My Path from Columbia to a Nobel Prize

How a War Launched My Career in Research
By Robert J. Lefkowitz’66 with Randy Hall

I had yearned to attend medical school since the age of 8 but had not the slightest bit of interest in research during my medical school days. I was determined to become a practicing physician, and research seemed like a distraction from my single-minded goal.

I did have one brief exposure to research during medical school at Columbia, and it did not leave a positive impression. After finishing the formal coursework in the first two years of the curriculum, I won a prize for having the best grades in my class. This prize, which was sponsored by the drug company Roche, consisted of a swanky new wristwatch and an all-expenses-paid trip to an exotic location: New Jersey. Specifically, I won a day at Roche’s U.S. headquarters in Nutley to see how drugs were developed. During this visit, I observed a team of Roche scientists who were searching for new cough medications. Their job was to screen every drug made in any program at Roche for the ability to suppress coughing, because cough suppressants were big moneymakers.

This research group’s main experimental technique was to use a Rube Goldberg-type contraption to tickle cats’ throats to induce coughing, then inject the cats with dozens of different drugs, one by one, to search for drugs that might reduce the feline hacking. I tried to hide my disgust from the researchers who were hosting me, but I was absolutely mortified by these studies. I felt sorry for both the cats and the poor bastards who had to spend all day tickling their throats. After this experience, I became even firmer in my conviction that I would never go into research.

As medical school wound down in the spring of 1966, my family’s future was endangered by a looming threat: the Vietnam War. At that time, all graduates of American medical schools were required to enter the military to serve a year in Vietnam. There was no lottery system—the military had an acute shortage of doctors, so every medical school graduate was mandated by law to serve. I believed in the importance of serving one’s country but also dearly wanted to avoid being separated from my young family and sent halfway around the world for a year to support a war that I and most of my classmates believed was wrong. I felt a growing sense of trepidation and searched for some kind of alternative path that might allow me to serve honorably and also stay close to my family.

There were several ways to avoid the “doctor draft” during the Vietnam War. Medical school graduates were allowed to request a one- or two-year deferment to complete their internships and up to one year of residency training. After that, though, service in Vietnam was required unless some other arrangement was made. One attractive possibility was to gain a commission in the United States Public Health Service (USPHS), which was considered part of the U.S. military and thus fulfilled one’s draft obligation. USPHS physicians could work as prison doctors in the federal penitentiary system, help to track global pandemics at the Centers for Disease Control, or conduct research at the National Institutes of Health (NIH). Despite my previous lack of interest in research, I decided to pursue this last option.

I hoped to become an academic physician, maybe even a chair of medicine at a top medical school someday, and was becoming aware that such positions required at least some research experience. Most of the prominent doctors who trained me at Columbia were alleged to have done research at some point in their pasts, and a handful were even supposedly still active. For example, one of my attending physicians, William Manger, was a subject of fascination amongst the medical students. Whenever he walked past, you’d hear people say in hushed tones, “I hear he does research.” It clearly gave him a special cachet and cool factor.

Manger was also notable because he was the heir to a hotel fortune. He dressed sharply in three-piece suits, complete with a pocket watch dangling on a gold chain. Late in my last year of medical school, he invited several of us who were on rounds with him over to one of the Manger hotels downtown. After we enjoyed lunch in the luxurious dining room, Manger casually asked, “Would you like to see my laboratory?” We were curious, of course, and even more curious when he got into the elevator and pressed the button for the penthouse. When the elevator doors slid open, we strode into a spectacular suite that had been converted into a research lab. Hundreds of glass beakers were glinting in the abundant light, and the windows on all sides looked out over jaw-dropping views of New York City. I was in awe and began to think that maybe research wasn’t so bad after all.

Robert Lefkowitz posing with his parents at his medical school graduation. “I smiled for a photo but was feeling stressed about the ‘doctor draft’ that might send me to Vietnam.” His father said it was the proudest day of his life.

Having decided that a bit of research might be a nice addition to my resume, I submitted my application to the NIH. I was accepted for an interview and drove to Bethesda, Maryland, for my interviews on July 1, 1966. Unfortunately, the first of July also happened to be the start date for my internship at Columbia-Presbyterian Medical Center. As if beginning my internship wasn’t stressful enough, I had to miss my first day (and beg someone to cover for me) in order to conduct my interviews in Bethesda.

The interview process was a match-based system: Applicants had to rank the group leaders with whom they wanted to work, and the group leaders in turn had to rank all the applicants. It was a highly competitive process, with hundreds of the best and brightest young doctors across the country applying for a limited number of slots.

My interviews at the NIH went poorly. For one thing, I had no research experience at all, which I began to realize was a major negative when interviewing for a research position. I had to explain over and over again to different NIH scientists why I hadn’t bothered to take advantage of the various research opportunities that had existed at Columbia. My lack of research experience was compounded by my lack of enthusiasm, as I wasn’t actually very excited about research but rather just trying to bluff my way through the process by pretending to be enthused.

The toughest interview of the day was my last, with a tall, hyperkinetic scientist named Jesse Roth. He asked why I wanted to come to the NIH. I said the words I thought he wanted to hear.

“My goal is to become a triple threat: I want to be a great physician, great researcher, and great administrator.”

“That’s bullshit,” Roth replied. “You’ll never be great at all three. You have to choose. Which would you choose if you could only be great at one?”

I was taken aback by his tone and stammered my way through an incoherent answer. When I left Roth’s office and staggered back to my car, I was certain that I’d screwed up and wouldn’t receive an offer for one of these coveted positions. I felt an impending sense of doom that I would soon be torn away from my family and sent on a tour of duty in the jungles of Vietnam.

During the first few months of my internship at Columbia, as I honed my clinical skills as a physician overseeing a whole roster of patients each day, I kept waiting to learn whether my next move would be to the NIH or Vietnam. Finally, a phone call came for me at the hospital and someone yelled down the hall that it was from the NIH. I raced to the phone and picked up the receiver. The call was from Jesse Roth himself, and he wanted to know if I would be interested in joining his research group. I accepted on the spot and raised my arms in triumph when I hung up the phone.

 

This is excerpted from “A Funny Thing Happened on the Way to Stockholm: The Adrenaline-Fueled Adventures of an Accidental Scientist” by Robert Lefkowitz with Randy Hall. Dr. Lefkowitz, one of two Nobelists in the Class of 1966, shared the 2012 Nobel Prize in Chemistry. His memoir was published in February by Pegasus Books.