The Dust Has Settled; Now
What? How About Getting Back in Shape

By

Leonard Zwelling

         The trial of the month is over. The defendant is now in
jail. Her lawyers will be searching for ways to get her out, but I doubt they
will find any. Frankly, they should have thought of that before. I do not know
if their case was just weak, the prosecution just masterful, the defendant just
unwilling to take a plea or some combination of the above, but I guess it all
worked out about as it should have given all the damage the principals laid on
each other over the months of sex, lies and audio tape.

         As I have written already, a whole lot of soul searching
among a host of very good people who did some very outrageous things (or didn’t
do some things that would seem obvious to a school child) would be appropriate.
The same is true of the institution that served as the background for all of
this nonsense. MD Anderson has had more than its fill of bad behavior by people
who should know better. As someone who was once charged with overseeing some of
this professional behavior and who was constantly playing whack-a-mole with
faculty who wanted to do things the way they wanted to as opposed to the way
the government regulations said they had to, I get it. There was rarely a day
that I didn’t go home shaking my head wanting to meet the mothers of these
physicians who did some pretty dumb things for bright people. Now what used to
generate warning letters from the FDA has graduated to police investigations,
accusations of aggravated assault with a conviction and, the ever-popular
breach of business ethics by the institution’s leaders.

         I know as an administrator I was only occasionally
successful in heading off the cavalry from Washington, DC, but at least I never
had to deal with policemen with guns or district attorneys. It appears the MD
Anderson faculty has stepped up its game by jumping the shark.

         My critics, who are many among those whose conduct I used to
watch, will say I am being overly holy, judgmental and expect way too much of
people. They are correct, but I was reared believing that we in medicine report
to a much higher authority than the federal government or the UT police, so
when we are face-to-face with those guys, we are already where we don’t belong.

         Article after article is written about greed and corruption
in modern medicine. Doctors overbill. They double bill. They order tests that
aren’t needed and do surgery that is not indicated. They back themselves into
conflicted relationships where they try to serve two masters, their patients
and a drug company or their own biotech start-up and the integrity of the
clinical trial using the product they invented and with which they started the
company. I think we can safely say this is not the age of the ethical high
ground for medicine. I suppose the moral relativism defense will come next.
Everyone is doing it, why not us?

         My mother used to ask me if everyone jumped off the Brooklyn
Bridge would I?

         We know what to do (except those of us who are psychopaths
and there are a few out there). We just have to be mindful enough in the heat
of battle, clinic, grant writing, crushing patient loads and electronic medical
records that don’t work to do the right thing. It is very, very hard and we all
slip.

         We also have to give ourselves and each other the space to
be human. I have been impressed that the leadership of several clinical units
at Anderson has been unreasonable in its demands of the faculty and very lax
with the demands on itself. Stop talking the talk without walking the walk.
Stop taking exorbitant salaries while blocking the bonuses of more junior
faculty members who fall a percentage point short of fulfilling their
salary-on-grants obligation, especially in this research funding environment.
And, yes, I understand that adultery, nepotism and shacking up on the road are
not illegal, but they are unseemly and certainly send an untainted message of
permissiveness and non-discipline to the rest of the faculty. Knock it off! For
a bunch of folks who claim to be consenting adults, some of us are behaving
like self-indulgent teenagers.

         I know, I know. Len, you are such a prude and a scold!

         You are so right.

         On Saturday evening, the BW (Beautiful Wife) and I went to Dosey Doe in the
Woodlands and saw John Sebastian do a solo set. He was the lead singer of a
popular 60’s band called the Lovin’ Spoonful who were hot stuff between 1966
and 1968 before they faded along with most other bands of the era except for those guys
looking for shelter.

         During his set he noted that he was in a disadvantaged
position compared to other songwriters of his era because he did not have
divorce to spur his creative juices. He is married to the same woman for 44
years.

         Folks, he was a hippie and a rocker. He is 70 now. He has
two grown sons and one woman with whom he spent his whole life. You tell me
what his greatest message to those kids was, “Do You Believe in Magic” or a 44-year
relationship with their mother?

         You think I’m a scold? You should have met my father and
mother-in-law.

         MD Anderson. Shape up!

Leonard Zwelling