Author: [AUTHOR] Published on 9/1/2021 12:00:00 AM
Steven L. Shafer, MD, Professor of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California
What Is the Most Important Leadership Lesson You Have Learned the Hard Way?
My most important leadership lesson is that I am a terrible businessman. I’ve been founder or co-founder of four companies, starting with Soft-Pack, a computer software company that I started in 1976 to develop business software for Wang Minicomputers. I took 2 years off from college to start Soft-Pack and ran it from my dorm for my last two years at Princeton and my first 3 years at Stanford Medical School. Soft-Pack died in the 1981 Reagan Recession. My next company, Aesculapius Systems, wrote software that created the medical “history and physical” report from clinical templates. We created Aesculapius decades before Epic came along. Aesculapius worked well, and my computer generated H&P always made a splash when I added it to the chart, but we wrote it for the Osborne computer. Oops… In the 1990s I was one the many academic founders of Pharsight, and was Vice President of Product Development when the company went public. Shortly after that, the internet bubble burst. I laid off most of my team, including myself. A few years after returning to Stanford, I co-founded PharmacoFore to developed opioid prodrugs to reduce the risk of diversion. The opioid crisis was just getting underway, and we invented and patented dozens of opioid prodrugs that could not be diverted to parenteral administration. Shortly after changing the name to Signature Therapeutics we went bankrupt and our assets were acquired by Ensysce. Francis Collins still presents my slides when talking about novel technologies that the NIH supported to address the opioid epidemic. I’ve decided to stick to academia.
What’s the Strangest Experience of Your Career?
The single weirdest experience in my life was my 9 months of involvement in the trial of Conrad Murray for the death of Michael Jackson. I was initially contacted by the Los Angeles District Attorney, David Walgren, in March 2011. The trial was scheduled for May. I laughed out loud when the defense claimed that Jackson drank the propofol that killed him, because propofol’s clearance exceeds liver blood flow, ruling out any oral bioavailability. I was then told that this theory had been put forward by Paul White, a friend and colleague, prompting an “OMG” response. I spent six months reviewing charts, pouring over the statements of witnesses, reading the relevant literature, preparing exhibits, and generally playing “whack-a-mole” with increasingly bizarre arguments put forward by defense counsel. My goal wasn’t to achieve a conviction – that’s the DA’s job. I wanted to figure out what actually happened to Michael Jackson. I feared reproach from medical colleagues for criminalizing what the defense characterized as merely a “medical malpractice case.” My fears were misplaced; the jury reached the right conclusion, and I got a handful of terrific “visiting professor” lectures out of it.
What Was Your Childhood Dream Job?
My childhood dream job was to be a professional jazz pianist. I’ve played the piano since I was 6 years old. I chose a career in medicine for the simple reason that I don’t have the talent to be a professional musician.
Do You Have a Favorite Tip or Trick for Clinical Practice or Research That You Want to Share With Fellow Members?
I’m happy to share two research tips! First, choose a line of research that you would pursue if you were unemployed. If I were unemployed and looking for work, I would go into the office, design and execute clinical trials, and analyze pharmacokinetic data just for fun. My most satisfying activity for the past 40 years has been writing computer code. That’s why I chose to pursue clinical pharmacology as my academic focus: it lets me spend all day designing and implementing algorithms and call it work.
Second, latch onto the best mentors you can find. My research mentor was Don Stanski, MD, who launched my career in clinical pharmacology. Don has continued to be my mentor through my retirement from Stanford this month. Dr. Bill Ebling taught me the basic principles of pharmacokinetics. Drs. Stuart Beal, Louis Sheiner, and Carl Peck mentored me in data analysis. Dr. Dick Mazze was my mentor for building an academic career at Stanford. Dr. Larry Saidman was my mentor for how to be an Editor-in-Chief. Dr. Dennis Fisher taught me R. My wife Pamela Flood taught me everything I know about molecular biology.
What’s One Thing People Would Be Surprised to Know About You?
Finally, I’ll share a fun fact. For many years I held the world record for the most retractions for misconduct by any medical journal editor. This occurred during my 10 years as Editor-in-Chief of Anesthesia & Analgesia, the oldest and largest journal in perioperative medicine. The slew of retractions started with the misconduct of Scott Reuben, but eventually included the cases of serial fraudsters Joachim Boldt and Yoshitaka Fujii, who themselves hold records for the most retractions for fraud by any author. My world record may have been eclipsed in the past few years by a recent slate of retractions by other medical journal editors. I certainly hope so – this isn’t a record that anyone aspires to hold. One consequence is that after 3 decades of studying the clinical pharmacology of intravenous anesthetic drugs, I’m known to my academic colleagues for the death of Michael Jackson and research misconduct.
Dr. Shafer has been a member of ASCPT since 2020.
