Both Iraq and MD Anderson
Are Gone: There Is No Restoration Pending, But There Could Be

By

Leonard Zwelling

         Iraq is no more. Iraq never was.

         Iraq was a made-up country formed by the British after WWI.
It consisted of three oppositional forces that really don’t like each other. I
am not talking about not liking each other like Republicans don’t like
Democrats. I mean they really don’t like each other and would just as soon kill
the next fellow as form a government with him. There are Sunnis, Shia and Kurds
within the borders of what was the Iraq that Saddam Hussein kept under his
thumb. Then W swarmed in with the US military and killed Saddam and any hope of
keeping the factions from each other’s throats. This became the political Petri
dish that has been overrun by the vermin known as ISIS. ISIS is an infectious
disease spread from an equally repellant Petri dish in Assad’s weapons of mass
destruction Syria, and Assad really had them and used them!

         Syria doesn’t really exist either nor does Lebanon, nor
Libya. Even Israel is a made-up country carved from 78% of the British Mandate
of Palestine (BMP). In 1967 Israel took the rest of the BMP plus some former
French territory called the Golan Heights by force. Israel, however is a
country that has at its core a single founding group known as Jews. That group embraced
democracy and capitalism, but now may have to resolve the underlying conflict
of harboring within its 1967 borders an Arab population that does not wish to
be Israeli, but wants its own state. In each case, the US had a role in the
current chaos but so did the Arab Spring and the communications revolution that
is the Internet.

Regardless
of why the map of the Middle East is being remade, it is, and that’s a reality
that we will likely have to live with for a long time. We also need to come to
grips with the fact that there is very little the US can do to alter the
outcome of what is transpiring in the Middle East today. There is no back to
the future in the Middle East. We need to help where we can, but understand
that those instances may be few and far between.

         If the Obama Administration’s policy in Iraq is to restore
the territorial integrity of what Saddam Hussein kept in order, forget about
it. That will not happen and neither will peace in Syria as long as Assad is in
charge. The Middle East has become Armageddon for the forces of Saudi Arabia
(Sunni) and Iran (Shiite) and their various surrogates to vie for dominance
over the Arab world. Israel will struggle to stay out of this. So will the US.
Both should.

         The institution formerly known as the MD Anderson Cancer
Center and still known as the MD Anderson Cancer Center also has two
time-dependent identities like pre- vs. post-Saddam Iraq. The past identity
under Presidents numbers one and two was that of an academically-driven place
for cancer care and research with a great emphasis on clinical research and the
application of the newest cancer biology to patient care. While never an agile responder
to market forces, MD Anderson was small enough to be led by visionaries who
could implement their visions and plans rapidly and without straining the
sources of revenue to pay for the implementation.

         That began to change during the latter days of the second
Presidential Administration when managed care threatened the patient care
revenue and MD Anderson’s leadership was able to convince the Texas Legislature
and Governor Bush (yes, him again), that the mandate to have all patients
referred to MD Anderson was an anachronism and patients needed to be able to
self-refer. It worked. Hillary Care did not. MD Anderson saw its coffers swell
with money and the third President used that money to build, build, build.
That’s fixed costs you see going up in pictures of MD Anderson under its third
President, especially when his plans for basic science supremacy and
internationally recognized integrity ran afoul of Enron and ImClone.

         The addiction to money had ended the manageable MD Anderson
of the first 50 years and given way to a behemoth that is virtually
unmanageable, at least by its current leaders. The old MD Anderson is gone and
will never return.

         There are some who think that the destruction of Iraq and ridding
it of Saddam Hussein was a good thing. But a lot of American blood and treasure
have been expended to produce another bloodbath on the sands of Iraq and it ain’t
over yet or likely to be any time soon.

         Similarly there are those who believe that the changes
wrought by the third President of MD Anderson brought a modernity to a static
institution needing a bit of freshening. That he got caught up in two of the
biggest business scandals of the past 15 years was an unfortunate by-product
that has only gotten worse with the coming of a tyrannical and despotic fourth
President, more narcissistic and ethically compromised than the last guy.

         Whether you were pro-W and thought the Iraq invasion was a
good idea or pro-MD Anderson in 2001 when things really got bumpy, I believe
you can agree that the quiet that pervaded the sands of Iraq under Saddam and
the faculty of MD Anderson under Clark and LeMaistre are history.

         Either we continue in both places in making a disaster worse
with continuing failed policies or we plot a new course to improvement. To a large
extent, the outcome of  the next American
election may be determined by how Americans perceive the American position in
the world including changes to policies in the Middle East. There are no
pending elections at MD Anderson. The system there doesn’t work that way. But
the faculty can have a voice in the future, if it so chooses.

         The leadership of the United States will be new on January
20, 2017. The leadership of MD Anderson also needs to change. The sooner, the
better.

Leonard Zwelling