Stupidity: My Favorite Subject


Leonard Zwelling

            I know I
have to stop writing about stupidity. But, as Woody Allen said about death in
Annie Hall, it’s a very important subject.

            After my 29
years at Anderson plus that memorable year in DC, I really thought I had seen
stupidity on display at its zenith. My program director in Washington told us
that Congress was not there to make good laws but prevent the making of bad
laws. Then, in less than a week, I get to work on two terrible bills that eventually
became law. (Our office opposed both).

The first stupid piece of
legislation was the tobacco bill that put the regulation of the deadliest of
legal consumer products under the auspices of the same agency that is to
protect us from faulty drugs and medical devices but does such a lousy job, the
FDA. That might be ok but Congress reserved the right to ban tobacco for itself
when the FDA’s only logical action should it handle tobacco like Vioxx would be
to outlaw it—the one thing they were precluded from doing.

Then there’s the ACA. I and many,
many others have written more than enough about the many flaws in this
legislation since it was signed in March of 2010. Then the White House tries to
actually implement it, and the whole thing melts down over software. People
it’s 2013. Can’t Mr. Obama find anyone in Silicon Valley to help him. If Ben
Affleck could find John Goodman and Alan Arkin in Argo, don’t you think the
billionaire geniuses of Cupertino would rise to the occasion when their country

            Then I
return from Washington to MD Anderson where firing productive leaders has
become a spectator sport. First, I had to pick up the pieces in Smithville when
the last administration of Anderson determined the chair there had to go and
with him millions of grant dollars and the talents of several faculty. Then,
the long-time Chief of Surgery is removed for unclear reasons by the current
leadership probably relating to personal differences between himself and the
Chief Medical Officer. Numerous other department chairs have left and/or been
replaced by folks who could barely qualify for leadership positions elsewhere
but due to their personal and family relationships, undying loyalty to the
administration, or the willingness to look the other way and be complicit with 20th
floor shenanigans qualified for leadership roles in the WAR, the World
According to Ron.

            I thought
this would have tapped my stupid meter out. Wrong again!

            In this
story published in the NY Times Saturday, November 23, an expert gynecologist
who wishes to prevent the rising rate of HPV-induced anal cancer through a
federally-funded screening program is told to desist. Why? Because she is a
gynecologist and cannot extend her practice to include men who would also
benefit from participation in the trial. That’s right. Gynecologists constitute
the only branch of board-certified medicine which cannot care for both sexes
according to their governing board, the American Board of Obstetrics and
Gynecology. It turns out the gynecologists are particularly adept at learning
how to do anoscopy, the screening procedure of choice in high risk populations,
and because this disease affects both sexes and both would qualify for the
study, the gynecologic investigators wanted to include the men in their
practices. The board refused their appeal and that’s that.

            Please do
read the story and let me know if you have any ideas to forward to our
gynecologic colleagues about how they can overcome this massive display of
stupidity by their governing body. They are the experts. The patients would
benefit. The study would benefit. It is likely that a new standard of care for
high-risk patients will be defined. Why not let the gynecologists see these

            And I
promise not to make any jokes about the anatomy involved here, the board’s decision
and who the real ones are.

Leonard Zwelling