February 17 2020
By Dr. Melody Cobleigh, Rush University
Dr. Janet Wolter graduated from Cornell College in 1946. That fall, she matriculated at The University of Illinois College of Medicine. Because many men had not yet returned from World War II, an unprecedented 12% of her class was female. The next year that number fell to 2%. Her subsequent medical training was at Johns Hopkins and Duke University.
Dr. Wolter returned to her roots in Chicago and joined the faculty at University of Illinois where she practiced internal medicine. She served in the Poliomyelitis Respiratory and Rehabilitation Center at the University of Illinois for several years until the advent of the polio vaccine rendered that center obsolete.
She was recruited to Rush University in 1963 by Dr. Sam Taylor III to work in a new field, medical oncology, which he is credited with helping to establish in the United States in 1954. Dr. Taylor’s background was in endocrinology and he was a pioneer in the field of cancer treatment, championing the role of the internist in the care of cancer patients.This concept, unique in its time, gave cancer patients new options beyond surgery.
She joined the National Surgical Adjuvant Breast and Bowel Project (NSABP) in 1970 when it was a fledgling organization, helping to design the first adjuvant chemotherapy trial in breast, B05. She described the small group of investigators with whom she designed that pivotal clinical trial in a piece she wrote for the NSABP’s 50th anniversary celebration. She was the Principal Investigator at Rush University until her retirement in 2010. She introduced dozens of young clinicians to that organization, myself included. She brought me to my first meeting in 1989 and I have attended their biennial meetings ever since. Like Dr. Wolter, I have encouraged my younger colleagues to do likewise and all of them serve its committees, now known as NRG Oncology.
In 1984, at age 58, Janet was diagnosed with the very disease she had spent her life treating.After her surgery for breast cancer, she did what came natural: she consented to a clinical trial, NSABP B-14, designed to prevent her cancer from returning. Half the patients received a pill, called tamoxifen and the others received a placebo. The trial was a huge success, reducing the relative risk of recurrence by 50%.When results of the trial were announced, she was informed that she had received the placebo.
Dr. Wolter, and her colleagues in surgery and radiation, formed the second Comprehensive Breast Center (CBC) in the US in 1985. This center was designed to provide multidisciplinary care for patients and families. At the CBC, patients met with a medical oncologist, surgeon and radiation oncologist at the same time. This facilitated communication among disciplines, education for physicians and opportunities for research. It has become a model for cancer care across the US. As of 2020, 26 physicians and 3 nurse coordinators have worked in the CBC.
I met Dr. Wolter in 1975, when I did an oncology rotation as a fourth-year medical student at Rush University. I sat with Dr. Wolter in her small examination room and observed her compassion, knowledge, and humor. I decided to become an oncologist because of this amazing woman and was privileged to join her as a colleague in 1989. We had lunch every week until she retired and dinner every couple of months thereafter.
Dr. Wolter became a mentor and friend to whom I am eternally indebted. She taught me how to deliver compassionate, practical care to women with breast cancer. Any physician knows that book learning is just the beginning. It’s translating that knowledge into the practice of medicine that makes a real doctor.Dr. Wolter’s philosophy was “treat smarter, not harder”. She believed that most breast cancers could be coaxed into remission with a kinder, gentler approach than was practiced at the time. While others were delivering very high doses of chemotherapy that caused severe toxicity, she was exploring new endocrine therapies for hormone receptor positive breast cancer, and a new immunologic approach to HER2-positive breast cancer.
She was the Principal Investigator of a national clinical trial involving a new cancer drug called Herceptin. Rush University was #1 nationally in accrual to the phase II trial and she allowed me present the pivotal paper to an international audience of thousands, thus launching my academic career.
As much as she was a mentor in medicine, she was a life coach. I recall discussing a politically delicate situation with a colleague as a young attending physician. I was really angry with this person and she said “well, you don’t have to like him, but you do have to love him”. I was dumbfounded. Of course she was right and her compassion became an example I have tried to emulate.
Dr. Wolter was a fabulous communicator. Her simplification of complex medical concepts was extraordinary. An example is her explanation of the pleural space to patients. This is normally a “closed space” between the lungs and the chest wall. But when cancer spreads there, large volumes of fluid can accumulate, causing shortness of breath. Dr. Wolter explained that it’s like a produce bag in the grocery store. At first, it’s difficult to open, but once open, you can easily put all of the apples in it. And after it’s opened, it’s hard to close it perfectly.
Dr. Wolter had a crackling wit and could tell a joke well. She was often surrounded at parties by a group listening intently. Suddenly, laughter would ring, but no one laughed harder than Janet. This led to another round of laughter, and so on. Her jokes often involved grammar, spelling, puns or rhymes. She told this one after a meal with friends. “It’s better to belch and bear the shame than to squelch the belch and bear the pain.”
Janet loved music. She played piano and guitar. Her stamina was enviable. After ten hours at the hospital she regularly attended the opera or symphony at night. On weekends she sang in the St. James Cathedral Choir, where she was a member for thirty-five years. I recall her many hours of evening practice before the Easter and Christmas services.
In 2000, she became the first female president of the Rush University Medical Staff where she spent countless hours helping resolve issues. She brought femininity to the cancer field. One’s cancer experience had previously been described in militaristic terms such as “a war on cancer” or “a battle” or “a fight ‘til the end”. Dr. Wolter described it as a journey, which often led to favorable changes in other aspects of a person’s life.
She volunteered, serving as president of the Illinois chapter of the ACS, as co-founder of The St. James Cathedral Counseling Center, and as VP for Episcopal Charities and Community Services Board. She chaired the Rush institutional review board, an uncompensated position at the time. I remember her lugging stacks of folders home on a Friday afternoon to review over the weekend.
She was a wonderful cook and many of us have benefited from her recipes. A favorite, which my family calls “The Blueberry Thing” is enjoyed many times each summer. When I planned a party she sent menus. If I was missing an ingredient in the middle of preparing a meal, she knew what to substitute.
Janet Wolter was a physician, a teacher, a volunteer, a music lover, a jokester and a dear friend to many. We are so lucky to have known her.
Quotes from Dr. Wolter’s Colleagues:
“Some physicians know a lot, some have superior judgement, some are master educators, some are brilliant researchers, and some have the innate ability to connect with their patients with compassion and empathy. Very few can do it all. Janet was one of those very few.”
Dr. Thomas Witt, Professor of Surgery, Rush University Medical Center
“One of my memories of her is as a doctor's doctor. She cared for my father, an obstetrician and gynecologist, when he was afflicted with hepatoma in the early 1970s. She was wonderful.”
Dr. David Turner, Professor of Radiology, Rush University Medical Center
“Her legacy is the many trainees in all oncology disciplines who base our clinical practice on what we learned from her and, when confronted with a challenging case, think ‘what would Dr. Wolter do’. I am sad I cannot ask her now. (Also that I can't ask her about good books, restaurants, operas, etc.)”
Dr. Katherine Griem, Professor of Radiation Oncology, Rush University Medical Center