Prague

Lubos Turek: Detours of ‘Dr. Doom’

in Opinion

Czech pathologist in Iowa becomes a friend in dire need

“What will decide Alan’s diagnosis and therapy,” Lubomir Turek wrote my wife from Iowa when I was between hospitals and biopsies here, “is whether the nodules in his liver could be inflammation (abscesses treatable by antibiotics) or are a tumor. Although liver abscesses that would look like Alan’s liver nodules would be quite unusual, they need to be either confirmed or excluded.”

When my second biopsy (at Motol hospital) established that the growths on my liver were cancerous (“My father’s three conditions,” Prague Profile, Feb. 4-10), we went on to Turek’s next paragraph:

“In the case his disease should turn out to be cancer, whether it is of a kind that would respond to (1) surgery (unlikely because there are two or more lesions on his liver); (2) radiation, or (3) chemotherapy.”

The matter-of-fact tone in Turek’s e-mails at first alienated my wife (here) and two daughters (in France and New York). They called him “Dr. Doom” and “Professor Gloom” and asked me if I wanted to go on corresponding with him.

My resounding affirmative took them by surprise but eventually he won them over with his knowledge and candor. While we were drowning in a sea of medical uncertainty — with even the honest truth hard to comprehend and not always in such good English — a stranger in Iowa City had thrown me a lifeline of expert reality: what he calls “a conduit of clear information.”

What’s more, professor Turek, 52 — a Prague-born pathologist who heads the molecular and tumor virology program in the Holden Comprehensive Cancer Center of Carver College of Medicine at the University of Iowa — is so well-connected here that the senior pathologists at both university hospitals, Roman Kodet at Motol and Ivana Vitkova at Karlovo namesti, with my consent were sharing their findings and exchanging insights with him almost as fast as they were informing my local physicians. As I “progressed” from CAT scan to PET scan and more tests and began chemotherapy (outpatient at Karlovo namesti) on Friday the 13th of February, Lubos Turek was looking for more-promising alternatives on his side of the Atlantic. So far, his answer is that I’m receiving the best and latest care here.

Splitting the difference

Appropriately, I first met Lubos Turek after I wrote a 2002 column on my travails with Cesky Telecom. A Letter to the Editor appeared a month later to salute “the story’s structure of a classic Central European joke with sad underpinnings” but also to question my Czech slang reference to a “kilo” note as 1,000 Kc (now almost $40). Weren’t 100 Kc a kilo and 1,000 Kc a tac?

I stood corrected — and made it up to him by inviting him to a 5-kilo lunch at U Ciriny the next time he was in Prague.

A charming white-haired cherub with a look of innocence that belies his knowledge of the human body, Lubomir Petr Turek had left communist Czechoslovakia in 1975, three weeks after winning his medical degree from Charles University. The only child of an ear-nose-and-throat doctor and a biochemist, he’d been working nights and weekends as an “auxiliary assistant” at the Academy of Sciences’ Institute for Experimental Biology & Genetics, but any future there had been precluded when his senior adviser fled the country.

“My departure was mostly a matter of timing and convenience,” he told me. “I’d applied for an exit visa for a vacation in Greece that spring on the supposition that the police could rely on a sixth-year medical student to return to complete his diploma. But, on graduation day, the visa hadn’t come and I despaired. But 10 days later my passport arrived with exit visa in it, so I got out as fast as I could.”

He traveled by train through Hungary and Yugo-slavia to Greece, and, after a five-day pilgrimage to Mount Athos, made his way north to Munich, “where I turned myself over to the Bavarian police. They sent me to a refugee camp near Nuremberg. After a week the West German government gave me a plane ticket to West Berlin, where I could stay with the parents of my German friends.”

Upon finding a paid job as a full-time postdoctoral research associate at the Institute of Human Genetics at the Free University of Berlin, he wrote 18 letters to university laboratories and institutes abroad and received offers from half a dozen: three of them in the States.

He chose the University of Southern California’s microbiology department because of the world-class reputation of its leader, Peter Vogt, and arrived in Los Angeles on a “conditional-entry” visa June 30, 1976, “four days before the Bicentennial. My hosts in L.A. took me up to San Francisco and we watched the fireworks over the Bay.”

Research and romance

In the 1960s, Dr. Vogt and Turek’s mentor at the Academy in Prague, Jan Svoboda, had launched the hunt for a viral link to tumors and pioneered a new science called oncovirology. Svoboda was demoted and harassed by the secret police in communist Czechoslovakia’s “normalized” 1970s for accepting research funds from the U.S. March of Dimes charity while discoveries in the field led to two successive Nobel Prizes in medicine given to Vogt’s and Svoboda’s collaborators and competitors. Ironically, the first was awarded in the fall of 1975, just as Turek was fleeing his country to continue his research elsewhere.

His two years in Los Angeles led to four years just outside Washington, D.C., in Bethesda, Maryland, to study viral carcinogenesis and qualify as a pathologist at the National Cancer Institute. But the limitations of working for the government bureaucracy didn’t agree with Turek, so one hour after he finished in Bethesda he drove west to Iowa and sought shelter in academia at Carver, where he has thrived since 1982.

In 1984, a petite but resolute blonde planted herself in front of him in a corridor at Carver and said: “I know who you are and what you’re doing, and I want you to teach the cancer part of my class in ‘Epidemiology of Human Disease.'”

She was Elaine Smith and, unlike many teachers who use guest lecturers to take time off for other work, she sat in on his classes, asked questions and began a working partnership that blossomed quickly into romance and flowered as marriage in 1997.

Elaine had been looking into the possibility that cervical uterine cancer in women was caused by a viral infection. The molecular-research laboratory Turek was creating at Carver was geared toward exactly the kind of clinical research Elaine was doing, so together they applied for a grant from the National Institutes of Health (NIH) and to their amazement, won it right away. As the link was established (with their early help) by others, Lubos and Elaine moved on to connect the same type of virus with cancer of the head and neck. Their work has been continuously funded since 1992 by the NIH and now involves seven scientists at the University of Iowa and five more in the division of experimental virology at the Czech Health Ministry’s Institute of Hematology and Blood Transfusion in Prague, which is what brings the Tureks to his hometown often.

A mellow Saturday

On Valentine’s Day, my first day recovering at home from chemotherapy, Lubos came and spent the whole afternoon and early evening (including two meals) sharing his wisdom and insights:

“Because we deal with the end result, we pathologists tend to be a pessimistic lot; oncologists tend to be more optimistic because they sometimes see miracles and remissions.

“You will not outlive the disease, but you’re gonna live with it. It’s not going to go away. With no chemotherapy and with the cancer progressing as it has, you wouldn’t last very long — certainly not years. But because of the combinations of chemicals you’ll be getting, there’s a good chance the disease will be arrested.

“The crapshoot part is: For how long?”

My oncologist here, Dr. Filip Janku — a straight-talker with a year of medical training at Yale University in New Haven, Connecticut — tends to agree.

VITAL STATISTICS

Born Aug. 3, 1951, in Prague

Education Medical degree, Charles University, 1975; postdoctoral work in tumor virology, University of Southern California 1976-78; National Cancer Institute, Bethesda, Maryland, 1978-82

Career Carver College of Medicine, University of Iowa, professor of pathology, since 1982; Holden Cancer Center, since 1994

Married epidemiologist Elaine Smith, 1997

PostScript

Since Prague Profile is not a medical column, I have discussed my condition only in the course of profiling my father and Turek. Unless I encounter a personality, I won't discuss my battle with cancer in future Prague Profiles, which will no longer appear weekly.

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