BRIAN LAMB: Dr. Wayne A. I. Frederick, Interim President of Howard University. Why do they call Howard the Mecca?
WAYNE A. I. FREDERICK: They call it a Mecca for several reasons. It has been a place that has drawn people from all over the world and has been a source of, I guess, great education but as our motto says truth and service. And so those people who have come from all over the world to gain knowledge and get an education have then gone out and changed the world around them. And so it's like going into the Mecca where you can come and really nourish your spirit, nourish your soul, expand your mind and the possibilities of the world around you and then go out and change the world and so we feel it's akin to a Mecca.
LAMB: What were the circumstances that you became interim president?
FREDERICK: So my predecessor decided that he was going to retire and step down and I was in a position of Provost which at most universities is considered the number two position at the university and so I was asked to fill in on the interim basis.
LAMB: Where are you from originally?
FREDERICK: I was born in Trinidad and Tobago. You know, many, many miles away from here but Howard had a very great reputation in Trinidad, many physicians and so on that I interacted with while I was growing up were trained at Howard University and so it was a natural fit for me to come here to be educated myself.
LAMB: Where is Howard University located?
FREDERICK: Howard University is here in nation's capital, in Washington D.C., we're located on Georgia Avenue. I like to point that out because I think Georgia and Florida is the center of the city. You get a little bit of everything right on that very corner and I think it represents exactly the cosmopolitan nature of Howard University itself.
LAMB: How many students are attending there right now?
FREDERICK: We have 10,300 students, we have about 6,500 or so in our undergrad campus and the rest in our graduate and professional programs.
LAMB: What was the original creation of Howard based on?
FREDERICK: You know, there was a charter back in March 2, 1867--was founded by 10 men who put it forward. And that charter really spoke to giving opportunity to those who otherwise would not have an opportunity. Howard has a hospital on its campus which was known as Freedmen's Hospital and that hospital was started five years before the university. The concept was to allow freed slaves an opportunity to get medical care as they move from the south to the north. But also as the university came about, it was -- again to give an opportunity to those who did not have an opportunity. Race and ethnicity was never mentioned in our charter. We evolved into a circumstance where obviously we catered for African Americans in a large way, especially as we came up through the civil rights era. We've had 16 presidents, 10 of whom were Caucasian and the last six have been African American.
LAMB: What's a historically black college and university and where does Howard fit in this size of all that?
FREDERICK: So. HBCUs -- that's a designation by the federal government that distinguishes universities that are catering to a particular segment of the population. And again providing that opportunity in order to get that education that otherwise they would not have an opportunity elsewhere.
Howard University represents maybe the second or third largest of those universities. And of those universities in terms of spectrum, Howard University would be the largest private university in that segment as well. When you look at the breadth of offerings, how we give, there are probably about a 105 HBCUs now that have that designation of each of the historically black college and university. And when you look among those I would say that we have one of the widest offerings, we have a divinity school, we have a law school, we have med school, we have the only dental school in the District of Columbia and we have a wide variety of undergraduate programs that we offer as well. We are high-intensity, safe university, we are the only one in that category as well. So we really represent a unique offering in that space.
LAMB: I read that there are north of the 105 HCBUs there are 200,000 plus students nationwide. You thought say you're a private school but you get couple of 100 million from the Federal Government, why?
FREDERICK: Yeah, that's correct. Back in 19 - well the funding of the school we did receive money from a governmental agency right from the founding based on the charter that was in place at that time. Subsequent to that and around 1922 there was actually an act of Congress that creates a federal appropriation to Howard University. And then as we came through the civil rights era and you had official HBCU designation by the Federal Government we continue to receive that appropriation. And when you look at data output in terms of what we have done today, we'll see America's workforce and more importantly its leadership. Brown versus the Board of Education was one that would not have existed if it would not for Howard lawyers and the type of impetus to have the Howard campus really give to that, the Thurgood Marshalls of the world, Vernon Jordans, Lasalle Leffalls of the world who are preeminent alumni move going out and really made the market different in their areas, that would not have occurred. But that experience is still occurring today, we have a very contemporary experience with that. When you look at the Kamala Harris from California, the attorney general, you look at Mayor Kasim Reed in Atlanta, we're continuing to really put forward very, very prominent alum who are making significant differences in their field. So that appropriation was coming to private universities really affecting America and the globe behind it.
LAMB: What the budget per year, total budget?
FREDERICK: Our total budget is probably just shy of a billion dollars in terms of on revenues.
LAMB: Here's some video back in 2010 where you got an award and you're talking about your upbringing.
FREDERICK: OK.
VIDEO: I was born in Trinidad some four decades ago. Being born with sickle-cell my parents were informed that my life expectancy would be pretty short and so I kind of grow up living for today. I ultimately chose Howard University, which had a sickle-cell center and that was the only place that my mother would be comfortable sending a 16-year old who was 5'6", 88 pounds to go to school. So with her blessing I came here, did the BSMD program and became a physician at the age of 22 going on 23.
LAMB: Start with that, how did you become a physician at age 22, normally it's 26, 27.
FREDERICK: Yes, so Howard gave me an incredible opportunity. Back to my upbringing, one of the other reasons I came to Howard was because the first prime minister of my country Eric Williams was part of the political science department here. He graduated from Oxford in England and came over here because he felt Howard was a black Oxford. And he laid the ground work for what would then turn into a fight against colonialism and lead to Trinidad's independence in 1962, August 3, 1962. But he revolutionized our country, he provided free healthcare, free education for the public. And my mom was a beneficiary of that and so again she was very enamored by Howard University because of what she felt it represented. I myself became enamored by that as well as I grew up listening to her and tell stories about him and watching that man lead our country as well. That led me here to Washington D.C. to Howard University. Howard has a BSMD program which I benefited from. I graduated from high school at age of 14, I skipped a couple of grades. I think having sickle-cell was a blessing in disguise, my mother doesn't like to hear me say that but it afforded me a lot of time during hospitalization to really then focus on my school work. And I was very enamored and intrigued by science, you know, every time I would pickup something to do with science I would just be, you know, so fascinated by it. My mom being a nurse I would go on visits with her and I became enthralled by medicine. My grandmother tells a story about me turning three and talking about becoming a doctor to find a cure for sickle-cell and I guess I never deviated from that. So when I came to Howard and they presented me the opportunity to do my bachelor of science and my doctor of medicine degree on a combined six-year program instead of an eight-year program, I come to it, so I had an early start because I graduated early from high school. And then on top of that I was able to matriculate in what would be an eight year program in six years and so that led to me going to med school at the age of 19 and finish at the age of 22.
LAMB: On your worst day that you remember, how bad do you feel was sickle-cell anemia?
FREDERICK: It has been bad, I had some very difficult times, especially as a child growing up. I have days where, you know, I've begged my mom and physicians to amputate the limb that was hurting me because the pain was so severe. I have now broken my right leg playing soccer and my right arm playing soccer in two separate occasion and I have that experience a type of pain that I have experienced when I have a sickle-cell crisis. So the pain has been very intense, it can be very severe. And more importantly I think just the emotions around all of it, remind of the limitations of physical body can sometimes be difficult to bear specially as a young child who wants to be active. And yes, okay, I fell in love with soccer and so knowing that I couldn't play competitively as a results, all of those things it's a hard reminder. I have been that ill that frequently in my adulthood since coming to the U.S. My heath was remarkably well and I think a lot of that has to do with the care that I received at Howard University, as well as the knowledge that I have gained about what my triggers are. I know when to rest and shut it down and I know how to hydrate myself. Most people who know me well, you know, would tell you I would probably drink a few gallons of water a day, you know, and that has helped me significantly. So I still play soccer actively, I play in over-40 league on Mondays and Wednesday nights. So I'm trying to relive my youth as it were - through that mechanism.
LAMB: Forty-two years old?
FREDERICK: forty-two, I will be 43 in June 17.
LAMB: What is sickle-cell anemia?
FREDERICK: So sickle-cell is a hemoglobin disorder in which your hemoglobin, the proteins that make up the hemoglobin because of a genetic defect shaped differently and react differently and deoxygenated states. So in deoxygenated states that hemoglobin becomes very firm and rigid and it causes the cells to take up a sickle shape instead of their usual round shape. That sickle shape also allows our cells to become stickier and so as they try to pass through and navigate the blood vessels they tend to stick to each other and kind of conglomerate as it were that causes inflation locally, swelling, and it causes intense pain. Usually at your joints or in your limbs, so usually along the long bones, those types of things. So moving the arm and using it becomes, you know, very difficult, if not impossible, without causing excruciating pain.
LAMB: When you remember first realizing that you had it?
FREDERICK: I think as a very young child my mother and father stayed near, I was the firstborn, so they stayed literally walking distance from the hospital as a result of my diagnosis. In Trinidad they had started screening for kids I think the year before I was born and so it became a mandatory test. So once they found early stage very close, so for the first six months of my life I live across the street from the hospital. And I would say as a very young child I had, you know, pains and difficulty, would get hospitalized, would really ask a lot of questions about why. And so it's something I have known all my life, I've always associated myself with whether it's going to the beach and being not able to swim for a long periods because I would get sick every time, you know, flying in planes was a difficulty as well because of the pressurize cabin. I would sometimes land on a long trip from Trinidad to the U.S. and would be sick almost immediately. You know, things like that, so it's always been associated with me for as long as I can remember.
LAMB: Do white people get sickle-cell anemia or Asian people?
FREDERICK: White and Asian people can get sickle-cell anemia, it's a very interesting disorder, it has a lot of built over diaspora in the world around us. People in the lower parts of the Mediterranean and the lower European part of the Mediterranean, so lower parts of Italy et cetera. Because of the African Diaspora you can meet fair-skinned people with blue eyes who get sickle-cell. And I actually met a couple of people like that in my career, practice in medicine. It clearly affects those of the African Diaspora in larger degrees and there is a theory in Africa, it became more prevalent because the whole cells don't last very long, those red blood cells in the host don't - people with sickle-cell don't last very long. So, malaria for instance, it's very difficult to contract malaria as a result. And so they think it proliferated Africa as a result of that benefit gave. And in between you have sickle-cell, you have people with normal bloods cells, people would have trait where they have inherited one gene of sickle-cell from one parent and one normal gene from the other parent. And they have a trait like my two younger brothers do. And so they have a chance of probably getting malarias a little less and they don't have the negative effects of what I have with having both defective genes.
LAMB: How do they treat sickle-cell?
FREDERICK: Most of the treatment now is comfort care is what we would call it, supportive care, hydration, pain medication when you have a crisis. In terms of a cure there are studies that's being done where during bone marrow transplants and now progressively stem cell transplant are leading to cures. And I think that that would be the treatment of the future - stem cell transplantation.
LAMB: When was the last time you have a sickle-cell crisis?
FREDERICK: I would say probably three four years ago for a full-blown sickle-cell crisis. I had been hospitalized for a sickle-cell crisis, during my tonsils being taken out at the end of my fellowship in 2003 where I couldn't drink, you know, to hydrate myself and got dehydrated. I would say that was the last time I was hospitalized and so that was over 10 years ago.
LAMB: What were the circumstances of how you became interim president of Howard and when did it happened.
FREDERICK: So it happened October 1st and as I said it was related to the president at the time stepping down, announcing his resignation, his retirement I should say. And so I was asked to fill in since I was the Provost and Chief Academic Officer at that time. And, you know, it was very humbling honor being a triple alum of the university to take on such a task.
LAMB: That's because you have an MBA?
FREDERICK: Yes, that certainly is.
LAMB: And why did you do that, why did you get a master of business?
FREDERICK: Yes, I was an associate dean for clinical affairs at the time in the medical school when I decided to pursue that. I always been interested in business in terms of how it works and I felt that it was time for me to get a little more savvy about that, about spreadsheets, about strategy around acquisitions and mergers and things of that nature. And I thought the best way do that at that time would be to pursue my MBA. It also had a secondary benefit because I sat in class with the various students that I, you know, and charged with making sure they get a great education. So I heard from them directly about the things that they like and didn't like. And for the most part most of them didn't realize that I was a faculty member and a dean in the medicine which is kind of down the hill in the campus. I would say it was a great education from both perspectives.
LAMB: How many people are there in the med school?
FREDERICK: In med school I know we have 452 students in all four classes, we take in a class of about 115 to 120 every year.
LAMB: How many in law school?
FREDERICK: In law school we have I think roughly 88 a class so I would say in the 300 range.
LAMB: So when the board of directors trustees came to you and the president sat down and said we want you to become the interim, what was your reaction?
FREDERICK: I was - I would say I was surprised. I was deeply honored, very humbled by it. And I also was, you know, very motivated and determined that they would put that type of faith in me because what Howard represents to me just on a personal level in terms of what it has afforded me career-wise through education. I couldn't definitely never pay her back enough so it was certainly an opportunity for me to do all that I can to make sure that she thrives. And I feel very strongly about the university prior to being accessed to be put in the position to steer the ship was one that I certainly had to take a deep breath and say that dreams do become reality.
LAMB: Are you a candidate for the permanent job?
FREDERICK: I am.
LAMB: And how long is that process going to take?
FREDERICK: I'm not sure. I have been participating in the process as any candidate would.
LAMB: How do you like it?
FREDERICK: I love it. I love it. I love everything about it, this has been a great opportunity as I move around the country and meet alum. I'm fascinated because my story I don't think is an exceptional story, my story is a true Howard story. As I move on to the country, I hear about so many people, their first time in college the first person in the family to graduate from college, I mean, this story is incredible. And when I look at what those people have gone back into their communities and do it's incredible. They're not just leaders in the business and the industries they've received a technical knowledge for. But they've gone back to the communities and volunteered and made a difference, you know, to the community that we are sensitive to. So it's a very humbling honor.
LAMB: Here's a video from this year where you're talking about the goals of the Howard medical school.
VIDEO: They understand that the sons and daughters of Howard their charge is to serve. They strive to provide excellent medical treatment specially in underserved and minority communities. Fulfillment of the mission begins with Howard's pipeline to prepare African American and people of color for careers in medical sciences. Howard University is one of the top producers of Africans to medical school in this country. And when you look at minorities and African American in particular, we lead the way in terms of sending people to medical school via application process and then when you look at enrollees, we are number two only to one other school in the country. I think that says a lot about where Howard is positioned in terms of really fulfilling the dream of that pipeline to medicine.
LAMB: Talk about the trend, I mean, I read statistics that back in the 70s that the historically black colleges had 85 percent of black students in the United States and now it's down as low as 9 percent. So what's going on here?
FREDERICK: Yes, clearly the opportunities have increased. When you look at historically black colleges and universities across the board for African-American students, we actually enroll about only 3 percent of all African-American students when you take community colleges into that number as well. However, we graduate 22 percent of all the African Americans who graduate from colleges and universities in this country. So although we only have 3 percent of that population our ability to get them through and graduate them is significant and therefore the role that we play is still a very, very important role and is one that we think is a sacred and moral obligation. So that trend does speak to the fact that opportunity is there and we believe strongly that opportunities are America's promise. We believe that education in that contract was written. But at Howard like many other HBCU we believe that we are unequaled when it comes to African-American education.
LAMB: What's the - what's your medical specialty?
FREDERICK: I'm a surgical oncologist.
LAMB: LAMB: What does that mean?
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FREDERICK: So I do cancer, I do surgical, I do basically surgery on patient with major GI cancers in particular things like pancreas, stomach, colon, liver. I also do breast cancer work as well. And I do a little bit of the other surgical oncologist specialties that I would say the rest of that makes up about 10 to 15 percent of my practice which will include thyroid and skin cancers, soft tissue cancers. But my main focus is in the gastrointestinal tract cancers.
LAMB: When was the last time you did an operation?
FREDERICK: Two weeks ago.
LAMB: How can you be the interim president and operate at the same time?
FREDERICK: Well, you know, you have to be very organized. I'm the interim president, I think the interim is key there. It means the outcome of the switch may results am I going back to practicing fully and therefore have to keep my skills honed, especially because of the complex operations that I do. But I'm very organized about it, I have a great team around me that keeps me straight and it's my passion taking care of patients and seeing them. You know, with these types of diagnoses you see things in patients that you otherwise wouldn't see. I've seen courage in patients that otherwise shouldn't have courage. Patients with hope that otherwise shouldn't have hope as my mentor Dr. Leffall has often said. And he said it's inspiration to see those patients.
LAMB: What's been in your opinion since you've been in medicine - especially as applied to cancer - the biggest advance?
FREDERICK: I would say the biggest advance that I have seen in my career, I would say is bringing the issue of quality to the forefront. Medicine for a long period of time was treated as a bit of a mystery, what physicians did, you know, had a large mystique around it. And rightly so, it does take a lot of training and does take a lot of, you know, clear acumen around being precise to practice medicine. However, the issues around the fact that we are human and we make mistakes was one that, you know, we never spoke about, we spoke about it in a closed setting. But the rigorous nature of interrogating why those mistakes occurred and avoiding them was not like it is in the airline industry. And I think now you're seeing that in medicine, I've seen that in my time where we're more open about speaking about the things that may go wrong. And doing things in a better way to ensure that they don't go wrong. And all of that I think ultimately makes the patient the center of our affection and that's really the right way for us to do it, the patient has to be the center of what we do.
LAMB: What's the toughest operation you've ever handled?
FREDERICK: I do a pancreatic operation which is called a Whipple, it's technical term, is pancreaticoduodenectomy it involved removing the head of the pancreas, the first part of the small intestine, usually about 40 percent of the stomach, the bile duct, the gallbladder, and then putting all of those organs back together with a loop of small intestine. It's very complicated, the average time I think nationwide for doing the operation is about six hours. At Howard I think we do it at an average time just under four hours. And our outcomes are very good, the patients do very well but it's a very complicated operations, technically demanding.
LAMB: What's the hardest part about it?
FREDERICK: The hardest part about it is identifying all of the anatomy because sometimes they have variations of the anatomy that you don't see, that's one difficult part. Another difficult part is that you're operating around very major blood vessels that are critical. And that operation have done a few times which includes taking out the portal vein, which is the main vein to the liver and replacing it with a vein that I have taken out of the neck, the internal jugular. So, it can be technically demanding. The other thing I would add on that operation, I think it's difficult, what makes it very difficult is that you do all of the removal upfront and that can take hours and then you have to go in and put everything back and do it in a meticulous fashion to make sure it doesn't leak. And I think that also makes the operation tough when you're maybe tired or succumbing to fatigue, when you're doing some of the more complex parts of the operations.
LAMB: I might as well ask you this even though I'm not in your office but if you have - somebody has pancreatic cancer, what's the chance of survival?
FREDERICK: Yes. Survival still isn't great, it's a very, very dreaded disease. If a 100 patients come to see me with pancreatic cancer, 80 percent of them would not ever get an operation. It's that advanced of a disease because of where the organ is located and because of the symptoms that do not become obvious until it's too late. So 80 percent of the patients will never have the operation which means that they will succumb to their disease probably within 6 months. The other 20 percent would have an opportunity to be evaluated for an operation. So they may get chemo and radiation upfront or we may take them directly to the operating room. If we took all 20 of those 100 patients we're describing with pancreatic cancer to the operating room, another 5 to 10 would have the operations aborted because something we found that we did not know upfront. And of the other 10 who would have completed the chemo and radiation or get an operation subsequent to that or before that, that other - those other 10 patients would then develop other distant sites of disease after the operation sometime within the following five years on the order of about six or seven of them. So of the 100 patient we started talking about, two or three maybe cured by an operation or have no disease beyond five years.
LAMB: Is there a cancer that you seen in the last 20 years since you've been in this profession that is more treatable today than it was?
FREDERICK: I would say, necessarily in my time, I would say the biggest advance that I have seen would be in childhood cancers. But that progression has started before my time and as a trainee I saw what I would describe as more of the tailwind of that success story. Our ability to cure childhood cancer is significant today and it has had a major impact. In terms of the cancer I treat, I would say we become more sophisticated in identifying the ability to intersect or intervene with the right type of therapy and not necessarily expose people to things that they may not need and we've seen some of that progression I would say in breast cancer. We have seen the operation in pancreatic cancer probably become more well-defined and we trained more people to do it well. Esophageal cancer is another area where again I think the operation is getting better instead of having to go into everyone's chest we've been able to do what's called a transhiatal esophagectomy where we do the operation through the abdomen and the neck and to the chest and so the result of the operation itself, not the cancer cure, but the operation itself has been better with less mobility. So I think there are several areas where we had significant success. The treatment of cancers that have spread to the liver specially colon cancer I think has also got better in my time because of the drugs, not so much the operations that we've been able to do. But the chemotherapy drugs have gotten substantially better.
LAMB: How often have you have to tell a patient that they've got a serious cancer?
FREDERICK: Yes, too often And it's one of the most humbling things that you would do, it's one of the things that I think on a daily basis which is my life on a different way. To give people bad news is one thing to tell people that they have cancer or that they have a relative who's dying or you know is dead, it's one of the things in life that I think puts everything in perspective for me and I tell people often, you know, there are complex problems in the world but once you have to sit in front of an individual and have that discussion and see that hope drain away from then. And then see that person turn around and display courage and give you back that hope in humanity you see the relatives around them who otherwise would have had a strange relationships and, you know, have difficulties, that whether it's with finances or other things of the things going on in their lives and see them put those things behind them and focus on that person. It shows you the life that we live is a wonderful one. It reminds you that things like love have - love is journey with no end. And the despite the fact that we may have an end of our physical bodies, that love goes on, well beyond the people that we love being around us.
LAMB: I'm sure you have the same experience in your life I have a lot of people tell me when they were first told by a doctor that they have cancer, what's your - I don't what to call bedside manner, what's your approach to it and how fast you get to the point that you're not going to survive in some cases?
FREDERICK: Yes, so I try to be very direct, I also tried to encourage patients that come with relatives. Because once I say that, the rest of the conversation is out the window, they do not hear anything. Most patients begin to be very introspective, not just about their lives, but the other thing about the human condition is that it's one that isn't in isolation. The human condition requires interaction. And the first thing patient tends to do is to think about others, think about their love ones, thing about their kids, think about graduations they may not see, they think about weddings, they may not see. It's amazing. While you're speaking to them their minds are racing away about a timeline of things that they may need to do. And so they don't hear most of your instructions that follow or even perceive that. And so having an advocate in the room who can process, remind them about things, you know be the person to probably take note of instructions is I think important. The other thing that I tried to do is I don't do any diagnosis over the phone, I tell patients you have to come to the office and we have to sit down and have a conversation because regardless of how big or how small you think the issue is, I think it requires a conversation, it requires my eyeballs to meet yours and it requires my attention to detail so that you can ask me any question that you want and make sure that you get as fulfilling an answer. And I often tell patients we have to do this again because often that first time does not cover the breadth of the concerns that a patient would have. And when they go home and have a chance to, you know, really just calm down and think about it they end up with a plethora of questions that need to be answered.
LAMB: What's the strongest reaction you've ever got?
FREDERICK: I would say as strong as it comes. I have had the unfortunate situation of telling patients that or telling family members that their family member has passed, you know, during an operation for trauma for instance. And, you know, I've been in an room with 50 family members of a police officer who were shot and killed and having to tell the family members and it was one of the most awful things that I have ever experienced before we could finish the words, you know, they were in hysterics. I remember that night vividly because I was a trainee at that time I went back on my room and I called my mom. And who was, I said, was a nurse, it was midnight, I was just so traumatized and in fact my father was a police officer and he died one month shy of my third birthday so it was a very difficult situation. While I was speaking to her my pager went off again. There was a young black male in the emergency room with a stab wound in his abdomen. It said a lot about bad in our society at the time, you know, you value those lives and I think I remember hanging up with my mom and going back downstairs and seeing this young man having to take him back to the same operating room suite where this gentlemen has just died . This life just keep marching on despite the fact that this gentlemen has lost his life and for his family, time had stopped. And here I was trying to extend time for this other young man, I think it was one of those moments in my career that really grounded me around the sacred nature of what I was doing and the obligation that I have to do and the best that I could do it.
LAMB: When did you learn how to do it?
FREDERICK: I trained at Howard University in general surgery and…
LAMB: I mean, you know, where did you learn the technique that you use, I don't know if you want to call it technique of dealing with people? Has anybody taught you or…?
FREDERICK: Yes, you know, I have a mentor Lasalle Leffall, he came back in 1948, he was an 18-year-old graduate from what was then known as Florida A & M College. He could only apply to two medical schools at that time. I mentioned his history because I think how he came to be a physician is important. And so he could not get into - he did not get into either medical schools despite that he had in his entire undergrad career all As, couldn't take standardized tests, it was a nature of the education of disparity of that time, which still unfortunately has a legacy today. And his university president petition, Howard admitted him, he graduated at number one in his class and since gone on to be I think one of the most if not the most illustrious surgeon this country has produced. He's been the president of the American Surgeons, the American Cancer Society, you name it, he's been there. And he has always thought about putting the patient first, he was always talked about talking a time to make sure the patient understands, always talked about the hope - making sure we always give patients who always thought about the courage that patients displayed and we should have admired and take to heart, and so I think I gleaned a lot of things from him. I have another mentor, Clive Callender, who's a transplant surgeon. And one day I was in clinic and I was with him, you know, taking care of a Caucasian women from Minnesota where he trained - she had a transplant and was in DC, didn't have money and was getting in trouble with her transplanted organ, she had a transplanted kidney. And she came to the office and she went with her prescription for her meds and he could tell that she wouldn't be able to pay for it. And when he thought no one was looking, I saw him take money out of his pocket and give it to her to get her meds. And I thought to myself wow. He is already extending himself to her by seeing her. Her out-of-network insurance company probably wouldn't have been happy so he didn't charge her. And then yes he was also giving her money to get her meds. And I think those two men among many others really set the bar for me in terms of how I should treat patients.
LAMB: You spoke about that at commencement back in early May. Here's a brief excerpt where you're posing a question to the students.
(BEGIN VIDEO CLIP)
FREDERICK: I pose a question to my 2014 graduate. What will you frame your degree with? Will you frame it with fame and notoriety, with wealth and recognition or will you frame it with mentoring, with love, with service, with family, with compassion? You earn your degree not just to adorn your wall but, at Howard University, that degree is for you to change the world around you.
(END VIDEO CLIP)
LAMB: Why did you want to focus on framing your degree in your life around fame and notoriety or on wealth and recognition? Where does that come from?
FREDERICK: You know, that question is that those are choices that you could choose. You know, we give a technical competence to go out and earn a living to make themselves famous to do things that would bring them recognition. But I feel strongly that at Howard truth and service is our motto. And our degrees really come alive if you go out and change the world around you, that's what our alum have done. That's what Thurgood Marshall did with his degree, that was Vernon Jordan has done with his degree, that's was Lasalle Leffall did with his degree, that's what Mayor Reed is doing with his degree today, that's what Kamala Harris is doing with her degree today. And that 2014 class is made of fascinating number of individuals who already doing that with their degrees and I think it's important. Because young men and women of our society today we tend to characterize them and label them because they don't do things quite the way we did and I am not always sure that that's fear.
We have alternative spring break in our campus and I have students who apply to do that, I have 300 students go to five cities in this country and Haiti and give up their spring break instead of going to Daytona Beach, instead of sun tanning and frolicking, and warm waters, they were all within their communities mentoring, teaching students. And these are kids that could probably even get a job during that period of time or be it for a week and raise required necessary funds for them to matriculate. But they think it's more important to go out and give service. So I have a renewed faith in our youth and a renewed faith in the type of students who are coming to Howard and try to frame the degree the way they would frame their lives.
LAMB: We found this video with a couple of about Howard students on YouTube talking about Howard University.
VIDEO: Do you think it's worth coming at Howard?
STUDENT: I think a world experience but the venue, yes, it's definitely worth it. The school could use some renovation, you don't have to pay a lot of money to come here, you know, and like major things are wrong,. It might have been like ceilings falling and, you know, floors with water on the campus. So I think it should be more work
Oh, it's definitely worth coming here. HBCUs, you know, get a bad rep about it and I have, being like the real world, or if you're a black person you don't need to go to an all-black school because you don't really get the true, you don't really get the true real world experience. But two-thirds of the world if you want to talk globally, two-thirds of the world is not white. So, in fact, at Howard University, you're getting the real world experience and also you get all people from all types of diversity, then if you realize that that diversity goes beyond race and goes beyond ethnicity.
I'm going to tell you a little secret, a long time, for a long time like up until I was like 15, I wished I was white because of where I grew up. I grew up around a whole lot of white people, black isn't beautiful, you know. I thought it was ugly. And then I came to Howard University and completely eradicated all of those negative feelings.
LAMB: What's your reaction to any of those?
FREDERICK: I think it's great, I think you kept it - captures a lot of the Howard story. The reality is that we have students on our campus from 44 countries and from just as many states. So when you look at what is happening on our campus, to speak to the young man who spoke about the diversity, it is a very, very diverse campus in that respect. And the other thing I think is important that you have videos, the ability to self identify with who you are and the role that you need to place in the world is not one that can be undermined for students of that age for that 17, 18-year-old. That period of time before you go out to the workforce is a critical period of time. And I think we afford students an opportunity to find themselves, we afford them to embark on that journey to excellence in a way that self-fulfilling.
LAMB: What's the ratio mix at Howard?
FREDERICK: We have about - it's still 90 to 96 percent African American students. We have students, as I say, from all over the world and of the diversity, we have students there that are coming from Brazil, from Saudi Arabia, from China, et cetera, so very mixed.
LAMB: In 2000, tuition was $10,000 and supposedly the latest is around $22,000 plus. What happened?
FREDERICK: That's correct. Well, you know, I think higher education, the chances of higher education is what we're really continuing to explore and try to put our arms around. And we're trying to meet that challenge. We still however represent, of the private universities in our peer group and in the District of Columbia right here, are still very cheap compared to those institutions. Among the largest historically black colleges and universities we still charge less than probably two colleges. We are a full research university and our undergrads end up being exposed to graduate experience and we still charge less than even those institutions. So I still believe that we are a great bargain in terms from a cost point of view. The other difficulty we have is that 56 percent of all undergrad students are Pell grant eligible. That means that their families are on the lower income part of the spectrum, I think that's the real difficulty at Howard University. We have private institution and we are attracting a student body that you would see more at a pubic institution. And that's another beauty about what we do, we're still able to afford those students an opportunity to get the world-class education despite their financial circumstances and that sticks to our mission.
LAMB: As you know there's been a lot controversy about Howard over the last, I don't know, pick--20 years or so. And mostly because of financial problems, straighten us out on that. And I've read that the last couple of years that the budget has been balanced but you do get a quarter of your money from the federal taxpayer, what's the status? And one of the young kids said the ceilings are falling.
FREDERICK: Yes. So I would say we - let's put it in a perspective, we have an aging campus, there's no doubt about that. And we certainly have a lot of what we call deferred maintenance that needs to take place and we're actively engaging in doing that. We're also engaged in trying to bring new facilities through the new research building that we're building - a $70 million facility later this fall - and two new residence halls that will open this fall as well, with a new dining facility to come in the spring. So we certainly are making progress on the capital needs.
And we have three major revenue streams, one of which you mentioned in terms of the federal appropriation. And the reality is that we see a need to diversify those revenue streams and to expand our philanthropic efforts and those are things that the board of trustees have been able to zero in on and to set out strategies for us to go out and do that and you will see us doing that. Our endowment is the largest amount to historically black colleges and universities and is pretty health and just shy of $600 million.
Now to put that in perspective Vanderbilt is in our peer group and they're at $6 billion. Harvard which represents the pinnacle of the nations endowment is at $34 billion and they have a $6 billion campaign going on right now just to put it in perspective. If we are going to aspire to have that type of excellence those types of facilities to produce that type of excellence in our campus, then we have to have that type of investment.
And so it is my responsibility now and in turn it would be the next president's responsibility when he or she is named to go out and ensure that we expand those revenue streams and we monetize real-estate assets, that we are out raising money, that we have more corporate foundation donations, et cetera.
LAMB: You've got a board of how many?
FREDERICK: Around 30.
LAMB: The most controversial time was back in April of 2013 when you had a trustee by the name of Renee Higginbotham-Brooks who wrote a letter to her fellow trustees. This is before you were involved at all. She says, "I can no longer sit quietly not withstanding my personal preference to avoid confrontation and therefore I'm compelled to step forward to announce that our beloved university is in genuine trouble and time is of the essence." That's in quotes. She even suggested it may not be around in three years, that was a year ago. How do you deal with this because I know you're a candidate for president, she's still on your board, I assume, and you do have a new chairman, though?
FREDERICK: Yes, so we have two more years to try to outlive that on one end. And then on the other end this is a very - this has been a very dedicated trustee who I think was trying to bring attention to concerns that she had. And I think we all prone to probably add a little bit of hyperbole when we're trying to make a point, especially in her private discourse and I think that was intended to be a private discourse. I think it was unfortunate that it got out to the public domain. Nevertheless, the discussion around the things that we need to do and all of us rallying around it so that we could come together and move forward is something that has been ongoing. It was ongoing before that letter came out and I think it has even strengthened beyond that. The current chair-elect Stacey Mobley and the two vice-chair-elects - all three of them I think really rallied the board together to ensure that we can move forward together. And as you pointed out she is the vice-chair, the former vice-chair is still on the board, and has continued to contribute to the board as well.
LAMB: How do you get on the board and do you have to be an African American?
FREDERICK: No, I tell you a lot of questions, no. We had a long history of having a very diverse board as well as a very diverse board with ideology as well. Secretary Jack Kemp was on our board, one of the greatest board members, I would say. Getting on the board is an internal process that's conducted by one of the committees on the board in conjunction with the president.
LAMB: Does the Fed does have anything to say who's on your board?
FREDERICK: They don't. They don't dictate who's on our board.
LAMB: You were not around but it was a time when a president nominated Lee Atwater. Did you ever heard that story?
FREDERICK: I was a student.
LAMB: You were?
FREDERICK: Yes. I started Howard in 1988. That issue occurred in the fall of '88 into the spring of '89.
LAMB: Did you demonstrate against it?
FREDERICK: It was 25 years ago. I didn't because I didn't understand the issue fully and I would submit that many of us at the time probably didn't understand this issue fully. In retrospect and retroscope, I can look back at the issue and I think that his nomination occurred at the time where people were also disgruntled about a lot of other things with the school.
LAMB: Does the president have any say, would they have any say about a board member at all?
FREDERICK: Sure, the presidents have always been involved in, you know, selecting board members and making suggestions. And like I said it's done in conjunction with the board as well and with the committee that puts forward those nominations and then the entire board vets that. But the president has always been involved in participating in that process.
LAMB: Higginbotham-Brooks also wrote in her letter the hospital has become a serious drain on the budget on the university and we need either to sell it or get the D.C. government to properly reimburse us for the care provided to its citizens. How many citizens walk in the door and can't pay?
FREDERICK: First let me say that the district, the District of Columbia, even before the Affordable Care Act had a very high insurance rate among our citizens. I would say as high as 94 to 96 percent. So let's just start with that. So the self-pay population still represents a small percentage of the entire population. The issue is that the rest of that population we have about 70 to 80 percent that are patients who come to see us and have Medicare- or Medicaid-types of insurance instruments. And the reimbursement rates from those are very low. So the difficulty that we have is that we provide a very high level of care that is costly with a very low reimbursement so making that margin is difficult. The hospital is owned obviously by the university but it is a small hospital. And therefore again when you look at things like supply chain, if I order 10 hips for hip replacement versus I'm part of a bigger system where I can order 10,000 hips, you can tell again that what I will pay versus what other institutions is going to pay is very different. So the margin that I will make every time I do one of those procedures will automatically become very difficult.
LAMB: How many beds do they have in the hospital?
FREDERICK: We're licensed for 452 beds and we probably occupy about 250 of those. So overall, from a size and skill point of view, you know, she's absolutely right. We can't survive as an independently owned hospital and so we have embarked with a process which we're still in the middle of in terms of for looking an appropriate solution for the hospital business.
LAMB: Back in the commencement you also invited someone to be as speaker, we're going to run a little bit of this and obviously ask you if this was controversial at all.
VIDEO: Only this family could take one of the sons that's already had three name changes, all right, and give them a fourth: Dr. Combs. I know the board of trustees is looking at me back, like, this is not the regular type of commencement speaker that we're used to. Well, it's time for us to evolve, you know, we're changing things out here, do you feel me? And it's thanks to this board right here.
LAMB: Rapper Sean Combs had three names. He's talking about P. Diddy, Diddy and Puff Daddy. Controversial at all to have a two-year - it was two years at Howard and didn't get a degree but you brought him back and gave him a doctorate.
FREDERICK: Yes, I would say no controversy for me. Let me be absolutely clear. I was never - I can't say that it was controversial for me on that particular issue, not at all.
LAMB: Why did you do it?
FREDERICK: I felt strongly about that. This is a young man who attended Howard University around the time I did. Left Howard University in good academic standing. I think it's unfortunate that news reports described him as a college dropout. The reality is that African-Americans in this country who attend higher education, some 75 to 80 percent do not finish because of financial circumstances. It has nothing to do with academic aptitude. And when we talk about college dropouts we automatically paint people with a scarlet S because we we're saying to them that you did not succeed despite the fact that you went beyond your high school and attempted to go to college. And because you did not have the finances, we must now label you in a certain way.
And the reality is we don't do that for many other segments of our society. When you look at Steve Jobs, who never finished college, Zuckerberg, Maya Angelou, who I believe received 30 honorary degrees and didn't finish high school.
LAMB: Bill Gates
FREDERICK: Bill Gates. We could go on and on. I hear Brian Williams talk about his college experience, attending three universities and earning 18 credits. And I get my news from him every night and I think he does an excellent job and I think the intelligence here that evolves around that speaks to it. So my point being that I am a college president, I want people to come to university and get a tertiary education but I also recognize that a lot of them who dropout don't dropout because of poor academic aptitude. So let's put that in perspective. To give a commencement address, you want someone who's going to be able to give a charge to students that will give them some type of inspiration and help them understand the journey because that graduation is a destination that we kind of become obsessed with. It's not the end of the journey, it is part of the journey, it's a milestone. So you want a speaker who's going to speak to the greater life that they have to go out and live. And here's someone who cleaned toilets in a gas station who is now running a company that's worth $700 million and who is evolving, as he said. I'm not crazy about some of the lyrics he used in the past but when I look at the business things that he's doing now, the entrepreneurship, and what he is giving back in terms of philanthropy, I think he is and was a good choice for commencement speaker.
LAMB: You paid tribute to your mom earlier, is she still alive?
FREDERICK: She's still alive and she's here in D.C. visiting right now.
LAMB: Where does she live today?
FREDERICK: She lives in Trinidad and she's still a nurse.
LAMB: If you have to go Trinidad and get on an airplane how long does it take you to get there?
FREDERICK: It takes about six hours, a couple of hours to Miami and then about 3.5 hours from Miami.
LAMB: How many people live there?
FREDERICK: Right now, the population is about 1.3 million between the two countries Trinidad and Tobago.
LAMB: And what do you remember most about your first 16 years in Trinidad?
FREDERICK: I would say the freedom of not having things and having to be innovative about having a good time. That really stimulates your mind when you have to go out and make a makeshift ball or you have to go out and play with your friends and the social interaction that you're forced to have that my kids--that I'm creating circumstances to force them to have two play dates, where they would probably sit and play in front of computer screens.
LAMB: Where did you meet you wife?
FREDERICK: In Trinidad at Carnival, one of the greatest festivals on Earth.
LAMB: How long have you been married?
FREDERICK: I've been married since 2004.
LAMB: And how many kinds do you have?
FREDERICK: I have two kids.
LAMB: How old are they?
FREDERICK: One, my son will be 10 on the 13th of June and my daughter would be 8 on July 24th.
LAMB: Both born in this country?
FREDERICK: They're both born in this country. My son would be considered an African-American male.
LAMB: So if you don't get the full job, permanent job as president of Howard, what will you do? What would be your number one after that?
FREDERICK: I means that I get back on the duty that I was on in terms of teaching and taking care of patients. And as I do with everything I value around my family and we'll decide on what we do next.
LAMB: Will you continue to operate on people if you become president?
FREDERICK: It's something that I will think about.
LAMB: Full-time?
FREDERICK: It's something that I will think about. The outpatients I do are too complex to do frequently. And so I will strongly have to consider not doing them anymore.
LAMB: Our guest has been for the last hour, Wayne A. I. Frederick, and I got to ask you. What is A stand for? What does I stand for?
FREDERICK: A is for Alix with an I, A-L-I-X and Ian with an I, I-A-N. Alix is my dad's name.
LAMB: What does your closest friends call you?
FREDERICK: They call me Freddie.
LAMB: Currently Interim President of Howard University here in Washington D.C., we thank you very much for joining us.
FREDERICK: Thank you.