An Interview with Dr. Jake Haimson

By Richard Hoppe, MD, FASTRO, and Tarita Thomas, MD, PhD

RH: Just by way of introduction, this is an interview with Dr. Jake Haimson, a very accomplished physicist who was intimately involved in the development of the technology that we have exploited in our specialty. The interviewers are myself, Rich Hoppe, and Terita Thomas. Jake, we thank you very much for agreeing to this interview, and we thank ASTRO staff, especially Alana Ryan, for setting this up. We've known each other for a long time, Jake, but simply for the record, I'm the Henry S. Kaplan Harry Liebeson Professor in Cancer Biology Emeritus in the Department of Radiation Oncology at Stanford. I serve on the History Committee, and I'm joined by Dr. Tarita Thomas. Tarita, would you like to introduce yourself?

TT: Yes, thank you. I'm just so grateful to have this opportunity to be part of this interview and to interview one of the legends in our field. I'm a radiation oncologist and medical director at University of Wisconsin Northern Illinois and also part of the History Committee of ASTRO.

RH: For starters, Jake, can you tell us a bit about your childhood and early life experiences?

JH: Yes, I was born in Melbourne Women's Hospital, Australia, and I became the middle child of three, with an older brother and a younger sister. We lived in Melbourne throughout my childhood years, and my remaining Australian family continue today to live in the family home in Toorak section of Melbourne. 100 years ago, almost exactly, my parents immigrated from Russia during a civil war. And from an area now known as — well, we think we know what it is, but it's Odessa, Ukraine. They were married and had a 1-year-old baby and desired to make a life together in a new country, and they chose Australia.

RH: How were those early years in Australia and what was school like?

JH: My parents expected their three children to work hard and get an education by following the traditional pathway of going to a university. However, at age 11, rather than following my brother, who became a surgeon, and my sister a teacher. That — let's see, I announced — I can't remember because I was 11 years old. Right. But I didn't feel like I wanted to go on that traditional path. And so I had to ask permission of my parents about where I would like to go. So rather than following my brother, I wanted to go to South Melbourne Junior Technical College. And the curriculum included basically learning a variety of practical skills such as carpentry, metal machining, welding, and similar skills. I was keen to learn these skills. And with some reluctance, my parents permitted me to attend this school. After South Melbourne Tech, I then went on to the Royal Melbourne Institute of Technology. immersing myself in mechanical and electrical engineering with a strong mathematical program. That was where I graduated 3 — I really liked that technical college and I immersed myself in mechanical and electrical engineering with a strong mathematical program and that was where I graduated three years later. With a fellowship in electrical engineering. I was two years younger than my classmates, and rather than stop my studies at age 17, I yearned to learn more about physics, especially nuclear physics. Thus, I applied and was accepted by Melbourne University, where I graduated three years later with a BS with honors in nuclear physics. Now is the time to earn a living. And with interest and experience in both engineering and physics, I applied to work at the Australian General Electric in Melbourne. Rich, you're muted.

RH: Australia General Electric was your first big job. That gets you into the world of physics. Tell us a bit about those early job experiences.

JH: Australian General Electric was affiliated with International General Electric, and after two years of designing and testing large transformers for power stations, I had an opportunity to gain further experiences overseas. I was given a choice of going to England or America, and I chose England. A position was set up for me in Metropolitan Vickers in Manchester. This was 1950, and there was a massive post-war World War II expansion and development throughout England and Western Europe. To get to England, I traveled my way on an Italian freighter which took me from Melbourne to Genoa, Italy. With a backpack and only £50 Australian, I hitchhiked from Italy through Switzerland and France, then crossed the English Channel and made my way to Manchester. Metropolitan Vickers was a large company. Well-known during World War II for its wide range of military equipment and for its industrial electrical equipment and sophisticated scientific instruments such as an electron spectrometer, electron microscope, and mass spectrometers. 

The first medical linear accelerator in the world was built by Metropole and Vickers and installed at Hammersmith Hospital in London in 1951. This machine had been supported by the Ministry of Health, and the British government wanted similar machines to go into production. At Metropolitan Vickers, I had the opportunity to gain experience in several company divisions, and I ended up in research department. I became part of a large research team tasked with designing, assembling, and testing a batch of 4 MeV linear accelerators designed for the treatment of cancer. My first function as part of the research team was to carefully study the details of a new 4 MeV medical linear accelerator with emphasis on the control systems. After two days, I discovered an error that would have destroyed the electron gun filament. And from that time on, I was considered to be a useful member of the team. There was immense pressure to build these machines and get them distributed into the British Empire hospitals. Three medical centers were selected to be the first recipients of the new 4 MeV LINACs: Manchester, London and Edinburgh. I was selected to supervise the installation of the Edinburgh machine, with my prime responsibility being to demonstrate to the physicists the various control capabilities and to calibrate the dosimeters involved in testing the required radiation shielding that we suggested for this hospital. This was a truly exciting time for all of us. Metropolitan Vickers began getting many new orders for machines. After Britain, Australia made a request to install three machines in Melbourne, Brisbane, and Adelaide hospitals. As the only Australian on the Manchester team, I was sent — I was sent to supervise the installation and commissioning of these machines. So I left England and returned to Australia in July 1955. Just before completing these projects, I was requested to install a machine, another machine in Auckland, New Zealand.

RH: So Jake, you were at ground zero in the development of medical linear accelerators. But all of that was in Europe and Australia. How did you wind up in the U.S.?

JH: Well, in 1958, before returning to Metropolitan-Vickers, I was asked to stop off at Stanford to give a series of talks. And I showed slides of the basically Metropolitan-Vickers medical machines installed in British and in the Australian hospitals. The Stanford team were very interested in the rapid development and installations in the British medical accelerators and asked many questions about Metropolitan-Vickers machines; which had isocentric features that provided increased flexibility in patient positioning and reduced setup times. During my visit to Stanford, I learned that in the early 1950s, Professor Kaplan, Henry Kaplan, and Ed Ginsson at Stanford had planned and built on campus the first medical machine in the Western Hemisphere. I toured the Stanford Microwave Laboratory, and I was also invited to visit Varian Associates, where I met the two Varian brothers, Sieg and Russ, and met Craig Noonan, manager of the radiation division, and several others. While visiting at Varian, I saw a new type high vacuum pump that they were developing, and I realized this compact vacuum pump, if it was successful, the oil diffusion pump and the large vacuum chambers as used in the 12-foot-high, 8-ton Metropolitan Vickers machine would not be needed. This would allow the development of a compact, fully rotatable machine for hospital use. This would have enormous potential. 

After my visit at Stanford, I returned to England and told my colleagues about the new vacuum pumping developed by Varian that could allow us to develop a newer medical machine with 360-degree capabilities. This was not great news to Metropolitan Vickers managers, who were ready to go into production and not interested in developing another machine. Soon thereafter, I received a follow-up invitation to return to Stanford to work with their microwave structures and simultaneously study for a PhD. I accepted the Stanford invitation as Palo Alto reminded me of Melbourne due to the numerous eucalyptus trees in a similar climate. I felt quite at home at this location. During my overseas journey back to America in June 1959, and after 5 years of working at Metropolitan Vickers and in many hospitals, I spent time thinking on the ship and making sketches of how a medical linear accelerator could be rotated 360 degrees around the patient and still maintain the advantage of an isocentric triple-axis layout. It was immediately clear that the patient support pedestals should be offset so the patient couch could be cantilevered to allow the X-ray head to pass under the patient. Also, it was necessary to make a large reduction of the gantry height. I eventually realized that this could be achieved by repositioning the microwave structure from its vertical to a horizontal orientation, and then bend the electron beam 90 degrees so it could be focused appropriately at the target. I kept these sketches, and they were used to assist in patenting this concept. 

When I arrived at Stanford to work with Ed Ginzel, Professor of Physics and Director of the Microwave Group, I soon learned that he had resigned his Stanford professorship to become chairman of Varian Associates. Thus, my invitation to Stanford was transferred to Varian Associates that had large laboratories adjacent to Stanford. Ed Ginsten wanted to sell new improved linear accelerators for clinical use. I then learned from my new boss, Craig Noonan, manager of the radiation division, that Varian intended to develop a new medical unit machine and that I would be the manager of the radiation research team. Ginson confirmed to me that he would give me his complete support in this project. This appealed to me as I was interested in designing a fully rotational machine, I was also interested in designing the microstructure in the X-ray head, with needing a flattening filter, uniform fields, and ionization chambers. I also had experience with designing the room shielding and firsthand experience assembling and testing machines in hospitals through England, Australia, and New Zealand. I was a perfect fit.

RH: Wow. So, so this was among the first efforts at producing a commercial linear accelerator. Tell us about your involvement.

JH: Well, for the next several years, I worked on the new medical machine. I was responsible for the detailed design and tuning of the microwave structure, the X-ray head, the control console, and the patient support system. I wanted the machine to have an isocentric layout like the Metropolitan Vickers machine for maximal flexibility and to provide 360-degree rotations. At Varian, we had to expand our research team to include mathematicians, to assist in computer programming, mainly to design a chosen 3 GHz magnetron-driven, 6 MeV beam-loaded microwave structure. It was 1959, and we used an IBM computer center, which was a great time saver for us. During construction, of the prototype 6 MeV LINAC. I made many visits to the new Stanford Hospital on campus and had regular meetings with Dr. Kaplan and Bagshaw and three medical physicists: Bob Levenger, Mitch Weissbluth, and CJ Karzmak. We discussed the progress of the prototype machine And especially the eccentric layout and the X-ray head contents, jaws, and minimal penumbra. The introduction of megavoltage radiation required a major change in the field and there was understandable reluctance to accept an entirely new way of thinking regarding a delivered air dose as measured in roentgen to a new absorbed dose called rads. The clinicians could no longer use the erythema skin reaction as a guide to the needed dose and had to accept the standardized guidelines using a radiation dose no longer that could be seen but was calculated using newly developed dosimetry principles. This universal standardization was accomplished through the NCRP. It was the National Council of Radiation Protection and Measurements in America and I was asked to serve as a consultant to NCRP and be a participant in the Scientific Committee Number 22, which was focused on the radiation of X-ray and gamma rays, equipment and structural shielding designs now required by the broad distribution of megavoltage accelerators.

RH: So these were major changes in thinking about radiation therapy. How long did this project take?

JH: At Varian, we worked full-time for several years. to complete the prototype 6 MeV machine and finalize the depth dose measurements using a phantom water tank. The Varian brothers told Dr. Kaplan they would make the first 6 MeV Varian medical LINAC a gift to Stanford. The medical machines went into production. After several years, most of the medical accelerator research work was completed, and I was beginning to — and LeVarin was beginning to receive orders for a variety of high-energy research linear accelerators, 10 to 500 MeV, from European universities and other institutions. The Radiation Division research team was responsible for designing and testing these research machines. And linear accelerators for other applications.

RH: So were there new problems that you faced developing these high-energy research linear accelerators?

JH: Yes, a very difficult problem known as the beam breakup occurred with high-power electron linear accelerators. The U.S. government wanted higher-power accelerators for intense X-ray experiments. And laboratories around the world were trying to solve this problem, including Varian's radiation research team. We had been working on the problem for several years already, and I thought I might have a solution, but I couldn't prove it without a high-powered testbed. Fortunately, the Boeing Company Ordered a high-power linear accelerator from Varian, which gave me the needed testbed. When I completed the high-power tests, I was surprised we had exceeded the Boeing specifications by a factor of 2 with no indication of breakup. This was a huge breakthrough, but I did not publish results at that time.

RH: So this was all happening in Palo Alto. I know that you also spent some time at MIT. Tell us about that.

JH: Well, MIT wanted to make a special physics research machine, a large machine, and asked several laboratories to respond with a proposal. But essentially, no one could guarantee a solution to this universal problem. MIT needed a 500 MeV, long pulse, high duty factor linear accelerator with very tight specifications and no beam breakup. They needed someone with accelerator experience to design the linear accelerator and injector. MIT asked if I could design such a machine without beam breakup. It represented a challenge that other reference laboratories had not solved, and this only intrigued me more. I spent many hours thinking about the problem and realized it required a new concept to avoid this type of beam breakup. This was true because our preliminary studies indicated that this large special linear accelerator would require many accelerator waveguides, 7 to 8 meters long. And before I did not want to — because I did not want to leave California until the design was completed, the Atomic Energy Commission set me up at SLAC where I could work on this project. This was ideal, and I assembled a team of four people which included Beverly Mecklenburg, our mathematician who had been responsible to computerize Averian work. Our team of four worked intently on this program, and after 6 months of many calculations and experiments, we designed We designed a completely new and different approach by using the Stanford Computer Center and Beverly's skills. Many calculations suggested the results appeared favorable. So I went to MIT as a technical manager. This was the ideal scenario. I had a laboratory on the MIT campus. To develop an advanced injector for the accelerator, while without guidance, Varian fabricated 7.5-meter-long microwave structures to be assembled and installed at Middleton, Massachusetts. The MIT research machine broke many records and continues to work today, now 55 years later.

RH: Wow, that's, that's quite an achievement. But then you returned to Palo Alto to start your own research lab. How did that happen?

JH: After the MIT Linear Accelerator was constructed and demonstrated its unique performance, the US government suggested they could arrange for me to have an independent research laboratory so I could continue my accelerator research work. So I moved my laboratory, Ames Research Corporation, from Massachusetts to Silicon Valley, bringing along my initial team. For more than two decades, we designed and installed a wide variety of research accelerators throughout the world. And over the final three decades, we were funded by grants from DOE.

RH: Well, that's quite a story, Jake. But I know that you've have had a long interest in philanthropy. How did you become interested in that effort?

JH: Well, I had a long and wonderful relationship with both Drs. Kaplan and Bagshaw. So I accepted their invitation to become a member of the Friends of Radiology, and I started my support to your department. When Charlotte Jacobs solicited my support to help build a clinical cancer center at Stanford, I was happy to gift a departmental resident education center, which included a dedicated resident room and library. It was under your leadership, Rich, when I grew to understand the many rewards of naming an endowed professorship, which, with your assistance, Sarah and I jointly established the Haimson Donaldson Endowed Chair of Radiation Physics. Supporting medical physicists as partners to radiation oncologists has been central to my thinking. Philanthropy is a way of leaving an enduring legacy, and I feel strongly about both education and innovation. In my case, I also have loyalty to University of Maryland. Where I was awarded my Doctor of Science degree, my most prestigious honor. So it had been very rewarding. By the way, that's a British type of doctorate. It doesn't exist in America. So it has been very rewarding for me to support the next-generation physics facility at the University of Melbourne. with a named physics lectureship.

RH: Well, Jake, your philanthropy has always been appreciated. I believe the chair that you and Sarah endowed in radiation physics was the first one so designated in the U.S. And Jake, you've had a really interesting and fabulous career. You've seen it all and done it all. To think of how far we have come from that original Metropolitan Vickers machine to the current technology that our specialty offers is incredible. Not to mention the research efforts that have dominated your career. Tarita, any comments?

TT: Yes, I agree. This is a fascinating contribution to radiation oncology and oncology and to the history of medicine. Do you have anything additional that you'd like to add, Jacob?

JH: Well, in rethinking this journey, I now realize how very fortunate I was to have the hands-on initial technical experience acquired at the technical schools, and then more advanced studies and degrees in engineering and physics to round out my knowledge base. The post-war opportunities I had in England provided additional experience that was perfect for me in learning the basics of the world of microwaves and accelerators, adapting them for medical use and beyond for more advanced research. Along the way, I met many wonderful colleagues. I was able to build a team who worked with me at Varian, Stanford, MIT, and then my own laboratory in Silicon Valley. This journey, working in my own private company, allowed me to do what I really wanted to do without the hassle that often accompanies large organizations. Perhaps I feel most rewarded for, as a young man, I was awarded a DSc degree from Melbourne, which is very much a lifetime achievement. It's an award in the British system, and in my case, it came before I made my most important contributions. The journey has allowed me to stay connected with 3 wonderful academic institutions, Stanford, MIT, and the University of Melbourne, as well as to contribute to the health and well-being of cancer patients worldwide. I want to thank the ASTRO History Committee for your interest in my early experience of medical linear accelerators and inviting me to tell my story. I've always felt that medical physicists and radiation oncologists should partner together in the advancement of clinical care. Thanks to your efforts, we are achieving this goal, and for this, I thank you.

RH: Well, and thank you very much, Jake, for sharing your lifetime story with us. And I'm sure that many others who will listen to this in the future will be inspired by your accomplishments. I thank you and the Astro History Committee And Dr. Thomas for all of your efforts in putting this together.