Reminiscing about his 65 years in medicine, LaSalle Doheny Leffall, Jr, MD, FACS, cites three events in his early childhood that would ultimately lead him to his position today as the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC.
First, he was drawn to the compassion of the profession through the example of a family friend who was the only African American physician in his hometown of Quincy, Florida. In addition, he recalls an encounter with a wounded bird he nursed back to health when he was 9 (“my first patient”). And most important of all, he credits the unbridled encouragement of his parents. Martha and LaSalle Leffall, Sr, both schoolteachers, instilled in their son the belief that any obstacle could be overcome and any goal achieved.
“My father always told me, ‘with a good education and hard work, combined with honesty and integrity, there are no boundaries,’” said Dr. Leffall. “He also said medicine is an honorable profession and that I could help people, be proud of my work, and make a decent living so I could take care of my family. I like that last statement, because he wasn’t saying I could make a lot of money, he was saying I could make enough money to take care of my family.”
Born on May 22, 1930, in Tallahassee, Florida, Dr. Leffall was a good student, graduating from high school at just 15, and summa cum laude from Florida A&M University 3 years later, in 1948. Despite graduating with high honors, he admits he did not score well on his medical college admission test (MCAT), and was later rejected for admittance to Meharry Medical College. He was, however, accepted to Howard University College of Medicine.
“The dean of the medical school at Howard and the admissions committee decided that with my college grades, I should do well in medical school and admitted me,” said Dr. Leffall. That decision proved to be the right one. “I graduated first in my class.”
Breaking the Color Barrier
Dr. Leffall’s strong work ethic and belief in the principle of “no boundaries” has carried him through a nearly 6-decade stellar career in surgical oncology—a career that broke the color barrier for others following in his footsteps, and is chronicled in his autobiography, No Boundaries: A Cancer Surgeon’s Odyssey (Howard University Press, 2006). He became the first African American President of the American Cancer Society in 1978, and the first African American President of the American College of Surgeons in 1995.
Dr. Leffall was a protégée of Jack E. White, MD, the first African American to train in surgical oncology at Memorial Sloan-Kettering Cancer Center, and who in the 1950s launched the Tumor Clinic and Cancer Training Center, now the Howard University Cancer Center. In 1957, he would follow the path of his mentor and get his surgical training at Memorial Sloan-Kettering, the third African American to do so.
Civil Rights Struggle
The late 1950s was a time of immense upheaval in the struggle for civil rights in the United States. It was also a time in which few African Americans were accepted into medical school. In 1957, only 14 of the 26 medical schools in the South admitted African Americans1—and by 1960 the number of black physicians and surgeons nationwide numbered just 4,706.2 Fifty years later, the news is not that much better, with only 29,717 African Americans practicing medicine,3 4,340 of whom are oncologists.4
Although Dr. Leffall said he rarely encountered overt signs of prejudice or discrimination during his career, he does remember an incident, when he was a resident at Memorial Sloan-Kettering, where a white patient being treated for cervical cancer refused to let him examine her.
“The woman said, ‘I can’t let you examine me. I want somebody of my own race to examine me.’ When we made rounds later that afternoon, the attending physician told the patient she was being discharged because she refused to be treated by his resident. The woman became so upset, she begged us to help her, which we did, and we later became friends,” he said.
In addition to heeding his parents’ counsel that there would be no boundaries to his success if he worked hard and got a good education, Dr. Leffall’s oncology career has also been strongly influenced by the words of his professor at Howard, Charles R. Drew, MD, a pioneer in blood transfusions, who told him, “Excellence in performance will transcend artificial barriers created by man.”
“I believed my parents and I believed Dr. Drew,” said Dr. Leffall. “The barriers Dr. Drew talked about were segregation and discrimination, but he said ‘if you do well enough, I don’t care what your race is, your ethnicity, or your religion, people will notice your hard work and accomplishments.’ And I took that advice to heart.”
The writings of physician Sir William Osler also impacted Dr. Leffall’s career. “I read Aequanimitas early in my career, which gave me my favorite quotation, ‘equanimity under duress,’ a concept emphasizing the importance of calmness and tranquility in confronting our daily problems,” he said.
A Lasting Legacy
A surgeon specializing in colorectal, breast, and head and neck cancers, Dr. Leffall recognized early in his career the health disparities in the treatment of African American patients with cancer. During his tenure as President of the American Cancer Society, the organization launched a program focusing on the rise in cancer incidence and mortality rates in minority groups and had a major role in establishing the first conference in cancer health disparities to ensure that all patients receive the best cancer care.
Wishing to combine his love of practicing medicine and teaching, in 1962 Dr. Leffall joined the faculty at Howard University College of Medicine, rising through the ranks from Assistant Professor of Surgery to Professor and Chairman of the Department of Surgery in 1970, and serving in that capacity for 25 years. In 1992, he was named the University’s Charles R. Drew Professor, the first endowed chair in the history of Howard’s Department of Surgery.
Over the course of his career, Dr. Leffall estimates that he has taught more than 6,000 medical students and helped train more than 280 surgical residents. Although he gave up performing surgery the week before he turned 76 and stopped actively practicing medicine earlier this year, at 83, he has no plans to retire, and still arrives at Howard by 6:00 every morning, ready to teach his medical students and consult with colleagues on difficult cancer cases.
When asked to name his greatest professional accomplishments, Dr. Leffall said there are two. The first is the number of new physicians he has sent into the world to treat patients with cancer. “I believe my greatest accomplishment is as a teacher because I will have a lasting effect on thousands of patients. I tell my students, ‘You must treat patients with respect and dignity and always give your best. You won’t be able to cure every patient, but you will be able to help most patients.’” And the second accomplishment he pointed to was being named Chairman of the President’s Cancer Panel from 2002 until 2011.
Married to his wife Ruthie for 57 years, the couple has one son, LaSalle III, a lawyer and investment banker.
Dr. Leffall is buoyed by the many advances he has seen in the treatment of cancer over his long career, especially in the increasing number of survivors and the attention paid to patients’ quality of life. However, what he really wants is an end to the disease.
“With ongoing basic and clinical research, we will continue to make progress that could eventually lead to a universal cure for cancer,” he said. “When that happens, I’ll applaud from Heaven.” ■
2. U.S. Census of Population, Characteristics of the Population, U.S. Summary, vol 1, pt 1, 1950; vol 1, part 1, 1960. Washington, DC, U.S. Government Printing Office.
3. Association of American Medical Colleges: Diversity in the Physician Workforce: Facts & Figures 2010. Available at members.aamc.org. Accessed August 24, 2013.
4. Kirkwood MK, Kosty MP, Bajorin DF, et al: Tracking the workforce: The American Society of Clinical Oncology workforce information system. J Oncol Pract 9:3-8, 2013.