I Don’t Get What They
Don’t Get

By

Leonard Zwelling

         Todd Ackerman’s piece in yesterday’s Chronicle might leave
anyone who is not a faculty member at MD Anderson scratching his head. Or
better yet asking, “what the heck is going on over there?”

         That latter response makes a great deal of sense. I surely
do not know although I try to make sense out of what I see and hear. It appears
that the institutional leadership is surprised at the discontent expressed by
the Faculty Senate in its recent communications to University leadership in
Austin. The MD Anderson leadership clearly believes it is making progress in
fighting cancer, in healing rifts among factions of the faculty and in general
making MD Anderson a fun place to work.

         The Faculty Senate seems to feel otherwise making one wonder
whether this drama is playing out on the same planet for the institutional
leadership and the elected faculty representatives.

         Finally, it seems as if the clinical leadership, the
Division Heads, is backing the perspective of the institutional leadership in
interpreting recent events as progress.

         What I can’t quite get my arms around is what the problem
is?

         Faculty morale comes up over and over, but this is an
effect, not a cause. Why is the faculty discontented? Is it frustration with
the leadership, the ever more complex systems in which they must work or the
general state of affairs of academic medicine which is poor as patient demands
increase, reimbursement per unit of work decreases, and grant dollars dwindle.
If this is the major problem, what is its major cause? And it cannot be just
Dr. DePinho as much of this predates his ever setting foot on campus.

         Is it really the selected spending dictated by the Moon
Shots? Obviously in any strategy, resources must be targeted to various
recipients and many others will not derive benefit. Is that the real problem?

         Faculty disenfranchisement is mentioned. This is not new. It
is almost part of MD Anderson’s DNA for the executive leadership to call most
of the shots. The Faculty Senate has been about as effective as the big Senate
in DC in having input into the course of the ship, regardless of who was
captain of the ship.

         I think the problem is all of that and much, much more.

First,
there is the four letter F word—FAIR. I think that many faculty view Dr. DePinho
as playing favorites when guiding resources to various programs. He would say
he is being strategic.  Those without the
largess would say “unfair.” He is certainly not transparent as things happen and no one ever knows why.

Second,
there is the manner in which the new leadership has comported itself which is
best classified as self-congratulatory and opaque meanness. These are all guys, but none
of them is nice. They dump faculty leadership in acute and unnecessary
fashions. I just cannot figure out why. Why not develop an orderly transition
when a change needs to be made in the judgment of the leadership? What is the
need for the “perp walk to the guillotine?”

I
really think the problem is not a series of bad decisions, although there have
been many of those. I think it is a general tenor of antipathy toward the
faculty, especially the clinical faculty, played out by leadership that flouts
the rules, knows or cares nothing of common decency, and in general is arrogant
and just simply unlikeable.

I
know when I was still at Anderson, interactions with these folks were always
unpleasant. Most of my friends echo this sentiment.

So
in the spirit of hope and change perhaps the leadership ought to represent
itself as either nicer people with some degree of beneficence in their hearts
or be transparently honest that MD Anderson has finally declined fully into The
Godfather saga and it’s every man for himself especially those not in the
“family.”

I
think this choice has been made.

“Leave
the gun, take the cannolis.”

Leonard Zwelling