MY LEGACY, MY DREAM

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My Legacy, My Dream (and officially according to blogspot, the 100th post)

By

Leonard Zwelling

            This
one is a little long as it is saying good-bye. Sort of.

            Don’t
worry. I am not going to write about all of the things I did that I believe to
be worthwhile, i.e., my legacy. History is written by the winners and, as Dr.
Draetta has pointed out, I am a loser. In fact, I believe that he considers me
the biggest loser. So, as I indicated in the last blog, it’s time for me to run
along.

            Before
I do, I want to write a little about the future, mine and yours.

            Presently,
in the fall, I will be retiring from MD Anderson and joining Legacy Community
Health, the largest federally-qualified health clinic in Houston as the Vice
President of Medical Support Services reporting to the Chief Medical Officer. I
have been a board member there for the past few years (unpaid but reported to
the Conflict of Interest Committee) and have come to admire the work that
Legacy does providing health care for anyone who walks in the door, regardless
of his or her ability to pay. (Remember when MD Anderson used to be like that?)

            It
is time for me to put my money where my mouth is when it comes to improving the
delivery of health care in Houston and working for the good of those less
fortunate than I. I say my money in my mouth because I am foregoing my final
year of tenure and taking about a 50% reduction in pay.

            Legacy
started in the early ‘80’s serving the needs of the gay community in the
Montrose at the dawn of the HIV epidemic. Legacy’s newly-opened Montrose
location on California Street, still does a great deal of this work, but Legacy
has spread across the city to sites in the Southwest area that treat mostly
Hispanic members of the Houston community and lots of mothers-to-be and their
families. We also provide eye and dental care. We have opened branches in
Beaumont and Baytown and are looking to expand even more given the acute need
for health care in the nation’s 4
th largest city and fastest growing
county.

            Some
of you know that I have career ADHD hopping from clinical rheumatology and oncology
to molecular pharmacology to business school and research administration to
Capitol Hill and the politics of health care reform. Legacy has given me an
opportunity to put all that I have done to work in a real world setting, implementing
a new strategic plan that I helped write and working with people who are among
the least confused and most eclectic who I have ever met. It’s a great melting
pot at Legacy. It looks like—-America!

            If
you need a community laboratory for your next research project, please think of
us at Legacy. You can always find me at
Leonard.zwelling@gmail.com. Two MD
Anderson faculty members have already started projects at Legacy and I will be
their liaison with the organization.

            As
for my dream, it is about all of you. Some of you have been my friends and
colleagues for almost 30 years. Some readers of the blog and I have never met.
Both groups have given me a much needed lift at a time when I was really struggling
to find an outlet for my energies that had not died in the least, but had been
shunned by the leadership here at Anderson for a host of political and personal
reasons. Some have been very personal, indeed, but not on my part.

            The
main reason I have been removed from making any meaningful contributions here
is that I refuse to shut-up and take orders. I was flat out told by a Senior VP
that I would no longer be allowed to make contributions to MD Anderson.


(I wonder if he told this to the Development Office for I
have contributed a great deal of money for me to my alma mater Duke Medical
School and might have considered doing the same here if I didn’t know that Dr.
DePinho and Pat Mulvey would waste the money. Dr. Kleinerman and I donated a significant
amount of money to Anderson in memory of my cousin who died here when Dr.
LeMaistre was still President. Check out which faculty members’ names are on
that plaque near the top of the escalator on the way from the Alkek lobby to
The Park.
)

            I
believe that this blog has been a contribution so just as that Senior VP (Hint:
he’s also an attorney) was wrong about me thinking that another year of salary
could buy my silence, he was wrong about me making no contribution. Writing
this blog has been fun, but this is enough of that as my main endeavor. (I am
also writing a book about my Washington, DC experience. I suppose it could be
considered a comedy if it weren’t so sad.)

            My
dream is that all of you return MD Anderson not to what it was, but to being on
the path to what it could be—The Once and Future MD Anderson.

            The
clinical skills of the faculty are amazing. They probably saved my wife’s life,
but surely the faculty and nursing staff should not have to fill surgical
gloves with ice chips because the hospital has not supplied the in-patient
neurosurgical unit with ice packs.

            The
investigators at MD Anderson in the basic sciences are unique in my experience
for being open to addressing the mechanisms behind real clinical problems. They
are fully committed to translational science to better the lives of patients.
These faculty and their technical staffs should not have to struggle battling a
research administration support system both ancient and dysfunctional. I cannot
believe the current faculty is forced to use the systems developed when I was a
VP at the dawn of the computerization of regulatory affairs (1997) when
commercial products are now available. This is far more than just a
malfunctioning system of clinical research oversight.

            As
the immediate past chair of the IACUC, I can assure you that this body is also
not functioning as it should and that my pleadings to improve things went
largely unheeded. The veterinarians here are first-rate, but the IACUC itself
and the investigators who depend upon it need a great deal of remedial
assistance in matters of compliance. Part of the problem is that service on
committees like the IRB and IACUC are little more than chores that gain no
credit for faculty at promotion and tenure time. Thus, service avoidance has
become the logical norm. My experience as IACUC chair was aided greatly by my
recruiting my more experienced faculty friends through arm-twisting so I had a
group of true experts to oversee animal care and use.  Thank you Drs. Meyn, Ulrich, Barton, Mitchell, and Menter
and the next time you bump into Peggy Tinkey and her fellow vets, please thank
them for their years of superb service.

            The
population-based and prevention scientists are an asset no other cancer center
can duplicate. The institution should consider supporting them adequately which
it does not. We need a real Department of Health Services Research (HSR) that
serves the needs of the clinical operation AND is a focus of true basic
research in all areas of HSR. Choosing between these two needs is a false
choice. Particular attention must be paid to the real costing and the economics
of our services and calculation of their value to patients, not just to our
institutional bottom line. I understand no money, no mission. But money cannot
BE the mission.

            The
education mission has taken some huge leaps forward, but I am unclear as to the
benefit of so many relationships all around the world and wonder if a more
select group of partners might not be more fruitful.

            But
my real dream is the same one I have for the United States. I dream of
leadership worthy of the people these leaders are supposed to lead. Right now
these leaders are doing their jobs poorly, whether in Houston or Washington. It
is the greatest crisis in the world today this lack of leadership. It seems
that the qualifications for a leadership position are the inability to do the
job. It is sad, but it is everywhere—Wall Street, Washington, DC, American
academia and right here on Holcombe Boulevard.

            Moral
relativism, group think and criminal and near criminal behavior among the very
people who we were taught to emulate is simply unacceptable. What the heck
happened? Where have you gone Joe DiMaggio?

            I
will be writing more columns and blogs as the fall approaches trying to tie up
loose ends knowing that I won’t be able to. I hope you found these as much fun
to read as I have to write.

            And
for all of you who wanted to know—YES—I am The Old Dog and I am Moonshot
Marvin. Thank you Warren Holleman for keeping our Faculty Voice secret even if
many of you guessed it. I never was a very good actor nor very good at hiding
my feelings. 

            As
Lewis Black would say, “ I have trouble with authority”. Indeed. I do.

            I
have always been the little boy at the parade saying the king was naked. It is
likely that I always will be.

            And
just to be absolutely clear, I believe that the current President of MD
Anderson and his immediate predecessor, neither of whom had the support of the
faculty for the majority of their time in office, ought to do some real
soul-searching.

            Dr.
Mendelsohn: Repeat after me. “I am sorry for what I put you all through. Here’s
how I will make amends”.

            If,
as I have been told, Dr. Mendelsohn is still drawing his prior salary, it is as
shameful as the administration paying me and then not letting me contribute,
for I know of no one on this faculty with the variety of experiences that I
have who is more willing to pitch in and been made to feel less welcome by the
leadership. No one likes being criticized, including me, but both the
executives and the ex-executives (me) should be able to take it and have
reasonable conversations without trying to marginalize one another. I can say
without reservation that the conversations that I have had with the SVPs, EVPs
and the DeP, as rare as they have been in the past few years, have been anything
but reasonable.  They all suffer
from a lack of receptors for rationality and they would like to and have largely been allowed to marginalize the rest of the people who work here.

            Dr.
Mendelsohn is like Eliot Spitzer, as Gail Collins noted in the NY Times on July
11. His idea of doing penance for bad deeds is drawing a huge salary as Spitzer
did going on CNN as a commentator. That’s service? Where’s the atonement?

            John:
Fess up. There’s still time, but it is getting short. Like me, you aren’t
getting any younger and having a building named after you is not really a
legacy. Half the current faculty members don’t know who R. Lee Clark was beyond a
figure on a portrait outside an auditorium named for another faculty leader no
one remembers, Bob Hickey. It is still not about bricks and mortar. It’s about
heart and you never got that. Those Core Values of Integrity, Discovery and
Caring were not just for the faculty or rank and file employees. They were for
the executives as well.

            Dr.
DePinho: You have managed to piss off more people in less time than I ever did
on a bad day. As far as I can see you have the same choices you have given the
rest of us.

            1.
Fight for your job by doing it well. (Yes, you need improvement).  OR

            2.
Continue your Moon Shot nonsense until we have to launch you from Cape Kennedy
into low Earth orbit so the rest of us can get back to work. OR

            3.
Run back to Boston or wherever it was you came from with your minions of
arrogance who have spread across this campus like a viral invasion of the
Harvard zombies. The Walking Dead became the Walking Red (Crimson, that is).

            And
take your wife with you if you choose the latter (door number 3).

            And
why can I say this last piece, DeP? Think about how you treated MY wife within
days of getting here. To be blunt, only my background as a Duke gentleman
prevented me from becoming vengeful with my deeds. Pens are better than fists
and blogs the best of all. Besides given my religious background, I am going to
be more effective with my words than my deeds. We Jews were “chosen” to be men and
women of the Book, even though our Israeli brethren have learned to use force
like King David did on Goliath. That’s not for me, but I love the metaphor.

            To
all (even we losers)—L’ Chaim. To life!!! 

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