‘The miracle was you got to see some part of that person’s life’

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‘The miracle was you got to see some part of that person’s life’

25 years after his death, infectious disease expert Dr. Joel Meyers honored at inaugural symposium in his name

June 7, 2016
Dr. Joel Meyers

Dr. Joel Meyers started the first program in the world dedicated to studying and treating the unique infections that plague bone marrow transplant patients.

Fred Hutch file

Barbara Thrasher remembers the exact moment she and Dr. Joel Meyers first reached Seattle on their cross-country move.

The couple had driven at high speed from Philadelphia with everything they owned, which in 1975 included a lot of hanging houseplants, Thrasher said. They reached the bridge to the city and it was like a whole new world opening up.

“We came over the 520 bridge into Seattle on this sparkling June day and looked at the sailboats and Mount Rainier and the houseboats and we thought, ‘Do people actually get to live like this?’ We’d never seen anything like that in the East,” she said.

Meyers’ arrival in Seattle was the start of a new world professionally, too. He was starting research that few others were doing at that time, studying infections in people with weakened immune systems, also known as the immunocompromised. And he would soon start a program unlike any other in the world — an infectious disease program headquartered at the brand new Fred Hutchinson Cancer Research Center to study and treat the unique infections that plague transplant patients.

“There was essentially no field” at the time, said virologist Dr. Larry Corey, Fred Hutch president and director emeritus and Meyers’ longtime collaborator and friend. “There was no field of bone marrow transplantation, let alone infectious diseases in bone marrow transplantation.”

What was once a one-person research program has now grown into the world’s largest group of infectious disease researchers at any cancer center. Today, these researchers study not only infections in cancer patients, but HIV, malaria, viruses that themselves cause cancer, and many more. 

But Meyers neither saw many of these advances nor the full impact of his own research.

In 1991, at the age of 46, Meyers died of colon cancer. A study he led on preventing a deadly viral infection in transplant patients — one of the most important findings of his career — was in press at The New England Journal of Medicine at the time. It would be published a few weeks after his death.

Next week, infectious disease researchers from around the world — all of whom now specialize in the field to which Meyers and his colleagues gave a name soon after that sparkling June day in 1975 — will gather in Seattle to share findings, catch up with collaborators and reminisce about their mentor, colleague and friend. The Hutch’s inaugural Symposium on Infectious Disease in the Immunocompromised Host, the first research gathering of its kind in the world, takes place next Monday as a tribute to Meyers.

CDC days

Thrasher and Meyers first met in Atlanta in the early 1970s — she’d moved there for a teaching job and didn’t know anybody. One of her college friends introduced her to another friend who worked at the Centers for Disease Control and Prevention, and that friend asked Thrasher if he could set her up on a date with one of his co-workers.

“And I said, ‘Oh my gosh, yes you can.’ And he got me a date with Joel,” she said. It was a blind date, “and when I opened the door I just had this overwhelming feeling that this is the person,” Thrasher said.

Meyers was working at the time as what is known as an Epidemic Intelligence Service officer, or EIS officer, one of the CDC’s “disease detectives.” It was during the Vietnam War; Meyers was in the middle of his medical training and was recruited to serve a two-year stint at the CDC in lieu of active military service.

He hadn’t yet selected a medical specialty and became enthralled with the little-known field of infectious disease research, Thrasher said.

“When you told people you were in infectious disease, they almost chuckled; they’d never heard of it,” she recalled. “They’d say, ‘Is that like colds or what?’”

During his time at CDC, Meyers was introduced to the late Dr. E. Donnall Thomas, the leader of Seattle’s newly formed bone marrow transplantation group that would later become the foundation of Fred Hutch. There was a mysterious outbreak of what turned out to be hepatitis C among Thomas’ transplant patients, and Meyers was dispatched to Seattle to investigate.

“Joel’s work on this outbreak … really illustrated the importance that the discipline of infectious disease had for the marrow transplant patient,” said Corey, who was also an EIS officer at the time. Corey met Meyers through his job and he and his wife, Amy, had become fast friends with Meyers and Thrasher.

Thomas was impressed with Meyers during that brief visit, and Meyers “fell in love with Seattle and the team there,” Thrasher said.

Thomas and his colleagues “were just starting to recognize that they were having a lot of deaths from cytomegalovirus,” or CMV, a type of herpesvirus, said Corey, although it wasn’t yet clear whether the virus was the killer or just along for the ride. “There was this recognition that they needed someone who had the infectious disease and epidemiological skills to do this.”

After Meyers finished his stint at the CDC and his residency, Thomas recruited him to join his growing transplant team as the group’s first infectious disease expert. Meyers and Thrasher were married a year after they moved to Seattle, in 1976.

CMV days

That period — the mid-to-late 1970s — was at the same time exciting but devastating for those involved in transplantation. Thomas and his colleagues were snatching very ill patients from the brink of death, but those they saved from cancer were the exception to the rule. Most patients died, and many of them died of CMV infection.

“I remember going on rounds and seeing a patient who was otherwise looking fine, listening to their lungs and hearing a few crackles in their lung. It would be CMV,” said Fred Hutch transplant researcher Dr. Fred Appelbaum, who joined the transplant team in 1978, in a previous interview. “And that patient was almost certainly going to die. They went from healthy to dead in a matter of weeks.”

Meyers’ first task was to understand whether CMV was truly responsible for those deaths. Through pivotal research, he showed that CMV was actually the pathogen that killed 40 percent of patients after bone marrow transplantation in those days, Corey said. “It was the major deterrent in advancing the field of bone marrow transplantation. We actually needed to do something about it; it wasn’t just a casual bystander.”

Meyers and Corey then helped test the antiviral drug acyclovir, showing that the treatment was incredibly powerful in treating infections with the related pathogen herpes simplex virus, which Corey studied. It worked to a certain extent against CMV too, and the transplant team started using it to treat their patients.

“It was an amazingly effective drug that totally transformed both our lives and patients’ lives,” Corey said. “The first studies we did were like, ‘Oh my god, something is happening here.’”

Meyers also took the (at the time) heretical step of testing whether treating transplant patients in advance with antibiotics or antivirals would reduce serious disease and death. This was incredibly controversial in the infectious disease field, Corey said. Such potentially harsh drugs were only used for treatment, not prevention — but Meyers showed through clinical trials that treating bone marrow transplant patients before they were severely ill saved lives from these deadly infections.

He later ran clinical trials testing whether the antiviral drug ganciclovir, a close relative of acyclovir, could prevent even more deaths from CMV in transplant patients. It did — that was the paper that would be published shortly after he died.

“Not only did he define that CMV was a pathogen, he did the first studies to show that he could treat that pathogen and almost make it go away,” Corey said. “Being able to discover it and then treat it, in such a short period of time — it was cool that he got to see that, he got to know that, before his premature death.”

Future days

Concurrently with his work on CMV, Meyers was also laying the groundwork for a growing research field and program on infections in the immunocompromised patient. Although the Fred Hutch team’s work initially focused on infections in bone marrow transplant patients, their studies would have implications for many others with weakened immune systems — including organ transplant recipients and those living with HIV/AIDS.

Meyers was always thinking about the next generation of researchers, Thrasher said. He loved traveling to meetings to share findings and talk research, and often looked for ways to bring trainees along with him to help them network and further their careers.

“His door was always open to young scientists,” she said. “He said they’re the most important people there because they’re the next line.”

Dr. Michael Boeckh, who now heads Fred Hutch’s Infectious Disease Sciences Program, was one of those young scientists. He came to Seattle as a fellow in 1990 to train with Meyers because the Hutch scientist was the world expert in CMV infection in transplant patients, Boeckh said.

“Joel was an iconic leader and inspiring mentor and role model,” he said. “He always looked out for his fellows in their careers.”

It was in that vein that Thrasher, with Corey’s help, established the Joel Meyers Endowment Scholarship shortly after her husband’s death. The endowment, which Thrasher has continued to support with her second husband, Rick Koffey, funds infectious disease researchers early in their careers. Eighteen “Joel Meyers scholars” have since launched their careers with the fund’s help, and many of them will return to Seattle next week for the symposium, along with others in the now-established field of infectious disease in the immunocompromised.

“[Meyers] would be just thrilled to see that this continues and that he’s had an effect, that his life had that effect,” Thrasher said. “You always wonder after someone dies, what did all that mean? To me this is an enormous meaning, to continue in his name.”

The last days

When Meyers was diagnosed with cancer, “everyone had this feeling of disbelief—how can this happen to a doctor?” Thrasher said. But the detachment Meyers was (mostly) able to maintain with his own patients slipped away with his own illness.

“It’s very hard when it’s you,” Thrasher said. “You try to intellectualize it and deal with it by attacking it from the academic side, but for him, it was difficult to do that, to depersonalize it and look at it and make these decisions.”

It was Meyers’ first trainee, Dr. James Wade, who stepped up to help Meyers and Thrasher make those tough decisions. As a “last ditch effort,” Thrasher said, Meyers went through a transplant himself, at the time being tested at the Hutch as a treatment for solid tumors. The transplant didn’t work against his cancer, and the approach was ultimately abandoned.

As painful as Meyers’ premature death was for Thrasher and everyone else who loved him, she wouldn’t trade the time she had with him for anything, she said.

“Even inside of losing a husband — and I can’t describe what that’s like to anyone — I still feel like I’m probably one of the luckiest people around. I feel incredibly lucky to have known Joel, even though it was all too brief,” Thrasher said.

She and Meyers were married for 15 years before he died.

“When someone has cancer, when you have that in your life, you hope for a miracle,” she said. “You hope for the miracle that there’s a cure, or the miracle that you’ll wake up some morning and it will turn out to be a bad dream. But I realized after Joel died that the miracle was that you got to be with that person. That you got to see some part of that person’s life.”

Rachel Tompa, a staff writer at Fred Hutchinson Cancer Research Center, joined Fred Hutch in 2009 as an editor working with infectious disease researchers and has since written about topics ranging from nanotechnology to global health. She has a Ph.D. in molecular biology from the University of California, San Francisco and a certificate in science writing from the University of California, Santa Cruz. Reach her by email at rtompa@fredhutch.org or follow her on Twitter at @Rachel_Tompa.

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