Good Decisions Require Identifying the Problem

A Correct Remedial Decision Starts With Identifying the


Leonard Zwelling

of you may remember my describing the meeting in Dr. DePinho’s office after the
Cancer Letter published the data from the faculty morale survey. The survey was
the work of the Faculty Senate. The Cancer Letter had obtained the actual
slides that had been presented at a Senate meeting. Dr. DePinho assumed that I
was the source of the leak of these data and so called me in with Drs. Durand
and Killary, the leaders of the Senate for a conversation.

you may remember, Dr. DePinho went on for about 25 minutes about his belief in
academic freedom, but also his contention that we needed to work together to
solve the problems unearthed by the morale survey. When he finally allowed me a
word in edgewise, I told him three things.

1.     I
am not the source of the leak although Paul Goldberg, Todd Ackerman and Eric
Berger are my friends and business associates and I intend to keep speaking
with them.

2.     The
Public Affairs and Public Relations people at Anderson had done a miserable job
handling the bad publicity garnered by the Cancer Letter’s articles.

3.     Before
you, Dr. DePinho, arrive at a solution to the problems you see occurring around
you, it might be best to understand what those problems really are.

is all reminiscent to me of the problem facing the Republican Party as it
approaches the 2014 and 2016 silly seasons known as election time. Here’s the
Republican dilemma:

did we lose the last two Presidential elections?

Was it because our candidates were simply not strong enough or were they poorly
matched to the situations facing the American people with an economic
recession in 2008 and a very rich guy running in 2012 who seemed not
to understand the plight of those less fortunate than himself?

3.     Or,
were our candidates insufficiently conservative having run the least
conservative candidates from the primary seasons in both 2008 and 2012, and if
we run a real Tea Party guy in 2016, we’ll win?


Dr. DePinho and the Republicans had better analyze their troubled, recent pasts
if they are going to arrive at a better future.

cause of the poor faculty morale is not the results of the survey. The survey
simply supported what we all knew to be true. The perception that the
leadership of the institution is in it for themselves, could care less about
the faculty and maybe not even care about the patients is the real source of
the problem. We faculty cannot know what the leaders are actually thinking. We
can only perceive and then infer what they are thinking by what they are doing. And what they
are doing is not encouraging.

Anderson is a clinical care delivery institution with a faculty of dedicated
physicians and care givers trying to use the most modern of approaches to fight
cancer as well as to improve its detection and prevention. We are not a drug
company or, for that matter, a furniture show room. Now start making better
decisions using that premise as a starting point and perhaps that morale will

Republican Party is not one party right now. It is two. That’s why John Boehner
has the worst job in Washington for he has to herd mountain lions leaping in
various, random directions while flinging bombs at one another. One part of the
GOP is the traditional business-oriented, conservative, self-starter group that
found in Ronald Reagan the right blend of sunniness and purpose. Since Reagan
they have been searching for a real standard bearer, pretty much in vain.

a recent survey asked who the best candidate for President among all comers
would be, Chris Christie edged out Hillary Clinton, suggesting a contest
between these two would be at a very high level, be very engaging and likely
would get us a great President no matter who won. Interestingly, among only
Republicans polled, Christie came in eighth behind a group of seven other
dwarfs bearing an uncanny resemblance to the dwarfs of 2012 Republican primary
season. Have you ever heard of anyone as lucky as Barack Obama? He never has to
win an election. He is always running against someone else who can’t win. He’s
gotten all the way to the White House twice never having to fight much for the
position for which he was competing because his competition has been so weak.

the GOP chooses to shoot themselves in the head again by nominating the wrong
candidate, be that Rand Paul, Ted Cruz or Marco Rubio, and the Dems go with
Hillary, this baby is over before it starts. Benghazi, Benshamzi.  She wins.

however, the GOP identifies the real problem as having nominated inferior
candidates and now the party picks the heavy guy from Blue New Jersey, it’s a
horse race.

if Dr. DePinho continues to believe his own pap about moon shots, converting basic
science into revenue, and institutes as poor imitations of drug companies as
the way for MD Anderson to contribute to the solution of the cancer problem, he
will continue to founder in a rip tide of ill will. On the other hand, if he
reforms his philosophy of “the beatings continuing until morale improves” and
rejuvenates the clinical enterprise with some fresh ideas and fresh faces
dedicated to clinical care and clinical research, he might prosper.

once again I ask him, what exactly do you think the problem is that you are
trying to solve? And please, come up with something other than you are trying
to cure cancer. Making Cancer History is Making Me Anxious.

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