Fair Through and Through

On January 3, William R. Fair, Jr., MD, died at the age of 66. For 13 years, Bill Fair was chief of urology at Memorial Sloan-Kettering Cancer Center in Manhattan . A past president of the American Urological Association, he was a born surgeon, who loved everything about the art and science of surgery. Bill Fair played "a major role in urological oncology, in developing treatments of cancers that affect the urinary tract system," according to Dr. Murray Brennan, chairman of the department of surgery at Sloan-Kettering. In the course of his career he published over 300 peer-reviewed medical journal articles.

Then, in 1995, at the pinnacle of his career, Bill Fair was himself diagnosed with colon cancer. He underwent a year of chemotherapy and many operations, only to have his disease recur twice. Faced with a bad prognosis, he explored the world of complementary and alternative medicine (CAM).

In 1997, Charles Simone, MD, introduced me to a meticulously dressed man at a National Institutes of Health meeting in Bethesda, MD. I was more surprised when this man asked me to be an advisor to his budding program on CAM cancer treatments at Memorial Sloan-Kettering. Because of my own experiences at MSKCC I was very skeptical about joining up with Dr. Fair. But in August of 1997 I wrote him a letter, concluding: "Personally, I would like to make a new beginning. Reconciliation is healing and will move us all forward. To continue to cling to old ways will only lead backwards."

Some time later, Bill invited me to visit him at his home on the East Side. It was a duplex with high windows on three sides. We sat alone in his living room for nearly three hours, as the sun set and the lights of the City came up. By the end of the conversation we were sitting in near darkness, talking quietly about our experiences, how our ideas about cancer treatment had differed and yet now converged. It is a moment I will cherish, the birth of a friendship.

I also became friends with others in his circle, including his wife, MaryAnn, his son, William Fair III, and Lucy R. Waletzky, MD, a prominent member of the Memorial Sloan-Kettering Board of Overseers, who supported his work. Bill asked me to serve on the advisory board of his new organization, Haelth, Inc. Haelth's annual Christmas parties were always high points of my year, as I watched the determined way that Bill and his colleagues developed this organization until it became a reality.

In 1999, Bill me invited to join him in giving the surgical Grand Rounds at MSKCC. It was a wonderful gesture, since it gave me some closure on my firing more than 20 years before. I could also sense the deep respect that his colleagues had for him, as well as their distress at his illness.

One evening, shortly thereafter, Bill and I sat next to each other at a dinner at a New York restaurant. In attendance were deans or prominent physicians from most of the medical centers in Manhattan. They all shared a desire to bring CAM programs to their hospitals. Bill leaned over to me and whispered, "I bet ten years ago you never thought you'd be having dinner with people like this." I quickly replied, "Bill, ten years ago I didn't think I'd be having dinner with you." His presence in the CAM field was always a surprise to me, a marker of just how far we had come towards acceptance by the medical establishment.

Although conventional medicine will long remember his numerous contributions, I believe that his greatest impact was in the field of CAM cancer treatments. Bill became synonymous with a new approach to CAM -- rigorous yet also sympathetic. He was exactly what his name promised, "Fair" through and through. Because of this his contributions were widely recognized. He was even the subject of a long and admiring article in the New Yorker, called "Dr. Fair's Tumor."*

After that, hundreds of patients sought out his opinions and advice. He was unstinting in giving what help he could. He himself adopted a judicious program that included dietary changes, yoga, meditation and some herbs. The tumors shrank and Bill felt, and looked, well. But he was facing a dire prognosis and never had excessive expectations for any treatment, orthodox or unorthodox. My impression is that he gained about four years of life from this program. More importantly, though, he had outstanding quality of life during that time. He and his wife set out on a hiking trip to Patagonia. Last year, he visited Saudia Arabia. He had more energy than most people who were not sick. His illness gave him a philosophical perspective that is not usually found in busy surgeons.

A Pivotal Figure

Other leaders of the cancer field have used alternative medicine before, but they usually kept it hidden. What set Bill apart was his willingness to share his experiences as a cancer patient and to explore unorthodox therapies with the same intellectual rigor that he had applied in his medical career. "What I expected after his diagnosis was that he would close ranks and deal with his health," his son said. "What he did was quite the opposite. He said, I'm not going to hide but I'm going to try to help, and he continued to be the physician, healer and teacher he always had been." Two years ago, Fair and his son opened Haelth, a complementary medicine center in SoHo. He also served on the White House Commission on Complementary and Alternative Medicine Policy.

Last year, my wife and I were invited to Bill's 65th birthday party at a Manhattan restaurant, which was also his retirement party from MSKCC. He had invited friends who represented different phases in his eventful career: his boyhood in New Jersey, his stint in the military (where he met his wife, who was a nurse), his medical school years at Jefferson Medical School in Philadelphia, his apprenticeship at Stanford and at Washington Universities and, of course, his 13 years at Memorial. It was a chance for me to see the many sides of this remarkable person.

Now the praise for Bill Fair is pouring in. "He was a giant not only in traditional medicine ... but also in complementary and alternative medicine," said Dean Ornish, MD. "He showed by his own example that when you make lifestyle changes it can have impact."

"I think he brought credibility: he had had cancer; he had been through it. I also think he brought a stability, sensibility and thoughtfulness to complementary medicine," said Murray Brennan said.

All true. He raised the bar of seriousness in the field of CAM cancer treatments. He was the perfect embodiment of "Integrative Oncology," which means taking the best from both conventional and complementary treatments and subjecting it to a rigorous, yet sympathetic evaluation. When the history of CAM cancer treatments is written, William Fair, Jr. will be a pivotal figure. Yet when I think of my friend Bill it is of a soft-spoken, elegant man sitting in near darkness sharing far-reaching plans on behalf of all cancer patients.

A funeral is scheduled for 10:30 a.m. Feb. 20 at Arlington National Cemetery in Arlington, Va. A memorial service is to be held in New York City on March 29. The location will be announced. Donations in memory of Dr. Fair may be made to the nonprofit Health Research Foundation at 599 Broadway, 4th Floor, New York, N.Y. 10012. Their phone number is 212-334-9600.

* "Dr. Fair's Tumor," the New Yorker profile by Jerome Groopman, MD, is available at barnesandnoble.com in an eBook anthology called "In Sickness & In Health: An Anthology of Medicine" (from The New Yorker), Henry Finder (Editor) / MS Reader eBook / The New Yorker / February 2001.

Till next week....best wishes for your safety, good health and peace of mind!

Ralph W. Moss, Ph.D.