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Vale Col. Coltman!
Texas has lost two amazing adopted sons in the past month, and one of them perhaps will not receive the appropriate kudos and lamentation that is his due.
There cannot be many citizens of this nation who are unaware of the loss of “41,” the late President George H.W. Bush.
One aspect of his life as president was that his achievements might not have been fully appreciated at the time, in part because of the overlap of political action and outcome in the continuum from his predecessor to his successor. What is not in doubt is that those who knew him appreciated his kindness, strength of purpose, intelligence and the partnership that he forged with his late wife, former first lady Barbara Bush (“the enforcer”).
There are parallels to someone who was perhaps a little less well-known, but an extraordinarily important figure in the history of medicine in the United States, the late Col. Charles A. Coltman Jr., MD. He was initially an Air Force officer, heavily decorated, and then one of the most prominent and influential translational oncologists, medical politicians, administrators and mentors of the modern era.
I wanted to devote this editorial to his memory, as I viewed Chuck as an amazing leader; an important friend with an important impact in my life; and a huge influence in modern oncology, particularly in the domain of clinical and translational cancer research trials.
Legacy of a leader
Chuck Coltman was born in November 1930, a native of Pennsylvania, and obtained a medical degree from University of Pittsburgh in 1955. He completed residency and training in hematology/oncology at The Ohio State University, and the majority of his early career was within the Air Force, eventually commanding the hematology/oncology division in the medical facility at Wilford Hall in San Antonio.
After retiring from the Air Force in 1977, he joined The University of Texas Health Science Center at San Antonio, where he served as professor of medicine at the medical school and chair of one of the first dedicated phase 1 facilities in the country, the Cancer Therapy and Research Center (CTRC).
In addition, he served as director of the NCI-designated cancer institute based in San Antonio, helping to launch and extend the careers of luminaries such as Ian Thompson, MD, C. Kent Osborne, MD, and the late Gregory R. Mundy, MD. In 1978, in partnership with the late Bill McGuire, MD, Coltman launched the San Antonio Breast Cancer Symposium, now unquestionably the major colloquium of breast cancer research and treatment in the world.
One of Coltman’s greatest contributions was in the leadership of the Southwest Oncology Group (SWOG), taking over from Barth Hoogstraten, MD, in 1981. During his more than 20 years of leading SWOG, it became the most productive cooperative trials group, producing innumerable paradigm-shifting trials.
Part of Coltman’s legacy was the promulgation of intergroup research protocols, which he championed tirelessly, often doing battle with NCI senior staffers to retain the scientific order and intent of proposed protocols, and to minimize interference from those whom he (sometimes) viewed as less thoughtful and talented. Many a NCI leader quailed at the thought of doing battle with the formidable Colonel, with his steely glare, military stance and occasionally combative verbiage.
However, at the end of the day, he delivered the goods — he led a group that innovated, recruited tens of thousands of patients into trials and translated concepts from lab to clinic, or from member institutions to the group at large. He championed young investigator training, developed a philanthropic entity — now known as the Hope Foundation — to help pay for the scientific agenda, and actively involved dozens of cancer research leaders in the workings and administration of SWOG.
Chuck had immense capacity for work and innovation, and brought these talents to bear for many organizations — he held administrative function in the American Association for Cancer Research, was an ASCO president, brokered international collaborations with cancer research groups in Japan and other domains, and helped to create the AACR/ASCO cancer research training course, now known as Vail Course.
Empathy and wisdom
Although known for his toughness, sense of purpose and ambition for SWOG, Chuck Coltman was a remarkably gentle and empathetic man, always with time to give support and good counsel.
I came to know him personally when leading an effort to secure a cooperative agreement (UO1) contract on geriatric onco-pharmacology, for an RFA offered jointly by the National Institutes of Aging (NIA) and the NCI. The NIA approved and funded our proposal, but a midrange staffer at NCI decided to rewrite a key protocol after approval. I sought advice from Coltman, who smiled grimly and commented that good clinical science would wear them down — and it did! We were awarded the contract, although the rewritten protocol was the one that did not accrue well.
He also created a unique connection with Porsche, and for some years Porsche and SWOG ran a national car rally as a fundraiser. In those days, I drove a different type of sports car, but Chuck recruited me as one of his team of drivers for a rally that covered every state in the continental U.S. — my first drive of a Porsche 911. He demanded very careful description of every aspect of my small part of the rally — including the speeding fine that I was able to evade — and took great pleasure in the fun that we all had in cahoots with the professional drivers that Porsche offered for the events. A good deal of money was raised for SWOG cancer research.
Around the time that Chuck wound up his tenure as chair of SWOG, he recruited me to take over from him as leader of the San Antonio Cancer Institute and CTRC, and accordingly we spent a great deal of time trying to figure out whether this mission was congruent with my own career aims, and whether we would work well together on an ongoing basis in the same space.
I came to appreciate so well his wisdom, strategic planning, empathy, kindness and real concern for the people who reported to him and for his colleagues at a broader level, and his very real wish for SWOG to continue to expand and increase its scope and influence. I eventually decided not to pursue the opportunity in San Antonio, but that did not adversely impact my relationship with Chuck, nor his support and friendship. He continued to be a great supporter of “Crusty” Crawford, MD, and me as leaders of the genitourinary committee, and I believe he was proud of what we achieved and of his role in ensuring that we had the resources to get the job done.
All of us who worked closely with Chuck in the SWOG Board of Governors and its various committees appreciated how effective he was in pushing an agenda forward, sometimes despite strong opposition, if he was sure that he was correct. He had an extraordinary capacity for recalling detail and leveraging it.
That said, Chuck was able to keep things steady, even when sustaining a dreadful injury to the cervical spine, after slipping down stairs, and bearing the discomfort and transient neurological issues with calm and courage while continuing at the helm. Many of us suspected that his spinal maladies helped him to retain that military bearing with such consistency.
Any description of the impact that Chuck Coltman had would be incomplete without mentioning the den mother of SWOG for decades, Marj Godfrey, his faithful administrator and colleague, who was there to broker diplomacy and tact when Chuck adopted a polemical or militaristic stance in negotiations. She also was amazing, and happily remains in retirement in San Antonio. I don’t dwell on his family because, while very proud of them, he created a distinct separation between work and home, and was innately a very private person.
I hadn’t seen Chuck for some years, but know that he remained staunchly loyal to his friends and his organizations, comfortable in knowing that his impact would be sustained for a very long time. He created the model of a very different quadruple threat, and the many initiatives that he created will be a testament to his extraordinary life. Vale Chuck Coltman!
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Derek Raghavan, MD, PhD, FACP, FRACP, FASCO, is HemOnc Today’s Chief Medical Editor for Oncology. He also is president of Levine Cancer Institute at Atrium Health. He can be reached at derek.raghavan@atriumhealth.org.
Disclosure: Raghavan reports no relevant financial disclosures.