When Joseph V. Simone, MD, was 6 years old, he had his first experience with the death of a child. His 9-month-old brother became sick with the croup and was taken to the nearby children’s hospital, where he died a few days later, leaving Dr. Simone and his family devastated. Caring for sick children facing their own mortality would later define much of Dr. Simone’s remarkable career. He headed the research that resulted in the first curative combination treatment for certain pediatric patients with acute lymphoblastic leukemia (ALL). Dr. Simone died on January 21, 2021. He was 85.
Dr. Simone was born on September 19, 1935, in Chicago, the son of Italian immigrants who forged a new life in the Windy City’s working class West Side. An enthusiastic and bright student, Dr. Simone excelled in the sciences, earning a scholarship in 1953 to Loyola University. After deciding to become a physician, Dr. Simone remained at Loyola, pursuing his medical degree at the University’s affiliate Stritch School of Medicine. Dr. Simone remained at Loyola for his internship, residency, and fellowship training, first in internal medicine and then in pediatrics, at Presbyterian St. Luke Hospital (now Rush) in Chicago. It was also where he met Pat, also a Windy City native, who later became his wife.
Joseph V. Simone, MD
Dr. Simone’s hematology career took seed in his sophomore year, while he was working an off-hours job in the laboratory of a nearby community hospital that had a large commitment to blood disorders. “The head of pathology would recruit three high-achieving sophomore medical students to cover the graveyard shift lab work. Thinking about it now gives me chills, doing lab work at night, basically with little to no training. Fortunately, it was a low-volume situation; there wasn’t too much going on at night, but the scientific process of lab work stirred my interest in hematology,” Dr. Simone recalled during an interview.
Heading South: A Career Blooms
After completing his fellowship at Loyola, Dr. Simone was offered a position at St. Jude Children’s Research Hospital in Memphis. The young couple had never ventured out of the Chicago area before heading south, to the institution where Dr. Simone would make his indelible mark in the field of pediatric oncology. The year was 1967, a period tormented by heated racial injustice, and Memphis became its flashpoint when civil rights champion Martin Luther King, Jr was killed on a balcony in the heart of the city.
Dr. Simone, a passionate supporter of Dr. King recalled: “I, along with several of my colleagues, marched with Martin Luther King in 1968, a week before he was killed. I still have the posters. For some reason, I had the presence of mind, as we were running away from what turned into a riot, to grab a couple of the posters. I still have them hanging on my wall.”
Dr. Simone worked tirelessly in the clinic and the laboratory. After 2 years on the job, his mentor, St. Jude’s Director, Donald Pinkel, MD, put him in charge of the institution’s fledgling leukemia program. Until then, the vast majority of children with leukemia died of their disease. However, by cultivating a communication model to better reach patients, Dr. Simone began to realize the difference in treating children vs adults, sparking an investigative hypothesis, a light Dr. Simone saw at the end of the tunnel.
According to Dr. Simone, he and his team initiated “some very good clinical trials; we were extremely systematic about it, and careful, and we just hit a homerun.” The homerun Dr. Simone referred to with inimitable modesty was the first curative combination treatment for select children with ALL, which led to the first patient to be successfully taken off therapy.
Dr. Simone would go on to spend 24 fruitful years at St. Jude. In 1983, under his leadership, the hospital was acknowledged as the first and only National Cancer Institute–designated comprehensive cancer center dedicated entirely to children. “There is no question in my mind that my biggest career impact was developing treatments for childhood leukemia. Everything is dwarfed against that. Becoming a pediatric oncologist was a godsend for me,” Dr. Simone remarked.
Thinking Big Picture for Oncology
Dr. Simone’s success in building St. Jude as a cancer center elicited knocks at his career door from other institutions seeking his dynamic leadership style. In 1992, Dr. Simone was invited to become Physician-in-Chief of Memorial Sloan-Kettering Cancer Center (MSK) in New York, an opportunity to begin thinking of oncology on a structural level. While at MSK, Dr. Simone began a career focused on quality improvement in cancer care. At the time, the Clinton administration’s health initiative was bent on reducing health-care costs, an admirable goal, but one which, in Dr. Simone’s insight, did not give enough consideration to the cost-value equation.
In response, Dr. Simone began collecting data on the quality of care, which he loosely dubbed, “the MSK Disease Management Program,” from which early practice guidelines were developed. Dr. Simone’s program became the precursor to ASCO’s Quality Oncology Practice Initiative (QOPI®). Moreover, he also saw the cost-saving trend of directing patients with cancer to less-expansive community hospitals instead of multidisciplinary cancer centers as being clinically pennywise but dollar foolish, given the better outcomes data at large centers of excellence.
Due to his national standing, Dr. Simone was asked to lead a subgroup to develop a plan around the idea of higher quality and, incidentally, to serve as the first head of the project. This project would become the National Comprehensive Cancer Network®, whose practice guidelines continue to serve the oncology community as the gold standard for delivering high-value care for patients with cancer.
Building the Community
Always seeking to better the field, after leaving MSK, Dr. Simone’s career path took him to the Huntsman Cancer Institute at the University of Utah. There, he served as the first Senior Clinical Director and then moved on to the Shands Cancer Center at the University of Florida. During these appointments, he also served as an external adviser for cancer centers such as Moffitt Cancer Center, the University of Southern California Norris Comprehensive Cancer Center, Cleveland Clinic, and the University of California San Diego Moores Cancer Center.
Along his forward-thinking journey, Dr. Simone did what all noted leaders before and after him do: mentor the best and brightest residents and fellows on their own journeys in oncology. As noted by lung cancer expert David Johnson, MD: “Joe was the quintessential mentor. His passing is a huge loss for the oncology community. I will always be grateful to him for his friendship and guidance.”
A Mentor Who Shared His Hard-Earned Lessons
Over his half-decade-plus career, Dr. Simone received numerous awards for his contributions to the field. As noted by his colleague, former ASCO President Daniel Hayes, MD, FACP, FASCO: “Dr. Joe Simone was one of the great ones. He had so many accomplishments, including starting ASCO’s QOPI, and ASCO’s award for quality improvement is named after him. One of my cherished possessions is a signed copy of Simone’s Maxims.”
Simone’s Maxims is roundly considered by the oncology community as a pearl of wisdom and clarity that has been eagerly shared, dog-eared, and annotated in the margins since its publication in 1999. Dr. Simone explained that throughout his various academic positions, he gained some wisdom and many “battle scars.” To make some sense of his experiences, he began establishing personal rules of thumb, “maxims,” to discern some meaningful patterns in what he describes as “seemingly chaotic events and baffling human behavior.” Thus, Simone’s Maxims gradually emerged to guide his own judgment. One such maxim he shared was “academic medicine is a noble profession.” Indeed, Dr. Simone would later say “I am grateful that fate and early training led me into academic medicine, and I would do it again in a New York minute.”
Dr. Simone will be missed; but he will be remembered for all he gave over a remarkable and extraordinary lifetime.