A Small Bump in an ‘Exception’ Undermines Exceptionalism:
The Newest Front in DePinho’s Confrontation With the Faculty

            I have
always objected to the concept of American exceptionalism, the inherent belief
that if its origin is in this country, it is, by definition, the best. In his
essential book The Healing of America, TR Reid dedicates this work about health
care delivery systems around the industrialized world to Dwight Eisenhower.
President Eisenhower utilized “comparative policy analysis” to justify infrastructure
investment in an interstate highway system after taking office in 1953. He did
this after having seen the advantages of such a system when conquering Germany
and its autobahn that had been built in the 1930’s. Ike knew a good idea when
he saw one even if it came from the very nation he had just defeated. Thanks to
Eisenhower’s willingness to embrace comparative policy analysis and a
non-American solution to an American challenge, we can crawl along the 4 lane
Loop at 6 PM instead of park on the two lane roads planned for Ike by American
transportation experts when he entered the White House.

Reid’s thesis is that the same
could be done with the American health care delivery systems (yes, it’s plural
and depends on your insurance status) if America borrowed the best ideas from
around the civilized world and developed a uniquely American system for
providing universal health care.

I know, I know. Forgheddaboutit.

But the principle is a good one. If
you want to get better, don’t walk around saying you are number one.  Always be on the lookout to learn from
others. If you really are the best, others will say it for you and even if you
are, it never is a bad idea to work like you are not exceptional. At their
best, Tiger Woods and Michael Jordan did just that. Mick Jagger still does and
none of them flaunted his exceptionalism beyond displaying it on their
respective stages and letting others heap on the praise.

            I bring up
exceptionalism because the faculty of MD Anderson is being challenged with the
concept in the form of having to decide if a rare event, an exception, is
occurring with sufficiently increased frequency as to no longer be considered
an exception and to be concerned that it may be damaging what little hold on
exceptionalism MD Anderson has which seems to be based on US News and World
Report and perhaps, Jim Allison’s well-deserved press if we are to believe what
the public relations office disseminates.

            A recent
post on the web site of Inside Higher Ed (www.insidehighered.com; April 3,
submitted by Colleen Flaherty and also written about in the Cancer Letter of
April 25) discusses a Faculty Senate report of another disturbing trend in
President Ron DePinho’s decision making. Apparently, although it happened only
a handful of times, the President is reversing the decisions by the Promotion
and Tenure Committee (PTC) to grant promotion and/or tenure or tenure renewal to
faculty members who garner unanimous support from their colleagues on the PTC.
While this happened a few times with past Presidents, it is viewed as becoming
more than just occasional by the authors of the report. What was once an
exception was becoming a bit more frequent. It was still an uncommon event,
but….

            There are
only a few reasons that could explain this trend.

            First, the
President’s criteria for promotion and tenure are stricter than those to which
the PTC holds applicants for tenure. In other words, he is increasing the
exceptions to attain greater exceptionalism for MD Anderson. The problem here
is that comparing those who passed Presidential muster and those who did not
did not reveal a clear distinction between the quantifiable qualities of the
two groups according to the report.

            Second,
this could be pure politics. Everyone has enemies and friends. Perhaps some of
those rejected by the President but unanimously passed by the PTC had made
enemies of the President or of his friends. This seems rather petty and
hopefully is not the case, but you never know.

            Third, and the
most disturbing explanation of all is that the President vetoed these
candidates deemed worthy by their peers because he could. Unfortunately, this
is absolutely true as such behavior is well within the purview of the MD
Anderson President and is consistent with a host of other bad behavior by
DePinho since arriving that includes nepotism, conflict of interest,
self-dealing equity on national television, some questionable judgment with
regard to a large CPRIT grant application and outlandish pronouncements about
the actual state of cancer research and the likelihood of making rapid progress
in applying research to the clinical cancer problem.

            I really
don’t know which of the explanations is the right one and they are not at all
mutually exclusive. I do know that as with so much of the actions of Dr.
DePinho and those he recruited to Anderson, this is inexplicable and needless
chaos injected into a system that needs all the positive energy it can glean
after the financial crisis and layoffs of 2008 and the rough Presidential
transition that followed 3 years later, not to mention the current financial
and regulatory pressure on all deliverers of health care, especially those in
academia.

            In other
words, why bother? What is the statement he is making and the faculty should
infer from these seemingly thoughtless or malevolent (?) and confrontational
actions on the President’s part? Got me. All I know is that his raising the
frequency of what was once a very rare exception rather than advance
Anderson’s exceptionalism is actually undermining it. I have to ask yet again.
How smart is that?

Leonard Zwelling