Dylan.

Do you have a diet and exercise regimen?

I have a fairly good exercise regimen. I workout or go to the gym or run five to seven days of the week, but my diet would be considered modified junk food. I’m not particularly healthy, but I try to stay away from large amounts of red meat.

What is your favorite travel destination?

I have two: Italy, especially around the area of Padua, and Cape May, N.J.

What is your favorite restaurant?

I’m fairly eclectic. I usually like Italian but haven’t found the perfect Italian restaurant. I also look for kosher restaurants because of my upbringing, and I’m still looking for the perfect one of those too. – by Christen Cona