A Sad Joke: Did You Hear the
One About the 5 White Guys That Walk Into an Executive Suite?

By

Leonard Zwelling

         And you thought it couldn’t get any worse.

         The Cancer Letter (January 17, 2014) reports that Dan
Fontaine has done exactly what this blog predicted he would do only a few short
weeks ago. He has further consolidated his power by stepping into Adrienne
Lang’s heels while still wearing his lawyerly wing tips and luminescent ties.

         Adrienne: welcome to the world under Dan’s bus. All of us
appreciate how hard you tried not to be here. All of us tried to escape as well.
Dan is nothing if not tenacious.

The
leadership of MD Anderson is all male and all white. For America’s number one
place for cancer care, it sure doesn’t look like America when they take the
group photo at the annual executives’ picnic. If ever there was a group that
did not need another  “selfie” posted on
Facebook, this is it!

         Mr. Fontaine has chewed up and swallowed a bit more of the
MD Anderson scenery in his new position as Executive Chief of Staff, a position
that never existed before as far as I know. I wonder who made it up.

Perusing
the list of activities that Dan will now oversee leaves one queasy with vertigo
as it stretches credulity that any one person could really embody the expertise
required to oversee all of these various functions.

        

Here
are some areas Mr. Fontaine will now oversee:

·      1.Moon Shots program external business opportunities (I
am unaware of Dan’s experience in pharma or biotech, but when he was assessing
such a venture on the west coast in 2007, I was invited along for advice. No
worries, I was ignored. I was likewise ignored when Mr. Fontaine tried to
privatize the Pharmaceutical Development Center. That one cost me though as I
was vilified and sold as a traitor to the Executive Committee for my
unwillingness to go along with the scheme when I was the Executive Director of
the PDC. Another bad move on my part. One of many causing my departure).

·      2. Technology-based ventures (Not sure how these differ
from above).

·      3. Strategic industries ventures (what does that mean?
Oil and gas or defense contracting for MD Anderson drones- –Making Competitors
History?–or are we finally fielding a football team?)

·      4. Children’s Art Project (This is a self-contained
business, if I am not mistaken, that has been well-managed historically so
probably will continue to do well. I am unsure of Dan’s proficiency in the
design of Christmas tree ornaments).

·      5. Communications (Given the current level of antipathy
between Dan and the rest of the Lesser World {that would be faculty and staff},
I would say this is not his long suit)

·      6. Development (an interesting way to position what was
historically the President’s. I suspect it will largely remain so).

·      7. Marketing (What exactly is MD Anderson marketing
beside Making Cancer History? If it is quality, as it ought to be, have the
data been acquired that prove this long held presumption of outcome superiority?)

·      8. Physician Relations (You really have got to be kidding.
I know Dan’s relationship is not good with Anderson’s docs. Perhaps he will do
better with those in the community).

·      9. Public education (I am not totally sure what this is
or why it went to Dan)

·      10. Volunteer Services (Why the hell not?)

The
real news is that this was Dan’s ticket to escape from Mr. Leach’s box on the
org chart into the President’s. (Frying pans and fires do come to mind). That
was really the purpose of all of this.

For
his part, Mr. Leach (MIA? Does he still work at Anderson? ) will over
see Facilities, HR and other areas with which he, like Mr. Fontaine, has
limited expertise, although Dan’s qualifications to oversee HR are not
insubstantial. I can attest that he knows how to fire people.

In
business school we were taught two theories of corporate leadership. The first
says that if you can lead one company in one industry you can lead any company
in any industry. There are certainly examples of CEOs who move from industry to
industry with varying degrees of success.

The
other school espouses a different view and it is one to which I adhere. The
truly successful leader knows the business he or she is leading from the bottom
up. I believe that is why the President of MD Anderson must be a physician,
although Dr. LeMaistre was not an oncologist and Dr. DePinho isn’t one either.
Both they and their credibility with the clinical faculty were challenged by
their absence of first-hand knowledge of cancer care and I actually believe
that future Presidents of MD Anderson ought to be real oncologic specialists in
one of the disciplines of cancer patient care.

It
also seems injudicious to have the Chief Medical Officer and head of the
hospital be a radiotherapist who doesn’t work often with hospitalized patients
and probably hasn’t for years. We’ll see how that works out, but my suspicions
are that if a search had been conducted for this position as it was for the
Provost’s job, the appointed winner would have come up short again. You
can’t lose a race with no starting gun and no competitors. (How much fun would the Super Bowl with only one team in it?)

Dr.
Dmitrovsky is the final middle-aged white guy in the President’s inner circle.
Ethan seems like a nice enough man who has yet to make his mark on the
institution. When people talk about him they always start the same way. “He’s a
nice guy”. When was that ever a criterion for leadership at MD Anderson? Hmmmm…the
new Provost sounds like the last guy, toiling at the feet of a science-loving
President who makes all the financial decisions on laboratory issues. At least
Dr. Mendelsohn’s wife didn’t have a lab, let alone a building. Good luck with
that, Ethan.

All
of this makes great theater and it is the source of unending material.

The
faculty and staff who have to live through it and those of us absentees who
still love the institution are not so amused.

I
think that the only thing I can be sure of is that it is likely to continue
getting worse until and unless someone stops the bleeding.

         I am glad that I am out. That doesn’t mean this doesn’t make
me sad. It makes me very sad.

         The punch line for this sad joke has yet to be written.

Leonard Zwelling