Physician, surgeon, cancer researcher, educator
Dr. LaSalle Leffall, Jr., is one of the most prominent public health leaders in the fight against cancer. As an oncology surgeon for more than 50 years, Leffall became known for his technical skill and compassionate care, but moreover, for his far-reaching vision of how cancer was a political as well as a medical problem. He championed public debate about cancer, leading such organizations as the American Cancer Society, the Society of Surgeons of Oncology, and the Susan G. Komen Breast Cancer Foundation. President George W. Bush appointed him as chairman of the President's Cancer Panel in 2002, and Leffall also led the National Dialogue on Cancer.
Leffall's leadership against cancer would be notable by itself, but it is even more extraordinary given the context of racial inequality from which he emerged. When Claude H. Organ, who featured Dr. Leffall's achievements in his book A Century of Black Surgeons, asked him about memorable moments from his various travels, Leffall remembered one group of black students who invited him to the University of Florida Medical School. The surgeon asked what particular topic they wished him to lecture about, and they said it didn't matter to them: he could lecture on anything, but he had to operate—not just assist, but lead a surgical team and perform an operation himself. No black surgeon had ever done that at their university hospital.
Leffall completed a subtotal gastrectomy (surgical removal of part of the stomach) while the students observed, and the patient did well after the operation. The procedure took "less than one hour, skin to skin," and Leffall called the experience "unforgettable." It was also an event of personal significance. Born in 1930 in Tallahassee, Florida, and raised in Quincy, a small town in the rural northwest portion of Florida, the doctor had attended a segregated high school where his father, LaSalle Leffall, Sr., was principal. Leffall's father taught him not to yield to the type of racist thinking that would set some people aside as second class.
And that day, as the residents scheduled an operation that would highlight Leffall's considerable surgical skills, the words of his father were fulfilled. As Leffall explained in an interview with Contemporary Black Biography (CBB): "Growing up in Florida, my father used to tell us that with a good education and hard work there were no boundaries. And I'd look around at the way things were and say, ‘Yeah, sure Dad.’ But in the end what my father said was true. I'm not saying racism doesn't exist. You can think that way. But if you do your work well, you don't have to think that way anymore. You're not automatically denied anything in life because of your race."
Set High Academic Standards
In the Leffall family, education was held up as "the equalizer" of institutionalized inequities. Leffall's father had come from a one-room schoolhouse in Texas to attend college at Iowa State and the University of Chicago. After a few years on the faculty at Florida A&M College, he became principal of Stevens High School, the school from which his son later graduated as valedictorian at the age of 15. Leffall credits his father with the inspiration and encouragement that drove him to medicine. It must have been a forceful inspiration, because at every step of his education Leffall was ahead of the pack. He followed his early graduation from high school with another accelerated exit at age 18 from Florida A&M University—summa cum laude. In 1948, he left for the Howard University Medical School in Washington, D.C., and four years later, at the age of 22, he graduated as the medical school's highest-ranking student.
As a teacher, Leffall has told students, according to A Century of Black Surgeons, "After reading an exam question, if you must consider each answer A to E, rather than look for the answer you know is right, then you're not ready and you have been found wanting." These are standards he has kept himself, learning the medical records of his patients by heart before he goes on his rounds at six a.m. Such preparation has made him a legend to his students. One surgical apprentice to Leffall caught him in an error—once. His colleague at Howard University, Dr. W. M. Cobb, recalled that the surgical assistant could be heard for the whole year repeating: "I caught Leffall one day."
Specialized in Oncology
It was in the area of oncology, or the study of cancerous tumors, that Leffall focused his efforts and research after his residency in surgery at the Freedmen's Hospital in Washington, D.C. From 1957 through 1959, he took a senior fellowship in cancer surgery at Memorial Sloan-Kettering Cancer Center in New York City. After a year as captain of the Medical Corps and chief of general surgery in the U.S. Army Hospital in Munich, Germany, he returned to Howard University Medical School as an assistant professor of surgery, where by 1970 he was promoted to full professor and chairman of the department, a position he held for the next 25 years.
Leffall's dedication and accomplishments in the field of oncology were recognized when the Society of Surgical Oncology named him president in 1978. The next year, the American Cancer Society elected him its president as well; he was its first black president. In the latter organization, he helped initiate programs geared to the special problems of cancer in blacks. "For no major cancer is the survival rate greater among Blacks than among Whites," Leffall told Ebony 's Michele Burgen at the time of his election. "In other words, Whites are ahead of us in every major cancer in terms of surviving such malignancies as lung cancer, stomach cancer and large intestinal [colon] cancer."
At a Glance …
Born LaSalle Doheny Leffall, Jr., May 22, 1930, Tallahassee, FL; son of LaSalle Doheny, Sr. and Martha (Jordan) Leffall; married Ruth McWilliams, August 18, 1956; children: LaSalle Doheny Leffall III. Education: Florida A&M University, BS, 1948; Howard University College of Medicine, MD, 1952. Military service: US Army, chief of surgery, 1960-61.
Career: Homer G. Phillips Hospital, St. Louis, MO, intern, 1952-53; Freedmen's Hospital, Washington, D.C., resident, 1953-57; Memorial Sloan-Kettering Cancer Center, New York City, senior fellow in cancer surgery, 1957-59; Howard University College of Medicine, Washington, D.C., assistant professor, 1962-66, associate professor, 1966-70, professor of surgery and chairman of the department, 1970-95, Charles R. Drew Chair in Surgery, 1992-. Member of the National Cancer Advisory Board. Visiting professor at numerous colleges and universities.
Memberships: National Medical Association, American Cancer Society, president, 1979; Society of Surgeons of Oncology, president, 1978; National Dialogue on Cancer, board of directors, 1998-; Susan G. Komen Breast Cancer Foundation, chairman; President's Cancer Panel, chairman, 2002-.
Awards: First Prize, Charles R. Drew Fundamental Forum, 1954; named outstanding educator in America, Florida A&M University, 1971 and 1974; William H. Sinkler Memorial Award, 1972; distinguished service medal, National Medical Association, 1979; Diplomate of the American Board of Surgery; Fellow of the American College of Surgeons and American College of Gastroenterology; M.D. Anderson Hospital and Tumor Institute; Biennial LaSalle D. Leffall, Jr. Award, 1987-; LaSalle D. Leffall, Jr. Surgical Society (created in his honor), 1995-; Metropolitan Washington Chapter of the American College of Surgeons, LaSalle D. Leffall, Jr. Prize, 1996-; Society of Surgical Oncology, American Heritage Award, 2001.
Addresses: Office—Howard University Cancer Care Center, 2041 Georgia Ave NW, Suite 220, Washington, D.C. 20060.
As president, Leffall tried to increase minority staffing of the American Cancer Society as well as recruit black volunteers. These were the first steps in beefing up policies of prevention and education among blacks.
Speaking of the fear of cancer that paralyzes so many patients until it's too late to treat successfully, Leffall told Burgen that it's "not that the care isn't there, but it's not accessible enough to patients. Black patients tend to come in with more advanced stages of the diseases than do White patients, and thus they have a poorer cure rate."
Some of the disparity in cancer rates among minorities could reflect sociological differences. Over the last 50 years, blacks have consumed a far richer diet than in the past, thus increasing their intake of carcinogenic proteins and animal fats over the more traditional diet of carbohydrates and fibers. "All of us in America are now eating essentially the same diet of protein. Our eating habits have made us all prey to the illnesses which afflict Whites," Leffall told Burgen. But Whites have better access to information on the warning signs of cancer and so are more likely to seek treatment sooner. For other cancers such as prostate cancer, the risk is far greater for Blacks. "We simply don't know why prostate cancer is increasing among American Blacks," Leffall told Jack Slater of Ebony. "But we do know there is a much lower incidence of the disease in African Blacks. We also know that when an African comes to the U.S., his chances of getting prostate cancer is so increased that within four or five years he is as vulnerable to the disease as the American Black man."
As much as he dedicated himself to the broader aspects of prevention, nutrition, and education as head of the American Cancer Institute, Leffall continued to remind others that "the one thing we must never forget [is] that the object of our attention and affection is the cancer patient." In an afterword to A Century of Black Surgeons, two doctors who had worked closely with him confessed that they sought him personally when they required surgery on themselves.
It was this thoroughness of practical and case-by-case knowledge that brought him once again to national attention in 1985. When President Ronald Reagan underwent surgery to remove a cancerous growth on his colon, CBS Evening News asked Leffall to explain the procedure to its viewers. Leffall told Black Enterprise that he received a call at his office a few days later from an 82-year-old patient. She told him, "I rarely see blacks on television discussing anything except entertainment, sports or civil rights. When I saw you explain something as intricate as surgery, I just had to let you know how proud I was." When he heard that, the usually well-prepared doctor said his "eyes got a little wet."
Leffall's dedication to medicine and his ability to command respect and attention kept him at the forefront of the medical community in the decades to come. A Diplomate of the American Board of Surgery and Fellow of the American College of Surgeons and American College of Gastroenterology, Leffall traveled the world lecturing and teaching at more than 200 medical institutions over the years. His speeches resonated with his audiences. Dr. Edward M. Copeland III shared a profound statement from one of Leffall's speeches during his own speech honoring Leffall as the Society for Surgical Oncology's first American Heritage Award winner in 2001. "In the course of human existence, what is important is not so much intellectual superiority or charismatic presence, but rather patience, stamina and good judgment," Leffall said according to Copeland in the Annals of Surgical Oncology. "But the prime virtue is courage because it makes all other virtues possible. As a surgical oncologist treating patients with cancer, I have seen the human condition in peril. I have seen the stubborn persistence of hope when under ordinary circumstances; there should be no hope…. I've seen a demonstration of courage that defies description and when I see these and more, it lets me know that as oncologists we must be more sensitive, more caring, and more compassionate to the patients committed to our care. It is these things that are the essence of our expectations for the future." Leffall spent 50 years as a surgeon striving to do just that: his autobiography, No Boundaries: A Cancer Surgeon's Odyssey, offered a detailed account of his quest. When he performed his last surgery on May 16, 2006, Leffall heard congratulatory remarks of "job well done." But he was not done.
Leffall's retirement from surgery at age 76 did not mark his retirement from the medical community. Established as one of the most influential public health officials, Leffall remained active as a professor and lecturer, and as a leader of such prominent organizations and councils as the Susan G. Komen Breast Cancer Foundation, the President's Cancer Panel, and the National Dialogue on Cancer. His leadership had inspired the creation of the LaSalle D. Leffall, Jr. Surgical Society, two awards in his honor, and an endowed chair at Howard University Medical School; he also received 11 honorary doctorates and numerous awards. But more importantly, Leffall's efforts helped create changes in public awareness and public policy that helped African Americans and disadvantaged populations gain greater access to medical care and preventative information. Leffall remained busy spreading the word that ‘cancer’ did not mean the end; that with prevention, detection, early diagnosis, and proper treatment, cancer could be stopped.
No Boundaries: A Cancer Surgeon's Odyssey, Howard University Press, 2005.
American Men and Women of Science, 18th ed., Bowker, 1992.
Organ, Claude H., and M. M. Kosiba, editors, A Century of Black Surgeons, Transcript Press (Norman, OK), 1987.
Black Enterprise, October 1988.
Ebony, July 1974; April 1978.
Journal of Blacks in Higher Education, Spring 2006, p. 74.
Washington Informer, May-June 2006, p. 21.
"Dr. LaSalle D. Leffall, Jr. Leaves Surgery in Good Hands," Washington Informer,http://www.washingtoninformer.com/SPECDrLeffall2006May25.html (November 15, 2007).
"LaSalle D. Leffall, Jr., MD, FACS: The First Heritage Award Winner, Society of Surgical Oncology," Annals of Surgical Oncology,http://www.annalssurgicaloncology.org/cgi/content/full/8/6/477 (November 15, 2007).
Additional information was obtained through an interview with LaSalle Leffall on April 27, 1992.
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