SLOWER (plus an extra link to today’s NY Times)

Slower (also see addendum at
end please)


Leonard Zwelling

         At this time of remembrance of the life and death of
President Kennedy, it is worth remembering how much he got done in so little
time. The young President was only 46 at the time of his death. He will never
grow old in reality or in the minds of those alive when he was in office. He
always appeared vibrant and full of life. Only later did we learn of the dark
side of his illnesses and addictions, his damaged back and Addison’s Disease,
his philandering and rapacious political nature. Whether he was or was not an
American hero, he certainly was a complex man and one who was in a hurry. It
has been said of him that he never expected to have a long life and thus was so
driven to succeed in the time allotted to him. He had been a sickly child and
always seemed to be making up for lost time.

         Most of us are far more fortunate than President Kennedy in
that we have had relatively healthy childhoods and enjoy reasonable well-being
into our 60’s and 70’s and beyond. This is not to say that we don’t get sick or
injured or have surgery or suffer chronic diseases. Few of us suffer physically
as President Kennedy did and few of us accomplish in our allotted time what he
did in his. He was special. So are we all. But we all don’t have to hurry like
he did.

         In my career in academics, I have been accused of having a
rocket up my rear—running about energetically, sometimes like a photon—all
energy and no mass. What I was really doing is collecting as many gold stars as
I could and I could never get enough. I suspect many of you are suffering from
a similar disorder or know others who suffer, too. Some you know with this problem
are those for whom you work. These people (including me) tend to do well on the societal scale
by sublimating their addiction, clothing it in acceptable social garb (or even
a white coat), most of the time.

         This need to succeed in lieu of all else is really an
addiction that I have called achievaholism. It is an unusual addiction. No one
will try to get you to stop and there are no 12-step programs to get addicts
like us to curb our hunger for gold stars. On the contrary, most people around
us encourage us to go faster. And we do until our coronaries, other vessels or
psychological illnesses catch up with us (two out of three for me—so far).

         I have been pondering this now that I have come to grips
with the notion that I will not be the Yankees’ shortstop, the next lead singer
for the Rolling Stones or, appropriately enough, the President of the United
States. This may sound a bit delusional (or maybe VERY delusional) but we
achievaholics tend to shoot high and crash and burn low. After all, it is an

         So for all of you out there with crazy bosses who are
driving you to distraction by working ungodly hours and expecting the same of
you, or who are encouraging you to see more and more patients to increase the
department’s billings despite the fact that the extra patient is one you often
cannot help, or who will not allow you to share in the Moon Shot largesse that
may be coming your boss’s way, I have a little advice that is 65 years in the
making. Slow down.

         I have loved my two months away from Anderson. It wasn’t
that I was working all that hard for the past two years. I wasn’t despite
having wanted to do more. There was nothing more for me to do. It’s really that
I have escaped the toxic environment that is the equivalent of a crack house
for an achievaholic with academic leader after academic leader extolling the
virtues of hard and harder work rather than hard thinking.

         I don’t believe that the cure for cancer will come from
working harder and harder. If that were the case, surely the Division of Cancer
Medicine would have put itself out of business by now. I believe that we need
to return to the arena of “don’t know” rather than the Moon Shot approach of
grind it out with current technology. If a cure for cancer is possible, it will
not come fast and it will not likely come soon for the depth and breadth of the
problem are still being defined. We need to take a deep breath and think. No
more big promises. No more “if you just give us another billion dollars we will
get there”. We are supposed to be academic scientists. We need to act more like
that than like industrialists and corporate moguls making Model Ts on an
assembly line of tumor biopsies and gene sequencers.

         If Making Cancer History is what we want to do, it is
crucial to remember that history winds out slowly and no one alive today gets
to see all of it.

Addendum for all the
docs out there:

Is this why you went to
medical school?:

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