The Crooks Were Higher Up


Leonard Zwelling

            One of my
favorite books is The Big Short, Michael Lewis’ description of the origins of
the financial meltdown of 2008 and how a group of really smart guys made a ton
of money selling mortgage securities short (betting their value would fall). It
is a technically daunting book written about as approachably as possible.

            One of the
smartest of the smart guys was Vinny Daniel, a friend of the protagonist Steve
Eisman. After returning from a convention in Las Vegas and meeting those
running the mortgage markets, they realized the house of cards on which that
market was built.

Vinny said, “There were more morons than crooks, but the crooks were
higher up”.

The first time I read that line I
howled with laughter for isn’t that really MD Anderson and the federal
government, my two most recent ex-employers?

            It has been
my argument, and both Drs. Kripke and Fidler can vouch for this, that MD
Anderson has been run by less than the intelligentsia for quite a while. No one
could take such a gem of clinical productivity and cutting-edge innovation and
bring it to the brink of financial collapse (2008 and perhaps yet again now)
and have even a modicum of intelligence regarding running an academic cancer
center. Just in case you believe that I am assuming this from afar, I was in
many conference rooms with these guys (and it almost all guys). Trust me, they
aren’t all that bright. And even if they were (and they aren’t—but they think
they are), most of those making these awful decisions knew nothing about cancer
care and research.

To quote what my late
father-in-law, one of the foremost pulmonary pathologists in the country said
repeatedly to me, “what do you know?”

            What did
these guys know about running a patient care organization in which research and
education were also key mission areas requiring support and balance? Answer:

            I got no
relief from the morons when I went to Washington. There being a less than
brilliant is seemingly a prerequisite for service in Congress or surely to get
elected. Have you ever heard dumber things said than the comments of some of
our representatives about the effects of a default on paying our debt? I

But when you meet these people,
they aren’t stupid at all. It’s only when they get in one room together (and
someone shows up with a TV camera) that they begin to say stupid things and act
accordingly. Like Ted Cruz or hate Ted Cruz, he clearly is not stupid, but he
sure says some stupid things. This does not advance the cause of the body in
which he works any more than another stupid statement by an MD Anderson vice
president advances the cause of Anderson or its patients.

            Okay. So
much for the morons. What about the crooks?

            I have
written ad nauseum about my view of the behavior of the current and immediate
past presidents of Anderson. I believe that the past president came within a
whisker of brushing up against the law (and we really don’t know all the
details, but we know what happened to his business associates) and the current
president surely has with his appearance on CNBC extolling the virtues of a
drug from his company that he should have known had no chance of ever getting
past the FDA and seeing the market place.

He promoted it. The stock value
went up. The FDA rejected it, and the value came down. Way down. Is it any
wonder his stockholders are angry especially the ones who bought the stock on
the heels of the president’s CNBC appearance.

In addition the current president
has exhibited no reluctance to color way outside the lines in his numerous
violations of the institution’s conflict of interest policy and the truly
horrible judgment of accepting nepotism into the highest reaches of a state

            In DC, I
have seen political muscle wielded like a club (by Luca Brasi-like lobbyists) on
Senate staffers and I suspect many of those lobbyists I met were making huge
fees manipulating the members on the Hill with lots of money changing hands in
all kinds of directions. Thanks to the Supreme Court and Citizens United (and
goodness knows what else those nine geniuses will allow the political
operatives on both sides of the aisle to do this session), we have the best
government money can buy.

They are everywhere. Just higher up.

            So, now

            Well, you
can see what happened to the high up Wall Street crooks. Nothing. They are still
making huge amounts of money today and the too big to fail crowd, just got
bigger. You can thank the morons and crooks in DC for letting the morons and
crooks in New York keep on, keepin’ on.

            As for
Anderson, I believe that the handwriting is on the wall, but remember it all
hinges on forces even higher up. At the highest level, the federal, the SEC
could bring a case against Aveo and its directors. That would take the heat off
the Regents to do what they need to. 
Correct their own error.

But if the SEC is too busy with
bigger fish than a small drug company whose stock tanked, the question will
rest with the Board of Regents, the Chancellor and the Executive Vice
Chancellor to prove that they are neither morons nor crooks (remember the last
Executive Vice Chancellor was loaded with conflict as a member of the board of United
Health. How many United Health insured patients were treated in the UT System?
Did they get any breaks? Better care? Lower prices? Contractual breaks with UT
System hospitals? No, you say? As my father-in-law might say, HOW do you

            So far the
Regents have been largely silent on the question of the future of the MD
Anderson leadership, rather passively supporting it to date. They have two
opportunities to show us that they are neither morons nor crooks. They need to
replace the Anderson leadership as soon as politically expedient and
demonstrate to the world that they are no longer error-prone morons and get us
a real president. Preferably, a she!

Then they need to enforce the
policies of the individual institutions in the UT System whether or not they
are more stringent than the ones at System level. Start with the conflict of
interest rules at Anderson. What’s good for the faculty is good for the
executives—and their wives. That should handle the crooks part.

In the end, this will be up to us
in the UT System to decide that we wish to operate out of intelligence and
integrity. All the mission statements and core values say we do. But do we act
that way? How about making morons and crooks history?

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