Where Are the Leaders?

By

Leonard Zwelling

         Have you seen or heard Bill Clinton recently?

He
is a shadow of his former self in every way. He is gaunt verging on anorectic
and the formerly voluble Chief Executive struggles to make a whole lot of sense
when he speaks in public. It has been getting worse since his by-pass surgery
and I suspect that is the origin of this change—too much pump time. While I
miss the old Slick Willy, he’s not running for office any longer and if folks
are foolish enough to pay half a million bucks to hear the nothing he has to
say or to have their pictures taken with him in what was once the Selfie Du
Jour, let them. I am not interested.

         By contrast, his wife Hillary is running for President and
she is making yet another announcement of that fact this weekend. Why you need
two grand openings is beyond me, but you try to stop a Clinton from doing what
he or she wishes to do. She hasn’t said anything newsworthy in over a month of
campaigning to groups as large as Girl Scout troops in Iowa and surfers in New
Hampshire.

         I am far more concerned about Mrs. Clinton’s unwillingness
to answer questions on a range of topics from Benghazi to the Clinton Global
Initiative than I am about her husband’s recent inability to answer them in
coherent sentences. Wait, that’s not recent, just the cause is, if you know
what I mean by is. I am sure her answers would be most entertaining, far more
so than the frozen Joker-like smile she has placed on her face when greeting
small business men with open arms and reporters with closed lips. All we know
that she believes in is coloring her hair so she doesn’t “turn white.”

I
don’t know about you, but I really have had enough of leaders who consider
themselves so privileged that they can make off with millions, claim poverty,
and run for the highest office in the land virtually unopposed and unwilling to
speak meaningfully about anything beyond peroxide. That’s not leadership.
That’s a waltz to a coronation and the Democrats ought to be ashamed that she’s
the best they can do. What’s more, the worst part is that she just may be the
best they can do. I spent 9 months staffing a Senate committee with Wild-Man
Bernie Sanders on it. He was funny like the guy next door who won’t throw you
back your ball that rolled on his lawn. He’s part Gene Wilder in Young
Frankenstein and part Mr. Wilson who lived next to Dennis the Menace. Then
there’s Martin O’Malley who I defy you to pick out of line-up and Lincoln
Chafee who used to be a Republican. The lefties are hoping Elizabeth Warren
will finally say yes so she can scold us all into blaming Wall Street for
climate change. Bring back Al Gore. At least he had slides!

         On the GOP side, unlike four years ago when we had Mitt and
the Seven Dwarfs, we have as many as 20 people vying for the right to challenge
Mrs. Clinton for the White House. They are no more appetizing than she is as
they try to coat themselves in the red meat of conservative ideology to rev up
the base into a Pavlovian lather so as to get the nomination and leave
themselves almost no room to run to sanity should they triumph in the
nomination wars.

         Can’t anyone act like a responsible adult and articulate a
clear set of policies that reflect the slightly right of center America that we
truly are? Can it be done without proposing to give away every dime the government can mint or
roll back the clock on social programs that are based on conflicts in areas
like civil rights, voting rights, abortion and sexual freedom that most
Americans have settled long ago? Where the hell are the leaders?

         This is also a question I ask of academic medicine and
medicine in general. When the insurers, big pharma and the hospital chains
hijacked the Affordable Care Act leaving doctors and patients to vie for the
crumbs they left in the smoke-filled rooms of Congress, where were the
legislative leaders on Capitol Hill saying ‘wait a minute.’ This bill sucks. It
doesn’t lower costs. It doesn’t raise quality. It doesn’t really even insure
the majority of those needing coverage. The bill was passed in a fashion that
upends the “regular order” that is supposed to characterize meaningful
Constitutionally-defined debate on Capitol Hill with not a single Republican
vote. Then the Supreme Court torpedoes the Medicaid expansion and may well sink
the whole bill in a week or so if it rules for the plaintiffs in King v.
Burwell and removes the subsidies for those obtaining Obama Care through the
federal exchanges.

Where
were the docs saying this isn’t right? I don’t know. I was there in DC when
this all transpired and I never saw them. And I certainly could not a word in
edgewise among the multitude of Red and Blue Kool-Aid drinkers. After all, what
did I know? I was just a doctor and they were Senate staffers.

         Finally, what is happening to academic medicine? It is being
sold to the highest bidder exactly as Marcia Angell predicted in 2000 in the New England Journal of Medicine (http://www.ncbi.nlm.nih.gov/pubmed/10816191). L. Ron DePinho wanted to sell technology and do the
trials to test it at Anderson undoubtedly hoping that Dr. Cooper would be the
vehicle to the pot of gold until Dr. Cooper took the pot for himself. Now Ron
doesn’t have a pot to…well, you know, and he doesn’t have a Chief of Pediatrics
either to handle the latest fall out from what is depicted as faculty anger in
the media. Again, where were the adults to truly handle this crisis? The public
relations people did great with the Houston media, but what about the faculty
of Pediatrics shaken by a leadership change that is incomplete, the loss of its
most highly regarded researcher, and now the jailing of a promising young
investigator. These folks need a break! Talk about Gimme Shelter! The
pediatricians can’t always get what they want let alone what they need.

         It is likely that I will sit out the election for President
in 2016. I absolutely refuse to vote for Mrs. Clinton. I don’t want to
encourage her or other rich crooks for I have had enough of them in my recent
work life. Whether it is Cruz, Rubio, Walker or one of the other kiddies of the
GOP, or even another Bush (oh no Mr. Bill!), they will sell their souls to the
far right to gain the nomination and then deny they said the crazy things they
said to get nominated when we all can view their public pronouncements of
insanity on you tube.

         A plague on all of their houses and yours too if you allow
the leaders of MD Anderson to cheapen what was once the greatest cancer
fighting institution in the world but now has just regressed to the mean of
every other conflicted, compromised and cacophonous academic center claiming to
care about patients but fully addicted to money.

         Not me, man. Everyone has to believe in something. I believe
I’ll have another beer.

Leonard Zwelling