Dr. Audrey Evans was double lucky when she grew up.
Evans (1925-2002) knew at an early age exactly what she wanted to do when she grew up: She was going to be a doctor. But unlike many girls at the time, she had parents who supported her dreams. "Fortunately my parents believed that girls should do as well as boys, so off I set," she was quoted as saying in her obituary in the New York Times.
And off she went on a career as a top pediatric oncologist. She came up with new treatment protocols that improved survival rates for children with neuroblastoma — a childhood cancer that involves the nerve cells — by 50%.
She also helped create the first Ronald McDonald House, a network that has grown to nearly 700 away-from-home facilities. The Ronald McDonald House organization has aided tens of millions of children and their families.
Despite a barrage of obstacles thrown in her path, she smashed one glass ceiling after another. She trained at the Royal College of Edinburgh — where she was the only female student in the medical school — followed by two years of residency at the Royal Infirmary of Edinburgh. There she again was the only female and was not even allowed to dine with her male colleagues.
A Fulbright Fellowship brought her to Boston Children's Hospital. There she studied with Dr. Sidney Farber, a renowned cancer researcher considered to be the father of modern chemotherapy — and discovered her passion for pediatric oncology.
Deal With Disappointment Like Audrey Evans
When Evans returned to England, however, more disappointment awaited. At the time, pediatrics was a hospital specialty and, she said, "they explained (to me), of course, it would be a man (doing the work), so you wouldn't have an opportunity to do pediatrics."
So she returned to the United States. She headed first to Boston's Children Hospital and then to the University of Chicago's hematology and oncology unit. In 1969, Dr. C. Everett Coop, the former U.S. Surgeon General and chief surgeon at Children's Hospital of Philadelphia (CHOP), recruited her to create a pediatric oncology unit.
It was a difficult job emotionally because, as Evans said, back then "you couldn't change the disease very much ... there wasn't much else you could do but care." Still very much an optimist, she preferred to look at the silver lining. "It sounds like a terrible ward of kids who probably have a fatal disease. (But) it wasn't a terrible ward because of the staff that ran it and the philosophy of 'anything goes.'"
Take A Different Route
How did Evans manage to stay optimistic despite these conditions? "Fortunately, nobody liked oncology," she said. "The people who ran the place would rather not go to the oncology floor. So I got away with things I could do in oncology which I'm sure you couldn't have done in a healthy ward."
As a result, Evans could do things a little differently — well, maybe more than a little. Children afraid of the X-ray machine could bring stuffed animals (and sometimes live ones) with them.
There were nights Evans would stay at the hospital and not go home, especially when one of her patients wasn't expected to survive until the next morning.
"I was there at 4 a.m., talking to him (the patient). What would he like (to eat)?" Evans had said. "And he wanted a piece of chocolate cake. OK, I'd call the dining room and (say), 'I need a piece of chocolate cake, and I need it now.'"
Julia Fisher Farbman wrote and produced "Audrey's Children," a film about Evans scheduled to be released in the United States on March 28. Because the doctor was a family friend, Farbman knew her virtually all her life.
Farbman described Evans as "fearless." "She wasn't one to ask for permission," Farbman told Investor's Business Daily.
Find Patterns Like Evans
Early on in her tenure at CHOP, Evans noticed patterns in the way her patients reacted to treatment. These reactions were partly based on the patient's age and how far the disease had progressed. So she started a study using histories of patients treated at CHOP. But that wasn't nearly enough data to produce a statistically valid result. So she cajoled and begged for patient data from other hospitals. Given her mission, one might think hospitals would be eager to cooperate. Not so, said Farbman.
They felt the information was proprietary and were afraid if the results of the study proved successful, credit would go to CHOP.
But she persevered, and her study, released in 1971, produced the Evans Staging System. It's a protocol for assessing patients with neuroblastoma that divided the illness into four stages. This helped determine which children needed more aggressive treatment and which might do well with less invasive methods, depending upon the stage their disease was in. She also created a fifth category called 4S, when she discovered that in children less than six months old, the disease frequently regressed on its own.
She also faced opposition to her more aggressive use of chemotherapy. "She was a trailblazer," Farbman noted. "Part of the resistance (to her treatment methodology) was 'hey, we've never done this before.'"
"She was determined to change the way things were done, and that she was a woman didn't help. Also, then a lot of doctors considered chemo (as) poison," Farbman said. "But Dr. Evans thought it was an important tool (and created chemo cocktails) trying to attack cancer from all angles. It's something we do all the time now. She was pushing new treatment methods others were afraid to use."
Look At The Broader Challenge
Evans' treatment methodology involved more than medical science. She believed "a family with a sick child is a sick family. So you must think about everybody"
As her and the hospital's reputation grew, CHOP attracted patients from around the world. Some stayed on mattresses on the hospital floor. Others slept in their cars or had to cut their child's treatment short because they couldn't afford a lengthy hotel stay.
Evans believed that when a child was ill, the family should concentrate on getting them care and not worry about anything else.
Prepared to use her own money to create a healing home, she found a house on Spruce St. in Philadelphia. This was still a time when a woman couldn't even apply for a credit card. And when she first approached the owner, he insisted she bring her husband to negotiate.
Turn Big Dreams Into Reality
At about the same time, Fred Hill, a tight end on the Philadelphia Eagles (1965-71) was raising funds for leukemia research because his daughter suffered from the disease. After a particularly successful fundraiser, the team looked for a visible local cause rather than a national leukemia organization to donate the funds to.
The team contacted Evans, who had no idea what American football or the Eagles were. But she told them about her dream for a home near the hospital where families could stay free of charge and support their children.
The Eagles went all in — and further. Team reps contacted a Philadelphia-area McDonald's marketing executive with a proposal. The chain was promoting Shamrock Shakes at the time. The organizers of the charity asked if McDonald's would donate 25 cents to the cause for each shake sold.
The restaurant did better. It offered all the proceeds from that promotion. There was one set of conditions. The cause had to be named after the company's clown mascot — and plans had to be made to take the program international.
That probably did not surprise Evans, who was religious, Farbman says. "I talked to her a lot. She stressed she believed deep in her soul that God put her on earth to help sick children and their families," she said.
Evans' Keys:
- Created protocols and treatments that improved children's cancer survival rates by 50%.
- Overcame: The natural desire to step away.
- Lesson: "I have a strong empathy for my patients and their families which is a help in pediatric oncology."
