Lucky is as Lucky Does
Treating the Untreatable
Money and Manpower
Breaking New Ground
No Time for Weeds

Talmadge King, Jr., likes to describe himself as "fortunate." In his high school days in Darien, Georgia, for example, Dr. King had the good fortune to be named valedictorian. The stars were aligned in such a way that he was also named president of his class and student body, best all-around athlete, and most likely to succeed. His luck held up at Gustavus Adolphus College, where he was elected to the honor society; at Harvard, where he received an MD in 1974; and at Emory, where he became a resident in medicine the same year.

The Fates still smile today. Dr. King, vice chairman of clinical affairs at the University of Colorado Health Sciences Center and co-author of the definitive text about interstitial lung disease, takes office next year as president of the American Thoracic Society, the leading medical society in his field.

Lucky is as Lucky Does

If asked to settle on a single adjective to describe Talmadge King, those who know him might pick "modest" over "fortunate." And they would certainly agree that ability, not luck, has fueled his accomplishments.

But Dr. King was truly fortunate in one respect: being born into a family that values education. Few children growing up in the 1950s in Darien (population, 2,000) fared as well, but in Dr. King's family "it was a foregone conclusion that everybody was going to college. None of us questioned it," says Dr. King, speaking for himself, two brothers, and two sisters.

He chose Gustavus Adolphus in Minnesota, graduating in 1970 with honors in psychology and biology-and with a wife, Mozelle, and a baby daughter, Consuelo. (The Kings have another daughter, Malaika, born five years later.) Following his sophomore year there, he attended Harvard's health careers program, a summer session designed to introduce minority students to medicine and biomedical research.

"I was assigned to two professors in the neurobiology department and spent a lot of time talking to them and seeing their labs," he says. As luck would have it, both men were on the Harvard admissions committee.

Match Day at Harvard found him fortunate once more. "Whoever is watching out for me did it again," says Dr. King, "because going to Emory was without question the best thing for me-ideally suited to where I was and what I needed.

"I was ready to be a doctor," he says, "and one thing Emory does so well is train you to be a good doctor. Willis Hurst was chief of medicine, and Ken Walker was head of residency training in medicine. Emory was like a family. It was a wonderful place to study and learn."

During his residency, Dr. King spent most of his time at Grady. "I used to tell people," he says, " 'If I get hurt, take me to Grady.' The people there know how to take care of you and get things done."

At Grady, he put his trademark talent for networking to good use. "I know some residents have difficulties working at an inner-city hospital like Grady," he says, "because there's a tremendous amount of work and, as you would expect, it's sometimes an inefficient place. But my approach was to get to know everybody in a position to influence my patients' care, so I never had any problems getting things done."

When he left Emory in 1977, Dr. King was convinced "there was nothing I couldn't take care of-any patient with any problem-because we had seen so much and had been taught a system for thinking through the patient care process, for coming up with good solutions."

Talks with Dr. Hurst had helped him target pulmonology as his subspecialty and the University of Colorado as the place to train for it. According to Thomas Petty, head of Colorado's pulmonary program, Dr. King came highly recommended for a fellowship there. Dr. Petty tells the story of a phone call he received from Dr. Hurst, who was so confident of Dr. King's ability that he asked, without preliminaries, "When are you going to let Talmadge know he's accepted?" Equally confident, Dr. Petty replied, "Oh, don't you know? He is accepted."

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Treating the Untreatable

Dr. King stayed in Denver after completing that fellowship 16 years ago. In his first five years, spent at the VA Medical Center, he rose through the ranks from staff physician to director of the intensive and coronary care units. He then moved on to the National Jewish Center for Immunology and Respiratory Medicine, where he is today.

"I came to National Jewish in 1984 to help develop an outpatient program," he recalls-an effort that evidently succeeded. The center had historically been a 130-bed long-term care facility for patients with lung disease. A typical length of stay, particularly for children, was three months to a year.

"That changed dramatically ten years ago," says Dr. King. "There are now only 60 beds, and what we see are referrals of the most difficult cases involving the lungs, the immune system, and drug-resistant tuberculosis." Most of the work is done in the outpatient departments, but the hospital is "one of the few places in the country that takes people as inpatients whose drug-resistant TB is untreatable by conventional methods and is a threat to the community."

In addition to clinical and administrative duties, Dr. King pursues his major research interest: the diagnosis and treatment of idiopathic pulmonary fibrosis. "The condition is devastating," he says. "All the patients I saw when I first started this work are dead. We know if we can identify it early enough we can suppress the inflammation that causes scarring, but how do we identify it? How do we get there soon enough in the course of the disease, and how do we switch it off?"

Moreover, he says, because patients are treated with powerful steroids and cytotoxic drugs, "the big agony for those of us who work with them is to make sure the treatment is not worse than the disease. It's quite a challenge."

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Money and Manpower

When I came into this specialty 20 years ago," Dr. King says, "we didn't have enough lung specialists. Now the question is, Do we have too many? And what should we do about that?"

The question of physician manpower, he says, is "the biggest issue facing the American Thoracic Society and our profession," and it is a problem he will meet head-on as he assumes the presidency of the 12,000-member ATS in May 1997. Also on the table are the problems of shrinking financial support for subspecialists, especially those in academic medicine, and the need to maintain federal support for research while trying to balance the national budget.

"As president of ATS, I will continue to address these difficult issues," he says. "We are actively investigating physician manpower needs, in conjunction with representatives of other societies; when I am president, I will seek to implement the recommendations of this task force. Through active advocacy efforts, I will try to encourage continued support of biomedical research."

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Breaking New Ground

As the first African-American president of ATS, Dr. King joins a select group of other black physicians who have recently been named to head up some prominent national medical societies and institutions-including the American Medical Association, the Centers for Disease Control and Prevention, the American Osteopathic Association, the American College of Physicians, and the American College of Surgeons. This emergence of minority medical leadership is especially notable in the field of pulmonology: For years, Dr. King was one of the few black members of the American Thoracic Society, and even today, less than 2% of ATS membership is African-American. It is a situation Dr. King has worked hard to rectify.

When asked about the issue of racial discrimination, Dr. King admits, "I am aware of the role of race in our society. Throughout my career, my focus has been on pursuing my goals and interests, and to that end, I have not been deterred by race. My parents never made a big deal about it, even though we lived in the Deep South. Race has, perhaps, opened some doors and closed others, but my abilities and the content of my character have carried me forward.

"I am encouraged by the progress these leadership roles signify. Many who have gone before us deserve the credit," he says. "My goal is to try to be a positive influence and to put something of lasting value in place."

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No Time for Weeds

Seemingly oblivious to the limits of the 24-hour day, Dr. King continues to crowd professional and personal commitments into his life. But, he admits, "I realize now I'm going to have to make a few decisions about what I can and cannot do." These days he arrives at the office a little before 7:30 instead of his former 6 am, usually heading home around 8:30 at night. "I'm getting older," he says, "and I can't turn it around the way I used to. I'm trying very hard to work things differently."

Well, maybe.

"One of Talmadge's virtues may also be troublesome for him-he likes to take on challenges," says Samuel Aguayo, Dr. King's former fellow, now associate professor at Emory. "Maybe his biggest fault is that he doesn't know how to say no."

Nor how to slow down once he gets home. He has a passion for the arts (books, photography, theater) and also for sports. "I have season tickets to the Broncos, Nuggets, Rockies, and Buffaloes," he says. "It gets pretty hectic when everything is going on at once."

His traveling is legendary. His colleagues relay the story of a former ATS president who was invited to Japan by the medical community and was entertained lavishly. As a special favor, Japanese doctors invited him to a prestigious tea ceremony, usually inaccessible to foreigners. But not to Talmadge King, he observed wryly as he signed his name to the ornate hand-painted guest book, one line below the familiar signature of his friend.

How does Dr. King do it?

"He's the best time manager I've ever known," says Dr. Aguayo, "although his wife may not agree." (She finally rocked in his garden because her husband was too busy to do the weeding.)

"I'd say he's a perfectionist," Mrs. King says diplomatically. In academic medicine there are two ways to get to the top, Dr. Aguayo observes. "One is by being an expert in a narrow field. The other is by knowing a lot of people in a lot of places that do a certain type of work and being able to collaborate. Talmadge is the second kind. He is the quintessential facilitator. As an administrator, he can get different people from different places and backgrounds to work together and accomplish things. And he's one of the best teachers: He opens doors to learning and encourages it."

"I love what I'm doing," Dr. King says. "I'd like to be a really good doctor one day. I hope when it's all over people will say I did the best I could with what I had.

"There are some days I go home unhappy, but I never come to work unhappy. I'm ready to go, looking forward to the day, and thinking today maybe something I do will make a difference. I really like that idea."

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