Circling the Wagons,
Compartmentalizing the Truth

By

Leonard Zwelling

         Before the jury comes back and before we learn the fate of
Dr. Ana Maria Gonzalez-Angulo, perhaps we should consider the behavior of
others in this lurid affair. By others, I mean the MD Anderson faculty who were
close to the principals.

         From the testimony given, several faculty members, most of
whom were female, surely knew that the defendant was deeply troubled. She was a
highly regarded colleague with great clinical skills, lots of energy and a
bright future. She was being recruited to the Massachusetts General Hospital, a
fact I knew because she told me so over a year ago. I actually urged her to
look at the position seriously.

From
the little we know about the substance of the dinner at Feast on the evening of
January 27, 2013, she was a key figure in the planning for a rather large
transplantation of MD Anderson faculty talent to some other academic
institution. She was a comer and a likely future star in medical breast oncology.

         So when the signs of angst appeared, as several witnesses
said they did, when the defendant claimed to be a victim of a mugging when the
outward signs of this did not support her inconsistent story and when, after
Dr. Blumenschein was poisoned, the defendant admitted to a colleague less than
24 hours after his admission to the ICU that she knew what the offending substance was and
that she would be a focus of any investigation, why didn’t these educated women
speak up? It’s not the Indians that are supposed to circle the wagons.

         Let’s take it a step further.

         Many of these women are researchers. They do both laboratory
and clinical studies trying to ascertain the causes of cancer and develop new
treatments to help patients. As is traditional, that means the world is looking
to them for honest evaluation of research results unbiased by any sorts of
conflicts, financial or otherwise. Why should the world trust them to report
honestly about their research when they couldn’t be straight with the
authorities when one of their colleagues almost died? Were they just being
great friends to the defendant? Or did they just not want to get involved? Did
they fear any time in court would take away time from their careers and
families? OR, were they just so terrified of being caught up in something that
might reflect badly on them and interfere with their academic standing within
the MD Anderson community and jeopardize their promotion and tenure prospects or
worse, get them fired by an autocratic leadership team that seems as arbitrary
as it is tactless?

         I don’t know what happened here as I was not there. I only
heard what was on the court record and people I thought I knew well, people
whose word I took as gospel, people who I would be grateful to have as doctors,
people who frankly should know better acted badly. Of course that includes the
poisoning victim himself and the defendant with their pre-work dalliance under
the nose of the faithful girlfriend. It includes a lot of people I thought I
knew. But then, I wasn’t the one being tested.

         But recently, I was. I was in a position to see wrong being
done and I tried to stop it. It cost me my job and fortunately for me, it was a
job I did not need or want any longer. That doesn’t make me a good person. I
was just lucky. At other times in my career, when faced with similarly tough
decisions, I went the way of many of the witnesses on the stand in the 248th
District Criminal Court to preserve my position and my income. Understandable?
Yes. Am I proud of it? No. When I stumbled in 2002, I swore I would do better
next time and I did 12 years later.

         It is important in the wake of this affair that MD Anderson
take a good, hard look at what happened and how the system broke down for the
principals. When it was I in the position of having to stand up for what was
right, I failed in 2002, and did better in 2014. I learned. I think MD Anderson
could learn, too for what I have realized thinking back is how poor my support
for doing the right thing was as the people leading the institution in 2002
were among the offenders I was battling and those who should have been with me,
were not.

         Sometimes, circling the wagons to keep the outsiders out, is
not such a good idea when the outsiders are trying to investigate a potential
crime. And, if you are going to have the world believe what you say in the
science literature, don’t embarrass yourself in the real world by not being
truthful there, too.

         This is a hard, hard life, but we physicians are among the
most privileged in society. We are paid well, still reasonably respected and
have work that is both gratifying and beneficial to humanity. Let’s try to keep
these things in mind when reality comes calling and needs us to step up.

         Someone almost died here. It is likely that someone else’s
life will be forever changed possibly irrevocably. Did anyone act like an adult
when that was so badly needed? At least two women did, but received no support
from their superiors and those supervisors are not blameless in this tragedy.
By their inaction and their establishing an environment where individual
accomplishment in the form of grant dollars and clinical revenue was more
critical than collective well being, they were complicit in the events that
played out in a Houston courtroom for the past two weeks. Regardless of the
verdict, no one is guiltless.

         Please learn from my errors if not from your own. Doing the
right thing is not easy, but it sure feels better later.

Leonard Zwelling